Is "end-of-life" care more valuable? Measuring societal views using the new Q2S method

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Public sector resource allocation is an important area for research, especially now, when spending cuts are inevitable. In the health sector this frequently attracts media attention, especially with respect to the recommendations of the National Institute for Health and Clinical Excellence (NICE) and the denial of drugs to patients. However decisions to provide one treatment from a limited pot of resources will always mean that something else cannot be funded.Effective policies should incorporate the opinions of the general public and so policy makers need information about the views held by people in society. Firstly, information is needed about the nature of public opinion. What values and arguments exist around the topic in question? Usually there are a number of opinions about a particular issue and these can be described in terms of the features that set them apart as well as issues of consensus. Secondly, information is needed on how those views are distributed in a population - is there a dominant view? and what kinds of people subscribe to different opinions? This is often important for decision makers but requires a different kind of data based on larger samples of people. Research methods exist which can provide information of both types, using different approaches. In this project, we develop methods using an approach called Q methodology, which can link these two types of information within a consistent methodological approach. The issue we address here is the value to society of ?end-of-life? technologies. Decisions about the denial of expensive drugs for terminally ill patients, which extend life by only a short time, are controversial. We will explore the views of the general public regarding the provision of end-of-life technologies which will inform NICE and local organisations who make decisions about resources in health care. Our research will be conducted in two phases: the first will involve 250 people sampled from the general population and 50 from specific interest groups. They will sort cards, printed with statements of opinion, onto a grid, according to agreement. Based on an analysis of common patterns between respondents? sorts we will identify and describe shared views. In a second phase we will use these findings to design a survey which will allow us to analyse how common these views are in a large, representative sample of the population.