The aim of the study was to see how important patient characteristics were for someone when making a decision on who gets the ventilator. In other words, it looks at how social preferences affected allocation decisions. The study selected 10 characteristics:
- Age
- Gender 
- Socioeconomic status
- Criminal records, 
- Probability of survival after treatment
- Number of people the patient has infected
- Family members who have been infected
- Expected number of days that this patient needs to be put on a ventilator
- Costs paid by public finance
- Nationality


Who Gets the Ventilator? Study Purpose

Previous research has found four fundamental ethical values with regards to determining who receives the resources.
- Treating people equally - Using the lottery system to decide who receives treatment
- Helping the ones more severely affected
- Maximizing the total benefits - Treating those who are expected to have the highest remaining high-quality years
- Prioritizing social usefulness - Treating healthcare workers first


Previous Allocation Decisions during Times of Scarce Resources

The study population encompassed 11 countries who account for 48.8% of the world population and 69.56% of the confirmed COVID cases at the time of the study. 

Study Population of Who Gets the Ventilator?

Participants were asked to make a series of 15 decisions and later asked to disclose certain personal information. In each decision, two different patients who both required a ventilator to live were described. Only one ventilator is available, and they were asked to make the decision based on the 10 attributes. Each scenario was randomly generated, although impossible combinations (a 5 year old child with a criminal record) were eliminated.

Method of Gathering Data in Social Preferences with an Example of the Scenario

Results on the importance of the different characteristics were found on three levels:
- Global
- Country
- Individual

Who Gets the Ventilator? Study Results

The study showed that certain factors of a patient, which ethically should not be considered, have an influence on allocation decisions. This is concerning because it is possible that an already vulnerable population is more susceptible to the pandemic due to personal preferences. As a result, it may be necessary that a consensus reached by the government, media, and general public should be arranged to eliminate the possibility of biased decisions. However, the overall purpose of the study was to emphasize the dynamic relationship between culture, economy, and individual variables on social preferences and allocation decisions. 

Concerns Who Gets the Ventilator? Study Raises on Allocation Decisions

- Only 11 countries were used, meaning certain parts of the world will not be able to fall under the demographics of the participants
- The participants volunteered to participate in the study
- Each country had a different amount of people volunteer, meaning the results of the global preferences may be skewed
- The pandemic is still ongoing so moral preferences may change and should be researched further

Limitations of the Study in Determining Influence of Social Preferences in Allocation Decisions

As resources become scarce and the triage method is used to maximize the number of surviving patients, decisions on resource allocation result in many ethical dilemmas despite transparency. 

University of Pittsburgh

In hospitals, triage teams reduce moral distress for clinicians and legally protect them by deciding 1) which patients should receive allocation (life-sustaining intervention) and 2) whether resources will be withdrawn from one patient and given to another. They must be transparent about their principles and decision-making factors, but the team member identities may be private. 

Triage Teams for Healthcare Systems and COVID-19

Jin, L., Huang, Y., Liang, Y., & Zhang, Q. (2020). Who Gets the Ventilator? Moral Decision Making Regarding Medical Resource Allocation in a Pandemic. Journal of the Association for Consumer Research. doi:10.1086/711734

Who Gets the Ventilator? Moral Decision Making Regarding Medical Resource Allocation in a Pandemic

Corona-score algorithm is a point-based algorithm that was developed and validated to evaluate the likelihood of a COVID-19 infection in patients with respiratory symptoms based on information giving by demographic, laboratory, and imaging data. These data include age, sex, CT, CRP, ALC, ANC, LDH, and ferritin.

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