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Table 1 Ethical theories applicable to the allocation of scarce ICU resources during the COVID-19 pandemic

From: Prioritising ‘already-scarce’ intensive care unit resources in the midst of COVID-19: a call for regional triage committees in South Africa

Ethical principle Applicability to COVID-19 pandemic scenario
Utilitarianism Patients receiving priority for admission to ICU based on prognostic scoring, life-cycle considerations, societal value
Maximize overall benefits for the maximum number of people Contention: sacrifice of duty of care to individual to maximise public utility
Egalitarianism Equal treatment of competing patients by allowing rationing based on first-come, first-served basis or random selection (horizontal equity)
Eliminating inequality and equality as the overall goal Consideration be given first to those with greatest need (vertical equity)
  Contention: Conflict with current triaging frameworks, potential to deprive others who may benefit
Libertarianism Patients can access private health care if they have the means to do so
Resource distribution according to market principles  
Communitarianism Sharing of frameworks with greater society and ensuring public support and understanding of triage policies
Respect for communities, societal order and what binds them  
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