What ethical principles guide resource allocation during mass casualty incidents?

• A. Fairness, equity, transparency, and maximizing the number of lives saved while respecting basic rights.
• B. Profit maximization and prioritizing the wealthy.
• C. First-come, first-served only.
• D. Random selection with no policy.

Answer: (A)

In mass casualty events, decisions about who gets limited medical resources are guided by fairness, equity, transparency, and the aim of saving as many lives as possible while upholding basic rights. Fairness means applying consistent, objective criteria rather than bias or favoritism; equity ensures that vulnerable groups aren’t disproportionately harmed and that disparities in access are addressed. Transparency requires openly sharing the criteria and the decision process so clinicians, patients, and the public understand how choices are made. The goal of maximizing lives saved serves as the practical backbone for triage decisions, prioritizing those most likely to benefit from treatment within the resource limits, while still respecting each person’s inherent rights and dignity. Choices based on profit, or prioritizing the wealthy, conflict with medical ethics and erode trust. Relying on first-come, first-served ignores clinical severity and survival likelihood, often disadvantaging those who arrive later or have fewer resources. Random selection without policy lacks accountability and clear justification, leading to unpredictable and potentially unjust outcomes.