Search tips
Search criteria 


Logo of jmedethJournal of Medical EthicsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Med Ethics. 1996 August; 22(4): 238–242.
PMCID: PMC1377004

Random paired scenarios--a method for investigating attitudes to prioritisation in medicine.


OBJECTIVE: This article describes a method for investigating attitudes towards prioritisation in medicine. SETTING: University of Kuopio, Finland. DESIGN: The method consisted of a set of 24 paired scenarios, which were imaginary patient cases, each containing three different ethical indicators randomly selected from a list of indicators (for example, child, rich patient, severe disease etc.). The scenarios were grouped into 12 random pairs and the procedure was repeated four times, resulting in 12 scenario pairs arranged randomly in five different sets. SURVEY: This method was tested with four groups of subjects (n = 8, n = 47, n = 104 and n = 36). RESULTS: Children and patients with a severe disease were prioritised in all groups. The aged, patients with a mild disease and patients with a self-acquired disease were negatively prioritised in all groups. Poor or rich patients were prioritised in some groups but negatively prioritised in others. CONCLUSIONS: The validity and reliability of this method are good and it is suitable for investigating attitudes towards medical prioritisation.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (808K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cochrane M, Ham C, Heginbotham C, Smith R. Contemporary theme. Rationing: at the cutting edge. BMJ. 1991 Oct 26;303(6809):1039–1042. [PMC free article] [PubMed]
  • Charny MC, Lewis PA, Farrow SC. Choosing who shall not be treated in the NHS. Soc Sci Med. 1989;28(12):1331–1338. [PubMed]
  • Bowling A, Jacobson B, Southgate L. Explorations in consultation of the public and health professionals on priority setting in an inner London health district. Soc Sci Med. 1993 Oct;37(7):851–857. [PubMed]
  • Nord E. The relevance of health state after treatment in prioritising between different patients. J Med Ethics. 1993 Mar;19(1):37–42. [PMC free article] [PubMed]
  • Groves Trish. Public disagrees with professionals over NHS rationing. BMJ. 1993 Mar 13;306(6879):673–673. [PubMed]
  • Fowler FJ, Jr, Berwick DM, Roman A, Massagli MP. Measuring public priorities for insurable health care. Med Care. 1994 Jun;32(6):625–639. [PubMed]

Articles from Journal of Medical Ethics are provided here courtesy of BMJ Publishing Group