Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Joanna Coast, University of Bristol,
- Second opponent: Professor Jan Abel Olsen, UiT - The Arctic University of Norway,
- Third member and chair of the evaluation committee: Professor Jan Frich, University of Oslo
Chair of the Defence
Professor emeritus Ivar Sønbø Kristiansen, University of Oslo
Principal Supervisor
Senior Researcher Mathias Barra, Akershus University Hospital
Summary
With increasing demand and limited supply of healthcare resources, healthcare systems depend on priority-setting frameworks to guide resource allocation. The principles underlying these frameworks are the topic of ongoing debate in the academic literature, in policy, and in the public discourse. One of these principles is ‘severity’. Applied as a priority-setting criterion in Norway, Sweden, the Netherlands, and the United Kingdom, severity is intended to modify cost-effectiveness analyses to ensure that treatment for severe illnesses may be provided despite not necessarily meeting conventional cost-effectiveness thresholds. However, there is no consensus on exactly what ‘severity’ means. The aim of this thesis is to address the knowledge gap surrounding public views on the meaning of severity, within the context of medical ethics and priority setting.
The thesis comprises three studies. The first qualitatively explores public views on severity via thematic analysis of group interviews transcripts. The second identifies general viewpoints on severity, by building on data from the group interviews and conducting a second round of data collection applying Q methodology. The third examines the distribution of those viewpoints in a representative sample of the Norwegian population, also using Q methodological methods.
Overall, the findings presented in this thesis suggest there are multiple different views held by members of the public on the meaning of severity, many of which appear to represent additional concerns to those represented in policy operationalisations of severity. The thesis considers potential policy implications of this plurality of views, the role of public views and how this plurality might be addressed in policy. Finally, it highlights the challenge facing policymakers with such a misalignment between public views and policy.
Additional information
Contact the research support staff.