Medical Triage in a Time of Scarce Resources.

It is hypothesized that recalling ethical values before resolving dilemmas could modify the
ability to adopt a utilitarian approach in resolving ethical dilemmas.

To verify this hypothesis, the score on the Impartial Harm subscale of the Oxford
Utilitarianism Scale (IH-OUS) will be compared between a group with reading of ethical
guidelines and a group without reading of ethical guidelines, before they are asked to
complete the questionnaire and being exposed to triage dilemmas.

Number of subjects needed for the phase of study evaluating intensivists, anesthesiologists
and emergency physicians : 580 - based on preliminary data, assuming 70% complete response
rate of the survey and a standard deviation of 5

Secondary outcomes will be considered :

- Beneficence Harm subscale of the Oxford Utilitarianism Scale (IB-OUS)

- Values prioritized to resolve ethical dilemmas : impartial of benefits, prioritization
of the young age, saving life years, saving most lives, equality of treatment,
prioritization of the worst off, loyalty duty, principle of non-discrimination,
prospective and retrospective instrumental value.

First phase of the study will aim to include first-line caregivers : intensivists,
anesthesiologists, emergency physicians.

Other phases of the study will aim to include health care professionals from other categories
and non health care professionals.

Subgroup analyses are planned :

- Analysis according to the characteristics of the participant: gender, geographic
location, diploma and type of exercise, category of institution to which the participant
is attached.

- Analysis according to the degree of knowledge in ethics, the degree of familiarity with
ethical recommendations, the degree of familiarity with moral philosophy, the degree of
religiosity, whether the participants declare to have taken knowledge or not of
recommendations concerning medical triage in a situation of scarce resources.

It is also planned to carry out ancillary studies in parallel with the realization of the
study presented here:

- A study including non-physician participants aiming to identify the differences between
non-physicians and physicians in terms of ethical values mobilized in medical triage.

- A study including medical students aiming to identify an association between propensity
to make utilitarian and choices of the medical specialty.

- A study focused on the Oxford Utilitarianism Scale, integrating the results of the pilot
study and the confirmatory study, aiming to identify predictors of responses to the
dilemmas proposed within the scale.

- A study evaluating the association between delay in ethical dilemmas resolution and
utilitarian choices.