Crisis Altered Standards of Care, Triage and Ethics

What happens when a physician is inundated and has to let someone die to keep another patient alive? The military sees this at the battle lines, and relief organizations may also see this in conflict areas, but it is not an expected scenario in United States emergency rooms. American physicians must be trained, and hospitals must consider the scope of their investment in ethics training and counseling. 



  • Codes of conduct
  • Principles and morality
  • Guidelines for human action
  • Rights or standards for individuals or professions
  • Character of the group (expected behavior)


 Complexity of Ethics

  • Conflicting ethical expectations
  • Ethical expectations directly influence daily decisions
  • Decisions can affect many groups, each with different needs


Altered Standards of Care Issues

  • Hospital may require formal declaration or change in regulatory enforcement to implement
  • May be implemented at alternate care site
  • Changes in the usual standards of health and medical care
  • Required to achieve the goal of saving the most lives in a mass casualty
  • Allocate scarce resources in a different manner to save as many lives as possible















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