Managing limited resources in emergency care: striking a balance between ethics, triage, and fairness

Abstract

"During my previous job, when I was working at a tertiary care hospital in Bannu, Khyber Pakhtunkhwa, once, I found myself working in the Emergency Department of a hospital that served as the only tertiary care facility for three neighboring districts. It is the only tertiary care hospital in the vicinity, especially during the current military operations against terrorists in North Waziristan. We consistently faced a high patient turnover and struggled with a severe staffing shortage due to the lack of resources and opportunities. On one occasion, we received a group of patients who had suffered multiple fractures in a road traffic accident. While I was already attending to one of these patients, the attendant of another patient approached me, insisting that their loved one's condition was equally critical due to severe pain and multiple fractures. It placed me in a challenging dilemma as both patients were in urgent need of care. I took a moment to assess the situation and continued providing care to the patient I was already attending to. My decision was based on the utilitarian principle of justice. That is a benefit for the greater maximum, in our case, I continued providing care to the same patient as that patient has a greater prognosis and needs immediate attention."