Aim To explore the way people living with HIV and healthcare providers in Togo judge the priority of HIV-infected patients regarding the allocation of antiretroviral drugs. Method From June to September 2015, 200 adults living with HIV and 121 healthcare providers living in Togo were recruited for the study. They were presented with stories of a few lines depicting the situation of an HIV-infected patient and were instructed to judge the extent to which the patient should be given priority for (...) antiretroviral drugs. The stories were composed by systematically varying the levels of four factors: the severity of HIV infection, the financial situation of the patient, the patient's family responsibilities and the time elapsed since the first consultation. Results Five clusters were identified: 65% of the participants expressed the view that patients who are poor and severely sick should be treated as a priority, 13% prioritised treatment of patients who are poor and parents of small children, 12% expressed the view that the poor should be treated as a priority, 4% preferred that the sickest be treated as a priority and 6% wanted all patients to get treatment. Conclusions WHO's guideline regarding antiretroviral therapy allocation currently in use in many African countries does not reflect the preferences of Togolese people living with HIV. For most HIV-infected patients in Togo, patients who cannot get treatment on their own should be treated as a priority. (shrink)

AimTo examine the views of Guinean lay people and healthcare providers regarding the acceptability of HCPs’ refusal to provide care to Ebola patients.MethodFrom October to December 2015, lay people and HCPs in Conakry, Guinea, were presented with 54 sample case scenarios depicting a HCP who refuses to provide care to Ebola patients and were instructed to rate the extent to which this HCP’s decision is morally acceptable. The scenarios were composed by systematically varying the levels of four factors: the risk (...) of getting infected, the HCP’s working conditions, the HCP’s family responsibilities and the HCP’s professional status.ResultsFive clusters were identified: 18% of the participants expressed the view that HCPs have an unlimited obligation to provide care to Ebola patients; 38% held that HCPs’ duty to care is a function of HCPs’ working conditions; 9% based their judgments on a combination of risk level, family responsibilities and working conditions; 23% considered that HCPs do not have an obligation to provide care and 12% did not take a position.ConclusionOnly a small minority of Guinean lay people and HCPs consider that HCPs’ refusal to provide care to Ebola patients is always unacceptable. The most commonly endorsed position is that HCPs’ duty to provide care to Ebola patients is linked to society’s reciprocal duty to provide them with the working conditions needed to fulfil their professional duty. (shrink)

We applied a technique borrowed from the field of bioethics to test whether justice-related factors influence laypersons’ decisions concerning business ethics. In the first experiment, participants judged the acceptability of remuneration policies and in the second that of executive bonuses. In each study, participants judged a set of 36 situations. To create the scenarios, we varied retributive justice—the amount of remuneration; procedural justice—the clarity of the procedure that determined the remuneration; distributive justice—the extent of the distribution of bonus payments amongst (...) employees; and restorative justice—a special compensation for hazardous working conditions or accidents at work. K-means clustering of all 36 judgments revealed four different personal positions in both experiments. One group of people readily accepted all situations. The other three groups’ judgments were mainly a function of distributive justice modulated in different ways by the context determined by the other variables. Furthermore, people conceive of distributive justice as categorical: Acceptability judgments only increase if companies give bonuses to all employees. Granting bonuses to a subset does not increase acceptability. Our results are useful for policy makers and provide business ethics researchers with a novel technique. (shrink)