Solved!! Ethical Issues (Vaccine)

It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 25% of the U.S. population. It is now crucial to determine an appropriate method to ensure coverage for 100% of the U.S. population, but how?

Instructions:

  1. Re-read the statement above and reflect on a possible solution.
  2. Examine the following theories below:
    1. Utilitarianism
    2. Rights-based
    3. Duty-based
    4. Justice-based
    5. Virtue-based
  3. Please answer the following question:

  1. Is there any combination of the above theories or another theory that would guide you to a more ethical solution for distribution and the right order of distribution?
  2.  
  3. Answer the questions as thoroughly and concisely as possible.
  4. Be sure to reference any works that you utilize in answering the questions (1 page Be sure that references are in APA format).

Expert A+ Answer

In vaccine distribution, especially the COVID-19 vaccine rollout, individuals seeking care would be the ones whose actions would be facility selection and be quantified in terms of how individuals perceive vaccine risk, distance traveled, and degree of service available at a chosen facility. The degree of service can be expressed in terms of facility congestion or a supply-demand ratio.Step-by-step explanation

1. Examine the following theories below:

a. Utilitarianism

This act is typically chosen because it can be projected to bring the greatest amount of happiness and alleviate the greatest amount of suffering to the most number of people. By distributing vaccines, it can best promote happiness and alleviate suffering in society as a whole. The idea is not who deserves to have the vaccination first, but who should get it to benefit society the most in the long run. The concept is counterintuitive: the ethical rationale for giving the vaccination first to those who will benefit the most is not for them, but because by helping them, it is also a means of helping society as a whole.

According to Giubilini, et al (2018), establishing the presence of a moral need to get vaccinated (both for adults and children) despite the minor contribution each vaccination can make to achieving herd immunity is critical since such a moral requirement would bolster the case for coercive vaccination regimes.

b. Rights-based

Human rights are valued at the national level when it comes to vaccine prioritizing. Human rights have been widely ignored in discussions on how to prioritize allocation within national vaccine programs, but an intersectional human-rights approach to COVID-19 vaccine priority is the most fair and effective method to handle the issue. 

An intersectional human rights prioritizing process would undoubtedly be more logistically complex and costly to implement than a system based on single criteria, and it would also likely be slower. However, because it considers socioeconomic determinants of health and the impact of structural inequalities, it is the ideal tool for dealing with overlapping vulnerabilities of deprivation and vulnerability to infection. More crucially, an intersectional approach recognizes and strives to address the disparities in community health, lending validity to the need for a reinvented fairer and just society in the aftermath of the catastrophe.

As a result, states must distribute the first vaccines based on (1) infection risk and severity of pre-existing diseases; (2) societal vulnerabilities; and (3) probable financial and social consequences of illness. A vaccine allocation strategy that is more consistent with international human rights law should ensure that vaccines are free at the point of service, give priority to the poorest, and be allocated in a transparent, participatory, and accountable prioritization process, in accordance with WHO guidelines on universal health coverage (Sekalala et al, 2021).

c. Duty-based

Despite the fact that individual vaccination does not have a major impact on vaccination coverage rates as well as in herd community, the individual moral obligation exists. Establishing the presence of a moral need to get vaccinated (both for adults and children) in spite of the minor contribution each vaccination can make to achieving herd immunity is critical since such a moral requirement would strengthen the case for coercive vaccination regimes. A collective moral commitment to achieve herd immunity is based on a notion of fairness in the distribution of the responsibilities that must be borne to achieve herd immunity.

Binagwaho, et al (2021) stated that in some nations, imbalance in local distribution remains a concern, with evident prejudice against minorities and a lack of logistical planning. Pharmaceutical companies should share their technology to increase supply and lower prices as we continue to distribute COVID-19 vaccines, governments should prioritize equitable distribution to the most at-risk in all countries, and low-income countries should strengthen their logistical capacity in preparation for mass vaccination campaigns.

d. Justice-based

Immunization programs are morally acceptable, and society has a vital responsibility to play in giving measles vaccination and maintaining herd immunity in order to maximize the capacities of its members. SInce preventative actions interfere with people who perceive themselves to be well, public health methods, as opposed to clinical advice, necessitate a degree of confidence about the benefits and possible adverse effects of an intervention.

Individual autonomy, a basic element in bioethics, frequently makes talks about ethical dilemmas in public health initiatives difficult and ineffective in terms of finding practical answers. In meetings aimed at disseminating vaccine information, discussions about risks tend to reduce the issue to a personal one: either the child gets measles or not, or is impacted by side effects or not.

Rhodes (2021) explained that COVID-19 vaccine allocation policies were put in place in early 2021, as soon as the vaccine became available. Those in charge of planning and implementing COVID-19 vaccine had to make decisions regarding who should be vaccinated first, while a number of authors provided their own suggestions. It focuses on the facts of the circumstance at hand to provide an account of how such decisions should be made.

e. Virtue-based

Virtue ethics has a long history, yet its use in health ethics has been limited in comparison to other major ethical theories. Its application to health policy and population-level issues has been virtually non-existent. Structures of virtue, a new concept in moral theology, has prompted ethicists to investigate how virtue ethics can complement existing frameworks in public health ethics.

Larkin (2021) pointed out that the ancient virtues of fortitude, prudence, temperance, and justice, as well as six more, have been recommended as cardinal virtues of emergency medicine:

(1) unwavering positive respect; (2) generosity; (3) compassion; (4) dependability; (5) attentiveness; and (6) agility. Humility, resilience, and teamwork are also essential in responding to a mass casualty catastrophe or epidemic. It is worth noting that virtue is not just the absence of vice.

2.  Is there any combination of the above theories or another theory that would guide you to a more ethical solution for distribution and the right order of distribution?

Answer: All theories stated are considered as many public health specialists believe that vaccines should be distributed based on need rather than nationality. Many global public health achievements, such as the elimination of smallpox and large decreases in other deadly illnesses like polio and measles, are due to vaccines. Vaccinations, on the other hand, have long been the subject of many ethical debates. The main ethical issues surrounding vaccination regulation, development, and usage are often divided into four categories: mandates, research and testing, informed consent, and access disparities.

Due to the initial limited supply, frontline health workers and uniformed employees are prioritized, since they are more likely to be exposed while on duty, and they must continue to do their tasks in both the public and private sectors. The notion of equity is used to prioritize vulnerable groups such as the elderly and the impoverished.

References

  • Binagwaho, A., Mathewos, K., & Davis, S. (2021). Equitable and Effective Distribution of the COVID-19 Vaccines – A Scientific and Moral Obligation. International journal of health policy and management, 10.34172/ijhpm.2021.49. Advance online publication. https://doi.org/10.34172/ijhpm.2021.49.
  • Giubilini, A., Douglas, T., & Savulescu, J. (2018). The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue. Medicine, health care, and philosophy21(4), 547-560. https://doi.org/10.1007/s11019-018-9829-y.
  • Larkin G. L. (2021). Caring in a time of COVID: the vaccine of virtue. European journal of emergency medicine : official journal of the European Society for Emergency Medicine28(2), 88-89. https://doi.org/10.1097/MEJ.0000000000000805.
  • Rhodes R. (2021). Justice in COVID-19 vaccine prioritisation: rethinking the approach. Journal of medical ethics47(9), 623-631. https://doi.org/10.1136/medethics-2020-107117.
  • Sekalala, S., Perehudoff, K., Parker, M., Forman, L., Rawson, B., & Smith, M. (2021). An intersectional human rights approach to prioritising access to COVID-19 vaccines. BMJ global health6(2), e004462. https://doi.org/10.1136/bmjgh-2020-004462.
  • WHO chief warns against “catastrophic moral failure” in COVID-19 vaccine access. (2021, January 18). UN News. https://news.un.org/en/story/2021/01/1082362.

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