Triage in medicine, part II: Underlying values and principles

Part I of this 2-article series reviewed the concept and history of triage and the settings in which triage is commonly practiced. We now examine the moral foundations of the practice of triage. We begin by recognizing the moral significance of triage decisions. We then note that triage systems tend to promote the values of human life, health, efficient use of resources, and fairness, and tend to disregard the values of autonomy, fidelity, and ownership of resources. We conclude with an analysis of three principles of distributive justice that have been proposed to guide triage decisions.