Although I will most likely go down in winter forum history as the girl that would readily kill her “65 year old retired grandpa over a ‘more useful and potentially productive’ 5 year old,” the entire discussion on rationing and dictating who receives vaccines (and in a sense who determines who lives or dies) was very eye-opening. Doctors have long been said to have “God complexes” and criticized for this mentality. However today when you think of it, we were indeed playing the role of a higher power who had to dictate who was worthy of living. It was easy to laugh some of the comments off at the forum in order to take some of the weight from our shoulders. However, when we went into our breakout sessions we soon learned that being put into this decision is certainly stressful and I left the room with my head spinning, doubting whether I knew what criteria for selection was most important to me personally. The easy way out, would just be to give up and pray and hope for the best. However I think it is crucial, with each day new strains of viruses and spread being aided through the growth of infrastructure and commerce, the chances of another pandemic breaking out is likely. I also think it is important to put these measures in place because (just as Dr. Rosoff touched on a little through questions) in the end the people who end up having to make tough decisions (like in the case of Hurricane Katrina as he also spoke about) may be held accountable when the “wrong people are picked” or when socially unacceptable or pleasant decisions are made. Although it doesn’t sound pleasant, but I feel in the case of a pandemic there must be an acceptable loss of life and that we must set up a better system of who receives vaccines. If not, everyone loses in the end. Just some of the many thoughts that were swirling around up in my head.
Dr. Philip Rosoff, eloquently spoke about the ethical and moral obligation to provide palliative care for victims from the “pandemic”. However, he cautions that this isn’t an endorsement of euthanasia.
How do you think the one can decide how to prioritize between the treating survivors and those expected to die? How does the Hippocratic Oath (i.e. do no harm) conflict with palliative care and euthanasia?
Dr. Wald brings up the major issues of what determinants should be used to choose the recipients of a limited supply of vaccine.
How can we avoid racism, ageism, economism, among other potential bias in the measure systems?
What is the most socially just way?
The WHO Constitution states “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…” Health has become a near universal belief, but there remains a disproportionate fraction of individuals who are neglected when health services are not delivered in a fair and just manner.
What is a human right and how does health fit in that framework?
What is it about healthcare that makes it a moral and social obligation to individuals and how do we know that we have went past that limit?
What are the limits to the rights?
Or would you consider healthcare to NOT be a universal human right?
Dr. Broverman leads a spirited discussion in a resource scarce setting (i.e. low amount of vaccine) who should get this life saving treatment? What criteria could be used? What should one use? Who should make these decisions?