Scarce-Resource Allocation and Patient Triage During the COVID-19 Pandemic: JACC Review Topic of the Week

J Am Coll Cardiol. 2020 Jul 7;76(1):85-92. doi: 10.1016/j.jacc.2020.05.006. Epub 2020 May 11.


The COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that health care systems have faced or will face difficult decisions about triage, allocation, and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic. Transparent and clear communication is crucial, coupled with dedication to provide the best possible care to patients, including palliative care. As medical knowledge about COVID-19 grows, more will be known about prognostic factors that can guide these difficult decisions.

Keywords: COVID-19; end of life; ethics; palliative care; resource allocation.

Publication types

  • Review

MeSH terms

  • Advance Care Planning* / ethics
  • Advance Care Planning* / organization & administration
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Cardiology* / standards
  • Cardiology* / trends
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / therapy
  • Critical Pathways / trends*
  • Health Care Rationing* / methods
  • Health Care Rationing* / organization & administration
  • Health Care Rationing* / trends
  • Humans
  • Palliative Care / ethics
  • Palliative Care / organization & administration
  • Pandemics* / ethics
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / therapy
  • Resource Allocation
  • SARS-CoV-2
  • Standard of Care
  • Triage* / methods
  • Triage* / trends