Ethics of Covid vaccine rollout and ventilator allocation, OK, Boomer, MD

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December 17, 2020


** Covid Vaccine Rollout
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Hastings Center Scholars Respond
To track Covid vaccine doses, the United States is deploying the IZ Gateway, a first-of-its kind system that allows interstate searches and entries and connects health records from institutions. But some vulnerable people may be excluded, says Hastings Center research scholar Diane Korngiebel in an interview with Quartz. “What about undocumented immigrants?” she said. These individuals may not want to participate for fear of being caught, and people experiencing homelessness may also avoid the system. “Regardless of how well IZ Gateway works as an exchange medium, it’s not going to solve any of the underlying healthcare disparities that we already have.” Read the Quartz article ([link removed]) .

Gig economy companies such as Uber, Lyft, and DoorDash have been advocating for their workers to have priority access to Covid vaccines, but establishing their place in line is only part of the challenge. Another is communication. In an interview with CNET, Hastings research scholar Nancy Berlinger said that getting information about the vaccine to gig workers is critical. “What would it take to reach people who do not have a traditional workspace and who are on the go all day?” she said. “The phone is really important.” She also said that public service announcements should play a role. Read the CNET article ([link removed]) .

Berlinger discussed the ethics of vaccination more directly in another interview, noting that the focus is on protecting the community as a whole—“community immunity,” especially for infants, people who have a compromised immune system, and other people who can’t be vaccinated. “It’s not just, ‘Well, what’s the right thing I should do for myself?’ It’s, ‘What are my responsibilities concerning how we live together in society?’” Read her interview in Sojourners ([link removed]) .



** OK, Boomer, MD: The Rights of Aging Physicians and the Health of Our Communities
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How do we balance the rights of aging physicians against the right of the public to competent health care? This version of a classic public health ethics dilemma is explored in the latest issue of the Hastings Center Report. Peer review has long been the standard mechanism for assessing physician competence, but it is subjective and too easily subverted. New options are needed. “A just system would include objective measurements with national standards for appropriate cognitive testing,” writes Tia Powell, a Hastings Center fellow and psychiatrist who directs the Montefiore Einstein Center for Bioethics. She concludes that physicians have an ethical obligation to protect the health of the public by acknowledging, assessing, and addressing the cognitive effects of aging on medical competence. Read the article ([link removed]) .


** As Covid Surges, Do Not Reallocate Personal Ventilators
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With the pandemic surging across the country, many hospitals facing crisis standards of care are confronting dilemmas about ventilator allocation. Multiple voices in the media and multiple state guidelines mention the possibility of reallocation—taking personal ventilators from people with disabilities and other chronic conditions and giving them to people with Covid-19. But “taking away someone’s personal ventilator is a direct assault on their bodily and social integrity,” write Hastings Center senior advisor Joel Michael Reynolds and co-authors in a recent article in Cambridge Quarterly of Heathcare Ethics. They conclude that personal ventilators should not be part of reallocation pools and that triage protocols should be immediately clarified to explicitly state that personal ventilators will be protected in all cases. Read the article
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The position against reallocation of personal ventilators was advocated in a Perspective essay published in May in the New England Journal of Medicine by Hastings Center president Mildred Solomon and Hastings fellows Matthew Wynia Lawrence Gostin. Read the NEJM article ([link removed]) .

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Upcoming Events
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Society of Christian Ethics, annual meeting. Hastings Center scholar Nancy Berlinger will speak on Immigrant Health and Christian Ethics ([link removed]) . January 6, 2021 at 7:30pm.

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The Hastings Center seeks to ensure responsible health and science policy and practice. We work to secure the wisest possible use of emerging technologies and fair, compassionate, and just health care for people across their lifespan.

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