Abstract
The question of how to implement medical triages has become highly salient during the COVID-19 pandemic and continues to be actively discussed. It is important to know how members of the general public think about this issue. For one, knowledge about the public's standpoint can help resolve important questions where ethical considerations are by themselves not sufficient, for instance whether the patient's age should matter. It can also help identify if more communication with the public about medical ethics is needed. We study how members of the Swiss public would allocate intensive medical care among COVID-19 patients using data from two original conjoint survey experiments conducted in Switzerland in the context of the first and second pandemic waves in 2020 (N = 1457 &N = 1450). We find that our participants would not base triage decisions on the patient's age. However, they do give much importance to the patient's behavior prior and during illness, discriminate against non-nationals, and assign only a relatively small and inconsistent role to medical considerations. Our findings suggest that there is a need for more communication with the public about the ethics of medical triage.
Highlights
The question of how to implement medical triages has become highly salient during the COVID-19 pandemic
Members of the Swiss public would conduct a medical triage of COVID-19 patients only partly in line with medical guidelines
Participants gave considerable weight to non-medical criteria such as whether patients adhered to social distancing guidelines and vol unteered before falling ill, or if they complied with their doctors’ rec ommendations
Summary
The question of how to implement medical triages has become highly salient during the COVID-19 pandemic. Age can be considered a criterion for triage based on the principle of maximizing benefits, according to which resources should be allocated in a way that saves the most lives or life-years. In this case, older patients could be de-prioritized because, all else equal, they tend to have more comorbidities and fewer life-years to gain (Emanuel et al, 2020). Existing guidelines differ considerably in how they consider age as a criterion (e.g. Ehni et al, 2021), which underscores the lack of consensus about how this issue should be resolved. The public’s views can provide additional guidance
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