Table 2.

Recommendations for Triage and Allocation

Clinicians must not use crisis standards of care when at contingency capacity.

Special consideration may be necessary to ensure fair distributions of medical resources, especially to patients with disabilities.

A clear distinction should be drawn between withholding and withdrawing decisions made by triage teams for triage purposes in a crisis situation and withholding and withdrawing decisions made by the clinicians in the setting of inappropriate and/or futile interventions.

Bedside clinicians should focus on providing optimal care in adverse circumstances for their patients, including palliative care for those from whom life-sustaining therapies are withheld or withdrawn.

Clinicians should not coerce patients in end-of-life decisions but should discuss care that is consistent with their expressed values and recommend appointment or reconfirmation of a surrogate.

Clinicians have a professional duty to care for patients during a pandemic, but this duty should be supported by adequate personal protective equipment and public participation in practices that reduce illness transmission. Consideration must be given to the risk status of individual health care workers.

There is also a fiduciary duty toward patients who do not have COVID-19 and ensuring that cardiovascular morbidity and mortality in this group is mitigated, even as diagnostic and interventional procedures are postponed and resources are shifted.