Reciprocity as an Argument for Prioritizing Health Care Workers for the COVID-19 Vaccine

Authors

DOI:

https://doi.org/10.3384/de-ethica.2001-8819.237228

Keywords:

COVID-19, Utility, Deontology, Duty, Reciprocity, Priority Setting

Abstract

During the recent debates on whether to prioritize health care workers for COVID-19 vaccines, two main lines of arguments emerged: one centered on maximizing health and one centered on reciprocity. In this article, we scrutinize the argument from reciprocity. The notions of fittingness and proportionality are fundamental for the act of reciprocating. We consider the importance of these notions for various arguments from reciprocity, showing that the arguments are problematic. If there is a plausible argument for reciprocity during the pandemic, this is most likely one that centers on the risk that health care workers take on while working. We argue that the scope of this argument is not plausibly extended only to health care workers. Other essential workers at risk are in the position to make the same arguments. We also argue that there is no compelling argument from reciprocity that makes reciprocating with vaccines, rather than by other means, necessary. Furthermore, allocating vaccines based on reciprocity will conflict with utility-maximizing. Given the weak state of the arguments, overriding concerns for utility seem unreasonable. 

Author Biography

Carl Tollef Solberg, Centre for Medical Ethics (CME)

Senior researcher at CME, UiO. Concerned with health priorities, medical ethics, death and health measures.

References

Aristotle, Aristotle’s Nicomachean Ethics, trans. by Robert C. Bartlett and Susan D. Collins, Reprint edition (Chicago: University of Chicago Press, 2012)

Barra, Mathias, Mari Broqvist, Erik Gustavsson, Martin Henriksson, Niklas Juth, Lars Sandman, and others, ‘Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda’, Health Care Analysis, 28.1 (2020), 25–44 https://doi.org/10.1007/s10728-019-00371-z

Becker, Lawrence C., Reciprocity (London: Routledge, 2014) https://doi.org/10.4324/9781315780719

Becker, Lawrence C., ‘Reciprocity, Justice, and Disability’, Ethics, 116.1 (2005), 9–39 https://doi.org/10.1086/453150

Bicchieri, Cristina, and Giacomo Sillari, ‘Game Theory and Decision Theory’, (2016), 23

Bognar, Greg, and Iwao Hirose, The Ethics of Health Care Rationing: An Introduction (London: Routledge, 2014) https://doi.org/10.4324/9781315778242

Daffner, Kirk R, ‘Point: Healthcare Providers Should Receive Treatment Priority During a Pandemic’, Journal of Hospital Medicine, 16.3 (2021), E1–2 https://doi.org/10.12788/jhm.3596

Det Etiske Råd, ‘Etiske Hensyn Ved Visitation Og Prioritering Af Patienter På “Den Røde Kurve”’ https://www.etiskraad.dk/etiske-temaer/covid-19/etiske-hensyn-ved-visitation-og-prioritering-af-patienter-paa-den-roede-kurve [accessed 2 December 2021]

Falk, Armin, and Urs Fischbacher, ‘A Theory of Reciprocity’, Games and Economic Behavior, 54.2 (2006), 293–315 https://doi.org/10.1016/j.geb.2005.03.001

Feiring, Eli, Reidun Førde, Søren Holm, Ole Frithjof Norheim, Berge Solberg, Carl Tollef Solberg, and others, ‘Advice on Priority Groups for Coronavirus Vaccination in Norway’, 27

Folkehelseinstituttet, ‘Mer covid-19 i noen yrkesgrupper’, Folkehelseinstituttet https://www.fhi.no/nyheter/2020/mer-covid-19-i-noen-yrkesgrupper/ [accessed 10 November 2021]

Folkehelseinstituttet, ‘Mer covid-19 i noen yrkesgrupper enn i andre’, Folkehelseinstituttet https://www.fhi.no/nyheter/2021/mer-covid-19-i-noen-yrkesgrupper-enn-i-andre/ [accessed 15 December 2021]

Gamlund, Espen, Karl Erik Müller, Amalie C. Solberg, and Carl Tollef Solberg, ‘Heroes in White?’, Tidsskrift for Den Norske Legeforening, (2020) https://doi.org/10.4045/tidsskr.20.0702

Gauthier, David, Morals by Agreement (Clarendon Press, 1986)

Gustavsson, Erik, and Niklas Juth, ‘Principles of Need and the Aggregation Thesis’, Health Care Analysis, 27.2 (2019), 77–92 https://doi.org/10.1007/s10728-017-0346-6

Hogan, A, P Winskill, O Watson, P Walker, C Whittaker, M Baguelin, and others, Report 33: Modelling the Allocation and Impact of a COVID-19 Vaccine (Imperial College London, 25 September 2020) https://doi.org/10.25561/82822

Joint Committee on Vaccination and Immunisation, ‘Joint Committee on Vaccination and Immunisation: Advice on Priority Groups for COVID-19 Vaccination, 30 December 2020’, GOV.UK https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-30-december-2020/joint-committee-on-vaccination-and-immunisation-advice-on-priority-groups-for-covid-19-vaccination-30-december-2020 [accessed 20 December 2021]

Kagan, Shelly, The Geometry of Desert, Oxford University Press, (2014)

Kagan, Shelly, The Limits of Morality, Oxford University Press, (1989)

Laake, Jon Henrik, Magna Hansen, Skule Mo, Camilla Christin Bråthen, Eirik Adolfsen, and Gunhild Øverland, ‘Etikkeksperter på villspor’, Tidsskrift for Den norske legeforening, (2020) https://doi.org/10.4045/tidsskr.20.0952

Magnusson, Karin, Karin Nygård, Fredrik Methi, Line Vold, and Kjetil Telle, ‘Occupational Risk of COVID-19 in the First versus Second Epidemic Wave in Norway, 2020’, Eurosurveillance, 26.40 (2021), 2001875 https://doi.org/10.2807/1560-7917.ES.2021.26.40.2001875

Manela, Tony, ‘Gratitude’, in The Stanford Encyclopedia of Philosophy, ed. by Edward N. Zalta, Fall 2019, Metaphysics Research Lab, Stanford University, (2019) https://plato.stanford.edu/archives/fall2019/entries/gratitude/ [accessed 18 October 2021]

Molm, Linda D., ‘The Structure of Reciprocity’, Social Psychology Quarterly, 73.2 (2010), 119–31 https://doi.org/10.1177/0190272510369079

Molvik*, Mari, Anders Skyrud Danielsen*, Mari Grøsland, Kjetil Elias Telle, Oliver Kacelnik, and Hanne-Merete Eriksen-Volle, ‘SARS-CoV-2 blant ansatte i helse- og omsorgstjenesten’, Tidsskrift for Den norske legeforening, (2021) https://doi.org/10.4045/tidsskr.20.1048

Parfit, Derek, Equality or Priority, University of Kansas, Department of Philosophy, (1991) https://kuscholarworks.ku.edu/handle/1808/12405 [accessed 7 June 2021]

Persad, Govind, Alan Wertheimer, and Ezekiel J Emanuel, ‘Principles for Allocation of Scarce Medical Interventions’, The Lancet, 373.9661 (2009), 423–31 https://doi.org/10.1016/S0140-6736(09)60137-9

Rawls, John, A Theory of Justice: Revised Edition, Cambridge, Massachusets: The Belknap Press of Harvard University, (1999)

Taurek, John M., ‘Should the Numbers Count?’, Philosophy & Public Affairs, 6.4 (1977), 293–316

Thorsteinsdottir, Bjorg, and Bo Enemark Madsen, ‘Prioritizing Health Care Workers and First Responders for Access to the COVID19 Vaccine Is Not Unethical, but Both Fair and Effective – an Ethical Analysis’, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29.1 (2021), 77 https://doi.org/10.1186/s13049-021-00886-2

Trivers, Robert L., ‘The Evolution of Reciprocal Altruism’, The Quarterly Review of Biology, 46.1 (1971), 35–57 https://doi.org/10.1086/406755

World Health Organization, ‘Health and Care Worker Deaths during COVID-19’ https://www.who.int/news/item/20-10-2021-health-and-care-worker-deaths-during-covid-19 [accessed 14 December 2021]

World Health Organization, ‘WHO SAGE Roadmap For Prioritizing Uses Of COVID-19 Vaccines In The Context Of Limited Supply’ https://www.who.int/publications-detail-redirect/who-sage-roadmap-for-prioritizing-uses-of-covid-19-vaccines-in-the-context-of-limited-supply [accessed 22 September 2021]

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Published

2023-03-21 — Updated on 2023-04-01

How to Cite

Jølstad, B. and Solberg, C. T. (2023) “Reciprocity as an Argument for Prioritizing Health Care Workers for the COVID-19 Vaccine”, De Ethica, 7(2), pp. 28–43. doi: 10.3384/de-ethica.2001-8819.237228.

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