“I’ve never seen such a diverse group at a ‘Brown Bag’ discussion!”
Several nodded agreement as we watched an overflow audience disperse a few minutes before
What drew to
Try to recall or imagine the temporary sense of ‘community’ in the amphitheater. The ethics questions stirred by the new vaccine have public health as well as personal/private dimensions.
Entering the amphitheater, we quickly pushed past being a crowd -- pressing together . . . waiting patiently . . . limiting the refreshments we picked up . . . making room . . . noticing acquaintances . . . pointing out seats . . . chatting about why we had come. The session’s first question revealed more of our common ground –
“How many of us are here because we and/or individuals very dear to us are wrestling with decisions about the new vaccine?”
The show of hands indicated the subject we had gathered to discuss blurs the line that usually separates givers of care from receivers of care. Four panelists oriented us to (1) the demographic and clinical data that should anchor our decisions, (2) the central ethical issues associated with the new vaccine, (3) a cervical cancer patient’s counsel, and (4) a mother’s angst. As they spoke, it became apparent the desperately poor – those at greatest risk in our city and in developing countries -- were underrepresented . . . and no middle school or teenage girls – those recommended/targeted for the vaccine -- were present.
Several definitions of ethics can take you into reflection/discourse about ‘the ethical dimensions of patient care’. The Brown Bag discussion seemed implicitly based on this definition of ethics -- i.e., ethics has to do with determining what ought to be done, all things considered. Not surprisingly, the participants varied in what they took into consideration re the new vaccine and in the value they assigned what they took into consideration. During our short time together, we listened . . . commented . . . (re)shaped our views --
“The vaccine’s benefits seem obvious, but do we have sufficient information to assess the risks?”
“How do I relate statistics about teenage sexuality and HPV incidence to my child?”
“Will mandating the vaccine ironically result in widespread neglect of regular screening exams?”
“Is a middle school girl nearer a teenager or a young child re ‘informed consent’ for the vaccine?”
“The ads . . . – why should I trust drug companies that aim to make huge profits on the vaccine?”
A plurality told their hesitant neighbors in the amphitheater they would vote to mandate the vaccine for middle school girls. An impressive majority indicated a willingness to have their taxes raised if doing so would make the vaccine accessible to the desperately poor.
What ought to be done re the new vaccine – all things considered – as a pediatrician? a gynecologist? a teenager? a parent/guardian? a public health official? a legislator? a pharmaceutical representative for one of the companies marketing the vaccine? a . . . ?
Think about it. Perhaps talk to a coworker.
