Ethical and legal aspects of triage in times of COVID-19 epidemic

The main aim of the research project is to explore, what are the potential solutions to the question, how to allocate limited medical resources (personnel or other resources), when medical care cannot be provided to all in the time of epidemics, in particular:

1) to evaluate what are the ethical and value-based underpinnings of medical triage in conditions of overburdened healthcare system;

2) to examine potential legal consequences of triage decisions and international legal practices of evaluating such decisions-making;

3) to examine the response of criminal law system in situations of so-called collisions of duties (when an overburdened individual is unable to fulfil all binding obligations);

4) to analyze domestic and foreign guidelines and recommendations of various (medical) associations and ethics commissions or councils addressing the issue of triage during the coronavirus epidemic, and present their commonalities and differences,

5) to explore the backgrounds of triage reasoning and to examine how practitioners, who are deciding to whom to provide help and to whom to reject it, respond psychologically to the difficult decisions they are making;

6) to examine the concept of advance expressed will and its impact on triage dilemmas;

7) to develop proposals of solutions for ethically challenging dilemmas.

The issues addressed by our research are of paramount importance to decision-makers, general and professional public and patients. They alleviate the heavy psychological burden of the medical staff, who have to make decisions under time pressure and in stressful circumstances. Although the questions are delicate and controversial, discussing them is crucial to ensure transparency of the health sector. Legitimate answers to the ethical and legal questions of triage are also important for patients and their relatives (users) because they bring predictability into uncertain situations and thus alleviate anxiety. Last but not least, findings of the research will also be useful for the drafters of guidelines and recommendations in Slovenia and the criminal justice system. Abroad, law enforcement agencies are already dealing with some controversial cases in regards to providing medical care in the time of epidemic. Our research will address issues of criminal responsibility in the context of Slovenian legal system, prosecutors and judges will be able to rely on its findings. In doing so, we will proceed from an important starting point, that the criminal law should only be a final tool of social policy in this area.