I was waiting for this one.

Back when ventilators were the rage (before we found out that once you were on a ventilator, you were pretty much toast anyway–Science!), I had filed an article about the likelihood that Down Syndrome sufferers would be deemed unworthy of high priority when scarce equipment was being rationed. I never got around to writing about it, but I knew, like the giant swan in “Lohengrin,” the issue would be sailing by again. Sure enough, as the prospect of a Wuhan virus vaccine seems within view, the same basic question is being raised: if there aren’t enough vaccines for everyone, who gets the first shot  (pun intended)?

Well, there is no right answer to this one, unfortunately. All debates on the topic will become that popular game show, “Pick Your Favorite Ethical System!” or its successful spin-off, “What’s Fair Anyway?” That’s fun and all, but the debates are completely predictable.

The issue is essentially the same as the “meteor or asteroid about to hit the Earth” dilemma in movie like “Deep Impact,” where only a limited number of citizens can be sheltered as a potential extinction event looms. If you follow the Golden Rule or the John Rawls variation, you end up with survivors being chosen by lot, or pure chance. Kantian ethics also tends to reject any system that sacrifices one life for a “more valuable” one. Competent and rational public policy, however, has to take into consideration more factors than these over-simplified (and this appealing) ethical systems can.

Like it or not, a decision in the rationing of a vital resource problem has to come down to utilitarianism, or balancing. That means winners and losers, and the losers in such decisions always feel that the winners being favored is unfair. From their perspective, they are right. Policymakers, however, have a duty to society as a whole, and the long-term best interests of the whole population. Being human, they also have biases, and how they weigh the various factors involved in balancing interests inevitably is affected by their own agendas.

If the job of determining who got the vaccine first was delegated to Black Lives Matters, how do you think it would approach the problem? Continue reading →