Ethical Considerations in Scarce Resource Allocation Paper
Instructions
Students will form small groups of 5-6 people to conduct a public health ethics task force
simulation for the influenza vaccine allocation case study. Each group will take on the
role of a National Advisory Commission to the President charged with providing advice
on the ethical acceptability of a proposed prioritization scheme to distribute scarce
influenza vaccine in the event of an outbreak of pandemic flu in the U.S.
Each group will turn in a 5 page double spaced policy critique based on its analysis of the
case.
Your moral analysis should include ethical considerations employed in the allocation of
scarce resources provided below.
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Ethical Considerations in Scarce Resource Allocation
1. Medical Success (Effectiveness) - - priority given to those most likely to achieve
a good outcome
2. Medical Need - - priority given to those most in need of medical intervention
3. Public Health Utility - - achieving the least morbidity/mortality possible given the
resources available (maximizing good health/survival with the available
resources)
4. Immediate Usefulness - - priority given to those with special skills that could be
used to serve the common good in the immediate circumstance
5. General Social Value - - priority given to those who are considered by society to
have the greatest social worth (past or future)
6. Principle of Conservation - - priority given to those who use proportionally less
resources
7. Responsibility for Dependents - - priority given to those who have primary
responsibilities to dependents (parents, nursing home attendants, etc.)
8. Generally Neediest - - priority given to those considered most helpless or
generally neediest in society
9. None if not all - - no one should saved if not all can be saved
10. Queue - - priority given on a first-come, first-served basis
11. Random Selection - - allocation determined by chance (a lottery, for example)
12. Ability to Pay - - priority given to those who can pay for the resources
13. Merit based - - priority given to those who have earned it due to past actions
NOTE: The above considerations are not necessarily mutually exclusive. You may
develop a position based on one principle, or you could develop a position which
attempts to balance many principles.
For example, you may develop a position which favors use of the “Medical
Need/Effectiveness” principle until a certain point in the pandemic, at which time the
“Ability to Pay” principle may become primary for you.
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Adapted from Gerald Winslow’s work, Triage and Justice (1982)
You may also wish to include in your moral analysis references to the following
principles of ethical public health practice.
Principles of the Ethical Practice of Public Health
1. Public health should address principally the fundamental causes of disease and
requirements for health, aiming to prevent adverse health outcomes.
2. Public health should achieve community health in a way that respects the rights of
individuals in the community.
3. Public health policies, programs, and priorities should be developed and evaluated
through processes that ensure an opportunity for input from community members.
4. Public health should advocate for, or work for the empowerment of,
disenfranchised community members, ensuring that the basic resources and
conditions necessary for health are accessible to all people in the community.
5. Public health should seek the information needed to implement effective policies
and programs that protect and promote health.
6. Public health institutions should provide communities with the information they
have that is needed for decisions on policies or programs and should obtain the
community's consent for their implementation.
7. Public health institutions should act in a timely manner on the information they
have within the resources and the mandate given to them by the public.
8. Public health programs and policies should incorporate a variety of approaches
that anticipate and respect diverse values, beliefs, and cultures in the community.
9. Public health programs and policies should be implemented in a manner that most
enhances the physical and social environment.
10. Public health institutions should protect the confidentiality of information that can
bring harm to an individual or community if made public. Exceptions must be
justified on the basis of the high likelihood of significant harm to the individual or
others.
11. Public health institutions should ensure the professional competence of their
employees.
12. Public health institutions and their employees should engage in collaborations and
affiliations in ways that build the public's trust and the institution's effectiveness
Grade Assignment Criteria
1. Length 10%
2. Spelling & Grammar 10%
3. Clarity 20%
4. Organization 20%
5. Moral Analysis 40%