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dc.contributor.authorAwad, E
dc.contributor.authorBago, B
dc.contributor.authorBonnefon, J-F
dc.contributor.authorChristakis, NA
dc.contributor.authorRahwan, I
dc.contributor.authorShariff, A
dc.date.accessioned2022-09-28T12:21:30Z
dc.date.issued2022-07-25
dc.date.updated2022-09-28T10:22:11Z
dc.description.abstractObjective. When medical resources are scarce, clinicians must make difficult triage decisions. When these decisions affect public trust and morale, as was the case during the COVID-19 pandemic, experts will benefit from knowing which triage metrics have citizen support. Design. We conducted an online survey in 20 countries, comparing support for 5 common metrics (prognosis, age, quality of life, past and future contribution as a health care worker) to a benchmark consisting of support for 2 no-triage mechanisms (first-come-first-served and random allocation). Results. We surveyed nationally representative samples of 1000 citizens in each of Brazil, France, Japan, and the United States and also self-selected samples from 20 countries (total N = 7599) obtained through a citizen science website (the Moral Machine). We computed the support for each metric by comparing its usability to the usability of the 2 no-triage mechanisms. We further analyzed the polarizing nature of each metric by considering its usability among participants who had a preference for no triage. In all countries, preferences were polarized, with the 2 largest groups preferring either no triage or extensive triage using all metrics. Prognosis was the least controversial metric. There was little support for giving priority to healthcare workers. Conclusions. It will be difficult to define triage guidelines that elicit public trust and approval. Given the importance of prognosis in triage protocols, it is reassuring that it is the least controversial metric. Experts will need to prepare strong arguments for other metrics if they wish to preserve public trust and morale during health crises. Highlights: We collected citizen preferences regarding triage decisions about scarce medical resources from 20 countries.We find that citizen preferences are universally polarized.Citizens either prefer no triage (random allocation or first-come-first served) or extensive triage using all common triage metrics, with "prognosis" being the least controversial.Experts will need to prepare strong arguments to preserve or elicit public trust in triage decisions.en_GB
dc.format.extent23814683221113573-
dc.format.mediumElectronic-eCollection
dc.identifier.citationVol. 7, No. 2, article 23814683221113573en_GB
dc.identifier.doihttps://doi.org/10.1177/23814683221113573
dc.identifier.urihttp://hdl.handle.net/10871/131005
dc.identifierORCID: 0000-0001-7272-7186 (Awad, Edmond)
dc.language.isoenen_GB
dc.publisherSAGE Publicationsen_GB
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pubmed/35911175en_GB
dc.relation.urlhttps://github.com/bencebago/ventilatorsen_GB
dc.rights© The Author(s) 2022. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sageen_GB
dc.subjectcross-cultural studyen_GB
dc.subjectmedical ethicsen_GB
dc.subjecttriage preferencesen_GB
dc.titlePolarized citizen preferences for the ethical allocation of scarce medical resources in 20 countries.en_GB
dc.typeArticleen_GB
dc.date.available2022-09-28T12:21:30Z
dc.identifier.issn2381-4683
exeter.place-of-publicationUnited States
dc.descriptionThis is the final version. Available from SAGE Publications via the DOI in this record. en_GB
dc.descriptionData Availability Statement: Data and code are open and available at https://github.com/ bencebago/ventilators.en_GB
dc.identifier.journalMDM Policy and Practiceen_GB
dc.relation.ispartofMDM Policy Pract, 7(2)
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en_GB
dcterms.dateAccepted2022-06-14
dc.rights.licenseCC BY-NC
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2022-07-25
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2022-09-28T12:17:54Z
refterms.versionFCDVoR
refterms.dateFOA2022-09-28T12:21:33Z
refterms.panelCen_GB
refterms.dateFirstOnline2022-07-25


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© The Author(s) 2022. This article is distributed under the terms of the Creative Commons
Attribution-NonCommercial 4.0 License (http://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use,
reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and
Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage
Except where otherwise noted, this item's licence is described as © The Author(s) 2022. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage