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Peer reviewedOpen accessInfluenza

Understanding moral trade-offs in pandemic response: A discrete choice experiment on avian influenza policies.

The European journal of health economics : HEPAC : health economics in prevention and care·

Smeele NVR, Waltz CNM, Schreijer AJM, Dykstra PA

DOI
10.1007/s10198-026-01985-6
PMID
42645709
PMCID
OpenAlex
Study type
Journal article
Publisher
Publisher unavailable
Article type
journal-article
Integrity
current

Why this research matters now

The findings suggest that public acceptance of preparedness policies may depend on perceived moral legitimacy as well as expected effectiveness and financial cost. The abstract reports that incorporating these preference differences into economic evaluation could inform consideration of societal acceptability.

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Structured evidence summary

Research question

How does the Dutch public weigh health, social, and economic outcomes when considering policies for a possible highly pathogenic avian influenza outbreak?

Study design

The study used a discrete choice experiment with 1,045 LISS panel respondents and analyzed preference patterns with a latent class logit model. Six policy outcomes were examined, including mortality, lasting injuries, delayed healthcare, social restrictions, and one-time tax payments.

Population and setting

The participants were a representative sample of 1,045 people from the Dutch LISS panel. The decision context was a hypothetical potential outbreak of highly pathogenic avian influenza in the Netherlands.

Main findings

The analysis identified four preference groups, indicating substantial variation in how respondents made moral and economic trade-offs. Two groups were averse to exchanging human life or dignity for monetary costs, whereas more cost-sensitive groups placed greater weight on economic efficiency.

Public-health relevance

The findings suggest that public acceptance of preparedness policies may depend on perceived moral legitimacy as well as expected effectiveness and financial cost. The abstract reports that incorporating these preference differences into economic evaluation could inform consideration of societal acceptability.

Important limitations

The evidence comes from a stated-preference experiment about a possible outbreak, so the abstract does not establish how respondents would act during an actual event or how preferences would translate into policy outcomes. This summary is also limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade assessment of sampling, measures, model assumptions, and other limitations.

GIDS interpretation

The article is discoverable under influenza, health policy, and outbreak investigation classifications and provides context on public preferences concerning hypothetical HPAI preparedness policies. It does not provide surveillance findings or confirm any live surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topichas pathogen typeinforms policy domainstudied population settingstudies pathogenuses study design