# Fair allocation of resources in the moral dilemma of triage

## TL;DR

This study explores how people from around the world think resources should be fairly allocated during medical triage, especially during the COVID-19 pandemic.

## Contribution

The study introduces a novel approach combining ethical preferences and triage procedures using a conjoint experiment with a global sample.

## Key findings

- Citizens prefer allocation decisions based on medical urgency and likelihood of survival.
- Fairness ratings of triage procedures correlate with ethical preferences inferred from allocation choices.
- There is a mismatch between expert guidelines and public ethical preferences in triage scenarios.

## Abstract

Against the background of the COVID-19 pandemic that has shaken societies around the world, the debate about fairness of medical allocation decisions is gaining momentum. Studying a sample of a broad international public (N = 1,998), we investigate citizens' ethical preferences in the moral dilemma of triage decisions. First, we address the key problem of which of several contradictory ethical criteria and normative principles should be used to determine the fairness of outcomes in triage situations. Preferences about fair outcomes are inferred from observed allocation decisions in a conjoint experiment. Second, preferences in regard to fair procedures are measured via fairness ratings of a series of triage procedures. Third, we analyze the relationship between the observed allocation outcomes and the fairness ratings of procedures. Finally, we review the current expert discourse and reflect it with the citizens ethical preferences observed in our study.