Methods for multi-stakeholder deliberation of ethical dilemmas of access to expensive cancer treatments
Saturday, October 14, 2023
9:00 AM – 10:15 AM ET
Location: Galena (Fourth Floor)
While there are established methods for investigating moral preferences in individuals and groups (eg. semi-structured interviews and focus groups), less work has been done in bioethics to develop methods for conducting multi-stakeholder deliberation of ethical dilemmas in health care and health policy. Such deliberation is essential to inform and align policy-making with the moral perspectives of relevant publics. In this presentation, I will present a methodology used to conduct a series of what we call ‘societal dialogues’ in the Netherlands, on dilemmas of access to expensive cancer treatments. To help curtail the rising costs of newly approved medical treatments, however, the Dutch public healthcare system increasingly excludes expensive treatments from reimbursement. The system is characterized by a strong egalitarian ethos, in which out-of-pocket payments by patients are not customary, not allowed in many hospitals, and not deemed ethically acceptable. In practice, therefore, many patients do not have access to expensive cancer treatments. Can this be justified, or should other access models be explored? In earlier interview studies we elucidated moral perspectives of patients, physicians and hospital executives. In our societal dialogues, we bring representatives of these groups together with those of other relevant stakeholder groups, including health insurers, policy-makers, pharmaceutical companies, and citizens, to allow for open interaction and collaborative moral deliberation. In this presentation, I will describe our methodology and highlight the outcomes of the dialogues, and their value to better-justified, more equal policy-making.