Reorganising the pandemic triage processes to ethically maximise individuals' best interests.
OBJECTIVE
To provide a revised definition, process and purpose of triage to maximise the number of patients receiving intensive care during a crisis.


METHODS
Based on the ethical principle of virtue ethics and the underlying goal of providing individual patients with treatment according to their best interests, the methodology of triage is reassessed and revised.


RESULTS
The decision making processes regarding treatment decisions during a pandemic are redefined and new methods of intensive care provision recommended as well as recommending the use of a 'ranking' system for patients excluded from intensive care, defining the role of non-intensive care specialists, and applying two types of triage as 'organisational triage' and 'treatment triage' based on the demand for intensive care.


CONCLUSIONS
Using a different underlying ethical basis upon which to plan for a pandemic crisis could maximise the number of patients receiving intensive care based on individual patients' best interests.
Tillyard
Andrew
A
Derriford Hospital, Plymouth, UK. andrew.tillyard@phnt.swest.nhs.uk
D003695:Delivery of Health Care / Q000941:ethics* / Q000592:standards; D004636:Emergency Service, Hospital; D006801:Humans; D058873:Pandemics; D014218:Triage / Q000941:ethics / Q000458:organization & administration* / Q000592:standards