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 el
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Contact: Lee Ann Cox
leeann.cox@uvm.edu
802-656-1107
University of Vermont
15-May-2006