# Australia - Medical Triage Algorithm in the Pandemic
Australia, 2020 | Severity: N2

## What Happened
During the peak of the COVID-19 pandemic, several Australian hospitals implemented an automated medical triage algorithm to manage intensive care unit (ICU) admissions and ventilator allocation. Investigations later revealed that the algorithm systematically deprioritized patients with chronic disabilities or pre-existing conditions, automatically assigning them lower priority scores for ICU beds regardless of their actual, immediate survival probability. The biased allocation logic was embedded in the algorithm's clinical rating scale, which had not undergone public ethical review or independent safety validation, leading to several vulnerable patients being denied critical care before clinicians intervened.

## How MEG 1 acted
The triage algorithm failed the Index of Safety and Responsibility (ISR) audit due to its discriminatory scoring logic and violation of the core principle of medical safety and non-harm.

## MEG 2 Analysis - Legal Framework
* **Agent level:** N2 (management) - algorithmic triage and resource allocation system used by public/private healthcare providers to make critical medical decisions affecting patient survival.
* **Cause (6.1):**
  * **(a) system defect** - ethical design flaw and systemic discrimination against disabled populations built into the triage model (design defect).
  * **(b) autonomous decision error** - the system's decision to deny or deprioritize critical ICU access for specific patient groups without clinician consent.
* **Attachment of liability:** The hospital operators are liable for deploying an unvalidated, discriminatory triage tool; the developers are liable for the system defects (6.1a) regarding medical ethics and safety.

## Procedural Mechanism
* **6.2 (architectural human confirmation):** Decisions involving the denial or allocation of life-saving medical care (such as ICU beds) must require active, architectural human confirmation. The AI can only provide suggestions; a human clinical board must sign off on any final resource allocation.
* **7.1 (independent forensics):** Every triage score, the patient parameters entered, and the model's recommendation must be securely logged in an unalterable, independent ledger for medical and legal audits.
* **9.4 (least privilege):** The algorithm was granted direct influence over critical care routing without independent ethical validation layers, violating safe clinical boundaries.