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.