In the Netherlands, the COVID-19 pandemic raised an acute social dilemma where citizens could decide whether to comply with the precautionary measures recommended by the government. This paper examines the role of consideration of others and consideration of the future in explaining cooperation in a social dilemma.
Through an online survey (N=1,019), consideration of future consequences (CFC), consideration of others (COO) and compliance with the precautionary measures were measured. The data were analyzed by means of Tobit-regressions and ordinal logistic regressions.
Results show that COO and CFC are both positively correlated with compliance with recommended precautionary measures. Moreover, COO and CFC-future do not interact, although they are positively correlated. Gender, age, perceived risk of COVID-19 infection for others, perceived compliance by others and opinion about government response to the pandemic also have a significant association with compliance. These findings emphasize the importance of consideration of others as well as consideration of the future in the prediction of cooperation in social dilemmas.
Background
The first wave of the COVID-19 pandemic overwhelmed healthcare systems in many countries, and the rapid spread of the virus and the acute course of the disease resulted in a shortage of intensive care unit (ICU) beds. We studied preferences of the public in the Netherlands regarding the allocation of ICU beds during a health crisis.
Methods
We distributed a cross-sectional online survey at the end of March 2020 to a representative sample of the adult population in the Netherlands. We collected preferences regarding the allocation of ICU beds, both in terms of who should be involved in the decision-making and which rationing criteria should be considered. We conducted Probit regression analyses to investigate associations between these preferences and several characteristics and opinions of the respondents.
Results
A total of 1,019 respondents returned a completed survey. The majority favored having physicians (55%) and/or expert committees (51%) play a role in the allocation of ICU beds and approximately one-fifth did not favor any of the proposed decision-makers. Respondents preferred to assign higher priority to vulnerable patients and patients who have the best prospect of full recovery. They also preferred that personal characteristics, including age, play no role.
Conclusion
“Our findings show that current guidelines for allocating ICU beds that include age as an independent criterion may not be consistent with societal preferences. Age may only play a role indirectly, in relation to the vulnerability of patients and their prospect of full recovery. Allocation of ICU beds during a health crisis requires a multivalue ethical framework.”
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