Ethics-by-design: efficient, fair and inclusive resource allocation using machine learning

Abstract The distribution of crucial medical goods and services in conditions of scarcity is among the most important, albeit contested, areas of public policy development. Policymakers must strike a balance between multiple efficiency and fairness objectives, while reconciling disparate value judgments from a diverse set of stakeholders. We present a general framework for combining ethical theory, data modeling, and stakeholder input in this process and illustrate through a case study on designing organ transplant allocation policies. We develop a novel analytical tool, based on machine learning and optimization, designed to facilitate efficient and wide-ranging exploration of policy outcomes across multiple objectives. Such a tool enables all stakeholders, regardless of their technical expertise, to more effectively engage in the policymaking process by developing evidence-based value judgments based on relevant tradeoffs.