Abstract

The challenge of the covid-19 pandemic brought to consciousness the severe ethical problem of apportionment of limited resources in medicine. In pre-covid times, this challenge was more the concern of a minority of key specialists, rather than an issue that troubled the majority of medical ethicists. While military medicine was quite familiar with the phenomenon, allocational problems resulting from a limited number of personnel or material resource troubled civil medical care only in exceptional cases (e.g., disaster medicine, transplant medicine). By now, the allocation of scarce medical resource has become a widespread major concern. The tragic choices linked to allocational strategies (e.g., triage) has to be ethically justified. Based on general terminological considerations, the relevance of biomedical ethical principles (autonomy, non-maleficence, beneficence, justice) will be discussed. Though the latter do not seem to matter at first sight in this context, they deeply affect both physicians’ and patients’ self-understanding as well as the resulting physician-patient relationship. Therefore, allocational ethics should be an integral part of military as well as civil teaching programs in medicine.