[blueash]

One measure that can be used in distribution of a scarce resource is its effect on Years of Potential Lives Lost YPLL. YPLL calculates how many years of living the victim of a disease or accident lost as a result of that disease or accident.

An action taken to save a 10 year old has a much greater effect on YPLL than that same action taken to save an 85 year old. Similarly you can consider cost benefit. A person disabled by Covid and living for 5 years costs far less than someone getting the same level of disability and living for 40 years. Morbidity alone is not the only factor that can ethically be used in decision making.

While my death from Covid might be more likely to be prevented by a vaccine than my child's death, I and likely all of you if there were only one dose left to be given and you could get it or give it to your child - would pass it on.

If that is an easy choice because you love your child, I'd simply point out that your choice was based on an ethical construct, what is best for your family. Women and children first into the lifeboat... ethical choice. Is all of society our family? Does love your neighbor mean anything in this context?

If you leave race out of it, an ethical justification can be found for protecting essential young workers, especially those with children over elderly persons with limited YPLL benefits and no one dependent on them. If it turns out that those young essential workers are much more likely to be not white than the elderly at risk group, it is fair to mention that fact and not be accused of making a racist statement.

The calculation of benefit is not as simple as who is more likely to die if not vaccinated. It is the job of an ethicist to bring differing options and approaches to the discussion. The Children's hospital where I attended had ethicists. They came into difficult decision making situations not to tell the families or doctors what to do, rather to present all the factors which could ethically be used in making one of many reasonable choices.