This chapter explores the ethical and legal foundations of triage in the context of public health emergencies, with a particular focus on the European framework. It opens with a discussion of the essential premises of utilitarianism, investigating whether and how such an approach—especially the goal of saving the greatest number of lives and the controversial criterion of age—can be ethically justified. The chapter then considers broader theories of justice, including egalitarianism, prioritarianism, and sufficientarianism, assessing their normative coherence and moral implications when applied to life-and-death decisions in contexts of resource scarcity. Special attention is given to allocation tools such as QALY and DALY, which are critically examined for their potential ableist biases and utilitarian underpinnings. Beyond the analysis of competing theories and practical criteria, the chapter argues that the true ethical dilemma does not lie merely in choosing how to allocate resources, but who has the authority to make those choices—and on what institutional basis. The concluding section therefore advocates for the development of a common European triage protocol, grounded in proportionality, human dignity, and the principle of justice, as an essential step towards ensuring transparent, accountable, and ethically sustainable decision-making in future crises.