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We’re often told that everyone is equal as we each possess intrinsic value that is impossible to quantify or compare. However, when a life-saving treatment is in limited supply, this idealistic idea goes out the window. There may be no better example of this than the aptly named “God Committee,” a group created in 1961 by hospital administrators to determine who could use the then newly created dialysis machine. They relied heavily on a measure of social worth based on economic status that is generally seen as a ‘black eye’ for medical ethics. Because of the limited supply of life-saving COVID-19 vaccine, comparisons of social worth are starting again, seemingly going against what’s been ingrained in us our whole lives.
The CDC created vaccination rollout recommendations with three different goals in mind: “decrease death and serious disease as much as possible […], preserve functioning of society,” and “reduce the extra burden COVID-19 is having on people already facing disparities.” The two groups that are in the initial 1a phase of COVID-19 vaccines are healthcare personnel and residents of long-term care facilities. This does not include all people over 75. Vaccines going to residents of long-term care are focused on trying to “decrease death and serious disease as much as possible.” After all, “while only 1% of the US population lives in long term care, the residents and the staff who work there account for 6% of COVID-19 cases and 40% of the deaths” (https://time.com/5916925/who-gets-covid-19-vaccine-first/). This is not a choice based on social worth. In fact, elderly people are routinely forgotten about or viewed as inferior in American society that focuses on how one can benefit it. Rather, this is a case of vaccines going to those who most need it to protect themselves.
In comparison, studies suggest that healthcare personnel get COVID-19 at lower rates than the public. This is because healthcare personnel have access to better medical protection from COVID-19 than the average American. Additionally, healthcare personnel range from dentists to physical therapists, a large group of people, many of which are not directly responding to COVID-19. Since a majority of healthcare personnel are not at a greater risk than the general public and are not responding to COVID, the reason for prioritizing their vaccination is not related to protecting those at higher risk. Rather, they are likely being vaccinated because the CDC believes they are essential to “preserve functioning of society,” which equates to a statement that healthcare personnel are the most valuable members of our society. More importantly, it’s a valuation that a 14-day stint with COVID-19 for a 30-year-old physical therapist is more necessary to prevent than my 94-year-old grandmother getting COVID-19.
How do we define importance? If you define importance as contributions to society, then this is an easy problem. Due to their education, physical therapists, and healthcare personnel in general, can contribute more to society than my grandmother at this point. For the most part, healthcare personnel do not need the vaccine more than my grandmother. However, they can do more for society because of the education they’ve received.
The CDC is evaluating social worth based on one’s contributions to society. In a case like this, it seems obvious that this evaluation of social worth is out of touch with who we are as humans. Yet, in other circumstances, it seems to fit well with who we are, both as humans and as a society. Let’s say you’re living in the 1700s and are put in the uncomfortable position of choosing who will survive between two people. Your choices: Beethoven and a steward named John. All other things being equal, you’re probably choosing Beethoven. Beethoven’s repertoire consists of some of the most performed classical musical pieces in the world. John, on the other hand, waits on tables to support his family. Most people would choose Beethoven. Everyone has different reasons, but most would likely choose Beethoven for what he could continue to contribute to society. Yet, if you’re doing that, you’re saving someone based on what they can do for society. You’re saying someone’s life is more valuable than another because of their potential contributions.
Our individual contributions to society are inherently unequal. The very nature of being a human means that your contribution to society is different from the person standing six feet away from you. If any aspect of our social worth is dependent on our contributions to society, then humans undeniably have different social worth. Humans seem to like that. After all, it was probably very easy for you to choose Beethoven rather than John. Growing up in American society, we’ve been pre-conditioned to evaluate social worth with what one can contribute, which is usually in the form of their job.
Yet, what are a society’s values, aside from the sum of its citizens’? While the problem of social worth may seem like a social question, it is a deeply personal one. Who and what one deems worthy of respect and intimacy reflects one’s own beliefs. Can you confidently say yours are any different than the society you’re growing up in? Finding answers to this question might give some value to this interminable year.
