Elsevier

Social Science & Medicine

Volume 285, September 2021, 114238
Social Science & Medicine

Public attitudes toward pandemic triage: Evidence from conjoint survey experiments in Switzerland

https://doi.org/10.1016/j.socscimed.2021.114238Get rights and content
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Highlights

  • We study how members of the Swiss public would allocate ICU beds to COVID patients.

  • We conduct conjoint survey experiments using two large (~1500) participant samples.

  • Participants would not use age as a triage criterion.

  • Participants would withhold care based on the patient's nationality and behavior.

  • More communication with the public about the ethics of medical triage is needed.

Abstract

The question of how to implement medical triages has become highly salient during the COVID-19 pandemic and continues to be actively discussed. It is important to know how members of the general public think about this issue. For one, knowledge about the public's standpoint can help resolve important questions where ethical considerations are by themselves not sufficient, for instance whether the patient's age should matter. It can also help identify if more communication with the public about medical ethics is needed. We study how members of the Swiss public would allocate intensive medical care among COVID-19 patients using data from two original conjoint survey experiments conducted in Switzerland in the context of the first and second pandemic waves in 2020 (N = 1457 & N = 1450). We find that our participants would not base triage decisions on the patient's age. However, they do give much importance to the patient's behavior prior and during illness, discriminate against non-nationals, and assign only a relatively small and inconsistent role to medical considerations. Our findings suggest that there is a need for more communication with the public about the ethics of medical triage.

Keywords

COVID-19
Pandemic triage
Intensive care
Attitudes
Survey
Conjoint experiment
Switzerland

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