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How to fairly allocate scarce medical resources? Controversial preferences of healthcare professionals with different personal characteristics

Published online by Cambridge University Press:  10 June 2021

Micaela Pinho Open the ORCID record for Micaela Pinho [Opens in a new window]  and
Alexandra Araújo Open the ORCID record for Alexandra Araújo [Opens in a new window]
Micaela Pinho*
Affiliation:
University Portucalense, Research on Economics, Management and Information Technologies (REMIT) & Portucalense Institute for Legal Research (IJP), Porto, Portugal University Aveiro, Research Unit in Governance, Competitiveness and Public Policies (GOVCOPP), Aveiro, Portugal
Alexandra Araújo
Affiliation:
Portucalense Institute of Human Development (INPP), Porto, Portugal
*
*Corresponding author. Email: [email protected]
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Abstract

The scarcity of medical resources is widely recognized, and therefore priority setting is inevitable. This study examines whether Portuguese healthcare professionals (physicians vs nurses): (i) share the moral guidance proposed by ethicists and (ii) attitudes toward prioritization criteria vary among individual and professional characteristics. A sample of 254 healthcare professionals were confronted with hypothetical prioritization scenarios involving two patients distinguished by personal or health characteristics. Descriptive statistics and parametric analyses were performed to evaluate and compare the adherence of both groups of healthcare professionals regarding 10 rationing criteria: waiting time, treatment prognosis measured in life expectancy and quality of life, severity of health conditions measured in pain and immediate risk of dying, age discrimination measured in favoring the young over older and favoring the youngest over the young, merit evaluated positively or negatively, and parenthood. The findings show a slight adherence to the criteria. Waiting time and patient pain were the conditions considered fairer by respondents in contrast with the ethicists normative. Preferences for distributive justice vary by professional group and among participants with different political orientations, rationing experience, years of experience, and level of satisfaction with the NHS. Decision-makers should consider the opinion of ethicists, but also those of healthcare professionals to legitimize explicit guidelines.

Keywords

Distributional justicedistributive preferenceshealthcare professional attitudeshealthcare rationingmedical scarcityprioritizingsocialization theory
Type
Article
Information
Health Economics, Policy and Law , Volume 17 , Issue 4 , October 2022 , pp. 398 - 415
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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