Final Exam Review Flashcards
What should be the overall goal of pandemic response and preparedness according to LIVES?
other things being equal, it’s right to maximise the number of lives saved under given constraints.
What should be the overall goal of pandemic response and preparedness according to YEARS?
other things being equal, it’s right to maximise the number of life years saved under given constraints.
What should be the overall goal of pandemic response and preparedness according to FAIR?
other things being equal, it’s right to maximise the number of lives saved below a reasonable lifespan (R) or, given all lives below R being saved, it’s right to maximise the number of lives saved above R.
Order priority
who gets the resources first, who gets it next, and who gets it last.
Zero-sum priority
who gets the resources and who doesn’t get any resources.
Proportional priority
who gets more resources and who gets less.
Restrictive approach to LIVES
the closer and more relevant the health care resource under consideration is to the event of death, the tighter and more restrictive the definition of a priority group must be.
LIVES priorities for critical care (ventilators, ICU beds, ECMO)
frontline health care professionals are first priority; patients with greater chance of survival are second priority; and then essential workers exposed to the disease are third priority.
LIVES priorities for hospital beds
patients facing a high risk of death are first priority; and then very old patients are second priority.
LIVES priorities for antiviral drugs
frontline healthcare professionals are first priority; and then symptomatic patients facing an increased risk of severe conditions and death are second priority.
Two complications for antiviral drugs
priority between preventative care for higher-priority groups and treatment of symptomatic patients; and determining priority of pre-exposure and post exposure preventative care for essential workers.
LIVES priorities for vaccines
uninfected frontline health care professionals are first priority; uninfected people at an increased risk of severe conditions and death are second priority; and essential workers exposed to the disease are third priority.
Is it ever ethically defensible to ration healthcare resources based on vaccination status? (3 views)
- Desert-based view: yes, when unvaccinated people were reasonably expected to get vaccinated.
- Luck egalitarian view: yes, but not when ICU beds are unoccupied.
- Financial penalty view: not for critical care, but the unvaccinated must pay some financial price for not being vaccinated.
3 steps for allocating heath care resources during pandemic outbreaks
- “treat similar patients similarly, regardless of socioeconomic status.”
- aim at correcting the disproportionate burden of risk all the way up to hospitalisation.
- non-pharmaceutical interventions should also be targeted at the socioeconomically disadvantaged
Vaccine nationalism
when a government of a country gives a greater priority to its own residents over non-residents in the provision of vaccines.
Fair Priority Model vs COVAX
Fair Priority Model: (a) reducing premature deaths; (b) reducing economic and social deprivations; and then (c) reducing community transmission
COVAX: (a) proportional allocation for all countries, then (b) maximising the impact of a limited supply of vaccines.
Total Good
restriction on a person’s freedom against their will is permissible if and only if the bad of the restriction is outweighed by a sufficiently large sum of good that the restriction does to them and others.
Harm Principle
restriction on a person’s facts against their will is permissible only if it prevents harm to another (necessary condition).
Paternalism
restriction on a person’s act against their will is permissible if it prevents harm to themselves (sufficient condition).
“Thin” vs. “Thick” common ground
- “Thin” common ground: it is right to minimise the instances and extent of restrictions of freedom
- “Thick” common ground: it is permissible to restrict a person’s freedom just in case that they are likely to cause substantial harm to both themselves and others
The problem with PCR tests
it’s ineffective and ethically wrong to “test all” people.
The problem with human challenge trials (HCTs)
although few individual HCTs have serious incidents, there might be multiple serious incidents out of many HCTs over time.
Excess mortality
difference between the total number of deaths from all causes during a certain period and an average of the number of deaths during the same period in the past several years.
counterfactual scenarios
what ‘could have been’ under different circumstances
3 methods of developing counterfactual scenarios
- Assessment of the impact of the pandemic
- Mathematical modelling of pandemic outcomes
- Comparing light-handed and heavy-handed approaches to pandemic response and preparedness in different countries
Cost benefit analysis (CBA)
CBA assesses the pros and cons of climate policies in purely monetary terms according to people’s willingness to pay for them; the course of action recommended by CBA is the one that is least costly.
3 objections against cost benefit analysis (CBA)
- it is monistic about value
- it cannot support aggressive climate measures
- it misunderstands our duties to future generations.
Why are ethics necessary in discussing climate change?
(1) it’s difficult to say why climate change is a problem without making value judgments and because (2) we cannot make sense of climate change policy without invoking ethical considerations at the international and intergenerational levels.
Why might ethics not be adequate in discussing climate change?
if climate change isn’t like other paradigmatic moral problems and if commonsense morality needs to be revised or revolutionised to grapple with climate change.
The Precautionary Principle and its dilemma
The Parties should take precautionary measures to anticipate, prevent or minimise the causes of climate change and mitigate its adverse effects. Dilemma: either too weak or too banal advice.