Should We Use Behavioural Predictions in Organ Allocation?
Medical predictions, for example, concerning a patient's likelihood of survival, can be used to efficiently allocate scarce resources. Predictions of patient behaviour can also be used—for example, patients on the liver transplant waiting list could receive lower priority based on a high likelihood...
| Published in: | Bioethics Vol. 39; no. 8; pp. 737 - 748 |
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| Main Authors: | , , , , , |
| Format: | Article |
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Wiley-Blackwell
Oct2025
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=187780707&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 187780707 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 02699702 6PJ jtl: Bioethics issn: 02699702 maglogo: Y pubinfo: dt: Oct2025 vid: 39 iid: 8 pid: 480 pub: Wiley-Blackwell artinfo: ui: 187780707 10.1111/bioe.13440 ppf: 737 ppct: 11 formats: tig: atl: Should We Use Behavioural Predictions in Organ Allocation? aug: au: Drezga‐Kleiminger, Max Wilkinson, Dominic Douglas, Thomas Demaree‐Cotton, Joanna Koplin, Julian Savulescu, Julian affil: Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne Victoria,, Australia Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore John Radcliffe Hospital, Oxford, UK Monash Bioethics Centre, Monash University, Melbourne Victoria,, Australia Murdoch Children's Research Institute, Melbourne Victoria,, Australia su: United Kingdom Patient compliance Autonomy (Psychology) Empirical research Organ donation Ethical decision making Psychology Health behavior Drugs Alcoholism Discrimination (Sociology) Health care rationing Medical ethics Adults Statistical power analysis Conceptual models Immunosuppressive agents Research funding Descriptive statistics Data analysis software Liver transplantation sug: subj: Patient compliance Autonomy (Psychology) Empirical research Organ donation Ethical decision making Psychology Health behavior Drugs Alcoholism Discrimination (Sociology) Health care rationing Medical ethics Adults United Kingdom Pharmaceuticals and pharmacy supplies merchant wholesalers Drugs and Druggists' Sundries Merchant Wholesalers Pharmaceutical and medicine manufacturing Statistical power analysis Conceptual models Immunosuppressive agents Research funding Descriptive statistics Data analysis software Liver transplantation keyword: artificial intelligence behaviour ethics liver allocation medicine predictions resource allocation artificial intelligence behaviour ethics liver allocation medicine predictions resource allocation ab: Medical predictions, for example, concerning a patient's likelihood of survival, can be used to efficiently allocate scarce resources. Predictions of patient behaviour can also be used—for example, patients on the liver transplant waiting list could receive lower priority based on a high likelihood of non‐adherence to their immunosuppressant medication regimen or of drinking excessively. But is this ethically acceptable? In this paper, we will explore arguments for and against behavioural predictions, before providing novel empirical evidence on this question. Firstly, we note that including behavioural predictions would lead to improved transplant outcomes. Fairness could also require prioritising those predicted to engage in healthier behaviours: consistent with using behavioural predictions in other contexts such as psychiatry and substance misuse. Conversely, behavioural predictions may be judged too inaccurate or discriminatory, or it may be thought unfair to deprioritise based on future behaviour. In part two, we performed an online survey of 172 UK adults. When presented with possible factors relevant to liver allocation, most thought predictions of higher medication adherence (78.6%) and lower future alcohol use (76.5%) should be used but not predictions of lower future criminality (24.7%) and higher societal contribution (21.2%). Randomising participants into two groups, 69.8% of participants found deprioritising a patient based on their predicted medication adherence acceptable (91.9% found a nonbehavioural prediction acceptable). We did not identify an ethically relevant difference between behavioural predictions and other medical predictions already used in organ allocation. Our sample of participants also appeared to support behavioural predictions in this context. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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