ABSTRACT
In 1988 the BMA attempted to address the ethical problem of priorities for treatment among survivors, in the forum of the BMA 'SNAC' Report. 111 Part 1 of the report updated the BMA report of 1983112 and Part 2 considered how casualties might be selected for treatment. In disaster and mass casualty situations a method called 'triage' is used for allocation of medical resources to those in need. Casualties are sorted according to severity of illness (need) and priority for treatment (allocation). 113 In peacetime emergencies there is usually adequate backup, from on-site services and also outside agencies, to ensure eventual treatment for all casualties. In nuclear war this would not be the case. Not only will medical provisions be of a basic type, they will be extremely limited in availability. Doctors and other health workers will have to select those 'suitable for saving'. The difficult question of what criteria should be used has been a subject of much debate. The SNAC Report lays down the basic principles of treatment, attempting to list priorities (dependent on available resources), and advises that there must be no racial, political or religious bias. That this has to be spelt out, to doctors, is comment in itself. But it also says that food and health care priority would be given to children and previously 'healthy' young adults, particularly those with skills in agriculture and construction.
