BMC Medical Ethics 17 (1):69 (2016)

Authors
Julian Savulescu
Oxford University
Michael Selgelid
Monash University
Abstract
BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There were 119 respondents who entered the questionnaire, and 109 who completed it. The respondents were adult US and Indian participants of the online crowdsourcing platform Mechanical Turk. Respondents were asked to decide which of two infants to treat in a situation of scarce resources. Demographic characteristics, personality traits and political views were recorded. Respondents were also asked to respond to a widely cited thought experiment involving rationing.ResultsThe majority of respondents, in all except one scenario, chose the utilitarian option of directing treatment to the infant with the higher chance of survival, higher life expectancy, less severe disability, and less expensive treatment. As discrepancy between outcomes decreased, however, there was a statistically significant increase in egalitarian responses and decrease in utilitarian responses in scenarios involving chance of survival, life expectancy, and cost of treatment. In the classic ‘lifeboat’ scenario, all but two respondents were utilitarian.ConclusionsThis survey suggests that in situations of scarcity and equal clinical need, non-health professionals support rationing of life-saving treatment based on probability of survival, duration of survival, cost of treatment or quality of life. However, where the difference in prognosis or cost is very small, non-health professionals preferred to give infants an equal chance of receiving treatment.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
ISBN(s)
DOI 10.1186/s12910-016-0152-y
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 64,132
Through your library

References found in this work BETA

Justice as Fairness: Political Not Metaphysical.John Rawls - 1985 - Philosophy and Public Affairs 14 (3):223-251.
Equality and Priority.Derek Parfit - 1997 - Ratio 10 (3):202–221.
Should the Numbers Count?John Taurek - 1977 - Philosophy and Public Affairs 6 (4):293-316.
Toward Methodological Innovation in Empirical Ethics Research.Michael Dunn, Mark Sheehan, Tony Hope & Michael Parker - 2012 - Cambridge Quarterly of Healthcare Ethics 21 (4):466-480.

View all 8 references / Add more references

Citations of this work BETA

Add more citations

Similar books and articles

Costs and End-of-Life Care in the NICU: Lessons for the MICU?John D. Lantos & William L. Meadow - 2011 - Journal of Law, Medicine and Ethics 39 (2):194-200.
Withholding Hydration and Nutrition in Newborns.Nicolas Porta & Joel Frader - 2007 - Theoretical Medicine and Bioethics 28 (5):443-451.

Analytics

Added to PP index
2016-11-08

Total views
17 ( #617,783 of 2,454,689 )

Recent downloads (6 months)
1 ( #449,768 of 2,454,689 )

How can I increase my downloads?

Downloads

My notes