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Original Article
- Public Preferences for Allocation Principles for Scarce Medical Resources in the COVID-19 Pandemic in Korea: Comparisons With Ethicists’ Recommendations
- Ji-Su Lee, Soyun Kim, Young Kyung Do
- J Prev Med Public Health. 2021;54(5):360-369. Published online August 26, 2021
- DOI: https://doi.org/10.3961/jpmph.21.333
- 3,836 View
- 158 Download
- 5 Crossref
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Abstract
Summary
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Supplementary Material - Objectives
The purpose of this study was to investigate public preferences regarding allocation principles for scarce medical resources in the coronavirus disease 2019 (COVID-19) pandemic, particularly in comparison with the recommendations of ethicists.
Methods
An online survey was conducted with a nationally representative sample of 1509 adults residing in Korea, from November 2 to 5, 2020. The degree of agreement with resource allocation principles in the context of the medical resource constraints precipitated by the COVID-19 pandemic was examined. The results were then compared with ethicists’ recommendations. We also examined whether the perceived severity of COVID-19 explained differences in individual preferences, and by doing so, whether perceived severity helps explain discrepancies between public preferences and ethicists’ recommendations.
Results
Overall, the public of Korea agreed strongly with the principles of “save the most lives,” “Koreans first,” and “sickest first,” but less with “random selection,” in contrast to the recommendations of ethicists. “Save the most lives” was given the highest priority by both the public and ethicists. Higher perceived severity of the pandemic was associated with a greater likelihood of agreeing with allocation principles based on utilitarianism, as well as those promoting and rewarding social usefulness, in line with the opinions of expert ethicists.
Conclusions
The general public of Korea preferred rationing scarce medical resources in the COVID-19 pandemic predominantly based on utilitarianism, identity and prioritarianism, rather than egalitarianism. Further research is needed to explore the reasons for discrepancies between public preferences and ethicists’ recommendations. -
SummaryKorean summary
코로나19 대유행으로 가시화된 의료자원의 부족 상황에서 서로 다른 의료자원 배분 원칙에 대한 일반 대중의 선호를 조사한 연구이다. 제시된 여러 원칙 중에서, 공리주의, 한국인 아이덴티티, 약자우선주의에 기초한 배분 원칙이 가장 높은 선호를 보였다. 이러한 결과는, 일반 상황과 달리 감염병 대유행 상황에서는 공리주의에 기초한 배분 원칙을 강화하되 사회적 유용성도 자원 배분의 주요 원칙으로 받아들일 수 있다는 윤리학자들의 견해와는 차이를 보인다. -
Citations
Citations to this article as recorded by
- Explicit discrimination and ingroup favoritism, but no implicit biases in hypothetical triage decisions during COVID-19
Nico Gradwohl, Hansjörg Neth, Helge Giese, Wolfgang Gaissmaier
Scientific Reports.2024;[Epub] CrossRef - Health Professional vs Layperson Values and Preferences on Scarce Resource Allocation
Russell G. Buhr, Ashley Huynh, Connie Lee, Vishnu P. Nair, Ruby Romero, Lauren E. Wisk
JAMA Network Open.2024; 7(3): e241958. CrossRef - What are the views of Quebec and Ontario citizens on the tiebreaker criteria for prioritizing access to adult critical care in the extreme context of a COVID-19 pandemic?
Claudia Calderon Ramirez, Yanick Farmer, Andrea Frolic, Gina Bravo, Nathalie Orr Gaucher, Antoine Payot, Lucie Opatrny, Diane Poirier, Joseph Dahine, Audrey L’Espérance, James Downar, Peter Tanuseputro, Louis-Martin Rousseau, Vincent Dumez, Annie Descôtea
BMC Medical Ethics.2024;[Epub] CrossRef - Consensual ideas for prioritizing patients: correlates of preferences in the allocation of medical resources
Adrian Furnham, Charlotte Robinson, Simmy Grover
Ethics & Behavior.2023; 33(7): 568. CrossRef - Public voices on tie-breaking criteria and underlying values in COVID-19 triage protocols to access critical care: a scoping review
Claudia Calderon Ramirez, Yanick Farmer, Marie-Eve Bouthillier
Discover Health Systems.2023;[Epub] CrossRef
- Explicit discrimination and ingroup favoritism, but no implicit biases in hypothetical triage decisions during COVID-19
Comparative Study
- Disability Weights for Diseases in Korea.
- Jung Kyu Lee, Seok Jun Yoon, Young Kyung Do, Young Hoon Kwon, Chang Yup Kim, Kidong Park, Yong Ik Kim, Young Soo Shin
- Korean J Prev Med. 2003;36(2):163-170.
- 14,951 View
- 45 Download
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Abstract
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- OBJECTIVES
This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. METHODS: To develop the valuation protocol, the Global Burden of Disease (GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. RESULTS: The disability weights were valued in a two step panel study. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. CONCLUSIONS: It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies. This would provide a rational basis for an international comparative study of disability weights. -
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