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Abstract: In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit on June 29, 2006, in Washington, D.C., of leading experts and emerging thinkers in public health law, ethics, and practice. Participants were tasked with generating a series of discrete principles that could facilitate effective public health allocation decisions at the state and local level. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being benefit; and good preparedness practice. As discussed in this article, these principles should be considered in the contexts of underlying public health, legal, and ethical perspectives.
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