IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v282y2021ics0277953621005037.html
   My bibliography  Save this article

Awareness of ethical dilemmas enhances public support for the principle of saving more lives in the United States: A survey experiment based on ethical allocation of scarce ventilators

Author

Listed:
  • Rai, Birendra
  • Wang, Liang Choon
  • Pandit, Simone
  • Handfield, Toby
  • So, Chiu Ki

Abstract

Recommendations by health experts to deal with public health emergencies are primarily guided by the principle of “saving more lives”. It is unclear whether people perceive this principle as ethically more legitimate than some other principle such as “saving more life-years”. Understanding the answer to this question is particularly relevant to the allocation of scarce medical resources during public health emergencies. Different principles typically lead to different allocations, and consequently have dramatically different implications as to who survives and who dies. We fielded an online randomized controlled survey experiment in the context of scarce ventilator allocation with a demographically representative sample of US adults (n = 700) from October 22 to October 30, 2020. Participants faced hypothetical situations where they had to allocate few available ventilators among several needy patients. The experiment was designed such that the allocation decision made by a participant can be used to infer the principle in line with their personal ethical values. We interpret this inferred principle as the one that the participant perceives to be most legitimate. The treatment group, but not the control group, was provided balanced information that described the ethical dilemmas faced by experts in developing ventilator allocation guidelines. Nearly half of the participants in the control group perceive saving more lives the most legitimate principle. Despite the balanced nature of the information, the perceived legitimacy of saving more lives was 7·6 percentage points higher in the treatment group. The magnitude of this impact was particularly strong among republican-leaning participants, a subgroup that has less trust in experts according to previous research. Our findings suggest that enhancing public awareness of ethical dilemmas faced by health experts can increase the perceived legitimacy of their proposed guidelines even among those with lower trust in experts.

Suggested Citation

  • Rai, Birendra & Wang, Liang Choon & Pandit, Simone & Handfield, Toby & So, Chiu Ki, 2021. "Awareness of ethical dilemmas enhances public support for the principle of saving more lives in the United States: A survey experiment based on ethical allocation of scarce ventilators," Social Science & Medicine, Elsevier, vol. 282(C).
    • Handle: RePEc:eee:socmed:v:282:y:2021:i:c:s0277953621005037
    DOI: 10.1016/j.socscimed.2021.114171
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953621005037
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2021.114171?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Cooper, Russell, et al, 1990. "Selection Criteria in Coordination Games: Some Experimental Results," American Economic Review, American Economic Association, vol. 80(1), pages 218-233, March.
    2. Islam, Asad & Pakrashi, Debayan & Vlassopoulos, Michael & Wang, Liang Choon, 2021. "Stigma and misconceptions in the time of the COVID-19 pandemic: A field experiment in India," Social Science & Medicine, Elsevier, vol. 278(C).
    3. Michael Blastland & Alexandra L. J. Freeman & Sander van der Linden & Theresa M. Marteau & David Spiegelhalter, 2020. "Five rules for evidence communication," Nature, Nature, vol. 587(7834), pages 362-364, November.
    4. Callaghan, Timothy & Moghtaderi, Ali & Lueck, Jennifer A. & Hotez, Peter & Strych, Ulrich & Dor, Avi & Fowler, Erika Franklin & Motta, Matthew, 2021. "Correlates and disparities of intention to vaccinate against COVID-19," Social Science & Medicine, Elsevier, vol. 272(C).
    5. Motta, Matthew & Callaghan, Timothy & Sylvester, Steven, 2018. "Knowing less but presuming more: Dunning-Kruger effects and the endorsement of anti-vaccine policy attitudes," Social Science & Medicine, Elsevier, vol. 211(C), pages 274-281.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chiang, Chun-Fang & Kuo, Jason & Liu, Jin-Tan, 2022. "Cueing quality: Unpacking country-of-origin effects on intentions to vaccinate against COVID-19 in Taiwan," Social Science & Medicine, Elsevier, vol. 314(C).
    2. Bosch-Domènech, Antoni & Vriend, Nicolaas J., 2013. "On the role of non-equilibrium focal points as coordination devices," Journal of Economic Behavior & Organization, Elsevier, vol. 94(C), pages 52-67.
    3. Martinovici, A., 2019. "Revealing attention - how eye movements predict brand choice and moment of choice," Other publications TiSEM 7dca38a5-9f78-4aee-bd81-c, Tilburg University, School of Economics and Management.
    4. Casey A. Klofstad & Joseph E. Uscinski & Jennifer M. Connolly & Jonathan P. West, 2019. "What drives people to believe in Zika conspiracy theories?," Palgrave Communications, Palgrave Macmillan, vol. 5(1), pages 1-8, December.
    5. Konstantinos Georgalos & Indrajit Ray & Sonali SenGupta, 2020. "Nash versus coarse correlation," Experimental Economics, Springer;Economic Science Association, vol. 23(4), pages 1178-1204, December.
    6. Haruvy, Ernan & Stahl, Dale O., 2007. "Equilibrium selection and bounded rationality in symmetric normal-form games," Journal of Economic Behavior & Organization, Elsevier, vol. 62(1), pages 98-119, January.
    7. David Schüller & Thorsten Upmann, 2013. "When Focal Points are Out of Focus: A Game-Theoretic Analysis of Come Dine with Me," CESifo Working Paper Series 4138, CESifo.
    8. Helland, Leif & Iachan, Felipe S. & Juelsrud, Ragnar E. & Nenov, Plamen T., 2021. "Information quality and regime change: Evidence from the lab," Journal of Economic Behavior & Organization, Elsevier, vol. 191(C), pages 538-554.
    9. Wilfred Amaldoss & Richard Staelin, 2010. "Cross-Function and Same-Function Alliances: How Does Alliance Structure Affect the Behavior of Partnering Firms?," Management Science, INFORMS, vol. 56(2), pages 302-317, February.
    10. Keser, Claudia & Suleymanova, Irina & Wey, Christian, 2012. "Technology adoption in markets with network effects: Theory and experimental evidence," Information Economics and Policy, Elsevier, vol. 24(3), pages 262-276.
    11. Marco LiCalzi & Roland Mühlenbernd, 2022. "Feature-weighted categorized play across symmetric games," Experimental Economics, Springer;Economic Science Association, vol. 25(3), pages 1052-1078, June.
    12. Giovanna Devetag & Andreas Ortmann, 2007. "When and why? A critical survey on coordination failure in the laboratory," Experimental Economics, Springer;Economic Science Association, vol. 10(3), pages 331-344, September.
    13. El-Gamal, Mahmoud A. & Palfrey, Thomas R., 1995. "Vertigo: Comparing structural models of imperfect behavior in experimental games," Games and Economic Behavior, Elsevier, vol. 8(2), pages 322-348.
    14. Rami Zwick & Amnon Rapoport, 2002. "Tacit Coordination in a Decentralized Market Entry Game with Fixed Capacity," Experimental Economics, Springer;Economic Science Association, vol. 5(3), pages 253-272, December.
    15. Olga Shurchkov, 2013. "Coordination and learning in dynamic global games: experimental evidence," Experimental Economics, Springer;Economic Science Association, vol. 16(3), pages 313-334, September.
    16. Péter Bayer & Ani Guerdjikova, 2020. "Optimism leads to optimality: Ambiguity in network formation," Working Papers hal-03005107, HAL.
    17. Pronkina, Elizaveta & Berniell, Inés & Fawaz, Yarine & Laferrère, Anne & Mira, Pedro, 2023. "The COVID-19 curtain: Can past communist regimes explain the vaccination divide in Europe?," Social Science & Medicine, Elsevier, vol. 321(C).
    18. Holt, Debra J., 1999. "An Empirical Model of Strategic Choice with an Application to Coordination Games," Games and Economic Behavior, Elsevier, vol. 27(1), pages 86-105, April.
    19. Argyris, Young Anna & Kim, Yongsuk & Roscizewski, Alexa & Song, Won, 2021. "The mediating role of vaccine hesitancy between maternal engagement with anti- and pro-vaccine social media posts and adolescent HPV-vaccine uptake rates in the US: The perspective of loss aversion in," Social Science & Medicine, Elsevier, vol. 282(C).
    20. Claude Meidinger, 2018. "Cooperation and evolution of meaning in senders-receivers games," Post-Print halshs-01960762, HAL.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:282:y:2021:i:c:s0277953621005037. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.