The Clash of Ethics in Tragic Medical Triage and the Potential for Moral Distress

The need for tragic triage typically emerges in disaster circumstances when a health care professional must choose between patients who have an equal chance of successful treatment and will not survive without it. To reach the most ethical decision, one needs relevant information about the details and context of the case. Many people also want a moral rule set out in advance to guide them and lessen their burden of deciding between patients. Some states, medical organisations, and hospitals started to frame such ethical criteria by relying on various ethical theories and practices. As a result, the ethical rules of tragic triage in the West reflect fragmented, competing ethical dispositions. But even if any kind of a general rule is established, one will sooner or later have to apply it in real-life circumstances. The author believes the fragmentation of ethical convictions will then resurface again. Using a general rule for a particular case will create additional moral distress in cases where a decision-maker would prefer to employ different ethical criteria. Recent studies in experimental moral psychology reveal that many people thus try to avoid forming general, abstract rules for deciding grave moral dilemmas in advance. They fear that an established general rule would be ethically unsuitable in particular cases and contexts.