"We must first reject what often seems optimal in ordinary times, such as first-come, first-served, or even a lottery."

"These choices risk filling up ICU beds with patients unlikely to emerge alive, at the cost of the deaths of multitudes of patients who are likely to survive if given temporary care.... The save-the-most-lives strategy faces two plausible objections. The first questions how much survival counts, and whether a patient projected to survive a shorter period should have the same priority as one likely to live much longer. The second asks whether, on balance, younger patients should be favored over older ones.... In specific case... a pure save-the-most-lives rule could favor a 65-year-old over a more severely afflicted college-age patient. Many of us would root for the younger person, both because she might live longer if she pulls through and because the older patient has already enjoyed the decades of life that may be denied to the other. This modification of the save-the-most-lives strategy might be achieved by accepting a 'bias' in favor of the young, and not merely as tiebreakers. Ideally, this might be carried out without imposing formal age limits.... No preference is given to those most likely not merely to survive but also to enjoy the best health, let alone the highest quality of life. Nor does the strategy excuse abandonment of the disabled. Rather, it directs resources to providing the greatest assurance possible that each of us will achieve what we most value: our own survival and that of our loved ones and fellow citizens."

From "Here are rules doctors can follow when they decide who gets care and who dies/Ethicists like me have studied rationing for decades. In a few days, our guidelines will be needed" by Daniel Wikler, who is a Harvard Professor of Ethics and Population Health. He used to be in the Medical Ethics program here at the University of Wisconsin.