Scholarlink

<p>Cost-effectiveness analysis (CEA) is a mainstay of contemporary health care priority setting. However, priority setting in reference to cost-effectiveness may discriminate against people with disabilities. The ethical literature on priority setting suggests that the permissibility of such discrimination varies with the reason why people with disabilities receive lower priority. In a vignette-based survey experiment (N = 1100) in the UK, we tested whether five justifications for prioritizing people without disabilities affect the views of the broader public on priority setting based on CEA. In our vignettes, a hospital denies a person with a disability treatment for a disease based on CEA, and respondents were asked to assess the moral permissibility of this. The vignettes varied in terms of the reason the hospital emphasized in the decision. We tested vignettes emphasizing lower expected lifespan, lower quality of life, higher costs of treatment due to disability, less efficient treatment due to disability, and lower productivity due to infrequent labor-market participation. Our study is an initial exploratory survey experiment, exploring participant’s responses to CEA with respect to disability. Discrimination against the patient with a disability was deemed impermissible across all experimental conditions, and there were no significant differences between the various reasons. This suggests a discrepancy between folk intuitions and those of many ethicists.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The Moral Justifications of Disability Discrimination in Health Care Allocation: An Experimental Assessment

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月22日

查看全文
  • Andreas Albertsen,
  • Bjørn Gunnar Hallsson,
  • Lasse Nielsen

摘要

Cost-effectiveness analysis (CEA) is a mainstay of contemporary health care priority setting. However, priority setting in reference to cost-effectiveness may discriminate against people with disabilities. The ethical literature on priority setting suggests that the permissibility of such discrimination varies with the reason why people with disabilities receive lower priority. In a vignette-based survey experiment (N = 1100) in the UK, we tested whether five justifications for prioritizing people without disabilities affect the views of the broader public on priority setting based on CEA. In our vignettes, a hospital denies a person with a disability treatment for a disease based on CEA, and respondents were asked to assess the moral permissibility of this. The vignettes varied in terms of the reason the hospital emphasized in the decision. We tested vignettes emphasizing lower expected lifespan, lower quality of life, higher costs of treatment due to disability, less efficient treatment due to disability, and lower productivity due to infrequent labor-market participation. Our study is an initial exploratory survey experiment, exploring participant’s responses to CEA with respect to disability. Discrimination against the patient with a disability was deemed impermissible across all experimental conditions, and there were no significant differences between the various reasons. This suggests a discrepancy between folk intuitions and those of many ethicists.