The influence of social categories and patient responsibility on health care allocation decisions: Bias or fairness?

We investigated the influence of patient age, gender, race, and responsibility on the allocation of health care resources. Patient age and level of responsibility consistently affected participants' decisions such that they were more likely to distribute resources to younger and "blameless" patients. Participants were also more confident in their decisions to grant resources to these groups and withhold resources from older and "blameworthy" patients. Patient race and gender had little effect on treatment decisions. This pattern of effects, coupled with the findings concerning participants' intergroup attitudes and confidence in their decisions, suggest that the decisions were based on a relatively rational assessment of fairness in health care allocation and not on generalized prejudices.