The relationship between human values and support for distributive approaches in healthcare rationing : an exploratory study

Human values are a key component in understanding individuals’ choices. One such decision involves defining the criteria that should guide healthcare prioritization. The recent public health crisis (COVID-19) has underscored the insufficiency of healthcare resources in meeting growing demand. Preferences for allocating health resources are are deeply intertwined with ethical and moral judgments rooted in personal and societal values. Therefore, effective healthcare prioritization policies must consider the values of the population they serve. Drawing on Schwartz’s theory of basic human values, the present study aimed to identify the predominant human values among 1,148 Portuguese participants and examine their association withrespondents’ sociodemographic characteristics and their influence on support for three healthcare rationing approaches. A cluster analysis based on the higher-order dimensions of Schwartz’s value model identified four distinct groups: social focus, growth focus, strong social and personal focus, and weak social and personal focus. While egalitarianism emerged as the most widely accepted principle of justice in allocating scarce healthcare resources, participants with a strong social and personal focus prefered utilitarian and equity-based criteria more. Furthermore, positive associations were observed between utilitarian and equity approaches to healthcare rationing. Incorporating societalvalues into resource allocation decisions can can help establish priorities and guide more effective healthcare planning strategies.