The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

Far more than the dialectic philosophy of Socrates, the rhetorical humanist tradition avoids objectivist epistemology, charts a traversable path to practical wisdom, and aptly highlights the importance of aesthetic style. In those and other ways, we argue, it offers a preferable historical basis for today’s philosophical counseling. Advocates of that contemporary practice tend to cite Socrates as its historical progenitor and favor the narrow propositional logic that is ascribed to him. Some practitioners, though, have also grown more attuned to metaphorical (...) and narrative elements in a client’s worldview. We aim to supplement their claims by drawing from principles of classical rhetorical theory, showing a way to rethink the practice of philosophical counseling today. (shrink)