Building on our own past research on rationing medical resources, as well as American, British and Australian guidelines for a less daunting influenza pandemic, and just-released recommendations by the Italian intensive care unit physicians’ group, we offer these suggestions.

The priority should be health care workers; police, firefighters and other emergency workers; and those who keep water, electricity and other necessary systems functioning, because they can save the lives of others. This primacy should not be abused. For instance, physicians who are not involved in patient care, such as researchers or administration, should not get special treatment…

In order to best steward the resources available, arriving at the hospital first would no longer guarantee that one would receive lifesaving treatment over another patient. Moreover, first come first served may disproportionately benefit the well-off and well-connected who are able to learn where beds and ventilators are available and travel there quickly.

All patients deserve maximum treatment. But the tragedy of scarcity in a pandemic is that some will go without conventional treatment, no matter what.