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Ethics in Medicine, Economics, and Politics

已有 1471 次阅读 2020-4-18 22:39 |个人分类:S and T|系统分类:海外观察

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I recently watched an on-line conversation among participants conducted by Michael Sandell of Harvard on the title of this article. He raised and the audience participated in the discussion of the title of this blog article. 

Some examples: 1. You pay someone to shop grocery for you because of your fear of contracting deadly illness. Is this morally justifiable? 

    a. No, you are using money to remove risk against your life and to let people with less money to take the risk. 

    b. Yes, we transfer risk for us to someone else all the time, e.g. soldiers in the army, policemen and firefighters. It all depend on circumstance and cost-benefit analysis which the population as a whole determine over time and experience. 

2. Should government issue “passport” for students who are known to be infection-proof (e.g., survivals with anti-bodies in their blood) back to school so they don’t have to stay home and attend school on line? 

    a. No. This will be costly to administer and creates class division among people. Furthermore, once you start with student, what is preventing people from arguing for exemption from “shelter-in-place”. 

    b. Yes, this will allow economy to recover sooner and smooth transition back to normal. 

3. In the US we accept the fact some 40,000 persons die in auto accidents each year as normal and cost of convenience of travelling via automobile. Why can we accept coronavirus deaths as necessary cost of doing business and for the good of economy open up the market? 

     a. No, this is morally unacceptable. 

    b. Yes, then do you want to accept a maximum speed of 15 mph everywhere and suffer the consequences? It is all a matter of cost-benefit consideration. 

4. In the era of shortage of medical equipment and supplies, how does the doctors decide who get life saving ventilators and care? 

On the non-ethical side, here are some difficult issues 

    1. Currently the farmer in the US are deliberately destroying tons of fresh farm produce and milk products because of lack of demand from restaurants. Yet the grocery shelf in supermarkets are often empty. This is because the distribution channel for food are totally different for restaurants and for individuals. Logistic channels cannot easily be changed overnight. 

    2. Politician often like to share the glory when thing go right and shift the blame when thing go wrong. Currently there is the subtle hint of “blaming the Chinese” in the use of the phrase “Chinese virus” and the correlation with the rise of anti-Chinese incidents in the population.

    3. Trust becomes an issue when the government starts to promote use of certain medicine as cure for the virus illness without scientific evidence. 

Finally, there are almost unanimous agreement among the experts that “extensive testing” is the only other alternative beside the “shelter-in-place” as weapons against the resolution of this crisis. Yet currently the US is only doing 60K-220K tests/day while 20 million tests/day are needed. As a result there is no reliable count of the dead due to the virus because these dead were never tested and thus not counted as death due to virus.  

This series of hypothetical questions/issues promoted very heated discussions and the many unresolved ethical dilemma in our society. We, as a population, and politician as our leader, should reflect and think about them seriously in this crisis.



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