Alden March Bioethics Institute, Albany Medical College, Albany, New York, USA.
Department of Surgery, Albany Medical College, Albany, New York, USA.
Immunol Invest. 2021 Oct;50(7):857-867. doi: 10.1080/08820139.2021.1924771. Epub 2021 May 26.
In an effort to establish a consensus position on the ethical principles and ideals that should guide vaccine allocation during the Covid-19 pandemic, various organizations, including the Centers for Disease Control (CDC) and National Academies of Science, Engineering, and Medicine, released sample allocation frameworks to help guide government entities charged with distributing vaccine doses. One area of agreement among these reports is that front line health care workers, especially those who come into regular contact with Covid-19 patients, ought to be afforded highest priority. But this convergence, though significant, raises questions concerning the ethics of vaccine distribution those highest-priority health care workers: If a hospital has inadequate supply to vaccinate its entire workforce, which of its essential workers should it prioritize? In this paper, we begin with a general overview of ethical questions of vaccine administration before narrowing our focus to some of the most pressing theoretical and practical issues hospital officials must face in building justifiable and actionable frameworks for vaccinating their workers. We discuss and assess some potential ambitions of hospital allocation plans, concentrating especially on the goal of protecting the community from catastrophic loss of life. Finally, we consider some specific questions hospitals will encounter when developing distribution guidelines that aim to realize this aspiration.
为了在新冠疫情期间就指导疫苗分配的伦理原则和理想达成共识,包括疾病控制与预防中心(CDC)和国家科学院、工程院、医学院在内的各种组织发布了疫苗分配框架样本,以帮助指导负责分发疫苗剂量的政府实体。这些报告的一个共识领域是,一线医护人员,尤其是那些经常接触新冠患者的医护人员,应优先接种疫苗。但这种趋同虽然意义重大,但也引发了一些关于疫苗分配伦理的问题,即那些优先级最高的医护人员:如果医院的疫苗供应不足以为其全体员工接种疫苗,应该优先为哪些关键员工接种疫苗?在本文中,我们首先对疫苗接种的伦理问题进行了概述,然后将重点缩小到医院官员在为其员工制定合理且可行的疫苗接种框架时必须面对的一些最紧迫的理论和实际问题。我们讨论和评估了一些医院分配计划的潜在目标,特别关注保护社区免受灾难性生命损失的目标。最后,我们考虑了医院在制定旨在实现这一愿望的分配准则时将遇到的一些具体问题。