Pandemic Protection: Young and healthy first?

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Pandemic Protection: Young and healthy first?

Provocative thesis presents priorities in the vaccine distribution upside down

A bird flu pandemic would not only have devastating consequences, it represents health authorities and doctors also face difficult and potentially tragic choices: If flu vaccines are scarce, who should receive priority? Until now the main principle: children and the elderly first. But in an article in the journal Science now argue two bioethicists for an alternative approach.

Pandemic Protection: Young and healthy first?



Should avian flu change from an animal disease to be transmitted from person to person disease, millions of people could become ill. In the first year of a pandemic, according to experts, would be unprotected because of bottlenecks in vaccine production up to 90 percent of the population. In the allocation of scarce vaccine doses should be the primary objective, to save as many lives as possible. According to previous guidelines, this means that in addition to the health workers and disaster protectors, infants under two years and elderly aged 65, must be first supplied with vaccines.

Remaining lifetime as a benchmark?

But Alan Wertheimer, political science professor at the University of Vermont and Ezekiel Emanuel, head of the Department of Bioethics of the American National Institutes of Health, now put in "Science" in question, whether this strategy really could most lives saved. In your opinion, should not be treated with priority sick old but young, healthy adults. They would, it was argued, on the one hand have a higher life expectancy, on the other hand already invested in their lives.

"The idea is based on that it is important to ask whose life and at what point of life is," says Wertheimer their "life cycle" principle. "There is a big difference between saving the most lives and the most still expected years of life." In their view, people should be given the opportunity to live through all stages of life, from childhood through adolescence, maturity and the establishment a family. Seen from this perspective, the death of a child is more tragic than the death of an elderly person - not because they are less important, but rather because the younger still had no chance to go through all stages of life.

Playing with social Darwinism

If you were to follow only this principle, all vaccines would go exclusively to children - that could not survive without the help anyway. Wertheimer and Emanuel therefore seen as a second distribution principle the consideration of how many an individual have already invested in their lives. A 20-year-old, so her statement, have already more unfulfilled interests, plans and hopes developed as an infant and therefore deserve a higher priority for vaccine distribution.

The two scientists of the explosiveness of their easily interpretable as social Darwinism theses are well aware. Wertheimer acknowledges explicitly that this type of calculation is extremely controversial and difficult: "People do not like to confront such issues as reported in this paper," he explains. "" It would be nice if we would be not even asked before such a decision, perhaps it is indeed not so. But at a certain point there will be times likely that we will be faced with a pandemic or something like that presents us with such a dilemma. "

(University of Vermont, 16.05.2006 - NPO)


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