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Book, if needed, is THiNK 5th ed., Judith Boss, ISBN 978-1-260-80519-2 OR ISBN 978-1-260-24081-8 read passages and write short essays on moral dilemmas using moral reasoning frameworks Question 1: Moral Dilemma: Prioritizing Moral Concerns The Unfaithful Baroness There once was a jealous baron and an unfaithful baroness. One day, as the baron left for a visit to his outlying districts, he warned his pretty wife: “Do not leave the castle while I am gone, or I will punish you severely upon return!” As the hours passed, the young baroness grew lonely, and despite her husband’s warning she decided to visit her lover who lived in the countryside nearby. Their castle was situated on an island in a wide, fast-flowing river. A drawbridge linked the island to the mainland at the narrowest point in the river. “Surely my husband will not return before dawn,” she thought and ordered the castle servants to lower the drawbridge and leave it down until she returned. After spending several pleasurable hours with her lover, the baroness returned to the drawbridge, only to find it blocked by a gateman wielding a long cruel knife. “Stop!” he cried. “Make no attempt to cross this bridge, Baroness, or I will be forced to kill you. The baron ordered me to do so.” Fearing for her life, the baroness fled and returned to her lover and requested his help. “Our relationship is only a physical one,” he said. “I will not help you.” The baroness then sought out a boatman on the river. She explained her plight to him and requested kindly for him to take her across the river in his boat. “I can do it, but only if you pay me five marks,” he said. “But I have no money with me!” the baroness protested. “That is too bad,” the boatman said with indifference. “No money, no ride.” With her fear growing and time running out, the baroness ran crying to the nearby home of her friend, and after explaining her desperate situation, begged for enough cash to pay the boatman his fee. Her friend replied, “If you had not disobeyed your husband, this would not have happened. I will give you no money. Now leave here.” With dawn approaching and her last resource exhausted, the baroness returned to the bridge. In desperation she attempted to cross and was slain by the diligent gateman. Who is most responsible for her death? Baron_____Baroness_____Gateman_____Boatman_____Friend_____Lover_____ In a well-written paragraph describe which type of moral reasoning you used to determine who committed the biggest moral failing and is therefore responsibility for this murder. Explain which principle of moral reasoning each character upheld or violated. Use concepts from Chapter 9’s categories of moral reasoning: 1) relativist theories such as ethical subjectivism and cultural relativism, or 2) universal theories such as utilitarianism, deontology, rights-based ethics, or virtue ethics. Question 2: Moral Dilemma: Prioritizing Moral Concerns In this excerpt from an article first written in July 2020, medical professionals describe the ethical concerns in deciding who receives priority COVID-19 vaccinations. In a well-written paragraph, list the authors’ primary concerns in this moral dilemma. Explain examples of different types of universal moral theories you find considered in the article. Allocating Vaccines in a Pandemic: The Ethical Dimension By Joseph H. Wu, PhD, Stephen D. John, PhD, and Eli Y. Adashi, MD, MSc American Journal of Medicine, vol. 133, no. 11, Nov. 2020, pp. 1241-1242, doi: 10.1016/j.amjmed.2020.06.007 (Links to an external site.) . How should a limited supply of vaccines be fairly allocated? Which ethical values should guide these decisions? How can apparent clashes between different ethical values be mitigated? The objectives of vaccination are 2-fold. One is the direct protection of the vaccinated individual against future infection and its associated health consequences. The other is the indirect protection of the population at large by reducing overall viral transmission and, thereby, the risk of infection, even for those who have not been vaccinated. When a sufficient number of individuals becomes immune to infection such that the disease no longer spreads, the population is said to have achieved herd immunity. It follows that a vaccine distribution program must be prepared to achieve both of these direct and indirect aims. Under some circumstances, the aims of conferring direct and indirect benefits coincide. This concordance may well apply to health care professionals by dint of their high levels of exposure to the disease and their capacity to act as disease vectors. How, though, should one decide the relative priority of other potential beneficiaries? What is to be fairly allocated is not the vaccines per se but, rather, the benefits thereof. The ethical issue concerns how to distribute the benefits of vaccines fairly. Maximizing benefits is a commonly invoked value to guide allocation. Prioritizing those individuals who are most likely to directly benefit from vaccination, such as older adults, may not maximize the overall number of lives saved. Allocating vaccines to those most responsible for the transmission of COVID-19 may confer more benefit to the population at large. Allocation guidelines must balance the obligation to assist individuals most likely to benefit against the obligation to secure the greatest aggregate benefit across the population. In addition to maximizing benefits, allocation guidelines should also be informed by considerations of fairness. For example, fair allocation of vaccine benefits must take into account existing health inequities. Individuals burdened by comorbidities such as asthma, heart disease, and diabetes appear to be at increased risk of contracting severe illness from COVID-19. Unfavorable social determinants may likewise predispose to severe COVID-19 complications. There may thus be 2 arguments in favor of prioritizing vulnerable groups for vaccination: because members of such groups are most likely to benefit and because of justice-based imperatives to address health inequities. Better stratification of the population risks of COVID-19 may mitigate some of these ethical dilemmas. This paradigm entails using epidemiological research to identify the settings or subpopulations that disproportionately transmit the virus and the individuals who are most likely to suffer severely if infected. For example, recent models suggest that crowding and population density constitute important variables in determining the devastation from COVID-19. Crowded areas not only increase the risk of spread but may also affect the fatality rate. An argument could be made for prioritizing the vaccination of individuals in densely populated areas so as to maximize both the direct and indirect benefits of the vaccine. Ultimately, vaccine allocation criteria will need to be formulated in concert with other health policies. A key aspect of such an undertaking will likely be a program for testing and surveillance so as to identify individuals most likely to transmit the COVID-19 infection. It will also be necessary to consider how the transmission dynamics intersects with restrictive measures and broader ethical questions. For example, keeping schools closed may lessen the imperative of vaccinating the young, rather than the old, but this policy also deprives children of educational opportunities, thereby raising further issues around fairness and equality. The need to determine how to fairly allocate this scarce supply is imperative. The ethical dilemmas involved are further exacerbated by the fact that the distribution of the eventual vaccine will inevitably transpire on a global scale. Only transparent and consistently applied allocation procedures will ensure public trust, especially in the case of vaccines. Ensuring that the allocation of vaccines is effective, fair, and justifiable to all is a priority that must not be compromised.
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