Sante Publique. 2022 Mar 11;Vol. 33(6):803-811. doi: 10.3917/spub.216.0803.
The SARS-CoV-2 virus that appeared in December 2019 in the city of Wuhan in China spread rapidly. Severe forms of this virus infection cause acute respiratory distress syndromes (ARDS) requiring hospitalization of affected patients in intensive care units (IUCs), providing mechanical ventilation. The capacity of ICUs in the countries most affected by this health crisis quickly became overwhelmed, forcing healthcare providers to choose the patients who would benefit from care. Managing the overload of a healthcare system is the role of disaster medicine, for which one of the principles is the triage of patients according to their severity. Having to choose between patients means choosing a statement between deontology (judging the morality of an action according to its intention) and utilitarianism (judging the morality of an action by its consequences).
The aims of this article are, through the analysis of the trolley problem, to understand and justify the process of allocation of scarce resources found in the guidelines used in the context of the COVID-19 pandemic.
The analysis of the trolley problem allows us to understand in what way our choices are utilitarian or deontological. Saving as many lives as possible", as advocated in the guidelines, is utilitarian.
These answers will provide a better understanding of all of the different ways of allocating scare resources according to the deontological or utilitarian approach, especially the one found in the disaster medicine guidelines.
2019年12月在中国武汉市出现的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）迅速传播。这种病毒感染的严重形式会导致急性呼吸窘迫综合征（ARDS），需要将受影响的患者送往重症监护病房（ICU）住院，并提供机械通气。受这场健康危机影响最严重的国家的ICU能力很快不堪重负，迫使医疗服务提供者选择能够从治疗中受益的患者。管理医疗系统的超负荷是灾难医学的职责，其原则之一是根据患者的严重程度进行分诊。必须在患者之间做出选择意味着要在道义论（根据行为的意图判断行为的道德性）和功利主义（根据行为的后果判断行为的道德性）之间做出抉择。
本文的目的是通过分析电车难题，理解并论证在2019冠状病毒病大流行背景下使用的指南中所发现的稀缺资源分配过程。
对电车难题的分析使我们能够理解我们的选择在何种程度上是功利主义的或道义论的。指南中所倡导的“尽可能挽救更多生命”是功利主义的。
这些答案将有助于更好地理解根据道义论或功利主义方法分配稀缺资源的所有不同方式，尤其是在灾难医学指南中所发现的方式。
