In late July, Sarah Zhang published an article on The Atlanticthat detailed the many infrastructural shortcomings of the United States’ handling of the novel Corona Virus. Simple preventative measures, like mask wearing and social distancing, have been met with strong pushback from particular groups, claiming that these preventative measures are an attack on their liberties. We observe much of the mishandling through the lens of media platforms, but many of the negative implications of the virus fall into the complex web of institutional misprioritization of American lives. These misgivings in the hierarchal prioritization of handling the virus are well explained in Zhang’s article. As the attention of the general public is directed toward a vaccine as a solution to the pandemic, conversations of ethical distribution must be had to ensure the welfare of the American people. Personally, I would take on the framework of distribution through a utilitarian lens. Utilitarianism seeks the greatest benefit for the most amount of people, which, to me, serves as a good ethical base point to maneuver the intricate complications associated with the virus. Testing and vaccination should be provided at a rate conditional with the amount of exposure and cases that populations face, to ensure the greatest level of care. Underfunded communities with inevitably more potential contact points with the virus should be accommodated for. Currently, we observe affluence and access to capital to be a contributing factor to access to testing and care, which inherently takes resources away from many of the groups that need them the most. In the distribution of the vaccine, I suggest that we must insure a proportionally and equitably sound approach, so that the most people can benefit from the potential cure to the pandemic. At-risk groups, like healthcare and essential workers, should be afforded the vaccine at a prioritized rate, so as to slow the overall spread of the virus while maintaining the businesses that keep us fed and healthy. What we’ve seen in the past in access to testing, and even through the evaluation of previous diseases, is that the best care is afforded to affluent groups. Groups who exist on the wealthier side of the socio-economic infrastructure have had better access to care and preventative measures than those in low income communities. From a utilitarian perspective, the trope of allocating the best resources and prioritizing vaccination for these groups is seen as unethical, and something we should push back against if and when it comes to be the case.
Category Archives: COVID-19 Vaccine
The Politics of COVID-19 and the Race for a Vaccine
Earlier this summer, when the coronavirus was finally being accepted as our new reality, and media politicians and prominent government figures were attempting to debunk the seriousness of the virus, an article by Sarah Zhang, entitled “A Vaccine Reality Check” was published in the Atlantic. Within this article, Zhang describes the then current climate of COVID-19 and the responses it was garnering from all sides. Most importantly, she dove into the ethical issues that these sides were battling with and gave her perspective on the matter.
Furthermore, Zhang begins by telling readers the reality-a COVID-19 vaccine will not be arriving soon, especially not in October, which was predicted. This destruction of false hope is essential in all crisis scenarios because although it may decrease one’s will, it is an opportunity to help someone realize the reality of a situation and prepare for it. The fact of the matter is that the world has never seen anything like COVID-19. In addition, since every science laboratory in the world is working on a vaccine, resources are already scarce, and the competition to monetize this vaccine is unprecedented.
However, regardless of these harsh realities, what matters most is that a vaccine is being developed around the world. Yet, one of the other issues highlighted by Chang is the prioritization of vaccination. Zhang recalls the protocol used back in 2009 when the H1N1 vaccine was being developed and was rolling out. It was essential that people received the vaccine in waves since they were not all in the same risk-of-contraction category. This is also true for the rolling out of the the COVID-19 vaccine since, as we’ve seen for months, the virus attacks people differently due to their age and health history.
Lastly, the political aspect of COVID-19 is discussed in every paragraph of this op-ed, and with every month since its release, it is clear that politics have played a major role in the reception of COVID-19 as a global pandemic. Although Zhang spoke on the terrible deceptions presented by President Trump, it is important to note what she said about the CDC being awfully quiet during these times. This was notable to be because in another class we learned about the CDC’s political affiliations and how those have influenced their decisions to talk about the virus and the cases associated with it. All in all, this virus is starting to expose the U.S, of not actually being 100% about the people, but more so about the people with much more power above and their financial interests. Essentially, these times have been a reminder that “cash rules everything around us” and propaganda is willing to be spewed in order to protect the flow of cash throughout the economy and so much more. This brings us back full-circle to the questions raised in Zhang’s article, who will get to control the COVID-19 vaccine? Will it be affordable and readily available? Why is such an important vaccine for the world being valued more for its monetary benefits compared to its health benefits for the globe? These are questions that make us question the intentions of those in power around the world.
A Rawlsian Analysis of the COVID-19 Vaccine
In “A Vaccine Reality Check,” writer Sarah Zhang provides a thorough exegesis on the current stage of the Coronavirus Vaccine, while using a complex array of historical precedents and contemporary analyses to examine the effectiveness and distribution of the vaccine. To briefly lay out the major points within the article, she examines the definition of a vaccine in general, elaborates on their implementation with respiratory illness, speaks on the specific development of various COVID vaccines, and examines the political implications of these developments. While these points clearly provide valuable insight into this issue, especially with the election nearing, I found the ethical dilemmas and theories that dictate the narrative within the article to be vastly more fascinating.
With regards to development specifically, the question of ownership begins to govern how society views medical innovation: is it proprietary or collective? Zhang describes how the Trump Administration is encouraging many vaccine makers to invest in infrastructure and manufacturing systems to already prepare for FDA approval of the vaccine; while this may decrease the lag time between approval and availability, it raises the question of power imbalance in ownership once the vaccine is created. The two struggles are constantly at odds: the dichotomy between serving the public good by making these vaccines extremely affordable and the profit incentives for these companies to continue investing in manufacturing and infrastructure. If the medicine becomes specifically proprietary, then that allows companies to prioritize profits over public safety, but if the incentive of profit is removed, it reduces the economic interest of companies to invest in the first place. This ties back heavily to not only the ethical concept of ownership, but also to the essential idea of value-ordering. This will dictate how companies will act. In my opinion, a nuanced solution to this issue is a bit more free-market based. Instead of mandating companies to act a certain way, which I believe will largely de-incentivize their involvement to begin with, I believe the government should provide more market incentives for companies that make the vaccine more affordable. This may involve certain subsidies, but it will be more conducive to creating an economic equilibrium that also expedites the production of the vaccine. I strongly believe ethical principles should apply to institutions as well, because institutions are, in essence, a collective of individuals. Therefore, in respecting the autonomy of these collectives, I believe even more stringent government mandates would be a breach in the moral sense as well. Viewing pharmaceutical companies this way allows society to humanize them, and from that point, extrapolate a more nuanced solution.
In terms of distribution of the vaccine, I could largely extrapolate ethical subtexts of utility and societal responsibility. The question then revolves around who receives the vaccines first, or at all. Zhang specifically describes a tactic used in 2009, in which states and hospitals used a system of priority status to determine high-risk individuals such as health care workers to get the vaccine first, in order to save the most lives. I felt uncertain about prescribing priority to anyone during a public health crisis, but I also realized that people must be prioritized due to medical scarcity and developmental struggle. So the ethical question shifted: how do we decide who gets the vaccine first? This intrinsic dilemma draws back on two central ethical tools from our study of John Rawls. The first dictates action, and the second prescribes it. This dilemma can be examined through the difference principle, or alternative distributive justice. Essentially, Rawls prescribes that it is okay, and at times expedient, for communities to stray from strict equality, as long as the lower echelons of society are better off than they would be under strict equality. Using this perspective, it makes sense that healthcare workers and high risk individuals would receive the vaccines first, because if strict equality was imposed, the scarcity that ensued would induce a distribution that would not benefit the lowest echelons of society. Saving the lives of healthcare workers, specifically in minority and underprivileged communities, directly helps save more lives, so the lowest strata are lifted up as well with this system of priority status. The second Rawlsian tool that would be most helpful with distribution is the Veil of Ignorance. While improbable, encouraging interest groups and various identities to examine how they would want this vaccine distributed if they did not know their medical details (i.e. age, predisposition, compromised immunity) would allow societies to determine who should receive the vaccine first.
The article also evoked certain personal dilemmas from me. Zhang mentions that this virus can be used politically and the vaccine is no different. She also mentions the ensuing storm of misinformation and politicking that will follow. So I pondered how I could be helpful in a situation like this, and the most immediate solution that came to mind was voting. In exercising my constitutional right, I am not only electing a leader for the country, but also a global physician in a way. The next president will determine how the virus and the vaccine is handled, and it is an extremely important choice. I also wondered how this issue would play into systemic inequalities in the modern American paradigm. Having just finished The Immortal Life, I wondered how historically marginalized groups, Black Americans in particular would be affected by an improper distribution strategy. These questions only led me back to my first realization: it is extremely important that the will of the people is pronounced on Tuesday. In a moment of historic proportions, democracy is all we can look to for answers.
COVID Vaccine: A Matter of Trust
Since the COVID-19 pandemic began almost nine months ago, people around the world have been begging for an answer to the same question: when will a vaccine be developed so we can return to our normal lives? As numerous companies begin to claim they are close to developing working vaccines, many are starting to feel hopeful about this “return to normal.” However, in an article published in July in The Atlantic, Sarah Zhang suggests that we may be asking all the wrong questions about this vaccine.
Zhang points out that just because a vaccine is developed, our lives won’t go back to how they were before COVID immediately. It’s likely the vaccine will require more than one dose to be effective, making distribution a major complication. Additionally, many Americans have already stated that they are unwilling or unsure about whether or not they would choose to receive the vaccine.
To me, this brings about a very important question of trust: at what point should we all feel comfortable getting vaccinated? Who should we trust for the most accurate information about the safety and effectiveness of such a vaccine? The entire pandemic has become extremely politicized, and many people feel a great level of distrust towards our current leadership, consequently saying that they wouldn’t get the vaccine if President Trump told them it was safe: they’d prefer to hear it from a doctor. While those feelings are valid, I don’t think they should change depending on who is in office.
Politicians and physicians are two completely different occupations, and the line between them has been blurred to a point that could be detrimental for many Americans. There is a tremendous safety risk in taking medical advice from a politician, whether it be one you agree with on other issues or not. This is not the job they have been trained or elected to do. For any medical issue, especially one on this large of a scale, nobody should be taking any COVID vaccine until it’s been approved by medical experts. Politicians encouraging people to take vaccines not backed by medical professionals is a violation of informed consent. By using their power and influence over citizens who are otherwise uninformed on the subject, these politicians have the means to convince people to receive a vaccine that has not been proven as safe.
As we get closer and closer to finding a vaccine, it’s important to decide where the line can be drawn: at what point in time can we feel safe receiving brand-new medicines like this vaccine? Who can we fully trust to give us the most accurate information regarding the vaccine’s safety? Should government leaders be able to declare a vaccine as “safe” with no formal medical training?
Spread of misinformation and the politicization of the COVID pandemic
More than seven months into the current COVID pandemic, a number of ethical concerns have been and are still in the process of being disputed. Some of the most substantial debates have been about the politicization of public health issues, the spread of misinformation, and personal autonomy vs duty. These ethical issues have only become more pressing with hope for a vaccine just on the horizon.
First, the politicization of COVID has also led to widespread misinformation, not only about the effectiveness of mask and social distancing guidelines, but also on the speed at which a vaccine will be available to the public. In order to keep people optimistic, the national government has put a huge emphasis on speed of production. However, with worries of speed potentially causing errors in a process that usually takes years, some pharmaceutical companies have pushed back against claims of a vaccine that will be widely available in a month’s time. The ethical debate, then, is whether it is worth withholding factual information from the public for the sake of keeping spirits high. Based on Kant’s Categorical Imperative, the act of lying is always bad in and of itself because it could not become a universal law. In the long run, such misinformation and/or a botched rollout of the vaccine could cause the public to lose trust in the national government and public-health experts, making it even more difficult to distribute vaccines in future epidemics/pandemics.
Additionally, the debate of personal autonomy vs duty will continue to be relevant with a COVID vaccination. Currently, this debate mostly surrounds mask-wearing and social distancing guidelines. Scientific experts across the world have encouraged such measures, but because concepts of individual freedom are so instilled in the current American system, these measures have not been nationally enforced and therefore, many refuse to follow the suggested guidelines. However, I think it’s important to recognize that one’s rights are only justifiable insofar as they do not infringe upon another’s rights. Because it is scientifically proven that widespread wearing of a mask and social distancing significantly reduces spread, not taking these precautions under the justification of individual autonomy essentially infringes on others’ rights to life, which is why it is so dangerous for public health issues like this to be politicized. Similarly, in the context of a vaccine, many Americans will refuse to even receive the vaccine, so the question becomes: should receiving a vaccine be up to one’s discretion, or is it one’s duty to receive a vaccine, not only for themselves but also for prevention of spread to the rest of society? And more generally, are there situations in which individual autonomy should not be upheld, and if so, where is the line drawn?
CoVid Vaccine: Ethical dilemmas at every step
It’s surreal reading Sarah Zhang’s article on CoVid from 3 months ago – you can feel the frustration and angst in her tone , which is a reflection of how most Americans were feeling at the time. As we approach November, ushering us into the ninth month of the ongoing pandemic, there’s much less hope despite the prospect of a vaccine. The CDC is absent. Federal and state administrations are persistently inept – the upcoming election only exacerbates this fact. There’s just an overarching sense of somber acceptance that to outlast the pandemic, we must accept ethical compromises and I doubt vaccine distribution will be the exception to these sentiments.
Much like the approval of early faulty Covid testing material (resulting in a significant amount of false negatives and thus continued spread of the virus), rushing the process of medical equipment like a vaccine through the Trail 3 phase has a high chance of bringing as much harm as good, our best-case scenario is to have the vaccine be effective in merely 50% of those it is given to, but we as a country have made the ethical compromise to prioritize immediate chance over gradual certainty.
In prioritizing chance we have decided we need tens of thousands of research volunteers to create this vaccine. This presents one of the most challenging ethical dilemmas of all: selecting individuals who are likely to be exposed to and heavily affected by the virus. Many of these individuals are essential workers that work lower-wage jobs (delivery persons, grocery clerks, teachers, restaurant servers) who have continued to work through the pandemic as a means to stay financially afloat and individuals who are at high risks such as elderly people and those with pre-existing conditions. To even obtain a vaccine, we are essentially asking the most vulnerable populations to “take one for the team” and risk their lives for the betterment of the majority healthy and financially stable population. It’s especially heinous that many studies are targeting lower-income areas with the incentive of financial compensation, creating the equivalent of an economic Covid research draft.
And so we find ourselves at the most recent prompt of ethical compromise: who gets the vaccine and when? Since these communities are the ones being targeted, do they not deserve first priority when a vaccine is approved as reparation for their continued sacrifices throughout the pandemic? Were these not the citizens that helped the US function while the rest of us patiently waited safely inside our homes – how can they be “at-risk” enough to be guinea pigs but not “at risk” enough to be taken care of?
Zhang points out that providing vaccines to these communities has been an idea spread amongst professionals but that confusion of authority has delayed any sort of substantial distribution plans. I have to agree with her that the “vaccination program is likely to take place against a backdrop of partisanship and misinformation” and that’s a prediction from months ago. Resources are finite and its well known that the vaccine distribution will receive critique from every angle but in my opinion, and perhaps because I am partial towards the ethics of care and considering how this virus has disproportionately effected various communities, we should be prioritizing those that have been caring for us for the past nine months. We may not fully know who will get it right at the beginning but its very clear who should be recieving it last: all of us sitting at home waiting for a solution.
The Hierarchy of Priority
“A COVID-19 Vaccine Reality Check,” is an article recently published in The Atlantic by Sarah Zhang. In this article, Zhang looks at the current COVID-19 vaccine development that is taking place as well as the distribution plans to the public that are currently being assessed. Elements that most of the public is not involved in or that does not cross their minds. Zhang makes it evident that just because there is a high requirement for the vaccine due to the casualties, it does not change the fact that the vaccine needs to be rigorously tested before it can be mass-produced to try and save the lives of thousands. Despite the media giving regular updates claiming that the vaccine could be here as early as next month, Zhang believes it is going to be much longer. As well as this, Zhang creates a large ethical issue relating to the distribution of the vaccine, which is; who is given the vaccine first? When produced, it is still going to take time for the vaccine to be produced in numbers large enough that everyone is going to be able to receive it. Personally, when I think about this issue, I would look to a more logical and utilitarian method for distribution.
Taking this logical and utilitarian view on this issue, the best method would be to save the most lives possible and give to those that have the highest risk of contracting the virus. This would be the best possible scenario. In this case, those working on the frontlines as medical workers would be prioritized first. They are currently in the most danger by working with those who have COVID-19 every day, and because of their bravery and hard work, they should receive the safety of a vaccine first. This fits the utilitarian viewpoint as the person at higher risk has been saved first, and so the risk of life loss has decreased. This seems to be the most logical idea. Alongside this, the medical worker group fighting on the frontlines is not a large group of people meaning that the likelihood of being able to vaccinate all is high and even the possibility of still having vaccines left is also high. It seems simple for now.
Still keeping this utilitarian viewpoint, the next stage of distribution would be to give the vaccine to the group of people who are the most vulnerable of the rest. This would include those with underlying health conditions as well as the very young and old members of our society. Through research, it has proved that those groups have the highest percentage fatality rates from COVID-19; therefore, it is those whom we must protect next. From a purely utilitarian viewpoint, this argues stands, however, some arguments can arise when it comes to vaccinating the older generations. Due to the limited supply of vaccine, we must use them wisely – some research has been published that indicates that many of those older people dying of COVID-19 already had a high chance of dying through other causes by the end of 2020. Because of this research, some have argued that it is not worth vaccinating these people as they still have a high chance of dying soon after administration and so the vaccine could have been put to good elsewhere. This is extremely difficult to decide, though, as it based primarily on statistics.
The real issues, however, arises after these two groups have received the vaccine. Who should receive it next? It comes down to a decision between teenagers and the middle-aged—research proving that neither is at a very high risk of dying from COVID-19. As a 19-year-old, I feel confident in being able to fight the virus and opt for vaccinating the middle-aged first; however; some disagree with my viewpoint as they are less confident in their safety. On top of this should the vaccine be mandatory for all or are people allowed to choose whether they want it at all. This comes back to the anti-vax arguments. This distribution of the vaccine is a complicated matter from an ethical standpoint as to who gets it first due to the limited supply. It appears to be more subjective than objective. How safe do you feel without one? If given the opportunity to be vaccinated over someone at higher risk would you take it? What is your hierarchy of priority?
COVID-19 Vaccine: Distributional and Paternalistic Methods
In Sarah Zhang’s article, “A COVID-19 Vaccine Reality Check” in The Atlantic, she addresses the false hopes that the coronavirus vaccine is providing for America. She argues her case by stating America’s H1N1 vaccine procedures and how the coronavirus differs immensely. For example, the dosage is a two-step process and the uncertainty revolving around the coronavirus has yet to slow down. However, there are key similarities that, with ethical modification, America should implement. It is crystal clear that distribution will be an extremely complicated, particular process. America, as a whole, failed to address resource scarcity in the early stages of the pandemic, running out of masks and ventilators within weeks. While our focus must now shift towards a vaccine, keeping Zhang’s article and resource scarcity in mind, questions of what ethical practices that are justifiable must be put into place. I believe that America should take a modified, general utilitarian approach to distribution and heavily consider mandating the vaccine to a certain extent.
By taking the utilitarian approach to distribution, the allocation of resources will be properly addressed while respecting ethical practice. Zhang mentions the prioritization of certain groups of people as a successful procedure used during the 2009 H1N1 virus. This could be swiftly and effectively replicated for the coronavirus vaccine. The first group of people to be vaccinated and have priority should be healthcare workers, researchers, and officials on the frontlines of this pandemic. By vaccinating this group of people, we are adhering to the utilitarian perspective: a maximization of benefit and “good” produced in our society. These healthcare warriors could then devote their time and effort to save patients with great health, which is proven to increase productivity by economist Robert Fogel, and not have the preconditioned danger of receiving the virus. Furthermore, this group is fairly small with humongous value. With this method, we are still keeping in mind the scarcity of the vaccine.
To streamline the process of distribution along, the people most vulnerable to the virus should receive vaccinations after healthcare workers. This would mainly include those with underlying health conditions and older adults in America: those who can truly not function “normally” due to the virus in their lives. Once again, we are adhering to the utilitarian perspective by decreasing the danger and effectiveness of the virus by protecting those most vulnerable. Thus, producing the most good and benefit by decreasing the threat that the COVID-19 virus possesses in America. This is also fairly similar to the normal function philosopher Norman Daniels stated while addressing the right to healthcare. However, this method becomes problematic after the first two prioritized groups: as it is extremely difficult to determine whose lives have been affected the most by this virus.
Alongside questioning distribution methods, paternalism through the law (mandating the vaccine) could be justifiable to a certain extent and must be discussed. For example, if a healthcare worker or person with underlying health issues were, to hypothetically, deny the vaccine, should they still be able to work? Should we respect their autonomous decision? A golden rule when referring to paternalism in medicine is that overriding and/or restricting one’s autonomy is just if it is necessary to protect others in society. Refusing the vaccine is not only putting yourself in danger but putting others at risk that may be tremendously vulnerable to the coronavirus. To protect some autonomy, vaccines should be mandated to return to education at schools, the workplace, and other essential places. What is deemed to be an “essential place” is yet another complication to the hundreds of other logistical practices that must be addressed to successfully deliver the vaccine to the people.
The COVID-19 Veil of (Partial) Ignorance
Sarah Zhang’s piece, “A COVID-19 Vaccine Reality Check” examines the intricacies of vaccine research, development and distribution that are often overlooked by the general public. Zhang notes that this vaccine, currently being developed at record speed, will still take many more months of trials and necessary regulatory hurdles before it is cleared for universal use on the general population. Once the vaccine is deemed safe, public health officials will have to determine who gets the vaccine as limited doses become available. This will certainly lead to a shortage of supplies as the population rushes to get vaccinated. The ethical challenges that accompany dissemination of the vaccine can be examined through a lens of Rawls’ theories of distributive justice.
Though Rawls’ theory is rooted mostly in the abstract, his Veil of Ignorance has a somewhat tangible application in the case of the current pandemic, and his principles of justice can serve as a model for the type of national collaboration needed to rebuild our health and economy. The COVID-19 virus itself acts as a Partial Veil of Ignorance. Individuals are often acutely aware of their privilege or lack thereof, and this privilege can act as a shield from COVID-19. However, as has been evident with a recent COVID outbreak in the White House, the virus does not function strictly along the same socioeconomic or racial hierarchies. Individuals must then consider themselves at equal risk to get the virus and make decisions about the virus with that possibility in mind. This acts much like the Original Position, forcing individuals to choose a path under the assumption that they do not know where they will fall in society.
Rawls’ Difference principle provides a framework that could help with vaccine distribution and the greater challenge of ending the pandemic completely. The Difference principle, states that inequalities are acceptable as long as actions are taken to remedy these inequalities. As mentioned earlier, this virus may act indiscriminately, but people are put in positions based on inequalities that may change their chances of infection. In terms of vaccine distribution, an honest effort to remedy these inequalities would include getting the vaccine to groups who have been hit the hardest by the virus so that they have a better chance of fighting off the virus and limiting spread. “The committee, which is composed of outside experts, last met in late June, when they discussed prioritizing vaccines for health-care workers, the elderly, and those with underlying conditions. They also considered prioritizing vaccination by race, given the racial disparities in COVID-19 cases” (Zhang). This comparison to Rawls’ theory brings up questions of how these disadvantaged communities were put into this position in the first place, and brings up the other component to the Differences Principle, equal opportunity to office. In giving all individuals equal opportunity to office, would these social determinants of COVID have been alleviated or better identified? Can some of these structural inequalities be resolved so this country can battle future pandemics more equitably?
COVID-19 Vaccine Distribution: An Ethical Approach
America is and has been ethically and structurally unprepared for the Coronavirus pandemic. Practical shortcomings became clearly evident in the early days of the pandemic, on issues such as mask production. But as we move into the ‘late’ stages of the pandemic and everything is allocated to the possibility of a vaccine, even more infrastructural concerns are arising. Some of these are identified clearly in Sarah Zang’s article A Covid-19 Vaccine Reality Check: the complications relating to the vaccine are even more threatening. The complicated nature of the disease and the potential two-step nature of the vaccine threaten to throw the US healthcare distribution process into complete disarray. I believe that to organize this incredibly important ethical healthcare issue, we can apply ideals we have studied in this class- mainly, a combination of general Utilitarianism and Norman Daniel’s Normal Function models.
The utilitarian distributive approach– Sarah Zhang identifies in her article the method of ‘prioritization’ of distribution, where healthcare officials meet to decide which groups are a priority and therefore should receive the vaccine first. Zhang says this has been used before- in the 2009 H1N1 pandemic, a prioritization system was put in place with considerable success. However, I believe that this system needs to be modified to fit with the Covid crisis, and Utilitarianism theory can help. Utilitarianism, as we know, advocates maximum well-being for the maximum amount of people. Under this theory, I would strongly advocate priority immunization of groups who are actively fighting the pandemic, such as healthcare workers and researchers. This would result in them being able to devote maximum effort and time to caring for the sick and researching a vaccine without the fear of the disease itself. Therefore, by increasing their productivity, they in turn would produce the most good for society as a whole. They may not be the most numerous group, but their professions and actions will undoubtedly have the largest possible positive repercussions for our society in this pandemic. After these high-priority, society-affecting groups have been immunized, the distributive approach undoubtedly needs to focus on providing vaccination to those at risk. Yet as Zhang argues, there is endless discourse and speculation about ‘at-risk’ populations and who truly deserves the vaccine. It is because of this situation that I propose the use of the Normal Function model.
The Normal Function approach– To provide a quick summary of the normal function approach: Health philosopher Norman Daniels advocates that healthcare should be provided first to those who are not able to function ‘normally’ and achieve their goals (operating in a ‘red’ rather than normal ‘green’ zone). This could be almost flawlessly applied to this Covid vaccine distribution crisis. After the healthcare workers/other groups I identified above was immunized, the distributive professionals should use this model to identify groups that are operating out of their normal function range because of Covid. An example would be someone with a compromised immune system who cannot attend work and achieve goals because of fear of catching and dying from Covid. This person is operating out of their ‘green’ zone, and therefore that group needs to be designated as a priority. Do not prioritize groups that are not being directly pushed out of their green zone by Covid-19. Rinse and repeat. We have extensive knowledge of how Covid and similar viral diseases affect patients with pre-existing conditions that we didn’t have in the past. We need to use that knowledge to designate priority groups with the normal function model; streamlining the distributive process.
Although I believe this process would work, I do leave some questions after writing it. I wonder how officials would agree on the defining value zones that are critical to the normal-function theory? I also (sadly) wonder how we could balance utilitarianism with the ever-present diaspora of financial and lobbyist influence in the US, especially in the healthcare industry.
In conclusion, the Covid vaccine distribution process is undeniably technically and ethically complicated. The US administration was not adequately prepared for the structural difficulty of this complicated Covid crisis. However, in the lens of ethical distribution, I believe that by applying utilitarianism and the Normal function model to society, the distributive process would be immediately streamlined, allowing society to focus more on refining the technical aspects of the pandemic.