Crisis Standards of Care and Triage: Medico-Legal Conundrums

By: George P. Smith, II*

Abstract

This Article investigates the character, nature, and application of Crisis Standards of Care (“CSC”) in national emergency preparedness plans. Ideally, these standards allow a government to codify frameworks or models for allocating scarce medical resources. The principal mechanism used by healthcare decision-makers to evaluate individuals seeking medical assistance is through triage—a diagnostic process utilizing algorithms to sort, grade, or select those who “qualify” for medical treatment. This Article studies the principles and values incorporated into these medical algorithms and concludes that more federal government leadership is required to convince the states that CSC are an integral part of emergency preparedness; and, secondly, that diagnostic algorithms must be used in an equitable manner that does not discriminate among the medically injured, the aged, or those with comorbidities.

* Professor Emeritus of Law, The Catholic University of America. Resident Fellow, The Institute for Advanced Studies, Indiana University, Bloomington; Affiliated Scholar, Georgetown University School of Medicine, Center for Global Health and Security, Washington, D.C.

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