Patient traits shape health-care stakeholders' choices on how to best allocate life-saving care.

ABSTRACT

During global pandemics, health-care decision makers often face critical shortages of life-saving medical equipment. How do medical stakeholders prioritize which patients are most deserving of scarce treatment? We report the results of three conjoint experiments conducted in the United States in 2020, testing for biases in US physicians', citizens' and elected politicians' preferences for scarce ventilator distribution. We found that all stakeholders prioritized younger patients and patients who had a higher probability of surviving with ventilator access. When patients' survivability was tied, physicians prioritized patients from racial/ethnic minorities (that is, Asian, Black and Hispanic patients) over all-else-equal white patients, religious minorities (that is, Muslim patients) over religious majority group members (that is, Catholic patients) and patients of lower socio-economic status over wealthier patients. The public also prioritized Black and Hispanic patients over white patients but were biased against religious minorities (that is, Atheist and Muslim patients) relative to religious majority group members. Elected politicians were also biased against Atheist patients. Our effects varied by political party-with Republican physicians, politicians and members of the public showing bias against religious minority patients and Democratic physicians showing preferential treatment of racial and religious minorities. Our results suggest that health-care stakeholders' personal biases impact decisions on who deserves life-saving medical equipment.