Fairness evaluations of scarce medical interventions: the case of infectious disease (FairMed)
Fair allocation regimes of scarce medical services have been a matter of debate among practitioners, public health administrators, ethicists, development workers and others for years. A number of moral principles to guide medical resource allocation have been defined and balanced against each other. Yet, empirical data what people in general and certain stakeholder groups in particular perceive to be a fair allocation regime under certain conditions are rare. This pilot study aims to shed light on this for the case example of infectious disease prevention and treatment.
Objectives
The study aims:
- to provide first answers to crucial ethical questions that are of great practical importance for decisions about the allocation of scarce medical resources;
- to complement ethical reasoning with empirical data on how to fairly allocate scarce medical interventions;
- to make a methodological contribution to the field of empirical justice research by developing and testing a novel approach that combines computer simulations of disease spread with social scientific approaches to measure people’s justice preferences;
- to pursue an interdisciplinary approach integrating natural and social science which may result in novel research questions in either field.
Research questions
- Which allocation schemes for scarce medical goods are considered just by (i) general practitioners and (ii) medical laypersons?
- Do people choose a different allocation scheme (i) if their choice is made ad hoc or (ii) if they are informed by a simulation model that facilitates the understanding for disease dynamics and intervention outcomes?
- Do their choices differ depending on whether the medical service (i) solely helps to prevent new infections, as compared to a situation where the focus is (ii) treatment of existing infections?
- What rationales are underlying these choices of allocation schemes?
Methods
The methodological core consists of three elements:
- An epidemic simulation that translates a predefined epidemic scenario and a resource allocation choice into epidemiological outcomes;
- An online-experiment in which participants can decide about the allocation regime of scarce preventive and scarce disease containing medication;
- Quantitative and qualitative data collection that allow to better understand and interpret the outcomes of the experiment.
Research team
- Dr. Timo Smieszek, Public Health, London
- Dr. Pius Krütli, ETH-NSSI