How do duty ethics and consequentialism clash in the rationing debate, and which way of weighing costs and benefits is defensible?

Question

Accepted Answer

Doctors' associations argue deontologically, "we are healers, not selectors", and call the debate inhumane; consequentialists reply that scarcity is a fact, so cost-benefit weighing is unavoidable. Weighing case by case at the bedside is hardly defensible, because it measures people by their worth; weighing with prioritisation rules fixed in advance is.

Duty ethics (Pflichtenethik, judging acts by duties rather than outcomes): the doctor's duty is to heal the patient in front of them. Selecting among patients by cost betrays that duty.
Consequentialism (Folgenethik, judging acts by their outcomes): scarcity of means simply exists, so not weighing costs and benefits does not avoid selection; it only makes it arbitrary.

The defensible middle depends on how the weighing happens:

Way of weighing
Verdict

In the concrete case, with concrete people affected
hardly defensible: people would be measured by their worthiness (Würdigkeit)

By prioritisation rules set in advance (e.g. for capacity shortages of ICU beds)
defensible: the rule is set before anyone knows who it will hit

The advance rule works much like the veil of ignorance: it is chosen without knowing whose life will be on the line.
Go deeper:

Wikipedia: Deontology — the duty-based side of the clash.
 Wikipedia: Consequentialism — the outcome-based side.

Way of weighing	Verdict
In the concrete case, with concrete people affected	hardly defensible: people would be measured by their worthiness (Würdigkeit)
By prioritisation rules set in advance (e.g. for capacity shortages of ICU beds)	defensible: the rule is set before anyone knows who it will hit