scholarly journals Veil-of-Ignorance Reasoning Mitigates Self-Serving Bias in Resource Allocation During the COVID-19 Crisis

2020 ◽  
Author(s):  
Karen Huang ◽  
Regan Bernhard ◽  
Netta Barak-Corren ◽  
max bazerman ◽  
Joshua D. Greene
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Moral Reasoning ◽  
Healthcare Professionals ◽  
Decision Makers ◽  
Medical Resources ◽  
Veil Of Ignorance ◽  
Younger Patients ◽  
Scarce Resources ◽  
The Veil

The COVID-19 crisis has forced healthcare professionals to make tragic decisions concerning which patients to save. Furthermore, The COVID-19 crisis has foregrounded the influence of self-serving bias in debates on how to allocate scarce resources. A utilitarian principle favors allocating scarce resources such as ventilators toward younger patients, as this is expected to save more years of life. Some view this as ageist, instead favoring age-neutral principles, such as “first come, first served”. Which approach is fairer? The “veil of ignorance” is a moral reasoning device designed to promote impartial decision-making by reducing decision-makers’ use of potentially biasing information about who will benefit most or least from the available options. Veil-of-ignorance reasoning was originally applied by philosophers and economists to foundational questions concerning the overall organization of society. Here we apply veil-of-ignorance reasoning to the COVID-19 ventilator dilemma, asking participants which policy they would prefer if they did not know whether they are younger or older. Two studies (pre-registered; online samples; Study 1, N=414; Study 2 replication, N=1,276) show that veil-of-ignorance reasoning shifts preferences toward saving younger patients. The effect on older participants is dramatic, reversing their opposition toward favoring the young, thereby eliminating self-serving bias. These findings provide guidance on how to remove self-serving biases to healthcare policymakers and frontline personnel charged with allocating scarce medical resources during times of crisis.

scholarly journals Moral Decision Making: From Bentham to Veil of Ignorance via Perspective Taking Accessibility

2021 ◽  
Vol 11 (5) ◽  
pp. 66
Author(s):  
Rose Martin ◽  
Petko Kusev ◽  
Joseph Teal ◽  
Victoria Baranova ◽  
Bruce Rigal
Keyword(s):  
Decision Making ◽  
Perspective Taking ◽  
Moral Decision ◽  
Moral Decision Making ◽  
Veil Of Ignorance ◽  
Self Interest ◽  
Moral Behaviour ◽  
New Type ◽  
The Veil ◽  
Theoretical Proposal

Making morally sensitive decisions and evaluations pervade many human everyday activities. Philosophers, economists, psychologists and behavioural scientists researching such decision-making typically explore the principles, processes and predictors that constitute human moral decision-making. Crucially, very little research has explored the theoretical and methodological development (supported by empirical evidence) of utilitarian theories of moral decision-making. Accordingly, in this critical review article, we invite the reader on a moral journey from Jeremy Bentham’s utilitarianism to the veil of ignorance reasoning, via a recent theoretical proposal emphasising utilitarian moral behaviour—perspective-taking accessibility (PT accessibility). PT accessibility research revealed that providing participants with access to all situational perspectives in moral scenarios, eliminates (previously reported in the literature) inconsistency between their moral judgements and choices. Moreover, in contrast to any previous theoretical and methodological accounts, moral scenarios/tasks with full PT accessibility provide the participants with unbiased even odds (neither risk averse nor risk seeking) and impartiality. We conclude that the proposed by Martin et al. PT Accessibility (a new type of veil of ignorance with even odds that do not trigger self-interest, risk related preferences or decision biases) is necessary in order to measure humans’ prosocial utilitarian behaviour and promote its societal benefits.

Resource allocation and economic evaluation in Australia's healthcare system

2011 ◽  
Vol 35 (3) ◽  
pp. 278 ◽  
Author(s):  
Abdolvahab Baghbanian ◽  
Ian Hughes ◽  
Freidoon A. Khavarpour
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Decision Makers ◽  
Economic Evaluations ◽  
Healthcare Decision ◽  
Effectiveness Analysis ◽  
Allocation Decisions ◽  
Resource Allocation Decisions

Objective. To explore dimensions and varieties of economic evaluations that healthcare decision-makers do or do not use. Design. Web-based survey. Setting and participants. A purposive sample of Australian healthcare decision-makers was recruited by direct invitation through email. All were invited to complete an online questionnaire derived from the EUROMET 2004 survey. Results. A total of 91 questionnaires were analysed. Almost all participants were involved in financial resource allocations. Most commonly, participants based their decisions on patient needs, effectiveness of interventions, cost of interventions or overall budgetary effect, and policy directives. Evidence from cost-effectiveness analysis was used by half of the participants. Timing, ethical issues and lack of knowledge about economic evaluation were the most significant barriers to the use of economic evaluations in resource allocation decisions. Most participants reported being moderately to very familiar with the cost-effectiveness analysis. There was a general impression that evidence from economic evaluations should play a larger role in the future. Conclusions. Evidence from health economic evaluations may provide valuable information in some decisions; however, at present, it is not central to many decisions. The study suggests that, for economic evaluation to be helpful in real-life policy decisions, it has to be placed into context – a context which is complex, political and often resistant to voluntary change. What is known about the topic? There are increasing calls for the use of evidence from formal economic evaluations to improve the quality of healthcare decision making; however, it is widely acknowledged that such evidence, as presently constituted, is underused in its influence on allocation decisions. What does this paper add? This study highlights that resource allocation decisions cannot be purely based on the use of technical, economic data or systematic evidence-based reviews. In order to exploit the full potential value of economic evaluations, researchers need to make better sense of decision contexts at specific times and places. What are the implications for practitioners? The study has the potential to expand researchers and policy-makers’ understanding of the limited use of economic evaluation in decision-making. It produces evidence that decision-making in Australia’s healthcare system is not or cannot be a fully rational bounded process. Economic evaluation is used in some contexts, where information is accurate, complete and available.

scholarly journals Ethical Decision Making in Emergent Emergencies under a Veil of Ignorance

2020 ◽  
Vol 1 (1) ◽  
pp. 46
Author(s):  
Vaia Papanikolaou ◽  
Yiannis Roussakis ◽  
Panagiotis Tzionas
Keyword(s):  
Ethical Decision Making ◽  
Human Life ◽  
Emergent Behavior ◽  
Decision Makers ◽  
Ethical Framework ◽  
Veil Of Ignorance ◽  
Response Measures ◽  
Predominant Factor ◽  
The Veil ◽  
Feedback Responses

In this paper we initially propose a scheme for the determination of threats due to the Covid19 pandemic, followed by appropriate response measures. In order to devise successful response actions, one should pay extreme care in identifying the actual threats posed and, as a matter of fact, prioritize them with respect to their severity on human life, societal risks, democratic operation of the institutions and the state and irreversible environmental impact.But would everyone be benefited the same by these response measures? There lies the danger to be unfair of even ignoring socially disadvantaged groups and, thus, increasing social inequality gaps. And the new equilibrium attained runs the danger of being less stable than the old one, exhibiting degraded emergent behavior and capabilities for self-organization. In this case we would have achieved exactly the opposite of what we wished for, a system of lower resilience to perturbations.Thus, we argue that the ethical element is the predominant factor that should determine all types of feedback responses and actions taken by decision-makers in all political, social, economic and environmental aspects during the process of returning to normality.Towards this purpose, a method of determining the morality of response measures is required. A variation of the ‘Veil of Ignorance’ provides such a method, as introduced in this paper. It asks the decision-makers to make choices about social or moral issues related to the feedback responses to the pandemic and assumes that they have enough information to know the consequences of their possible decisions for everyone but would not know which person they will be themselves, in the new equilibrium. We believe that the proposed ethical framework will result to just and fair to all response measures. 

scholarly journals Ethical Issues in Decision-making Regarding the Elderly Affected by Coronavirus Disease 2019: An Expert Opinion

2020 ◽  
Vol 15 ◽  
Author(s):  
David Martínez-Sellés ◽  
Helena Martínez-Sellés ◽  
Manuel Martínez-Sellés
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Healthcare Professionals ◽  
Preventive Measures ◽  
Ethical Issues ◽  
Good Clinical Practice ◽  
The Elderly ◽  
Chronological Age ◽  
Scarce Resources ◽  
Ethical Decisions

The coronavirus disease 2019 (COVID-19) pandemic is resulting in ethical decisions regarding resource allocation. Prioritisation reflects established practices that regulate the distribution of finite resources when demand exceeds supply. However, discrimination based on sex, race or age has no role in prioritisation unless clearly justified. The risk posed by COVID-19 is higher for elderly people than for younger people, so older adults should be prioritised in preventive measures. In the case of people who already have COVID-19, healthcare professionals might prioritise those most likely to survive. Making decisions based on chronological age alone is not justified; in addition to age, other aspects that determine theoretical life expectancy must be taken into account. Individualised correct prioritisation in the allocation of scarce resources is essential to good clinical practice.

scholarly journals Veil-of-ignorance reasoning favors the greater good

2019 ◽  
Vol 116 (48) ◽  
pp. 23989-23995 ◽  
Author(s):  
Karen Huang ◽  
Joshua D. Greene ◽  
Max Bazerman
Keyword(s):  
Autonomous Vehicles ◽  
Probabilistic Reasoning ◽  
Social Dilemma ◽  
Policy Decision ◽  
Moral Dilemmas ◽  
Decision Makers ◽  
Policy Preference ◽  
Veil Of Ignorance ◽  
Greater Good ◽  
The Veil

The “veil of ignorance” is a moral reasoning device designed to promote impartial decision making by denying decision makers access to potentially biasing information about who will benefit most or least from the available options. Veil-of-ignorance reasoning was originally applied by philosophers and economists to foundational questions concerning the overall organization of society. Here, we apply veil-of-ignorance reasoning in a more focused way to specific moral dilemmas, all of which involve a tension between the greater good and competing moral concerns. Across 7 experiments (n = 6,261), 4 preregistered, we find that veil-of-ignorance reasoning favors the greater good. Participants first engaged in veil-of-ignorance reasoning about a specific dilemma, asking themselves what they would want if they did not know who among those affected they would be. Participants then responded to a more conventional version of the same dilemma with a moral judgment, a policy preference, or an economic choice. Participants who first engaged in veil-of-ignorance reasoning subsequently made more utilitarian choices in response to a classic philosophical dilemma, a medical dilemma, a real donation decision between a more vs. less effective charity, and a policy decision concerning the social dilemma of autonomous vehicles. These effects depend on the impartial thinking induced by veil-of-ignorance reasoning and cannot be explained by anchoring, probabilistic reasoning, or generic perspective taking. These studies indicate that veil-of-ignorance reasoning may be a useful tool for decision makers who wish to make more impartial and/or socially beneficial choices.

scholarly journals A qualitative exploration of proxy decision makers’ expectations of prescribed medications for people with advanced dementia

2018 ◽  
Vol 32 (6) ◽  
pp. 1114-1123 ◽  
Author(s):  
Bridgeen McCloskey ◽  
Carmel Hughes ◽  
Carole Parsons
Keyword(s):  
Decision Making ◽  
Decision Maker ◽  
Healthcare Professionals ◽  
Structured Interview ◽  
Decision Makers ◽  
Advanced Dementia ◽  
Goals Of Care ◽  
Active Involvement ◽  
Prescribed Medicines ◽  
The Impact

Background: Proxy decision makers often have to make decisions for people with advanced dementia. Their expectations regarding prescribed medications have the potential to influence prescription or withdrawal of medications. However, few studies to date have explored this. Aim: To explore proxy decision makers’ expectations of prescribed medications for people with advanced dementia and to consider how these change with changing goals of care and dementia progression. Design: This is a qualitative semi-structured interview study. Setting/participants: In total, 15 proxy decision makers of people with advanced dementia were recruited via general practitioners ( n = 9), Join Dementia Research ( n = 3) and the Alzheimer’s Society Northern Ireland ( n = 3). Results: Five key themes emerged: the role as advocate, attitudes to medicines and medicine taking, uncertainty over the benefit of anti-dementia medications, stopping medications, and communication and decision-making. Proxy decision makers desired more information about prescribed medicines, particularly the indications, benefits and risks of treatment. Despite uncertainty about the benefits of anti-dementia medications, proxy decision makers were reluctant for these medications to be withdrawn. Reluctance to stop other prescribed medicines was also expressed but reduced with changing goals of care and dementia progression. Although some proxy decision makers expected to be involved in medication-related decisions, the majority preferred to delegate these decisions to healthcare professionals. However, they expected to be informed of any medication-related decisions made. Conclusion: Proxy decision makers vary in terms of their desire for active involvement in the medication decision-making process. Healthcare professionals should facilitate proxy decision maker involvement if desired. Further research is required to consider the impact of proxy decision maker involvement in decision-making.

scholarly journals John Rawls and compliance to climate change agreements: insights from a laboratory experiment

2021 ◽  
Author(s):  
Klaudijo Klaser ◽  
Lorenzo Sacconi ◽  
Marco Faillo
Keyword(s):  
Climate Change ◽  
Decision Making ◽  
Laboratory Experiment ◽  
John Rawls ◽  
Dictator Game ◽  
International Agreements ◽  
Veil Of Ignorance ◽  
Voluntary Compliance ◽  
Open Issue ◽  
The Veil

AbstractThe most evident shortcoming of the international agreements on climate actions is the compliance to their prescriptions. Can John Rawls’s social contract theory help us to solve the problem? We apply the veil of ignorance decision-making setting in a sequential dictator game to study the compliance to climate change agreements and we test the model in a laboratory experiment. The veil of ignorance shows to be very powerful at inducing the subjects to converge on a sustainable intergenerational path. However, the voluntary compliance to the agreement still remains an open issue, because even small incentives to defect can undermine the compliance stability, and therefore break the whole sustainable dynamic.

scholarly journals People Behave as if they Anticipate Regret Conditional on Experiencing a Bad Outcome

2021 ◽  
Author(s):  
William Ryan ◽  
Stephen Baum ◽  
Ellen Riemke Katrien Evers
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Relative Reduction ◽  
Risk Averse ◽  
Regret Theory ◽  
Risky Decision ◽  
Scarce Resources ◽  
Reduce Risk ◽  
Anticipate Regret ◽  
As If

Decision-makers often must decide whether to invest in prospects to reduce risk or instead save scarce resources. Existing models of risky decision making assume that decision-makers consider the absolute improvement in probabilistic chances (e.g., increasing a 10% chance of winning $10 to a 20% chance is roughly similar to increasing an 80% chance of winning $10 to a 90% chance). We present evidence that people instead behave as if they consider the relative reduction in bad outcomes (increasing a 10% chance to a 20% chance eliminates 1/9th of all bad outcomes, while increasing an 80% chance to a 90% chance eliminates 1/2 of all bad outcomes). This bias in the anticipation of preventable bad outcomes drives risk preferences that violate normative standards and results in the same participants behaving both risk-seeking and risk-averse within the same decision-making task. We discuss how regret theory can be adjusted to accommodate these results.

Sign in / Sign up

Export Citation Format

Share Document