Weighted Lotteries for the Allocation of Scarce Covid Vaccines and Medicines
New in the Hastings Center Report
Many different considerations—including a person’s occupation, membership in a disadvantaged group, and potential benefit from a particular drug—are relevant in ethically allocating scarce Covid-19 vaccines and medications. But how should these various factors be balanced with one another? A new article in the Hastings Center Report proposes a model using a weighted lottery, a construct that has been used in other contexts that involve distributing scarce resources. The basic idea is to assign greater weight to certain factors when determining who gets priority for an intervention. How to set the weights for the lottery? For the process to be fair, the article concludes, the discussion should include a range of parties—"hospitals or health care administrators, clinicians, nurses, medical ethicists, infectious disease experts, patient advocates, community leaders, and representatives from groups that have suffered from health care disparities.” Read the Hastings Center Report article.
In the Media: Ethical Line-Jumping; Challenges of Vaccinating Rural Residents and Minority Groups
States may include nonmedical volunteers at Covid vaccination sites in groups of workers eligible for vaccination, even if they’re young and healthy. Hastings Center research scholar Nancy Berlinger told AP that prioritizing these workers for vaccination is ethically appropriate because of the risks associated with this essential work, which often involves long indoor shifts. “There would be easier ways to game the system” than volunteering at a vaccination site, she said. “The volunteers we’re talking about at registration centers are people who are part of the public health effort. They are performing a crucial role.” Read the AP article.
In an interview with Politico, Berlinger discussed the challenges of vaccinating people in rural areas, even when a region has an adequate supply of Covid vaccines. Rural residents “have less reliable access to health care” due to closures of rural hospitals and “they tend to be undervaccinated” as a population for reasons not limited to health care access. Read the Politico article.
Berlinger praised federal efforts to improve equitable vaccination access for minority populations by partnering with federally qualified health centers. “They’re very focused on patients having a medical home, that this is a trustworthy place where you’re going to see the same doctors and the nurses and social workers and you can come to them with issues in your life,” she told Roll Call. “They’re very used to doing community outreach in many languages.” Read the Roll Call article.
From Hastings Bioethics Forum: Undocumented Immigrants and Covid Vaccination; Why We Need a Covid-19 Commission
Undocumented immigrants constitute nearly 5% of the U.S. labor force and play a critical role in the economy. “This medically vulnerable population . . . should be protected from deportation or other negative consequences when they are in the process of being vaccinated for Covid-19,” write Hastings Center fellow Mark A. Rothstein, of University of Louisville School of Medicine, and Christine N. Coughlin, of Wake Forest University. Read “Undocumented Immigrants and Covid-19 Vaccination.”
Congress recently announced plans for an independent commission to investigate the facts and causes of the January 6 insurrection at the U.S. Capitol, modeled after the 9/11 Commission. We also need a Covid-19 commission to “help untangle the scope and role government-sanctioned misinformation played in the U.S. death toll from the pandemic,” write M. Sara Rosenthal, of the University of Kentucky, and Hastings Center fellow Arthur Caplan, of NYU. Read “Why We Need a Covid-19 Commission.”
Upcoming Events
"Which Public, What Comments? An Analysis of Public Comments on Human-Animal Chimera Research Submitted to the National Institutes of Health." Project managers/research assistants Isabel Bolo and Ben Wills will discuss oversight of human-animal chimera research: views of scientists, researchers, oversight committees, and the public at the ELSI Conversations, March 19, 12pm EST.
"Binocularity: A Conceptual Tool for Comprehending and Respecting Persons." Senior research scholar Erik Parens will be presenting as part of the Montreal Health Ethics Conference Series 2021: Wellness, health, and human flourishing. May 27, 12pm EST.
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