"Health care is either a human right, which means it’s a human right for the vaccinated and the unvaccinated, or it’s not a human right at all. Are are we saying that all human rights are okay to deny to unvaccinated people? Are we saying that taking a shot, the contents of which we have no idea and is scary to contemplate, is now the basis for all human worth?"
First of all, it's interesting to see you on the "health care is a human right" train. That wasn't on my bingo card, so thank you for starting off my day in a more novel way than I would have predicted.
If we follow down that line of reasoning, I think it's not a reach to say that anti-vaxxers who catch COVID are entitled to health care. However, a massive gaping hole in this reasoning is to what extent anti-vaxxers who catch COVID can deny *others* their healthcare when they overwhelm the available medical resources, and there are no beds available to the passengers in a horrific bus accident who need medical attention that is being spent on avoidable COVID cases. This is not a hypothetical, but happening now in Idaho:
"The Idaho Department of Health and Welfare on Monday activated its 'crisis standards of care' in 10 northern hospitals hard-hit by staff shortages, hospital bed shortages, and a "massive increase in patients with COVID-19 who require hospitalization," the department announced Tuesday."
"The crisis standards mean that the quality of care in those hospitals will be reduced for all patients. Resources will be rationed, and patients with the best chances of survival may be prioritized."
"In practice, that could mean that: emergency medical services may prioritize which 911 calls they respond to; some people who would normally be admitted to the hospital will instead be turned away; some admitted patients may be sent home earlier than typical or may find their hospital bed in a repurposed area of the hospital, like a conference room; and, in the worst cases, hospital staff might not be able to provide an intensive care unit bed or a ventilator to a patient who has a relatively low chance of survival."[1]
This is Sarah Palin's "death panels" being enacted not by evil technocrats in Washington DC, but hospitals and doctors on the ground who simply do not have the resources to treat everyone coming to them for medical attention. What's happening is that infected anti-vaxxers are executing a healthcare denial-of-service attack that adversely affects the rest of the population.
How do you expect the rest of the population to react? To shrug their shoulders when people in car accidents die due to a lack of resources or attention? To applaud the clot of anti-vaxxers clogging up the healthcare system for their fidelity to misguided values that led them from getting the shot, and keeps them from wasting medical resources in the first place? The people who did the responsible thing and got the shot have just as much of a right to healthcare as the snowflake anti-vaxxers, so is it really that unreasonable (especially for a self-proclaimed conservative) to prioritize and reserve resources for the portion of the population that acted responsibly, and let the irresponsible bear the consequences (reduced access to care, lower prioritization of attention, paying the full costs of an avoidable hospital stay, etc.) of the choice that they that they so proudly made? Healthcare is a very finite resource, so even if everyone has a "right" to it, would communities who shepherd and protect that limited resources by reducing its access to COVID free-riders be acting all that unreasonably?
Everyone gets the best healthcare all the time makes sense in a world where healthcare resources are infinite. Unfortunately, we (and especially northern Idaho) doesn't have the luxury of living in that alternative universe.
I'm a little late to the conversation Chris, but your points reflect my thinking. Because healthcare, like any good or service, is a finite resource, such scarcity requires rights to be accompanied with personal responsibility. It is not a matter of being cruel or heartless to the purposefully unvaccinated. I have sympathy and compassion for them, and do wish them to recover. But if personal responsibility is not factored in, then those of us who chose to act responsibility are forced to subsidize the deleterious consequences of their decisions. And unlike those who end up in the hospital for cardiovascular disease because they smoked, drank, and ate fast food every day of their lives(which are consequential effects gradually built up from a lifetime of bad choices.), those who end up hospitalized for COVID-19 due to their elective refusal to get vaccinated, almost always have their predicament directly tied to that simple, singular decision of omission. And because of the inordinate consumption of resources by the electively unvaccinated, the resulting scarcity of resources gives us little choice but to demand personal responsibility from them.
There is a difference between denial of service because of priority and because of scarcity. There's no way around scarcity and in reality, it's the rich who get the prize. People with means can go to a different hospital or find care at a high price. Those without means are subject to scarcity. If priority is given to vaccinated regardless of need, that's a silly policy. If care is denied first to the unvaccinated before the vaccinated in a situation of scarcity, you're blaming a whole class of people (unvaccinated) for the scarcity crisis. That's morally abhorrent. We can apply vaccination requirements to a variety of situations, like workplace, gatherings, activities, because we want to reduce the spread potential. We cannot apply it to people in need of immediate healthcare because someone who is unvaccinated is already sick and taking a hospital bed. Sure, prioritize based on medical need, that's fine. And blame the unvaxxed for making that poor outcome happen. But don't punish the sick because of the sick.
In a situation where two patients at similar risk of death or serious health repercussions if left untreated, one is an immuno-compromised person UNABLE to take the vaccine and the other is a regular person with no valid health reasons to take the vaccine, it seems imminently reasonable to treat the person who had no choice in the matter over the person who had a choice, and consciously chose poorly. Is there any disagreement there, if we are put in a situation where we have to chose one over the other? With respect to COVID expertise and equipment, that's a more likely conundrum we'll be facing, given that vaccination largely keeps people who end up catching COVID from having to be hospitalized in the first place. You can call that penalizing anti-vaxxers, or you can call it prioritizing people who had no choice - it's the same in the end.
"If care is denied first to the unvaccinated before the vaccinated in a situation of scarcity, you're blaming a whole class of people (unvaccinated) for the scarcity crisis."
Given that it's unvaccinated people who are creating the situation leading to the scarcity, I don't see how you don't blame them for the crisis. We're not seeing the same shortages in areas where more people got vaccinated. It's not like the burden on our health care systems is being randomly assigned and disproportionately falling in areas where the unvaxxed are present, there's a VERY clear causal chain that links a population's collective choice to avoid the vaccination with hospital shortages. A whole class of people are causing these crises, so I don't know why you're reticent to assign responsibility accordingly.
To be clear, if someone is sick (vaxxed or not) and goes to a hospital for treatment and the hospital has capacity to care for them - the hospital should take care of them. On the flip side, if a hospital is overrun with unvaxxed COVID patients, and there's a multi-car pile-up on the local Interstate that sends many people to the local hospital for life-saving care, I have ZERO objection to the hospital wheeling out enough adult anti-vaxxed COVID patients out to the parking lot for as long as it takes for the doctors and nurses to focus on taking care of the accident victims first, instead of forcing the accident victims to find care elsewhere.
I'd have problems if the hospital wheeled out a child whose parent made a bad decision for them, but I won't shed a tear over someone who finds themselves in a crappy situation and society is and has done everything it can to help keep them from that situation. Either personal agency and responsibility matters, or we resign ourselves to living in a society of man- and woman-children who act like spoiled adolescents because no one felt it was necessary to teach them the lesson that choices have consequences, and you are responsible for dealing with the consequences of the choices you make - good and bad.
Maybe it's callous to say this. Should an immune compromised individual who is unlikely to be healthy in the long run be treated instead of the vaccine hesitant patient who is likely to recover? Should a patient with a terminal illness be treated ahead of the patient with an operable tumor? Should the addicted and mentally ill be cared for while those who are merely lazy are left to perish? These are just a few of the many questions that nanny state advocates will have to answer.
While your examples are stupid, stuff like this is decisions we thought we wouldn't have to make anymore with the advancements of science. Sadly idiots have put many people in that exact position. Cancer patients sent home early because they had to treat a freaking moron. Accident victims having to wait hours because all the hospitals were full of the dregs of this country. This is reality for many now a days because of stupidity and selfishness.
So yeah, hard truth, those like myself how are immuno-compromised understand this fact. Although, funny enough, you forgot the first group that would be sent to the butchers. Old people. You know the ones this country has already declared expendable in their desire to not wear a freaking mask.
I don't think you are expendable Curtis I just think its sad you and Steve do.
What about before the vaccine? What about when you had to wait to get one? The hospitals were jammed and not doing many procedures then either. You’re treating the vaccine as a silver bullet. It’s good but it’s not a miracle cure or something that confers moral superiority to those who take it.
We have the evidence now proving that untrue. The percentage of vaccinated people who need hospital care can be observed through pure numbers. That's what makes this so freaking anger inducing. If everyone just took the shot Doctors and hospital administrators wouldn't have to make these decisions.
As for before the shot that is obviously a different story because we didn't have the silver bullet. Although, a case could be made for those who didn't follow the lock down or the other rules.
I'm probably not as stupid as you seem to think but have it your way. I have been vaccinated and will get a booster because I believe they are effective. I wear a mask only where required. So far, so good.
Which part are you objecting to? The part where I'd pull the anti-vax COVID patients into the parking lot to make room for the car crash victims or the part where I explicitly blame anti-vaxxers for creating this situation. Or the part where I argue that an anti-vax stance should put one lower on the priority list for COVID treatment versus a person (child, immuno-compromised, etc.) who were unable to to take advantage of the vaccination?
You keep casting this as "class guilt", but the people being penalized are *individuals* making *individual* decisions on their own. To the extent that there is a "class" in this situation, it's only the people who are unable to take the vaccine due to other medical issues (they have no choice), and it's the *individuals* choosing to not vaccinate themselves that are adversely affecting the unvaccinated "class".
TLDR: You're not in a "class" if you can make a voluntary low-cost choice to exit the "class". Race, sex, and religion (to a lesser extent) are meaningful classes. "People who make poor decisions" is not a class in any meaningful sense of the word.
You nailed it in that last paragraph. If we cease to demand personal responsibility for the exercise of one's agency, then we'll cease to be a free society. Personal responsibility cannot be severable from freedom.
I certainly can't argue with that. I just question how criteria to decide can be developed and who defines the standards for responsibility. Obesity, smoking, drunken driving, using cell phones while driving, carelessness, addiction and dozens of other behaviors are all evidence of irresponsibility. Some would even say that eating oysters on the half-shell should disqualify me from treatment for digestive distress.
I like to think of myself as an average old white guy who tries to pay attention to things that matter to me. After the last two days commentary, i found myself compelled to speak out. I have never in my lifetime used Jimmy Kimmel or the Rollingstone magazine as my go to sources for information, data or news.
I get it; trying to write a column or two a day is a drag and so to make your points you are forced to use obscure and outlandish commentary. I wouldn't even mind all that much if the thrust of what you write wasn't so impactful to those reading it. Nope, you guys don't have that big a following, but i suspect big enough to influence some, especially where you live.
Here's my point: Every freaking time you write about covid19 and or vaccinations you always encourage the shot. That's a good thing. Then you shift to the alternative reality like so many others and throw in, get the shot...BUT. And let me just say, IMHO, that BUTT becomes bigger than Kim K's.
Trump urged get the shot...but. Countless others, get the shot...but. Then you've got that whole feckless bunch like American Frontline Doctors out there telling people not to get the shot. You've got hundreds of people posting horror stories of how the shot disabled them. The nonsense about chips and magnets and idiocy beyond comprehension. The preachers from the pulpit telling them to trust God and not get vaccinated.
Then we can get to the asshats showing up at school board meetings and making a mockery of a system where they are trying to get kids back in school but doing it safely. Or how about the young man who showed up to talk about his grandmother, a teacher who died of Covid19 he claimed she caught from an unmasked student? You know, the one the jackasses in the crowd mocked and laughed at him.
Sorry Steve, the simple reality is we are never going back to normal. People will continue to die in frightening numbers and our health care system is overwhelmed. And the bigger reality is this is because we as a country refused to get the shots that would have stopped it near on dead in its tracks. There's no longer a reason for adding your "but" to the argument. We've lost because for too long, so many have been half-hearted or absolutely foolish in their responses. Be nice you say? Why? Where has it gotten us?
Georgia, your home state is at 42 % vaccinated. That is pathetic. It won't get a hell of a lot better, so now we can all live with the outcomes of the anti-vaxers and anti-maskers and covid deniers who have insured we all will be losers. It's sickening, and while in the beginning you led the charge, your continued "but" has been at least as shameful as the dummies...you understood it from the beginning and somehow could justify their actions or should i say non-actions.
I'm glad i am an old man with no kids. Here's the ugly reality you all will have to face. The children will be the next horrible statistic and then the anti-maskers will be screaming about why they had to die? Here's my answer to them...look in the freaking mirror.
Medical triage is a thing and it is the moral decision to treat those who did what was right before treating those who didn't.
When I went to see the lung transplant team about prolonging my life they told me i had to maintain a certain weight, be able to walk a certain distance, and not put anything bad for my lungs into my body. They didn't care whether I agreed with the science or not. This is what was required. Treating people for COVID should be exactly the same. If you can save everyone do so, but the minute you start having to pick and choose you kick those ignorant buffoons out and treat those who actually respect the people trying to save their lives.
I believe triage is intended to maximize survivors not to judge or reward individuals. I hope you are doing well and congratulations for making the right decisions.
A record of making good decisions should part of the triage decision. I'd rather effort be spent on trying to save someone who has a lower survival odds through no choice of their own, instead of saving someone with higher odds but are in that state due to bad decisions. The reason is that if we treat these incidents in isolation, we're maximizing the odds that we'll save a life. However, we are also reinforcing the notion that there are not consequences for bad decision making, and INCREASING the odds that we'll find ourselves in a similar triage situation in the future as the individual continues making poor decisions.
How may folks with lower survival chances are we going to be willing to sacrifice in order to keep saving the same idiot over and over and over, or other idiots mimicking the behavior of the first? At some point, we'll cross a threshold in terms of lives saved so that more people end up dying because we keep wasting resources on folks who could have avoided being in peril in the first place.
Triage cannot ignore the greater context in which it's being exercised, EVEN IF the sole goal is to maximize the number of lives saved, ignoring any positive or negative moral worth assigned to the individuals being treated.
Your logic is pretty good except for humans being involved in moral worth decisions. My idea of an individual's moral worth probably differs from yours. I do not think either of us is evil. We just have different ideas about what constitutes a perfect world.
The computer scientist in me is trying to remove the moral calculus from the decision and replace it with probability instead.
For example, in the isolated single case, imagine that the survival odds of an immuno-compromised patient (a Bob) who gets the full attention of the medical staff (owing to sufficient resources) is 90%.
Now, if we throw an infected anti-vaxxer into the equation (a Charlie), let's say that their odds of survival are 95% while pushing the Bob's odds down to 85%, since Bob wouldn't receive the same level of care if it were not for Charlies overrunning the local medical system.
In a single case if you're just looking at survival odds, you spend time and resources to save Charlie as he's 15% more likely to survive than Bob.
However, if Charlie gets sick again and comes back or (more likely) inspires someone else to skip the vaccination and remain another Charlie (he survived without no vaccine penalty after all) and that new Charlie gets infected and decreases another Bob's odds of survival, the overall survival rate for both Bobs and Charlies stays around from 90% (the average of 95% and 85%).
However, in the world where the first Charlie dies or is seriously disabled while doctors are rescuing a Bob, the overall survival rate starts to rise from that 90% to 95% on subsequent rounds as folks who would have become Charlies in the absence of mortal consequences get the vaccine, enjoy a 100% survival rate, don't overload the hospital, and each Bob enjoys the higher 90% survival rate owing to adequate treatment and attention due to not competing with a Charlie for the same resources.
From a purely mathematical perspective, we have the choice of sticking with the strategy of always treating Charlies, and keeping our overall hospital survival rates at a steady 90%. Alternatively, if we focus on treating Bobs, we will raise that rate over time when potential Charlies decide its safer to take the shot and raise their own survival rate to 100% by not appearing in the hospital in the first place.
Charlies can choose their survival rate. Bobs cannot. So it makes sense to treat Bobs (they will be present regardless), while providing the incentive for Charlies to make an alternative choice to get the shot and bump their survival odds up to 100%, not only for their own personal survival, but for the collective survival of their community as well.
If you want to get morality out of this altogether and simply maximize the number of lives saved, over a certain number of iterations, it makes more sense to exclusively treat Bobs so that enough Charlies end up serving as disincentives for becoming a Charlie in the first place. What the number of those rounds are will be determined by actual survival odds (as opposed to the artificial numbers I chose to illustrate the point) and the probability of one Charlie death serving as a deterrent to other potential Charlies, but at some point those lines will cross and you will save more total lives by prioritizing Bobs, even if their initial odds of survival compared to Charlies is lower.
I don't know a better way to save lives and leave the moralizing out of it than this. Let me know if you see any holes in this reasoning or additional moralizing other than choosing to maximize the number of lives saved.
Update: Instead of "treat" or "treatment" in the mental experiment above, mentally substitute it with "prioritize". I don't mean to suggest that Charlies should be left untreated altogether, just that in cases where you pick one over the other, you prioritize a Bob.
"Health care is either a human right, which means it’s a human right for the vaccinated and the unvaccinated, or it’s not a human right at all. Are are we saying that all human rights are okay to deny to unvaccinated people? Are we saying that taking a shot, the contents of which we have no idea and is scary to contemplate, is now the basis for all human worth?"
First of all, it's interesting to see you on the "health care is a human right" train. That wasn't on my bingo card, so thank you for starting off my day in a more novel way than I would have predicted.
If we follow down that line of reasoning, I think it's not a reach to say that anti-vaxxers who catch COVID are entitled to health care. However, a massive gaping hole in this reasoning is to what extent anti-vaxxers who catch COVID can deny *others* their healthcare when they overwhelm the available medical resources, and there are no beds available to the passengers in a horrific bus accident who need medical attention that is being spent on avoidable COVID cases. This is not a hypothetical, but happening now in Idaho:
"The Idaho Department of Health and Welfare on Monday activated its 'crisis standards of care' in 10 northern hospitals hard-hit by staff shortages, hospital bed shortages, and a "massive increase in patients with COVID-19 who require hospitalization," the department announced Tuesday."
"The crisis standards mean that the quality of care in those hospitals will be reduced for all patients. Resources will be rationed, and patients with the best chances of survival may be prioritized."
"In practice, that could mean that: emergency medical services may prioritize which 911 calls they respond to; some people who would normally be admitted to the hospital will instead be turned away; some admitted patients may be sent home earlier than typical or may find their hospital bed in a repurposed area of the hospital, like a conference room; and, in the worst cases, hospital staff might not be able to provide an intensive care unit bed or a ventilator to a patient who has a relatively low chance of survival."[1]
This is Sarah Palin's "death panels" being enacted not by evil technocrats in Washington DC, but hospitals and doctors on the ground who simply do not have the resources to treat everyone coming to them for medical attention. What's happening is that infected anti-vaxxers are executing a healthcare denial-of-service attack that adversely affects the rest of the population.
How do you expect the rest of the population to react? To shrug their shoulders when people in car accidents die due to a lack of resources or attention? To applaud the clot of anti-vaxxers clogging up the healthcare system for their fidelity to misguided values that led them from getting the shot, and keeps them from wasting medical resources in the first place? The people who did the responsible thing and got the shot have just as much of a right to healthcare as the snowflake anti-vaxxers, so is it really that unreasonable (especially for a self-proclaimed conservative) to prioritize and reserve resources for the portion of the population that acted responsibly, and let the irresponsible bear the consequences (reduced access to care, lower prioritization of attention, paying the full costs of an avoidable hospital stay, etc.) of the choice that they that they so proudly made? Healthcare is a very finite resource, so even if everyone has a "right" to it, would communities who shepherd and protect that limited resources by reducing its access to COVID free-riders be acting all that unreasonably?
Everyone gets the best healthcare all the time makes sense in a world where healthcare resources are infinite. Unfortunately, we (and especially northern Idaho) doesn't have the luxury of living in that alternative universe.
[1] https://arstechnica.com/science/2021/09/idaho-begins-rationing-care-as-hospitals-crumple-under-covid-load/
I'm a little late to the conversation Chris, but your points reflect my thinking. Because healthcare, like any good or service, is a finite resource, such scarcity requires rights to be accompanied with personal responsibility. It is not a matter of being cruel or heartless to the purposefully unvaccinated. I have sympathy and compassion for them, and do wish them to recover. But if personal responsibility is not factored in, then those of us who chose to act responsibility are forced to subsidize the deleterious consequences of their decisions. And unlike those who end up in the hospital for cardiovascular disease because they smoked, drank, and ate fast food every day of their lives(which are consequential effects gradually built up from a lifetime of bad choices.), those who end up hospitalized for COVID-19 due to their elective refusal to get vaccinated, almost always have their predicament directly tied to that simple, singular decision of omission. And because of the inordinate consumption of resources by the electively unvaccinated, the resulting scarcity of resources gives us little choice but to demand personal responsibility from them.
There is a difference between denial of service because of priority and because of scarcity. There's no way around scarcity and in reality, it's the rich who get the prize. People with means can go to a different hospital or find care at a high price. Those without means are subject to scarcity. If priority is given to vaccinated regardless of need, that's a silly policy. If care is denied first to the unvaccinated before the vaccinated in a situation of scarcity, you're blaming a whole class of people (unvaccinated) for the scarcity crisis. That's morally abhorrent. We can apply vaccination requirements to a variety of situations, like workplace, gatherings, activities, because we want to reduce the spread potential. We cannot apply it to people in need of immediate healthcare because someone who is unvaccinated is already sick and taking a hospital bed. Sure, prioritize based on medical need, that's fine. And blame the unvaxxed for making that poor outcome happen. But don't punish the sick because of the sick.
In a situation where two patients at similar risk of death or serious health repercussions if left untreated, one is an immuno-compromised person UNABLE to take the vaccine and the other is a regular person with no valid health reasons to take the vaccine, it seems imminently reasonable to treat the person who had no choice in the matter over the person who had a choice, and consciously chose poorly. Is there any disagreement there, if we are put in a situation where we have to chose one over the other? With respect to COVID expertise and equipment, that's a more likely conundrum we'll be facing, given that vaccination largely keeps people who end up catching COVID from having to be hospitalized in the first place. You can call that penalizing anti-vaxxers, or you can call it prioritizing people who had no choice - it's the same in the end.
"If care is denied first to the unvaccinated before the vaccinated in a situation of scarcity, you're blaming a whole class of people (unvaccinated) for the scarcity crisis."
Given that it's unvaccinated people who are creating the situation leading to the scarcity, I don't see how you don't blame them for the crisis. We're not seeing the same shortages in areas where more people got vaccinated. It's not like the burden on our health care systems is being randomly assigned and disproportionately falling in areas where the unvaxxed are present, there's a VERY clear causal chain that links a population's collective choice to avoid the vaccination with hospital shortages. A whole class of people are causing these crises, so I don't know why you're reticent to assign responsibility accordingly.
To be clear, if someone is sick (vaxxed or not) and goes to a hospital for treatment and the hospital has capacity to care for them - the hospital should take care of them. On the flip side, if a hospital is overrun with unvaxxed COVID patients, and there's a multi-car pile-up on the local Interstate that sends many people to the local hospital for life-saving care, I have ZERO objection to the hospital wheeling out enough adult anti-vaxxed COVID patients out to the parking lot for as long as it takes for the doctors and nurses to focus on taking care of the accident victims first, instead of forcing the accident victims to find care elsewhere.
I'd have problems if the hospital wheeled out a child whose parent made a bad decision for them, but I won't shed a tear over someone who finds themselves in a crappy situation and society is and has done everything it can to help keep them from that situation. Either personal agency and responsibility matters, or we resign ourselves to living in a society of man- and woman-children who act like spoiled adolescents because no one felt it was necessary to teach them the lesson that choices have consequences, and you are responsible for dealing with the consequences of the choices you make - good and bad.
Derp.
"the other is a regular person with no valid health reasons to take the vaccine"
should be
"the other is a regular person with no valid health reasons to NOT take the vaccine"
Maybe it's callous to say this. Should an immune compromised individual who is unlikely to be healthy in the long run be treated instead of the vaccine hesitant patient who is likely to recover? Should a patient with a terminal illness be treated ahead of the patient with an operable tumor? Should the addicted and mentally ill be cared for while those who are merely lazy are left to perish? These are just a few of the many questions that nanny state advocates will have to answer.
While your examples are stupid, stuff like this is decisions we thought we wouldn't have to make anymore with the advancements of science. Sadly idiots have put many people in that exact position. Cancer patients sent home early because they had to treat a freaking moron. Accident victims having to wait hours because all the hospitals were full of the dregs of this country. This is reality for many now a days because of stupidity and selfishness.
So yeah, hard truth, those like myself how are immuno-compromised understand this fact. Although, funny enough, you forgot the first group that would be sent to the butchers. Old people. You know the ones this country has already declared expendable in their desire to not wear a freaking mask.
I don't think you are expendable Curtis I just think its sad you and Steve do.
What about before the vaccine? What about when you had to wait to get one? The hospitals were jammed and not doing many procedures then either. You’re treating the vaccine as a silver bullet. It’s good but it’s not a miracle cure or something that confers moral superiority to those who take it.
We have the evidence now proving that untrue. The percentage of vaccinated people who need hospital care can be observed through pure numbers. That's what makes this so freaking anger inducing. If everyone just took the shot Doctors and hospital administrators wouldn't have to make these decisions.
As for before the shot that is obviously a different story because we didn't have the silver bullet. Although, a case could be made for those who didn't follow the lock down or the other rules.
I'm probably not as stupid as you seem to think but have it your way. I have been vaccinated and will get a booster because I believe they are effective. I wear a mask only where required. So far, so good.
Well, I have an objection. Go back and read what you wrote.
I wrote quite a bit.
Which part are you objecting to? The part where I'd pull the anti-vax COVID patients into the parking lot to make room for the car crash victims or the part where I explicitly blame anti-vaxxers for creating this situation. Or the part where I argue that an anti-vax stance should put one lower on the priority list for COVID treatment versus a person (child, immuno-compromised, etc.) who were unable to to take advantage of the vaccination?
Both are pretty immoral in my opinion. I don’t have time to get into it but class guilt is a concept which leads to poor results.
You keep casting this as "class guilt", but the people being penalized are *individuals* making *individual* decisions on their own. To the extent that there is a "class" in this situation, it's only the people who are unable to take the vaccine due to other medical issues (they have no choice), and it's the *individuals* choosing to not vaccinate themselves that are adversely affecting the unvaccinated "class".
TLDR: You're not in a "class" if you can make a voluntary low-cost choice to exit the "class". Race, sex, and religion (to a lesser extent) are meaningful classes. "People who make poor decisions" is not a class in any meaningful sense of the word.
You nailed it in that last paragraph. If we cease to demand personal responsibility for the exercise of one's agency, then we'll cease to be a free society. Personal responsibility cannot be severable from freedom.
I certainly can't argue with that. I just question how criteria to decide can be developed and who defines the standards for responsibility. Obesity, smoking, drunken driving, using cell phones while driving, carelessness, addiction and dozens of other behaviors are all evidence of irresponsibility. Some would even say that eating oysters on the half-shell should disqualify me from treatment for digestive distress.
I like to think of myself as an average old white guy who tries to pay attention to things that matter to me. After the last two days commentary, i found myself compelled to speak out. I have never in my lifetime used Jimmy Kimmel or the Rollingstone magazine as my go to sources for information, data or news.
I get it; trying to write a column or two a day is a drag and so to make your points you are forced to use obscure and outlandish commentary. I wouldn't even mind all that much if the thrust of what you write wasn't so impactful to those reading it. Nope, you guys don't have that big a following, but i suspect big enough to influence some, especially where you live.
Here's my point: Every freaking time you write about covid19 and or vaccinations you always encourage the shot. That's a good thing. Then you shift to the alternative reality like so many others and throw in, get the shot...BUT. And let me just say, IMHO, that BUTT becomes bigger than Kim K's.
Trump urged get the shot...but. Countless others, get the shot...but. Then you've got that whole feckless bunch like American Frontline Doctors out there telling people not to get the shot. You've got hundreds of people posting horror stories of how the shot disabled them. The nonsense about chips and magnets and idiocy beyond comprehension. The preachers from the pulpit telling them to trust God and not get vaccinated.
Then we can get to the asshats showing up at school board meetings and making a mockery of a system where they are trying to get kids back in school but doing it safely. Or how about the young man who showed up to talk about his grandmother, a teacher who died of Covid19 he claimed she caught from an unmasked student? You know, the one the jackasses in the crowd mocked and laughed at him.
Sorry Steve, the simple reality is we are never going back to normal. People will continue to die in frightening numbers and our health care system is overwhelmed. And the bigger reality is this is because we as a country refused to get the shots that would have stopped it near on dead in its tracks. There's no longer a reason for adding your "but" to the argument. We've lost because for too long, so many have been half-hearted or absolutely foolish in their responses. Be nice you say? Why? Where has it gotten us?
Georgia, your home state is at 42 % vaccinated. That is pathetic. It won't get a hell of a lot better, so now we can all live with the outcomes of the anti-vaxers and anti-maskers and covid deniers who have insured we all will be losers. It's sickening, and while in the beginning you led the charge, your continued "but" has been at least as shameful as the dummies...you understood it from the beginning and somehow could justify their actions or should i say non-actions.
I'm glad i am an old man with no kids. Here's the ugly reality you all will have to face. The children will be the next horrible statistic and then the anti-maskers will be screaming about why they had to die? Here's my answer to them...look in the freaking mirror.
Medical triage is a thing and it is the moral decision to treat those who did what was right before treating those who didn't.
When I went to see the lung transplant team about prolonging my life they told me i had to maintain a certain weight, be able to walk a certain distance, and not put anything bad for my lungs into my body. They didn't care whether I agreed with the science or not. This is what was required. Treating people for COVID should be exactly the same. If you can save everyone do so, but the minute you start having to pick and choose you kick those ignorant buffoons out and treat those who actually respect the people trying to save their lives.
I believe triage is intended to maximize survivors not to judge or reward individuals. I hope you are doing well and congratulations for making the right decisions.
A record of making good decisions should part of the triage decision. I'd rather effort be spent on trying to save someone who has a lower survival odds through no choice of their own, instead of saving someone with higher odds but are in that state due to bad decisions. The reason is that if we treat these incidents in isolation, we're maximizing the odds that we'll save a life. However, we are also reinforcing the notion that there are not consequences for bad decision making, and INCREASING the odds that we'll find ourselves in a similar triage situation in the future as the individual continues making poor decisions.
How may folks with lower survival chances are we going to be willing to sacrifice in order to keep saving the same idiot over and over and over, or other idiots mimicking the behavior of the first? At some point, we'll cross a threshold in terms of lives saved so that more people end up dying because we keep wasting resources on folks who could have avoided being in peril in the first place.
Triage cannot ignore the greater context in which it's being exercised, EVEN IF the sole goal is to maximize the number of lives saved, ignoring any positive or negative moral worth assigned to the individuals being treated.
Your logic is pretty good except for humans being involved in moral worth decisions. My idea of an individual's moral worth probably differs from yours. I do not think either of us is evil. We just have different ideas about what constitutes a perfect world.
The computer scientist in me is trying to remove the moral calculus from the decision and replace it with probability instead.
For example, in the isolated single case, imagine that the survival odds of an immuno-compromised patient (a Bob) who gets the full attention of the medical staff (owing to sufficient resources) is 90%.
Now, if we throw an infected anti-vaxxer into the equation (a Charlie), let's say that their odds of survival are 95% while pushing the Bob's odds down to 85%, since Bob wouldn't receive the same level of care if it were not for Charlies overrunning the local medical system.
In a single case if you're just looking at survival odds, you spend time and resources to save Charlie as he's 15% more likely to survive than Bob.
However, if Charlie gets sick again and comes back or (more likely) inspires someone else to skip the vaccination and remain another Charlie (he survived without no vaccine penalty after all) and that new Charlie gets infected and decreases another Bob's odds of survival, the overall survival rate for both Bobs and Charlies stays around from 90% (the average of 95% and 85%).
However, in the world where the first Charlie dies or is seriously disabled while doctors are rescuing a Bob, the overall survival rate starts to rise from that 90% to 95% on subsequent rounds as folks who would have become Charlies in the absence of mortal consequences get the vaccine, enjoy a 100% survival rate, don't overload the hospital, and each Bob enjoys the higher 90% survival rate owing to adequate treatment and attention due to not competing with a Charlie for the same resources.
From a purely mathematical perspective, we have the choice of sticking with the strategy of always treating Charlies, and keeping our overall hospital survival rates at a steady 90%. Alternatively, if we focus on treating Bobs, we will raise that rate over time when potential Charlies decide its safer to take the shot and raise their own survival rate to 100% by not appearing in the hospital in the first place.
Charlies can choose their survival rate. Bobs cannot. So it makes sense to treat Bobs (they will be present regardless), while providing the incentive for Charlies to make an alternative choice to get the shot and bump their survival odds up to 100%, not only for their own personal survival, but for the collective survival of their community as well.
If you want to get morality out of this altogether and simply maximize the number of lives saved, over a certain number of iterations, it makes more sense to exclusively treat Bobs so that enough Charlies end up serving as disincentives for becoming a Charlie in the first place. What the number of those rounds are will be determined by actual survival odds (as opposed to the artificial numbers I chose to illustrate the point) and the probability of one Charlie death serving as a deterrent to other potential Charlies, but at some point those lines will cross and you will save more total lives by prioritizing Bobs, even if their initial odds of survival compared to Charlies is lower.
I don't know a better way to save lives and leave the moralizing out of it than this. Let me know if you see any holes in this reasoning or additional moralizing other than choosing to maximize the number of lives saved.
Update: Instead of "treat" or "treatment" in the mental experiment above, mentally substitute it with "prioritize". I don't mean to suggest that Charlies should be left untreated altogether, just that in cases where you pick one over the other, you prioritize a Bob.
Your way might break even in situations of close calls. Otherwise, you're wrong.