Abstract
This chapter examines the relationship between social-scientific research on public preferences regarding allocation and ethical inquiry into how resources should be allocated. It also explains how social-scientific researchers might find an understanding of work in ethics useful as they design mechanisms for data collection and analysis. I proceed by first distinguishing the methodologies used in ethics from those used in the social sciences. I then provide an overview of different approaches to the ethics of allocating scarce medical interventions, including an approach—the complete lives system—which I have previously defended, and a brief recap of social-scientific research on the allocation of scarce medical resources. Following these overviews, I examine different ways in which public preferences could matter to the ethics of allocation. Last, I suggest some ways in which social scientists could learn from ethics as they conduct research into public preferences regarding the allocation of scarce medical resources.
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Alexander, S. (1962). They decide who lives, who dies. Life, 102–125.
Alvarez, A. A. (2001). How rational should bioethics be? The value of empirical approaches. Bioethics, 15(5–6), 501–519.
Chappell, R. Y. (2016). Against ‘saving lives’: Equal concern and differential impact. Bioethics, 30(3), 159–164.
Cohen, G. A. (2009). Rescuing justice and equality (pp. 229–273). Cambridge, MA: Harvard University Press.
Egan, T. M., Murray, S., Bustami, R. T., Shearon, T. H., McCullough, K. P., Edwards, L. B., … Grover F. L. (2006). Development of the new lung allocation system in the United States. American Journal of Transplantation, 6(5 Pt 2), 1212–1227.
Estlund, D. M. (1994). Opinion leaders, independence, and Condorcet’s jury theorem. Theory and Decision, 36(2), 131–162.
Kamm, F. M. (2007). Intricate Ethics (p. 5). Oxford: Oxford UP.
Gamlund, E. (2016). What is so important about completing lives? A critique of the modified youngest first principle of scarce resource allocation. Theoretical Medicine and Bioethics, 37(2), 113–128.
Hochschild, J. L. (1981). What’s fair?: American beliefs about distributive justice. Cambridge, MA: Harvard University Press.
Hope, T., Sprigings, D., & Crisp, R. (1993). “Not clinically indicated”: patients’ interests or resource allocation? BMJ, 306(6874), 379–381.
Irving, M. J., Tong, A., Jan, S., Wong, G., Cass, A., Allen, R. D., et al. (2013). Community preferences for the allocation of deceased donor organs for transplantation: A focus group study. Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association, 28(8), 2187–2193.
Kerstein, S. J., & Bognar, G. (2010). Complete lives in the balance. The American Journal of Bioethics, 10(4), 37–45.
Krohmal, B. J., & Emanuel, E. J. (2007). Access and ability to pay: The ethics of a tiered health care system. Archives of Internal Medicine, 167(5), 433–437.
Krütli, P., Rosemann, T., Tornblom, K. Y., & Smieszek, T. (2016). How to fairly allocate scarce medical resources: Ethical argumentation under scrutiny by health professionals and lay people. PloS One, 11(7), e0159086.
Lenton, A. P., Blair, I. V., & Hastie, R. (2006). The influence of social categories and patient responsibility on health care allocation decisions: Bias or fairness? Basic and Applied Social Psychology, 28(1), 27–36.
Lipsitch, M., Finelli, L., Heffernan, R. T., Leung, G. M., Redd, S. C., & 2009 H1N1 Surveillance Group. (2011). Improving the evidence base for decision making during a pandemic: The example of 2009 influenza A/H1N1. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 9(2), 89–115.
Malakoff, D. (1999). Bayes offers a ‘new’ way to make sense of numbers. Science, 286(5444), 1460–1464.
McMillan, J., & Hope, T. (2010). Balancing principles, QALYs, and the straw men of resource allocation. The American Journal of Bioethics, 10(4), 48–50.
Munson, J. C., Christie, J. D., & Halpern, S. D. (2011). The societal impact of single versus bilateral lung transplantation for chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 184(11), 1282–1288.
Norheim, O. F. (2010). Priority to the young or to those with least lifetime health? The American Journal of Bioethics: AJOB, 10(4), 60–61.
Ottersen, T. (2013). Lifetime QALY prioritarianism in priority setting. Journal of Medical Ethics, 39(3), 175–180.
Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Principles for allocation of scarce medical interventions. The Lancet, 373(9661), 423–431.
Rawls, J. (1999). A theory of justice. Cambridge, MA: Harvard University Press.
Rawls, J. (2005). Political liberalism (pp. 212–254). New York, NY: Columbia University Press.
Rid, A., & Emanuel, E. J. (2014). Ethical considerations of experimental interventions in the Ebola outbreak. The Lancet, 384(9957), 1896–1899.
Smith, L. J., Anand, P., Benattayallah, A., & Hodgson, T. L. (2015). An fMRI investigation of moral cognition in healthcare decision making. Journal of Neuroscience, Psychology, and Economics, 8(2), 116.
Strech, D., Synofzik, M., & Marckmann, G. (2008). How physicians allocate scarce resources at the bedside: A systematic review of qualitative studies. Journal of Medicine and Philosophy, 33(1), 80–99.
Sulmasy, D. P., & Sugarman, J. (2001). The many methods of medical ethics (or, thirteen ways of looking at a blackbird). In J. Sugarman & D. P. Sulmasy (Eds.), Methods in medical ethics (2nd ed., pp. 3–18). Washington, DC: Georgetown University Press.
Tong, A., Howard, K., Jan, S., Cass, A., Rose, J., Chadban, S., … Craig, J. C. (2010). Community preferences for the allocation of solid organs for transplantation: A systematic review. Transplantation, 89(7), 796–805.
Tong, A., Jan, S., Wong, G., Craig, J. C., Irving, M., Chadban, S., … Howard, K. (2012). Patient preferences for the allocation of deceased donor kidneys for transplantation: A mixed methods study. BMC Nephrology, 13, 18.
Tong, A., Jan, S., Wong, G., Craig, J. C., Irving, M., Chadban, S., … Howard, K. (2013). Rationing scarce organs for transplantation: Healthcare provider perspectives on wait-listing and organ allocation. Clinical Transplantation, 27(1), 60–71.
Vawter, D. E., Garrett, J. E., Gervais, K. G., Prehn, A. W., DeBruin, D. A., Tauer, C. A., … Marshall, M. F. (2010). For the good of us all: Ethically rationing health resources in Minnesota in a severe influenza pandemic. Minneapolis, MN: Minnesota Center for Health Care Ethics and University of Minnesota Center for Bioethics.
Vawter, D. E., Gervais, K. G., & Garrett, J. E. (2007). Allocating pandemic influenza vaccines in Minnesota: Recommendations of the pandemic influenza ethics work group. Vaccine, 25(35), 6522–6536.
Yamin, A. E. (2009). Shades of dignity: Exploring the demands of equality in applying human rights frameworks to health. Health and Human Rights, 11(2), 1–18.
Acknowledgements
I am grateful to Ezekiel Emanuel, Alan Wertheimer, and Timo Smieszek for discussion of these issues, and to Meng Li, David Tracer, and an anonymous reviewer for their comments. Thanks to Kristen Miller for her help with the references.
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Persad, G. (2017). Public Preferences About Fairness and the Ethics of Allocating Scarce Medical Interventions. In: Li, M., Tracer, D. (eds) Interdisciplinary Perspectives on Fairness, Equity, and Justice. Springer, Cham. https://doi.org/10.1007/978-3-319-58993-0_4
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DOI: https://doi.org/10.1007/978-3-319-58993-0_4
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