Doctoral Dissertation Research in DRMS: How Do People Value Life in Health Care Allocation? Inconsistencies and Mechanisms.

本论文的研究探讨了人们在资源稀缺的情况下如何珍惜生命的决策过程。研究了一个人可以使用的三种政策：（1）平等对待所有生命，（2）优先考虑那些将从干预中获得最大利益（例如额外寿命）的人，以及（3）优先考虑年轻人，无论他们还有多少年可活。 这些指标意味着卫生资源分配的不同战略，特别是在这种资源稀缺的情况下。 疫苗接种场景用于探索外行人在不同情况下使用哪些指标，以及问题类型如何影响所使用的指标。 在直接提问中，人们被问到他们的抽象原则（例如，所有生命都是平等的，优先考虑年轻人，等等）。 在间接问题中，人们被赋予一个分配问题（例如，有1000人处于危险之中，但只有500种疫苗;谁应该接种疫苗？ Co-PI将测试不同的心理学解释，为什么人们可能会在这两种类型的问题中表达不同的指标。这项研究的更广泛影响来自公众对卫生政策的支持可能是可塑性的：虽然亲年轻的倾向可能会推动对如何优先考虑稀缺卫生资源的具体政策的支持，（即2009年H1N1疫苗优先用于25岁以下的人），它们背离了“所有生命都是平等的”这一经常被引用的道德标准。这种倾向可能会被更直接的措施所掩盖，例如直接询问年轻人的生命是否比老年人的生命更有价值的问题，因为在这种情况下回答是的，与根深蒂固的“人人平等”道德标准有更明显的矛盾。研究这些不一致之处可以为如何设计公共卫生政策以及如何向公众介绍这些政策提供重要信息。

This dissertation research examines the decision processes underlying how people value lives saved in situations of resource scarcity. Three policies a person could use are examined: (1) treating all lives are equal, (2) prioritizing people who will gain the most benefit (e.g. additional life years) from an intervention, and (3) prioritize young people regardless of the number of years they have left to live. These metrics imply different strategies for health resource allocation, especially when such resources are scarce. Vaccination scenarios are used to probe which metrics lay people use in different situations and how the type of question influences the metric used. In direct questions, people are asked about their abstract principles (e.g., all lives are equal, prioritize the young, etc.). In indirect questions, people are given an allocation problem (e.g., there are 1000 people at risk but only 500 vaccines; who should get the vaccines?). The co-PI will test different psychological accounts for why people might express different metrics in these two types of questions.The broader impacts of this research derive from the fact that the public's support for health policies may be malleable: While the pro-young tendencies may drive support for specific policies for how to prioritize scarce health resources (i.e. the 2009 H1N1 vaccine was prioritized for people under age 25), they depart from the oft-cited moral standard that "all lives are equal". Such tendencies may be concealed in more direct measures, such as in questions directly asking whether lives of young people are more valuable than those of older people, because answering yes in this case is a more apparent contradiction to the deep-rooted "all lives equal" moral standard. Studying these inconsistencies provides important information on how to design public health policies and how to present them to the public.