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Triage scarce resources — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeTriage scarce resourcesUSMLE Step 3

A health system is revising its policy for allocating a treatment that may become critically scarce. Which proposed framework best follows the AMA Code of Medical Ethics?

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Correct answer: C — Rank medical urgency and expected benefit first; use an objective transparent mechanism only for clinically equivalent claims

The best answer is “Rank medical urgency and expected benefit first; use an objective transparent mechanism only for clinically equivalent claims”. AMA guidance first compares medically relevant need: urgency, likelihood and anticipated duration of benefit, and expected change in quality of life. Only when patients do not differ substantially on those factors should an objective, flexible, transparent mechanism decide among them. Caregiving role, past resource use, and clinician preference are nonobjective or nonmedical tie-breakers, while a lottery before medical comparison disregards the required priority structure.

Reference: AMA Code of Medical Ethics Opinion 11.1.3: Allocating Limited Health Care Resources: https://code-medical-ethics.ama-assn.org/ethics-opinions/allocating-limited-health-care-resources