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Against tiebreaking arguments in priority setting.

Borgar Jølstad1,2, Erik Gustavsson3,4

  • 1The Health Services Research Unit - HØKH, Akershus Universitetssykehus HF, Lorenskog, Norway borgarjolstad@gmail.com.

Journal of Medical Ethics
|June 8, 2023
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Summary
This summary is machine-generated.

When fair priority setting criteria are tied, lotteries are a sound method for impartial decision-making. Secondary considerations are not recommended as tiebreakers in allocation decisions.

Keywords:
Decision MakingEthics

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Area of Science:

  • Ethics
  • Decision Theory
  • Social Choice Theory

Background:

  • Fair priority setting relies on morally sound criteria.
  • Tied criteria in priority setting necessitate tiebreaking mechanisms.
  • Existing literature proposes two main tiebreaker approaches.

Purpose of the Study:

  • To evaluate two proposed tiebreaker methods for fair priority setting.
  • To determine the ethical soundness of lotteries versus secondary considerations.
  • To establish a robust framework for resolving ties in allocation decisions.

Main Methods:

  • Analysis of ethical arguments for different tiebreaking strategies.
  • Conceptual examination of impartiality and fairness in decision-making.
  • Comparative evaluation of lotteries and secondary considerations.

Main Results:

  • The argument for using lotteries to preserve impartiality is ethically sound.
  • The argument for using secondary considerations as tiebreakers is ethically unsound.
  • Situations requiring tiebreakers are precisely those favoring lotteries.

Conclusions:

  • All valuable factors should be primary considerations in priority setting.
  • Ties in priority setting should be resolved using lotteries.
  • Lotteries ensure fairness and impartiality when primary criteria are insufficient.