Choosing which COVID-19 patient to save? The ethical triage and rationing dilemma.

Killing someone directly is never morally right, but sometimes, choosing someone to save and leaving another to die is. The moral philosophy, law, and medical ethics have all wrestled with the problem of distinguishing between saving someone and leaving another to die. While this distinction might seem intuitively straightforward, it becomes far more complex when applied in treating patients of novel Coronavirus Disease pandemic (COVID-19). The World Health Organization reports more than eight million and half cases of infection and more than 450,000 deaths, 26% in USA. However, with the exponential rise in number of COVID-19 victims and the shortage of life-saving ventilators, the pandemic has imposed to health professionals an ethical medical triage decision-making based on the utilitarian theory to maximize total benefits and life expectancy. Moreover, the decision to put restrictions on treatment beneficence is not discretionary, but an indispensable response to the overwhelming impacts of COVID-19 pandemic. The main concern is not whether to underline priorities, but how to do so systematically and ethically, instead of building decisions on individualized institutional aspirations or health professionals' intuition. The serious glaring disequilibrium, in healthcare market, between supply and demand for scarce medical resources in several developed nations (including the USA, UK, France, Italy, Spain, etc.) imposes a fundamental question: which COVID-19 patient to save when facing scarce resources?