Distributing scarce livers: the moral reasoning of the general public.
The transplant system has been criticized for not paying enough attention to efficiency in distributing scarce organs. But little research has been done to see how the general public views tradeoffs between efficiency and equity. We surveyed members of the general public to see how they would distribute organs among patients with varying chances of benefiting from them. In addition, we asked subjects to explain their decisions and to tell us about any other information they would have liked in order to make the decisions. We found that the public places a very high value on giving everyone a chance at receiving scarce resources, even if that means a significant decrease in the chance that available organs will save people's lives. Our results raise important questions about whether the aims of outcomes research and cost-effective studies agree with the values of the general public.
Ubel
P A
PA
Veterans Affairs Medical Center, Philadelphia, PA, USA. ubel@cceb.med.upenn.edu
Loewenstein
G
G
D000328:Adult; D002648:Child; D004992:Ethics, Medical; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009014:Morals; D018579:Patient Selection; D010414:Pennsylvania; D011639:Public Opinion; D040841:Resource Allocation; D012945:Social Values; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome