Featured Research

from universities, journals, and other organizations

Infants Or Adults? NIH Ethicists Argue For New Bird Flu Priorities

May 15, 2006
University of Vermont
In a bird flu pandemic, prioritizing the elderly, infants and infirm for scarce vaccine supplies may not be smart, argue two bioethicists in a new paper appearing in the journal Science. Accounting for life expectancy and an individual's investment in the future might just move healthy college students towards the front of the line.

An American flu pandemic would present difficult and tragic choices: As many as 90 million people might become sick, and widespread shortages of vaccine would likely leave more than 90 percent of the population unprotected in the pandemic's first year.

When there is not enough medicine for all, how should government prioritize who gets the scarce doses first?

One seemingly obvious answer, and one endorsed by two federal committees, would be to ration the medicine in such a way as to save the most lives possible. But in a paper appearing in the May 12 issue of the journal Science, University of Vermont ethicist Alan Wertheimer, professor emeritus of political science and current visiting scholar at the National Institutes of Health, and Ezekiel Emanuel, head of the NIH's clinical bioethics department, argue for an alternative approach.

Attempting to save the most lives gives the oldest, youngest and sickest priority for vaccination. Guidelines from the National Vaccine Advisory Committee and the Advisory Committee on Immunization Policy, in fact, place healthy people aged 2 to 64 as the very lowest priority, below even funeral directors.

Emanuel and Wertheimer's distribution recommendations are different: they put healthy people from early adolescence to middle age toward the front of the line for vaccination. (Both sets of recommendations give first priority to frontline health-care workers and people involved in producing and distributing vaccine.) They argue for allocating scarce medicine by accounting for an individual's degree of investment in his or life, balancing that consideration with attention to life expectancy.

"The idea is that it's important to ask whose lives are they and at what point in life are they," says Wertheimer, who co-developed the UVM Honors College's first-year ethics curriculum before retiring last year. "There is a big difference between saving the most lives and the most life years."

He explains that a 20-year-old might have 65 years left to live; a 65-year-old, in contrast, might expect to live only 20 more years. To Emanuel and Wertheimer, it was not necessarily desirable to dedicate vaccines to sick retirees with few remaining life years at the expense of healthy college students. So they argue for an alternative approach, one partially based on what they call the "life-cycle principle."

The principle asserts that people should be permitted an opportunity to live through all stages of life, experiencing childhood, adolescence, a maturing career and family. From this perspective, the death of a child is more tragic than the death of an elderly person, not because older people are less important, but because the younger person has not yet had the opportunity to enjoy all of life.

But distributing vaccines solely to maximize years of life has problems of its own, chiefly because it would, if followed strictly, allocate all resources to infants. So Emanuel and Wertheimer argue that vaccine policy should also consider the amount an individual has invested in his or her life. A 20-year-old, they suggest, has developed more unfulfilled interests, plans and hopes than a baby and therefore deserves a higher priority for vaccine.

They also emphasize public order in their suggested vaccine-distribution priorities, giving vaccine priority to people in roles that help stanch the spread of disease. They say this actually reduce the overall death toll of an epidemic if it follows a trajectory similar to the 1918 outbreak rather than more recent epidemics.

Wertheimer concedes that making these kinds of calculations is extremely difficult and controversial.

"People don't like to ask the sorts of the questions in this paper," Wertheimer says. "It would be nice if we did not have to confront this issue. And we may not have to. But at some point, it seems likely that we may have to confront a pandemic or something else that poses a similar dilemma."

To read Emanuel and Wertheimer's article, see http://www.sciencemag.org/cgi/reprint/312/5775/854.pdf

Story Source:

The above story is based on materials provided by University of Vermont. Note: Materials may be edited for content and length.

Cite This Page:

University of Vermont. "Infants Or Adults? NIH Ethicists Argue For New Bird Flu Priorities." ScienceDaily. ScienceDaily, 15 May 2006. <www.sciencedaily.com/releases/2006/05/060515143741.htm>.
University of Vermont. (2006, May 15). Infants Or Adults? NIH Ethicists Argue For New Bird Flu Priorities. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2006/05/060515143741.htm
University of Vermont. "Infants Or Adults? NIH Ethicists Argue For New Bird Flu Priorities." ScienceDaily. www.sciencedaily.com/releases/2006/05/060515143741.htm (accessed October 20, 2014).

Share This

More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations

Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.


Breaking News:

Strange & Offbeat Stories

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News


Free Subscriptions

Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile

Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?

Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins