Resource allocation on the frontlines of public health preparedness and response: Report of a summit on legal and ethical issues

Daniel J. Barnett, Holly A. Taylor, James G. Hodge, Jonathan M. Links

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Objectives. In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. Methods. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. Results. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. Conclusions. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

Original languageEnglish (US)
Pages (from-to)295-303
Number of pages9
JournalPublic Health Reports
Issue number2
StatePublished - 2009
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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