Re: vaccine prioritization during a pandemic

*Society is too complex for some people
sitting in a star chamber to decide who is essential for the survival of
society.
*
Yes. And, the star chamber members have to decide first what you mean by
"society" and what sort of "society" is worth preserving. A society of
able-bodied workers? A society of ubermensch? All of that sounds familiar.

On 5/18/06, Bill Hamilton <williamehamiltonjr@yahoo.com> wrote:
>
> It seems to me that planners should try to preserve those people who will
> be
> most essential for the survival of society. Having said that, I hesitate
> to
> offer a set of rules derived from this. Society is too complex for some
> people
> sitting in a star chamber to decide who is essential for the survival of
> society.
>
> --- David Opderbeck <dopderbeck@gmail.com> wrote:
>
> > *We can talk all we want about the infinite value of a human life but we
> > just don't have infinite resources, & thus may have to make decisions
> about
> > who our finite resources will be used for.*
> >
> > Of course. In conditions of scarcity, decisions must be made about
> > allocation. I'd venture that none of us would be willing to let the
> market
> > make the allocation under these circumstances, and I'd further venture
> that
> > the reason for this has nothing to do with a market failure
> problem. What
> > we're trying to do is make a non-market allocation on some moral basis.
> >
> > But shying away from the market seems inconsistent with the otherwise
> > utilitarian thrust of the current draft policy. Generally, markets are
> > better than governments at determining welfare maximization questions.
> > Among other things, governments are notoriously ineffecient, subject to
> > special interest capture, and often corrupt, all of which increases
> > transaction costs and diminishes overall social welfare. If we want to
> > allocate the vaccine simply based on aggregate social utility, why not
> just
> > leave it to the market?
> >
> > The answer must be, I think, that we are intuitively not comfortable
> with an
> > allocation on strictly utilitarian grounds, because those grounds favor
> the
> > wealthy and powerful members of society. What other grounds can we
> > provide? Exploring the virtue ethics perspective, what I'd float is the
> > idea of an allocation that would exemplify and inculcate virtues such as
> > courage and love. This means that perhaps the weaker members of society
> --
> > the very young and the very old, for example -- should get their doses
> > before the stronger members, and that the stronger members should be
> willing
> > to sacrifice their doses to the weaker. Doesn't this sound perhaps a
> bit
> > more like the kind of decision Jesus would make?
> >
> >
> > On 5/18/06, George Murphy <gmurphy@raex.com> wrote:
> > >
> > > It seems to me that with *any* system of ethics, people dealing with
> > > large-scale disasters have to make choices. We can talk all we want
> about
> > > the infinite value of a human life but we just don't have infinite
> > > resources, & thus may have to make decisions about who our finite
> resources
> > > will be used for. Triage is sometimes an unpleasant necessity, & a
> refusal
> > > to use it may mean more deaths than necessary as sacrifices to some
> ethical
> > > principles.
> > >
> > > Shalom
> > > George
> > > http://web.raex.com/~gmurphy/
> > >
> > > ----- Original Message -----
> > > *From:* David Opderbeck <dopderbeck@gmail.com>
> > > *To:* drsyme@cablespeed.com
> > > *Cc:* asa@calvin.edu
> > > *Sent:* Thursday, May 18, 2006 10:52 AM
> > > *Subject:* Re: vaccine prioritization during a pandemic
> > >
> > >
> > > Just an observation: apropos to our recent discussion of different
> > > approaches to ethics, this proposal seems entirely
> utilitarian. Taking a
> > > deontological approach, how this proposal fare in light of scriptural
> > > injunctions to care for the poor and oppressed? Or taking a virtue
> > > approach, is this the sort of proposal that supports the development
> of a
> > > virtuous community? The idea that *"within this framework 20 year
> olds
> > > are valued more than 1 year olds, because the older individuals have
> more
> > > developed interests, hopes, and plans but have not had an opportunity
> to
> > > realize them"* seems troubling under either a Christian-influenced
> > > deontological or virtue approach.
> > >
> > >
> > > On 5/17/06, drsyme@cablespeed.com <drsyme@cablespeed.com> wrote:
> > > > In the May 12 2006 isue of Science, Ezekiel Emanuel,
> > > > from the department of Clinical Bioethics at NIH, and Alan
> > > > Wertheimer propsed a scheme for rationing flu vaccine if
> > > > there is a H5N1 pandemic. They propose that healthy
> > > > people 13 to 40 years of age have the second highest
> > > > priority of being vaccinated. Those that produce the
> > > > vaccine and frontline health care workers are top
> > > > priority. This contrasts with the current recommendations
> > > > from the National Vaccine Advisory Council (NVAC), and
> > > > the Advisory Committee on Immunization Policy (ACIP),
> > > > recommendations that vaccine first go to vaccine makers,
> > > > and health care workers, followed by people 6 months to 64
> > > > years of age that are at high risk of complications from
> > > > the flu, and those that are otherwise at high risk to
> > > > contract the illness.
> > > >
> > > > The article gives examples of possible ethical principles
> > > > that can be used for rationing. "save the most lives",
> > > > "women and children first", "first come first served",
> > > > "save the most quality years", "save the worst off" (as
> > > > in organ transplantation today), "reciprocity" (you give
> > > > an organ you get an organ), "save those most likely to
> > > > fully recover", "save those most instrumental in making
> > > > society flourish"
> > > >
> > > > He claims that the NVAC and the AICP recommendations are
> > > > based on the principle of "save the most lives". They
> > > > disagree with this prioritization, because there is time
> > > > to deliberate about priority rankings. They propose
> > > > prioritization based on what they call a "life cycle
> > > > allocation principle". This prioritization starts with
> > > > the idea that each person "should have an opportunity to
> > > > live through all of life's stages". Basically the idea is
> > > > that younger people have priority over older people.
> > > > However they refine this idea into an alternative
> > > > prioritization called the "investment refinement of the
> > > > life cycle principle including public order." In this
> > > > prioritization gradations are given within a life span
> > > > such that adolescence to middle age has the highest
> > > > priority. They state "within this framework 20 year olds
> > > > are valued more than 1 year olds, because the older
> > > > individuals have more developed interests, hopes, and
> > > > plans but have not had an opportunity to realize them."
> > > > They also invoke the principle of public order, which
> > > > emphasizes "the value of ensuring safety and provision of
> > > > necessities, such as food and fuel."
> > > >
> > > > To summarize the NVAC and ACIP vs Investment refinement
> > > > of LCP (IRLCP):
> > > >
> > > > Vaccine production workers and health care workers are
> > > > vaccinated first in both proposals.
> > > >
> > > > Then NVAC/ACIP recommend high risk individuals 6 to 64,
> > > > pregnant women, others at high risk of exposure,
> > > > emergency response workers, high ranking government
> > > > officials. Followed by healthy individuals over 65,
> > > > people 6 to 64 of moderate risk, healthy children 6 to 23
> > > > months, other, public health and emergency response
> > > > workers. Followed by other government workers, funeral
> > > > directors, and last healthy people 2 to 64 years.
> > > >
> > > > In contrast IRLCP recommends (after vaccine producers and
> > > > health care workers) people 13 to 40 years of age that are
> > > > of low risk, public health, military, police and fire,
> > > > utility and transportation workers, telecommunications and
> > > > IT workers, funeral directors. Then people 7 to 12 years,
> > > > and those 41 to 50 years old that are low risk. Then
> > > > people 6 months to 6 years and 51 to 64 years that are low
> > > > risk. Followed by people over 65 that are low risk.
> > > > Finally those 6 months to 64 years that are high risk,
> > > > followed by people over 65 that are high risk.
> > > >
> > > >
> > > >
> > > > This is an interesting proposal and I think could spark
> > > > some interesting debate. Comments?
> > > >
> > >
> > >
> >
>
>
> Bill Hamilton
> William E. Hamilton, Jr., Ph.D.
> 248.652.4148 (home) 248.303.8651 (mobile)
> "...If God is for us, who is against us?" Rom 8:31
>
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Received on Fri May 19 08:25:35 2006