Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.
Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.
Health Policy. 2022 Aug;126(8):770-776. doi: 10.1016/j.healthpol.2022.05.005. Epub 2022 May 20.
Prioritization of COVID-19 vaccines is one of the most relevant topics in the current pandemic emergency. Prioritization decisions are political decisions that are value-laden, and as such of ethical nature. Despite the clear political and ethical nature of this topic, prioritization decisions are often interpreted and presented as scientific decisions. The aim of this article is twofold. First, we aim to show critical points that characterize certain pandemic vaccination plans from the ethical viewpoint using four dimensions (problem definitions, incorporation of different perspectives, context, and specification). The four dimensions were drawn from findings of the European project "VALIDATE" (VALues In Doing Assessments of healthcare TEchnologies", https://validatehta.eu). Second, we aim to reframe the issue about prioritization itself in the light of the four dimensions mentioned. Our conclusion is that policy-problem definitions, incorporation of different perspectives, contextual considerations and specification of moral principles seem to be common critical points of some vaccination plan documents. The European project "VALIDATE" seems to be able to provide a useful and profitable approach to address many of these critical points.
新冠病毒疫苗的优先排序是当前大流行紧急情况下最相关的话题之一。优先排序决策是政治性的，且充满价值判断，因此具有伦理性质。尽管这个话题具有明显的政治性和伦理性，但优先排序决策往往被解释和呈现为科学决策。本文的目的有两个。首先，我们旨在使用四个维度（问题定义、不同观点的纳入、背景和具体说明）从伦理角度展示某些大流行疫苗接种计划的特征要点。这四个维度是从欧洲项目“VALIDATE”（评估医疗保健技术的价值观，https://validatehta.eu）的研究结果中得出的。其次，我们旨在根据上述四个维度重新构建关于优先排序本身的问题。我们的结论是，政策问题定义、不同观点的纳入、背景因素的考虑以及道德原则的具体说明似乎是一些疫苗接种计划文件的常见要点。欧洲项目“VALIDATE”似乎能够为解决许多这些要点提供一个有用且有利的方法。
