![]() Nurses and physicians may have no explicit guidelines to follow when two or more patients appear at the same time at the same level of severity and, in such situations, decisions would likely be vulnerable to a host of personal biases. The Emergency Severity Index ( Gilboy et al., 2011) defines five levels of priority for care, with Level 1 (“Resuscitation”) the most urgent because without immediate treatment, death would be imminent, for example, due to “massive bleeding.” ![]() The allocation of scarce resources in emergency departments is a long-standing problem for which several standardized triage systems have been developed. The COVID-19 pandemic has highlighted a particularly difficult dilemma that hospital emergency department personnel have faced in which they must decide which of several patients who are struggling to breathe will receive a ventilator or access to oxygen. Moral dilemmas are situations that require a choice between conflicting moral values or obligations. In the absence of explicit guidelines for allocating scarce resources, a systematic, objective method of random selection offers a potentially useful strategy. Settings that call for impartiality are not reliable “boundary conditions” against expressions of bias. Bias decreases when there is a decrease in severity of potential harm to the preferred stakeholder. With moderate fall risk, age bias reversed and kinship deservingness bias disappeared. In a hospital-room scenario with high risk of injury from falling, age bias disappeared. Both scales showed young favored over old, cousin (or daughter) over stranger, and policeman over shooter (largest difference). Participants rated each patient’s moral deservingness to receive immediate care and the likelihood they would choose the patient. ![]() Patients differed in ways that could reveal biases, e.g., age (8 vs. ![]() How effective are impartiality settings such as hospitals in suppressing personal biases? Portrayed as decision-makers in an emergency department, 431 college students made judgments on which of two victims of a mass shooting should receive immediate, life-saving care. Moral judgments can occur either in settings that call for impartiality or in settings that allow for partiality. ![]()
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