money since 9/11 to develop and improve responders' triage skills cited benefits from standardization of triage methodology, reproducibility and interoperability, and nims compatibilities avoided capital costs for taxpayer investment in additional ems and trauma infrastructure wasteful daily resource utilization and increased operating costs from acceptance of substantial levels of overtriage prescribed values of a statistical life and estimated savings in human lives that could reasonably be expected using evidence-based triage practices ongoing performance improvements that could reasonably be expected from a more objective optimization-based triage system and practices ethical considerations because treatment is intentionally delayed or withheld from individuals under this system, triage has ethical implications that complicate the decision-making process. individuals involved in triage must take a comprehensive view of the process to ensure fidelity, veracity, justice, autonomy, and beneficence are safeguarded. ethical implications vary between different settings and the type of triage system employed, culminating in no single gold-standard approach to triage. emergency departments are advised to preemptively plan strategies in attempts to mitigate the emotional burden on these triage responders. while doing so, standards of care must be maintained to preserve the safety of both patients and providers. there is widespread agreement among ethicists that, in practice, during the covid-19 pandemic triage should prioritize "those who have the best chance of surviving" and follow guidelines with strict criteria that consider both short-term and long-term survivability. likewise, the triage of other health services has been adjusted during the pandemic to limit resource strain on hospitals. utilitarian approach and critique under the utilitarian model, triage works to maximize the survival outcomes of the most people possible. this approach implies that some individuals may likely suffer or die, in order for the majority to survive. triage officers must allocate limited resources and weigh an individual's needs along with the needs of the population as a whole. some ethicists argue the utilitarian approach to triage is not an impartial mechanism, but rather a partial one that fails to address the social conditions that prevent optimal outcomes in marginalized communities, rendering it a practical but inadequate means of distributing health resources. special population groups there is wide discussion regarding how vips and celebrities should be cared for in the emergency department. it is generally argued that giving special considerations or deviating from the standard medical protocol for vips or celebrities is unethical due to the cost to others. however, others argue that it may be morally justifiable as long as their treatment does not hinder the needs of others after assessing overall fairness, quality of care, privacy, and other ethical implications. proposed frameworks in conflict a variety of logistical challenges complicate the triage and ultimate provision of care in conflict situations. humanitarian actors acknowledge challenges like disruptions in food and medical supply chains, lack of suitable facilities, and existence of policies that prohibit administration of care to certain communities and populations as elements that directly impede the successful delivery of care. the logistical realities of humanitarian emergencies and conflict situations threatens the bioethical principle of beneficence, the obligation to act for the benefit of others. technical challenges of triage in conflict settings to address the ethical concerns that underpin triage in conflict situations and humanitarian crises, new triage frameworks and classification systems have been suggested that aim to uphold human rights. scholars have argued that new frameworks must prioritize informed consent and rely on established medical criteria only in order to respect the human rights considerations set forth by the geneva convention of 1864 and the universal declaration of human rights, but no comprehensive triage model has been adopted by international bodies. veterinary triage emergency veterinarian jessica fragola wrote in 2022 about the ethics of animal triage. she said that pressures on veterinarians having been exacerbated by staffing shortages that resulted from the covid pandemic, coupled with growth in spending on veterinary care and on pet insurance.