Fairness preferences over allocation of scarce medical resources

Many argue that randomization is a fair way to allocate scarce resources. However, little is known about individual justice preferences for these mechanisms. This gap is particularly consequential, as public choices are often influenced by individual justice preferences. To address it, we propose a model using proportional probability weights for recipients’ claims and conduct an empirical analysis using a longitudinal survey on allocating medical resources between two patients of different ages. A three-year panel dataset was collected from 2020 to 2022, containing 301 representative respondents. Our results show strong support for randomization reflecting proportional claims: 17% of participants favored equal probabilities, 63% prioritized younger patients, and 20% favored older patients, indicating varied justice principles. The findings indicate that the use of weighted lotteries to allocate scarce medical resources – and scarce resources more broadly – is consistent with the public’s tradeoff between considerations of justice and efficiency.