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Public attitudes toward allocating scarce resources in the COVID-19 pandemic

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  • Wesley Buckwalter
  • Andrew Peterson

Abstract

The general public is subject to triage policies that allocate scarce lifesaving resources during the COVID-19 pandemic, one of the worst public health emergencies in the past 100 years. However, public attitudes toward ethical principles underlying triage policies used during this pandemic are not well understood. Three experiments (preregistered; online samples; N = 1,868; U.S. residents) assessed attitudes toward ethical principles underlying triage policies. The experiments evaluated assessments of utilitarian, egalitarian, prioritizing the worst-off, and social usefulness principles in conditions arising during the COVID-19 pandemic, involving resource scarcity, resource reallocation, and bias in resource allocation toward at-risk groups, such as the elderly or people of color. We found that participants agreed with allocation motivated by utilitarian principles and prioritizing the worst-off during initial distribution of resources and disagreed with allocation motivated by egalitarian and social usefulness principles. At reallocation, participants agreed with giving priority to those patients who received the resources first. Lastly, support for utilitarian allocation varied when saving the greatest number of lives resulted in disadvantage for at-risk or historically marginalized groups. Specifically, participants expressed higher levels of agreement with policies that shifted away from maximizing benefits to one that assigned the same priority to members of different groups if this mitigated disadvantage for people of color. Understanding these attitudes can contribute to developing triage policies, increase trust in health systems, and assist physicians in achieving their goals of patient care during the COVID-19 pandemic.

Suggested Citation

  • Wesley Buckwalter & Andrew Peterson, 2020. "Public attitudes toward allocating scarce resources in the COVID-19 pandemic," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-20, November.
  • Handle: RePEc:plo:pone00:0240651
    DOI: 10.1371/journal.pone.0240651
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    References listed on IDEAS

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    1. Pill, Juri, 1971. "The Delphi method: Substance, context, a critique and an annotated bibliography," Socio-Economic Planning Sciences, Elsevier, vol. 5(1), pages 57-71, February.
    2. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    3. Chang, H.-J. & Huang, N. & Lee, C.-H. & Hsu, Y.-J. & Hsieh, C.-J. & Chou, Y.-J., 2004. "The Impact of the SARS Epidemic on the Utilization of Medical Services: SARS and the Fear of SARS," American Journal of Public Health, American Public Health Association, vol. 94(4), pages 562-564.
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    As found on the RePEc Biblio, the curated bibliography for Economics:
    1. > Economics of Welfare > Health Economics > Economics of Pandemics > Specific pandemics > Covid-19 > Health > Allocation and rationing

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