After reading Julia Lynch’s latest draft paper, a typical layperson would likely be surprised to realize that despite decades of national concern about terrorists, biological warfare attacks, and dirty bombs, hospitals don’t have an actual how-to guide for deciding how to allocate scarce resources during such catastrophic incidents.

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Lynch, an associate professor of political science at the School of Arts and Sciences and an LDI Senior Fellow, realized this a few weeks ago. A colleague from a Michigan health system called her trying to find—or have her create—step-by-step instructions for how to make ongoing scarce resource allocation decisions in hospitals during emergencies like the current coronavirus pandemic.

“The call came in because political scientists like myself set up decision-making rules, and these decision rules were what was absent from existing guidance,” says Lynch. “Most hospitals have contingency plans designed to guide decision-making about scarce resource allocation during crises like a pandemic. But most of these plans start from abstract bioethical principles and then jump to detailed plans for triaging particular forms of treatment.”