Speaker: Gerard Vong

Using the recent COVID-19 and MPox international outbreaks as examples, Dr Vong argues that when distributing a public health resource that is too scarce (or logistically challenging) to allocate to all of a group of equally-worthy potential beneficiaries (even when/if divided into the smallest effective size), we morally ought to allocate the resource using a lottery that gives all such beneficiaries an equal chance at receiving the resource. The presentation is divided into four parts. In the first part, Dr Vong clarifies the aforementioned allocation thesis and presents three justifications for it: (i) that doing so is more equitable than the default alternative, namely first-come-first-serve; (ii) doing so avoids or mitigates potential implicit or explicit bias in allocation; and (iii) it is supported by John Broome’s theory of fairness. In the second part, he presents and responds to objections from Tim Henning against the use of allocative lotteries. In the third part of the presentation, he argues that future outbreaks will foreseeably result in scarce resource allocation cases of the aforementioned kind due to current public health resource planning and stockpile policy, lack of research and data for new or unprioritised infectious agents, and logistical challenges in outbreak response. If his arguments are sound, one ethically important step in preparing for future disease outbreaks is setting up lottery systems for the allocation of scarce public health resources. Dr Vong concludes by suggesting that such lotteries ought to have three features: (i) they should be designed such that information about them can be transparently shared in different languages with patients with varied heath literacy, (ii) that they should be able to respond to changes in the demand and supply of the resource over time, and (iii) they can exclude specific earlier lottery entrants from later lottery allocations in order to promote population-level fairness and other public health goals.   

Please note that these seminars are open to the public and in person only.