Does moral reasoning influence public values for health care priority setting?: A population-based randomized stated...

Area of Science:

• Health economics
• Public health policy
• Bioethics

Background:

• Public preferences are crucial for healthcare priority-setting, but data is limited.
• Understanding public values in resource allocation is essential for equitable healthcare systems.

Purpose of the Study:

• To investigate public preferences for allocating scarce healthcare resources between adults and children.
• To explore the impact of moral reasoning on these preferences.

Main Methods:

• An experimental stated preference survey was conducted with a national sample of Canadian adults.
• Participants rated preferences using a visual analogue scale across various resource allocation scenarios.
• A moral reasoning exercise was introduced to an intervention group before choice tasks.

Main Results:

• A consistent public preference was observed for allocating scarce health system resources to children.
• Exposure to moral reasoning exercises reduced, but did not eliminate, this preference.
• Younger age and parenthood correlated with a stronger preference for allocating resources to children.

Conclusions:

• Public preferences significantly favor children in healthcare resource allocation, influenced by age and parental status.
• Moral reasoning challenges this preference, underscoring a strong public commitment to equality of access.
• Healthcare priority-setting can be enhanced by incorporating public values like humanitarianism and equality beyond clinical and cost-effectiveness metrics.