Ari Ne'eman (
Elizabeth Bell, Florida State University, Tallahassee, Florida.
Health Aff (Millwood). 2022 Oct;41(10):1513-1522. doi: 10.1377/hlthaff.2022.00504.
The COVID-19 pandemic offers an opportunity to examine public opinion regarding the allocation of scarce medical resources. In this conjoint experiment on a nationally representative sample of US adults, we examined how a range of patient characteristics affect respondents' willingness to allocate a ventilator between two patients with equal likelihood of short-term survival and how this differs by respondents' attributes. Respondents were 5.5 percentage points less likely to allocate a ventilator to a patient with a disability than to a nondisabled patient. Disability bias was correlated with older age cohorts and higher education levels of respondents. Liberal and moderate respondents were more likely to give a ventilator to Black and Asian patients than to White patients. Conservatives were much less likely to allocate a ventilator to transgender patients than to cisgender patients. These findings demonstrate the importance of bias mitigation and civil rights enforcement in health policy making, especially under conditions of scarcity.
新冠疫情大流行提供了一个机会,可以观察公众对稀缺医疗资源分配的意见。在这项针对美国成年人的全国代表性样本的联合实验中,我们研究了一系列患者特征如何影响受访者在两个短期生存可能性相等的患者之间分配呼吸机的意愿,以及这种意愿如何因受访者的特征而有所不同。与非残疾患者相比,受访者将呼吸机分配给残疾患者的可能性低 5.5 个百分点。残疾偏见与受访者年龄较大和受教育程度较高有关。自由派和温和派的受访者更有可能将呼吸机分配给黑人和亚裔患者,而不是白人患者。保守派将呼吸机分配给跨性别患者的可能性远远低于顺性别患者。这些发现表明,在稀缺条件下,医疗保健政策制定中需要减轻偏见和执行民权,这一点非常重要。