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The role of social justice in triage revisited: a threshold conception

Holzer, Felicitas; Biller-Andorno, Nikola; Baumann, Holger (2025). The role of social justice in triage revisited: a threshold conception. Medicine, Health Care and Philosophy, 28(1):161-169.

Abstract

Saving as many lives as possible while ensuring equity for vulnerable groups through access to triage resources has been the dominant position since the onset of the COVID-19 pandemic in 2020. However, the exact relationship between the principles of social justice and efficiency remains a controversial and unresolved issue. In this paper, we aim to systematically distinguish between different models of this relationship and show that conceptualizing social justice as a ‘moral side-constraint’ or adopting a ‘balancing approach’ that attempt to reconcile social justice with efficiency inevitably lead to significant moral costs that require further justification. Based on this discussion, we propose a novel “threshold model” for trading-off moral costs. According to this model, the structural impact of triage must be considered in order to determine whether one opts for triage with the primary aim of efficiency or social justice. This contextualization further explains why, in some societies and circumstances, social justice can rightly be seen as the primary concern, while in other societies and circumstances, efficiency can be defended as the primary concern.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Ethics and History of Medicine
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Social Sciences & Humanities > Health (social science)
Social Sciences & Humanities > Education
Social Sciences & Humanities > Philosophy
Health Sciences > Health Policy
Language:English
Date:March 2025
Deposited On:20 Jan 2025 11:06
Last Modified:08 Feb 2025 02:07
Publisher:Springer
ISSN:1386-7423
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s11019-024-10232-9
PubMed ID:39579288
Project Information:
  • Funder: University of Zurich
  • Grant ID:
  • Project Title:
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