On Distributing The Wuhan Vaccine: An Old Ethics Dilemma With No Solution

[Michael Ejercito]

http://ethicsalarms.com/2020/09/23/an-old-ethics-dilemma-with-no-solution/

On Distributing The Wuhan Vaccine: An Old Ethics Dilemma With No Solution
SEPTEMBER 23, 2020 / JACK MARSHALL


I was waiting for this one.

Back when ventilators were the rage (before we found out that once you were
on a ventilator, you were pretty much toast anyway–Science!), I had filed an
article about the likelihood that Down Syndrome sufferers would be deemed
unworthy of high priority when scarce equipment was being rationed. I never
got around to writing about it, but I knew, like the giant swan in
“Lohengrin,” the issue would be sailing by again. Sure enough, as the
prospect of a Wuhan virus vaccine seems within view, the same basic question
is being raised: if there aren’t enough vaccines for everyone, who gets the
first shot (pun intended)?

Well, there is no right answer to this one, unfortunately. All debates on
the topic will become that popular game show, “Pick Your Favorite Ethical
System!” or its successful spin-off, “What’s Fair Anyway?” That’s fun and
all, but the debates are completely predictable.

The issue is essentially the same as the “meteor or asteroid about to hit
the Earth” dilemma in movie like “Deep Impact,” where only a limited number
of citizens can be sheltered as a potential extinction event looms. If you
follow the Golden Rule or the John Rawls variation, you end up with
survivors being chosen by lot, or pure chance. Kantian ethics also tends to
reject any system that sacrifices one life for a “more valuable” one.
Competent and rational public policy, however, has to take into
consideration more factors than these over-simplified (and this appealing)
ethical systems can.

Like it or not, a decision in the rationing of a vital resource problem has
to come down to utilitarianism, or balancing. That means winners and losers,
and the losers in such decisions always feel that the winners being favored
is unfair. From their perspective, they are right. Policymakers, however,
have a duty to society as a whole, and the long-term best interests of the
whole population. Being human, they also have biases, and how they weigh the
various factors involved in balancing interests inevitably is affected by
their own agendas.

If the job of determining who got the vaccine first was delegated to Black
Lives Matters, how do you think it would approach the problem?

This article by the American Council on Science and Health (Full Disclosure:
I acquired funding for an ACSH study when I ran the National Chamber
Foundation) discusses the vaccine problem and proposals that so-called
“superspreaders”—young people who are not at the greatest risk of fatality
from the pandemic but are the ones most likely to spread it—should get the
vaccine before the elderly. You can make up your own mind about the logic.
My own approach to “balancing” would begin with leaving anyone 80 or above
(what my father called “the Red Zone”) last on the the priority list, since
they might drop dead any minute anyway. The real battle is bound to be over
“essential” people, whoever they are. Again, there are no right answers
(though there are wrong ones), because priorities and relative values are
not reducible to certainly. Should parents have priority over single adults?
Are teachers essential or only good teachers? Elected officials? Citizens
over illegal residents? Artists over athletes? Lawyers over truck drivers?
Clergy over sex workers?

Yes, I was waiting for this one.

That doesn’t mean I am looking forward to it.

[Andrew B. Chung, MD/PhD]

MichaelE wrote:

> http://ethicsalarms.com/2020/09/23/an-old-ethics-dilemma-with-no-solution/
>
> On Distributing The Wuhan Vaccine: An Old Ethics Dilemma With No Solution
> SEPTEMBER 23, 2020 / JACK MARSHALL
>
>
> I was waiting for this one.
>
> Back when ventilators were the rage (before we found out that once you were
> on a ventilator, you were pretty much toast anyway–Science!), I had filed an

(ventilators remain the "rage" for severe COVID-19 where around 70%
survive versus 0% without vent support)

> article about the likelihood that Down Syndrome sufferers would be deemed
> unworthy of high priority when scarce equipment was being rationed. I never
> got around to writing about it, but I knew, like the giant swan in
> “Lohengrin,” the issue would be sailing by again. Sure enough, as the
> prospect of a Wuhan virus vaccine seems within view, the same basic question
> is being raised: if there aren’t enough vaccines for everyone, who gets the
> first shot (pun intended)?

The purpose of vaccines during a pandemic is to stop the pandemic by
mass vaccination, which means that from the outset the plan has been
and still is to have enough vaccines for everyone. Short of that would
mean failure to stop the pandemic.

The "basic question" is not "who gets the vaccine" but rather "what
percentage of the global population will be vaccinated." If the answer
to the latter question is less than 70%, then the effort is doomed to
fail even with the most effective of vaccines.

The more important question is whether ongoing phase III trials will
yield a vaccine(s) that is more than 70% effective (i.e. better than
cloth face-masks) in preventing infection by **all** the strains of
the COVID-19 coronavirus (i.e. not just the original Wuhan strain but
also the more prevalent Euro-American strain and other lesser strains)
for the amount of time it will take to complete the mass vaccination
of the world's population. If the answer to the latter question is
"no" then the vaccine(s) will not stop this pandemic even if 100%
vaccination is achieved.

Moreover, there is no historical precedent for vaccines ever stopping
a pandemic. What has stopped pandemics in the past are the public
health and epidemiological measures currently being undertaken.

The only **healthy** way to possibly stop this COVID-19 pandemic
earlier than conventional public health and epidemiological measures
would otherwise allow is our redoubling our efforts to rapidly find
out at any given moment, including while on-line, who among us are
unwittingly contagious (i.e. pre-symptomatic or asymptomatic), in
order to convince them to call their doctor and to self-quarantine per
their doctor.

Indeed, I am wonderfully hungry ( http://bit.ly/RapidTestCOVID-19 )
and hope you, Michael, also have a healthy appetite too.

So how are you ?










...because we mindfully choose to openly care with our heart,

HeartDoc Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist with an http://bit.ly/EternalMedicalLicense
2016 & upwards non-partisan candidate for U.S. President:
http://bit.ly/WonderfullyHungryPresident
and author of the 2PD-OMER Approach:
http://bit.ly/HeartDocAndrewCare
which is the only **healthy** cure for the U.S. healthcare crisis

[Michael Ejercito]

On Thursday, September 24, 2020 at 8:31:32 AM UTC-7, Andrew B. Chung, MD/PhD
wrote:

I am wonderfully hungry!


Michael

[Andrew B. Chung, MD/PhD]

MichaelE wrote:

While wonderfully hungry in the Holy Spirit, Who causes (Deuteronomy
8:3) us to hunger, I note that you, Michael, not only don't have
COVID-19 but are rapture (Luke 17:37) ready and pray (2 Chronicles
7:14) that our Everlasting (Isaiah 9:6) Father in Heaven continues to
give us "much more" (Luke 11:13) Holy Spirit (Galatians 5:22-23) so
that we'd have much more of His Help to always say/write that we're
"wonderfully hungry" in **all** ways including especially caring to
http://bit.ly/ConvinceItForward (John 15:12 as shown by
http://bit.ly/RapidTestCOVID-19 ) with all glory (
http://bit.ly/Psalm117_ ) to GOD (aka HaShem, Elohim, Abba, DEO), in
the name (John 16:23) of LORD Jesus Christ of Nazareth. Amen.

Laus DEO !

Be hungrier, which really is wonderfully healthier especially for
diabetics and other heart disease patients:

http://bit.ly/HeartDocAndrewToutsHunger (Luke 6:21a) with all glory to
GOD, Who causes us to hunger (Deuteronomy 8:3) when He blesses us
right now (Luke 6:21a) thereby removing the http://bit.ly/HeartVAT
from around the heart