Document Type


Publication Date





Taylor & Francis




After the spectacular failure to apply acceptable triage methods to evacuate patients from a flooded Memorial Hospital during Hurricane Katrina, preparedness planning was intensified (Fink Citation2013). Regarding physicians and hospitals, two approaches got the most attention: (1) diluting the legal “standard of care” for physicians and hospitals so they would be immune from lawsuit for negligent acts during a crisis (“crisis standards of care”); and (2) developing triage protocols for scarce resource allocation. Both can be considered crude works in process. Nonetheless, in the midst of the greatest national crisis since 9/11, I think it is time to declare the crisis standards of care approach dead, and the triage approach in need of significant therapy to survive.

The idea that unites these two approaches seems seductively straightforward: in a crisis there is a danger that medical resources, such as ventilators, may be in such short supply that at least some physicians may not be able to obtain them for all of their patients who need them. In these circumstances, it is suggested that the duty of physicians shifts from “standard of care” medicine focused on individual patients to “crisis standards of care” under which the physician’s loyalty is transferred from individual patients to “acting to prioritize the community.” (Berlinger et al. Citation2020; Institute of Medicine Citation2009).

Link to Publisher Site Link to Publisher Site (BU Community Subscription)



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.