Pandemic prioritarianism

Abstract

Prioritarianism pertains to the generic idea that it matters more to benefit people, the worse off they are, and while prioritarianism is not uncontroversial, it is considered a generally plausible and widely shared distributive principle often applied to healthcare prioritisation. In this paper, I identify social justice prioritarianism, severity prioritarianism and age-weighted prioritarianism as three different interpretations of the general prioritarian idea and discuss them in light of the effect of pandemic consequences on healthcare priority setting. On this analysis, the paper arrives at the following three conclusions: (1) that we have strong prioritarian reasons for special concern about the vulnerable and socially disadvantaged in reference to pandemic effects, (2) that severity of illness is an important factor in identifying the worse off in priority setting but that this must not over-ride the special priority to the socially disadvantaged and (3) that the maximisation rationale of the age-weighted view runs against the core prioritarian idea, and the age-weighted prioritarianism is thus unfitting as a prioritarian response to the COVID-19 case.

Allocation of COVID-19 vaccination: when public prioritisation preferences differ from official regulations

“…1 However, because of limited production capacities, it will take months or even years before everyone can be vaccinated. This elicited discussions on how the low number of vaccines should be allocated, [2][3][4] leading to country-specific prioritisation strategies. 5 For instance, in Germany, the Standing Committee on Vaccination, the German Ethics Council and the German National Academy of Sciences Leopoldina considered four allocation objectives: (1) the distribution should reduce severe and deadly infections, (2) protect people with high exposure due to their work, (3) prevent transmission and (4) sustain public life.…”

COVID-19 pandemic, the scarcity of medical resources, community-centred medicine and discrimination against persons with disabilities

“…Prioritarianism is another interesting perspective, which combines the criterion of general well-being by giving greater weight to worse-off individuals. Nielsen28 argued that, also in pandemic crisis, severity of illness and age should not over-ride the social disadvantage, and this should remain a primary concern. Health policies should be put in place to relieve the effects of inequality amplified by the pandemic.…”

Weighing the Costs and Benefits of Public Policy: On the Dangers of Single Metric Accounting

“…9 Of course, policy-making needs social scientific input, and recent philosophy of science is also rich in demonstrations that social science, just like any science, can't help but be value-laden. 10 But there are clearly ways in which social scientists can make sure to help, rather than undermine, democratic decision-making. When it comes to comprehensive frameworks for policy evaluation like the one advocated by Dolan, there seem to be two main strategies for doing so.…”

“…provides a good overview of defences and critiques of utilitarianism. See[8] for a recent, and[9] for the classic defence of the prioritarian view, and[10] for an application of prioritarianism to the public health response to the pandemic. For a defence of a utilitarian pandemic response, see[11], and for an exploration of the difference that the use of utilitarian or prioritarian social welfare functions in cost-benefit analysis is likely to make in evaluating pandemic responses, see[12].…”