It is also known as the rescue-principle or the principle of non-abandonment

[65]. However, giving priority to the principle of equality in emergency [10] care situation is not an optimal strategy to realize efficient use of scarce resources. The principle of utility, on the other hand, holds that actions should be judged by their consequences and Inhibitors,research,lifescience,medical how far they produce the greatest net benefit among all those affected. Or put simply, to do the greatest good for the greatest number. In fact, utilitarianism is the rationale for triage systems, insofar as they seek to use the available but scarce medical resources as efficiently as possible [11]. In itself, however, the principle of utility remains silent with regard to which goods or benefits are to be maximized [23]. In order to produce the greatest net benefit, we must have a clear account of which kinds of benefit are to be promoted. For instance, Inhibitors,research,lifescience,medical triage systems may seek to achieve the health benefits of survival (saving the most lives), restoration or preservation of function (by maximizing quality-adjusted life-years or disability-adjusted life-years), relief of suffering, and so on [10,23]. To maximize the chosen benefits overall, however, Inhibitors,research,lifescience,medical triage systems may dictate that treatments for some patients be delayed, often resulting in poorer outcomes for

those patients. Bad consequences for some may be justified if an action produces Inhibitors,research,lifescience,medical the greatest overall benefit. Triage systems recognize this because in emergency situations, the resources are scarce in relation to the needs of the patients. Consequently, the needs of some patients will be subordinated to those of others in order to maximize utility. Which one of the criteria will, in fact, maximize utility, depends on complex empirical aspects of the situation and on the triage officer’s assessment TKI-258 supplier capacities. One particular criterion, however, is being

reflected in the third principle of justice, i.e. the Inhibitors,research,lifescience,medical principle of priority to the worst-off. Here, much depends on how one defines the worst-off group. Are they the most needy? The most urgent cases? Or the ones with the lowest prospects? Or even the poor and disenfranchised people who most often use the emergency departments because they have no other choice of receiving health care? [18] Suppose the worst possible outcome would be death [66]. Accordingly, the worst-off group would be the severely ever ill or injured people whose risk of death is highest, and for whom the likelihood of successful treatment is low, i.e. the ones at the edge of life and death. Guided by this principle, triage systems would give priority to treatment of this clearly disadvantaged group. However, it would be highly inefficient if maximizing the benefits to this group would imply investing a disproportionate share of scarce resources into a group of patients who are not likely to survive.