Member-only story

The Ethics of Coercion in Mass Casualty Medicine: A Vital Examination of Triage and Decision-Making in Extreme Crises

Darren Blair

·15k Followers· Follow

Published in The Ethics Of Coercion In Mass Casualty Medicine

5 min read · 4 weeks before

657 View Claps

67 Respond

Save

Listen

###

The Ethics of Coercion in Mass Casualty Medicine

by Griffin Trotter

5 out of 5

Language	:	English
File size	:	474 KB
Text-to-Speech	:	Enabled
Screen Reader	:	Supported
Enhanced typesetting	:	Enabled
Print length	:	238 pages

In the face of unimaginable disaster, medical professionals encounter the profound ethical challenge of triage—the process of selecting who will receive life-saving treatment and who will not.

While triage is an unfortunate necessity in mass casualty situations, it raises complex questions about how we value human life, allocate scarce resources, and balance individual rights against the greater good.

### The Utilitarian Approach: Saving the Most Lives

One ethical approach to triage is utilitarianism, which prioritizes saving the greatest number of lives. In this view, medical resources should be allocated to patients with the highest probability of survival, regardless of their underlying conditions or future potential.

While utilitarian triage can lead to more lives being saved overall, it can also result in the sacrifice of individuals with disabilities, the elderly, or those with pre-existing conditions.

### The Egalitarian Approach: Equal Treatment for All

In contrast to utilitarianism, egalitarianism advocates for equal treatment of all patients, regardless of their prognosis. This approach values the sanctity of every human life and rejects the idea of prioritizing some lives over others.

Egalitarian triage may result in fewer lives being saved, but it ensures that each individual is treated with dignity and respect.

### The Modified Utilitarian Approach: Balancing Lives and Values

Seeking to bridge the gap between utilitarianism and egalitarianism, modified utilitarianism offers a nuanced approach to triage. This approach considers both the number of lives saved and the quality of those lives.

Modified utilitarianism allows for prioritizing patients with a higher probability of survival, while also taking into account their age, functional status, and potential to contribute to society.

### Coercion and Triage: A Complex Interplay

In extreme mass casualty situations, the allocation of resources may necessitate the use of coercion. Coercion refers to the act of compelling someone to do something against their will, often justified by a perceived greater good.

In triage, coercion can manifest as forcing patients to undergo procedures they do not want, denying treatment to those deemed non-salvageable, or redistributing resources from one patient to another.

### Ethical Considerations in Coercive Triage

The ethical use of coercion in triage requires careful consideration of several factors:

Necessity: Coercion should only be used when there is no other viable option for saving more lives or preventing further harm.
Proportionality: The level of coercion used should be proportional to the severity of the situation and the benefits it is expected to achieve.
Transparency: The decision to use coercion should be made transparently and with the involvement of multiple stakeholders.
Accountability: Those responsible for making and carrying out coercive decisions should be accountable for their actions.

### Legal and Institutional Frameworks

Legal and institutional frameworks play a crucial role in shaping the ethical use of coercion in mass casualty medicine. These frameworks provide guidance on when coercion is permissible, what procedural safeguards must be in place, and how decisions are made accountable.

In the United States, for example, the Uniform Health-Care Decisions Act (UHCDA) establishes guidelines for advance directives and surrogate decision-making in medical emergencies.

### Balancing Lives, Rights, and Resources

Navigating the ethical challenges of triage and coercion in mass casualty medicine requires a delicate balance of lives, rights, and resources. By carefully weighing the potential benefits and harms, adopting a transparent and accountable decision-making process, and adhering to legal and institutional frameworks, medical professionals can strive to make ethical decisions in the face of extreme adversity.

Ultimately, the goal of triage and coercion in mass casualty medicine is to maximize the overall benefit to society while respecting the inherent dignity and value of each human life.

###

The ethical implications of coercion in mass casualty medicine are profound. By exploring the complex interplay of triage, utilitarianism, egalitarianism, and legal frameworks, we gain a deeper understanding of the challenges faced by medical professionals in the most extreme of situations.

Through thoughtful consideration and ethical decision-making, we can strive to create a system that allocates resources fairly, protects individual rights, and honors the sanctity of every human life.

The Ethics of Coercion in Mass Casualty Medicine

by Griffin Trotter

5 out of 5