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Review
. 2020 Jul;162(7):1485-1490.
doi: 10.1007/s00701-020-04375-w. Epub 2020 May 14.

Ethical triage during the COVID-19 pandemic: a toolkit for neurosurgical resource allocation

Alexander F C Hulsbergen  1   2 , Marleen M Eijkholt  3   4 , Naci Balak  3 , Jannick Brennum  3 , Ciarán Bolger  3   5 , Anna-Margarete Bohrer  3 , Zeev Feldman  3 , Daniel Holsgrove  3 , Neil Kitchen  3 , Tiit I Mathiesen  3   6   7   8 , Wouter A Moojen  3   9 , Nicolás Samprón  3   10 , Martin Sames  3 , Ulrika Sandvik  3   8 , Magnus Tisell  3 , Marike L D Broekman  11   12
Affiliations
Review

Ethical triage during the COVID-19 pandemic: a toolkit for neurosurgical resource allocation

Alexander F C Hulsbergen et al. Acta Neurochir (Wien). 2020 Jul.

Abstract

Background: The COVID-19 pandemic confronts healthcare workers, including neurosurgeons, with difficult choices regarding which patients to treat.

Methods: In order to assist ethical triage, this article gives an overview of the main considerations and ethical principles relevant when allocating resources in times of scarcity.

Results: We discuss a framework employing four principles: prioritizing the worst off, maximizing benefits, treating patients equally, and promoting instrumental value. We furthermore discuss the role of age and comorbidity in triage and highlight some principles that may seem intuitive but should not form a basis for triage.

Conclusions: This overview is presented on behalf of the European Association of Neurosurgical Societies and can be used as a toolkit for neurosurgeons faced with ethical dilemmas when triaging patients in times of scarcity.

Keywords: Covid-19; Ethics; Neurosurgery; SARS-CoV-2; Triage.

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