Perceptions on principle of priority setting in disaster triage: A Q-method study

Area of Science:

• Medical Ethics
• Public Health Policy
• Disaster Medicine

Background:

• Ethical decision-making frameworks are crucial for prioritizing patient care during disasters.
• Disaster triage requires a systematic approach to allocate limited medical resources effectively.

Purpose of the Study:

• To explore the key factors influencing ethical decision-making in disaster triage.
• To identify measures used by experts for patient prioritization in resource-scarce environments.

Main Methods:

• Principal components factor analysis (PCA) applied to Q-statements from 54 Iranian experts (clinicians and non-clinicians).
• Data analysis involved Varimax and hand-rotation techniques to identify distinct perspectives.

Main Results:

• Key ethical considerations include patient medical need, survivability (individual and community), treatment capacity, maximizing health gains, and supporting long-term productivity.
• These factors collectively explain approximately 61% of the variance in triage decision-making.

Conclusions:

• A combined strategy of maximizing lives saved and positive outcomes is favored for ethical disaster triage.
• Public engagement is essential to foster broader acceptance of patient prioritization factors in situations of scarcity.