Veil-of-ignorance reasoning mitigates self-serving bias in resource allocation during the COVID-19 crisis

Karen Huang*, Regan M. Bernhard, Netta Barak-Corren, Max H. Bazerman, Joshua D. Greene

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

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 were younger or older. Two studies (pre-registered; online samples; Study 1, N=414; Study 2 replica-tion, N=1,276) show that veil-of-ignorance reasoning shifts preferences toward saving younger patients. The effect on older participants is dramatic, reversing their opposi-tion 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.

Original languageAmerican English
Pages (from-to)1-19
Number of pages19
JournalJudgment and Decision Making
Volume16
Issue number1
StatePublished - Jan 2021

Bibliographical note

Funding Information:
All study materials, preregistrations, raw data, and analyses code are publicly available on Open Science Framework (https://osf.io/nex9s/?view_only=63de515d891c4996b6fd557f32b98629). This work was funded by Harvard Business School. Copyright: © 2021. The authors license this article under the terms of the Creative Commons Attribution 3.0 License. ∗Co-first author. McCourt School of Public Policy, Georgetown University. Karen.Huang@georgetown.edu. ORCID: 0000-0001-6636-6273. †Co-first author. Department of Psychology, Harvard University. Email: regan.bernhard@gmail.com. ORCID: 0000-0002-8828-3046. ‡Hebrew University of Jerusalem. ORCID: 0000-0003-0941-5686. §Harvard Business School. ORCID: 0000-0002-7009-3340. ¶Department of Psychology, Center for Brain Science, Harvard University. ORCID 0000-0002-3451-2966.

Publisher Copyright:
© 2021, Society for Judgment and Decision making. All rights reserved.

Keywords

  • Bioethics
  • COVID-19
  • Fairness
  • Procedural justice
  • Self-serving bias

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