Leaving No Ethical Value Behind: Triage Protocol Design for Pandemic Rationing

46 Pages Posted: 13 Apr 2020 Last revised: 21 Feb 2021

See all articles by Parag A. Pathak

Parag A. Pathak

Massachusetts Institute of Technology (MIT) - Department of Economics

Tayfun Sonmez

Boston College

M. Utku Ünver

Boston College, Department of Economics

M. Bumin Yenmez

Boston College

Multiple version iconThere are 2 versions of this paper

Date Written: April 2020

Abstract

Rationing of medical resources is a critical issue in the COVID-19 pandemic. Most existing triage protocols are based on a priority point system, in which a formula specifies the order in which the supply of a resource, such as a ventilator, is to be rationed for patients. A priority point system generates an identical priority ranking specifying claims on all units. Triage protocols in some states (e.g. Michigan) prioritize frontline health workers giving heavier weight to the ethical principle of instrumental value. Others (e.g. New York) do not, reasoning that if frontline workers obtain high enough priority, there is a risk that they obtain all units and none remain for the general community. This debate is pressing given substantial COVID-19 health risks for frontline workers. In this paper, we analyze the consequences of rationing medical resources through a reserve system. In a reserve system, resources are placed into multiple categories. Priorities guiding allocation of units can reflect different ethical values between these categories. A reserve system provides additional flexibility over a priority point system because it does not dictate a single priority order for the allocation of all units. It offers a middle-ground approach that balances competing objectives, such as in the medical worker debate. This flexibility requires attention to implementation, especially the processing order of reserve categories. We describe our model of a reserve system, characterize its potential outcomes, and examine distributional implications of particular reserve systems. We also discuss several practical considerations with triage protocol design.

Suggested Citation

Pathak, Parag A. and Sonmez, Tayfun and Unver, Utku and Yenmez, M. Bumin, Leaving No Ethical Value Behind: Triage Protocol Design for Pandemic Rationing (April 2020). NBER Working Paper No. w26951, Available at SSRN: https://ssrn.com/abstract=3574416

Parag A. Pathak (Contact Author)

Massachusetts Institute of Technology (MIT) - Department of Economics ( email )

50 Memorial Drive
E52-391
Cambridge, MA 02142
United States

Tayfun Sonmez

Boston College ( email )

Utku Unver

Boston College, Department of Economics ( email )

140 Commonwealth Avenue
Chestnut Hill, MA 02467
United States
6175640771 (Phone)
+1 (617) 552 2318 (Fax)

HOME PAGE: http://www2.bc.edu/~unver

M. Bumin Yenmez

Boston College ( email )

140 Commonwealth Ave.
Maloney Hall 327
Chestnut Hill, MA 02467
United States

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