Ethics case study 1: What does fair mean when distributing treatment for a pandemic?

Ethical decision to be made: A vaccine distribution plan must be developed where the number of needed vaccinations significantly exceeds the supply. 

Link to worksheet

Background:

• You are the public health official for a country of approximately 360,000 people.
• Due to personal privacy and census information limitations, there is uncertainty in the demographic information.
• The chart below provides the most comprehensive overview until the next census. Recognize the limitation here that individual citizens may be counted in more than one category listed below.
• Nevertheless you are responsible for developing an initial 6 month schedule to allocate vaccines to the citizens.
• Only one pharmaceutical company has an approved vaccination.
• Currently it can produce 100 vials of vaccine per day.
• It will take greater than 12 months before another vaccine production facility comes online to manufacturer the vaccination.
• The country's public health department provided you the following information and bar chart of key demographic values that you will use to allocate the vaccine.
• People over the age of 70 years old are twice as likely to die from the virus.
• Financially poor people are at high risk of contracting the virus due to living conditions.
• Agricultural workers are needed to provide food to the population.
• Medical professionals and Emergency workers are needed to care for both pandemic and non-pandemic patients.
• Military personnel are critical to protect against aggressive neighboring countries.

Analysis questions:

• If 100 vials of vaccine are produced each day, how many vials are available each month?
• How many months are required to vaccinate the entire population?

Ethical decision-making process:

• What are the ethical issues? What does not feel right?
• What are the relevant facts? Is anything missing or distorted?
• Who are the stakeholders? What are their influence on the situation?
• What are the situational factors?
• What are the values in conflict?
• How do the ethical frameworks apply? Is anyone/any group not acting with virtue? Are any ethical rules being violated? How would the most benefit to the largest number of people be achieved? Should only people be considered?
• What are possible solutions? What are the consequences? What must be monitored in the future?
• What was your final solution and justification?
• As  you think through this, make a note of the unanswered questions you would like to receive answers to.
• Make a note of any demographic details you would recommend the country begin collecting in order to aid in responding to future public health emergencies?

Implement your solution:

• Complete the table below that will determine how to ration the vaccine to the citizens.