Professor Terry Myers (English, William & Mary) writes:
The Johns Hopkins piece notes that "Unless patients can be transferred, we would then enter the uncharted territory of having to ration life-saving care in order to save the most lives—something we have never done before in an organized way.”
Is there a consensus among ethicists as to the best criteria for choosing to save one patient’s life instead of another’s?
I don't know the answer to this. New York prepared a report in 2015 about criteria for rationing ventilators, but I don't know whether this reflects any kind of "consensus" outside this particular committee, which included philosophers but, thankfully, non-philosophers too. From page 4 of the Executive Summary:
This article suggests a similar kind of consensus among the bioethicists consulted (those with best chance of surviving get priority for treatment). Links and comments from more knowledgeable readers welcome.
UPDATE: Thomas Cunnigham, the Bioethics Director at KP West Los Angeles and a faculty member at the Loyola Marymount Bioethics Institute, writes:
Longtime reader of your blog and PGR since 2005, when I used it to apply to grad schools.
I write in my current capacity as bioethics director in a large health system. I wanted to share with you that, as you’ve discussed on your blog, hospitals and ethicists are generally underprepared for the possibility of a widespread need to triage. There are many models for how to triage, but almost all roads lead back to work by John Hick and colleagues, adopted by the NY State guidelines, which has emerged as the gold standard. However, this standard is generally untested in practice, and empirical validation of it (rather than its components) is lacking. Moreover, the details of how to operationalize and implement this approach are lacking in the literature. The US ethics community has coalesced around this as the top issue of the moment, with most of my colleagues working online and emailing back and forth from early morning until very late into the evening. I have put together a Google Drive repository of materials that others have sent to me (including those cited above). Please consider posting it so that others can view the material and share more with me. Link: https://drive.google.com/open?id=1B9Ub9Si-JHOHe9ElVy4ZTI81IGfK0EB-
Also, many of us have worked to create draft policies that could be rapidly tailored by hospitals to fit their needs and adopted. The sooner we get these committees up and functioning, the more likely we are to avoid undertriage and overtriage, and therefore, to minimize mortality in the event we face triage conditions, which rumors indicate New York facilities are close to, if not already there. I lead a group that has developed a model policy that anyone can access, in the hopes that hospitals who lack adequate personnel with expertise in bioethics and operations can use it as a starting point. Link: https://www.researchgate.net/publication/340022240_Pandemic_Triage_Committee_Draft_Policy
Work by Ellen Fox et al (2007 tables below) shows that most hospitals are small, and most of them have at best a rudimentary ethics committee structure. It seems likely, that at best, only a fraction of hospitals will be adequately prepared for triage conditions.
Fox, E., Myers, S., & Pearlman, R. A. (2007). “Ethics consultation in United States hospitals: a national survey.” American Journal of Bioethics 7(2): 13-25.
ANOTHER: Here's a Hastings Center ethics reporthttps://www.thehastingscenter.org/ethicalframeworkcovid19/ on responding to the COVID-19 pandemic. (Thanks to Hanna Pickard for the pointer.)