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Misguided Triage Ethics: Chances of Survival and Risks of Dying in the Coronavirus Pandemic

Manfred Spieker


The corona pandemic has forced us to examine rules for allocating survival chances and mortality risks when ICU beds and ventilators are not sufficient for all patients who need them. In the debate about triage ethics one must distinguish between ex ante triage and ex post triage. Ex ante triage addresses which of the patients arriving simultaneously in an emergency room should receive an intensive care bed and which should not. Urgency and prognosis are the decisive medical criteria. Ex post triage determines whether a respirator may be removed from a patient who has already been connected to it and given it to a newly admitted patient. The most frequently made mistake in ex ante triage is discrimination based on the patient’s age. Frequent aberrations in ex post triage are decisions based on the quantification of expected life spans, as well as an equivalence of ex ante and ex post triage, which is justified by the false equivalence of action and omission or the thesis of the inevitability of human culpability.

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