Trolley problem - Vaccinations

[thyme4change]

We played a game called Trial by Trolley recently. It is based on the trolley problem, where you have to make a decision on who to kill, given the inevitability that someone has to die. Fun game with the right people. Terrible decisions if you actually think about it.

en.wikipedia.org/wiki/Trolley_problem

www.amazon.com/Trial-Trolley-Dilemmas-Skybound-Happiness/dp/B07X5DV7T9/ref=mp_s_a_1_3?dchild=1&keywords=trial+by+trolley&qid=1611931053&sprefix=trial&sr=8-3#


I was thinking about the Covid vaccine as a trolley problem type of mindset. They are finding that many people, even those with relatively minor cases, are showing lung damage they believe will be permanent. But, Covid is killing people over 75. If I had to decide between protecting my 80 year old parents from death, or my 16-18 year old children from a lifetime of reduced lung capacity, and potentially a reduced life span, or me and my husband who are somewhat responsible for all of those people - what would my choice be? I honestly don't know. I would chose me last out of those 6 - but would I chose myself over donating it to someone else's 80 year old mother or 18 year old child? I do not know.



How about you? If you were given enough vaccines to protect 2 people in the world, who would you pick?

[thyme4change]

I asked my husband and I wasn't even finished stating the question and he said "My kids - obviously." So, now I feel like a bad Mom. 😂😂

[NomoreDramaQ1015]

My automatic response is my kids.  However kids tend to either be asymptomatic or mild illness.  So if I go with those odds I would pick myself and DH so the kids don't end up without parents.  Us vaccinated in turn would create a bubble around the kids.  We could put them in virtual school till this is over to keep them away from other kids and adults who aren't vaccinated.

[Bonny]

Jan 29, 2021 10:42:52 GMT -5 thyme4change said:

I asked my husband and I wasn't even finished stating the question and he said "My kids - obviously." So, now I feel like a bad Mom. 😂😂

It's going to be so dependent on the situation. There was a wonderful interview of a very spry 80+ woman in Phoenix that made the national news. Her attitude was that she had lived her life and it was more important to save younger people.

It sounds awful that we even have to discuss rationing of care in the country but it's a fact. 

[thyme4change]

Jan 29, 2021 10:50:53 GMT -5 NomoreDramaQ1015 said:

My automatic response is my kids.  However kids tend to either be asymptomatic or mild illness.  So if I go with those odds I would pick myself and DH so the kids don't end up without parents.  Us vaccinated in turn would create a bubble around the kids.  We could put them in virtual school till this is over to keep them away from other kids and adults who aren't vaccinated.

I may feel different if my kids were younger. Once they get to be a certain age, they are lumped in with adults. Granted younger/healthier adults have done pretty well against Covid, but I am more worried about even minor lifelong issues.

I already stated that my kid isn't going off to live in a dorm until she gets vaccinated, because I fully believe I have that luxury. I am thinking by August, Universities will have requirements to be vaccinated to come to school, and will have clinics available to get everyone done before school starts. If that isn't true, and she can't get it done - I will probably still send her off into the world - but I will bite all of my fingernails off.

[pulmonarymd]

We dealt with a similar issue when we had to come up with a ventilator and critical care allocation policy. How do you decide who gets what when resources run out? Difficult problems and decisions. In addition, somehow a policy that needs to discriminate in so way can’t appear to be discriminatory.

As to the question, I think the answer is the middle aged people. Older folks will contribute little in the future. Youngest have only a small chance of dying, so middle aged people would likely benefit the most. From a purely utilitarian viewpoint

[Lizard Queen]

This thread reminds me of the episode of The Good Place.

[sesfw]

We were talking about this at work a couple weeks ago.  Me being 79, if a choice had to be made between me and a parent with kids at home .... give it to the parent.

I've lived my life, and as much as I want to see my g-g-kids grow up I'm really an outsider.  A child needs a parent.

We are having so many problems getting through for an appointment for vaccines I'm ready to say enough and wait until a single vaccine can be given at my local pharmacy.  Just like the flu vaccine.

In the mean time, we are taking all the care we can.  Tomorrow is a combined b-day party for g-g-kids and it will be held at a local park, weather permitting.  We'll go, say hi to everyone (family), stay about half hour and say our farewells .....

Kids growing up too fast.

[Rukh O'Rorke]

Jan 29, 2021 9:46:27 GMT -5 thyme4change said:

We played a game called Trial by Trolley recently. It is based on the trolley problem, where you have to make a decision on who to kill, given the inevitability that someone has to die. Fun game with the right people. Terrible decisions if you actually think about it.

en.wikipedia.org/wiki/Trolley_problem

www.amazon.com/Trial-Trolley-Dilemmas-Skybound-Happiness/dp/B07X5DV7T9/ref=mp_s_a_1_3?dchild=1&keywords=trial+by+trolley&qid=1611931053&sprefix=trial&sr=8-3#


I was thinking about the Covid vaccine as a trolley problem type of mindset. They are finding that many people, even those with relatively minor cases, are showing lung damage they believe will be permanent. But, Covid is killing people over 75. If I had to decide between protecting my 80 year old parents from death, or my 16-18 year old children from a lifetime of reduced lung capacity, and potentially a reduced life span, or me and my husband who are somewhat responsible for all of those people - what would my choice be? I honestly don't know. I would chose me last out of those 6 - but would I chose myself over donating it to someone else's 80 year old mother or 18 year old child? I do not know.



How about you? If you were given enough vaccines to protect 2 people in the world, who would you pick?

wow - they call that a game? so - disquieting....

always to the youngest. They have the most years left, probability-wise. I always tell my kids - you only give your kidneys downward, not up. 

[Bonny]

Jan 29, 2021 13:27:40 GMT -5 pulmonarymd said:

We dealt with a similar issue when we had to come up with a ventilator and critical care allocation policy. How do you decide who gets what when resources run out? Difficult problems and decisions. In addition, somehow a policy that needs to discriminate in so way can’t appear to be discriminatory.

As to the question, I think the answer is the middle aged people. Older folks will contribute little in the future. Youngest have only a small chance of dying, so middle aged people would likely benefit the most. From a purely utilitarian viewpoint

I would think this is one of the hardest parts of medicine. Rational, yes. But we are also emotional human beings and living through something like this would haunt me. We all do our best but...

Thank you again for your and your colleages' service. 

[justme]

Me - and the highest bidder 


Honestly though I would take it myself I think - I'm pretty high risk and already deal with respiratory issues from my asthma. The second probably to my mom - she has similar immune issues to me and as I'm single and childless, my grandparents are dead, my nieces' mom wouldn't let them get the vaccine (though interested to see how that stands if countries start requiring it), none of my friends are higher risk than me. 

[Deleted]

I don't mean to be selfish, but I guess I am.  My grandkids are young.  My daughter has been vaccinated as a pharmacist but not my son.  He has no health issues that I know of.

So I guess me.  I wouldn't cut line in front of anyone else, but I want to be vaccinated.  

[NoNamePerson]

I see a Reality Show in the making!!

[oped]

I know this is the forbidden topic, so I'll just put it out there but lets not discuss. However, the best 'how do you really feel about an embryo' test I ever heard was kind of like this. Give this scenario to a person who is anti abortion: You are in a fertility clinic watching a friend's toddler when a fire breaks out. You can carry the toddler to safety, or you can carry a canister with 2000 frozen embryos. If you try to take both, you all die. You can take one to safety. Which one do you choose? 

On Covid Vaccines, yes the fact that you just don't know who and the fact that even seemingly asymptomatic people have been shown to have lung and heart issues is a concern. I'm trying to convince my daughter to try for an earlier group. My son won't qualify for quite a long time, but then he would also live in the house and avoid people forever even without a pandemic, so...

[The Walk of the Penguin Mich]

Jan 30, 2021 9:43:38 GMT -5 oped said:

I know this is the forbidden topic, so I'll just put it out there but lets not discuss. However, the best 'how do you really feel about an embryo' test I ever heard was kind of like this. Give this scenario to a person who is anti abortion: You are in a fertility clinic watching a friend's toddler when a fire breaks out. You can carry the toddler to safety, or you can carry a canister with 2000 frozen embryos. If you try to take both, you all die. You can take one to safety. Which one do you choose? 

On Covid Vaccines, yes the fact that you just don't know who and the fact that even seemingly asymptomatic people have been shown to have lung and heart issues is a concern. I'm trying to convince my daughter to try for an earlier group. My son won't qualify for quite a long time, but then he would also live in the house and avoid people forever even without a pandemic, so...

The semantics of this are if you have a tank that holds that many embryos, you cannot carry the tank plus the liquid nitrogen they are bathed in, it’s too flipping heavy.  You can’t remove the embryos from the nitrogen, or they die.  I have yet to see a tank that holds that many samples that is not on wheels.  So you balance the toddler on the lid and wheel them both out.  

<as someone who used to haul the 2 tanks we had in the lab to the liquid nitrogen canister to top it when the dishwasher was out on refilling days>

[oped]

My thought experiment. My rules. Lol

To be fair though it doesn’t have to be 2000, even 50 or 100 works. Does that fit the requirement? 😜

[thyme4change]

Maybe it is on wheels.

[Tiny]

Jan 29, 2021 20:04:18 GMT -5 Rukh O'Rorke said:

Jan 29, 2021 9:46:27 GMT -5 thyme4change said:

We played a game called Trial by Trolley recently. It is based on the trolley problem, where you have to make a decision on who to kill, given the inevitability that someone has to die. Fun game with the right people. Terrible decisions if you actually think about it.

en.wikipedia.org/wiki/Trolley_problem

www.amazon.com/Trial-Trolley-Dilemmas-Skybound-Happiness/dp/B07X5DV7T9/ref=mp_s_a_1_3?dchild=1&keywords=trial+by+trolley&qid=1611931053&sprefix=trial&sr=8-3#


I was thinking about the Covid vaccine as a trolley problem type of mindset. They are finding that many people, even those with relatively minor cases, are showing lung damage they believe will be permanent. But, Covid is killing people over 75. If I had to decide between protecting my 80 year old parents from death, or my 16-18 year old children from a lifetime of reduced lung capacity, and potentially a reduced life span, or me and my husband who are somewhat responsible for all of those people - what would my choice be? I honestly don't know. I would chose me last out of those 6 - but would I chose myself over donating it to someone else's 80 year old mother or 18 year old child? I do not know.



How about you? If you were given enough vaccines to protect 2 people in the world, who would you pick?

wow - they call that a game? so - disquieting....

always to the youngest. They have the most years left, probability-wise. I always tell my kids - you only give your kidneys downward, not up. 

The disquieting part is part of the fun of the game.  And the terrible moral/ethic places one goes to in an effort to reason why your "people" should not be the ones that die, playing the game.  It's not unlike  Cards Against Humanity.   

The Trolley Dilemma was a popular meme/popped up in webcomics a bunch of years ago - and then it showed up on the Good Place.    I think PBS featured it too -- in one of those series about "morality" and "ethics" and how people make decisions.       I'm guessing the Trolley Dilemma became part of a college course that was widespread across America.   For a while there - existential crisis was a popular meme amoung the college students in my life as well.    

(I'm biased I loved and laughed and chuckled sometimes for days after watching the Good Place.   I don't think it's for everyone though.  I have friends who were like why is that show funny? ) 

I managed to make a good enough case for saving "pet lovers" at the cost of trolleying over  "girl scouts".      I still kind of feel bad about that. 

[stillmovingforward]

The 'down not up' is good in theory but, there has to be someone who can take care of little ones. So, you shouldn't have 4 8 year olds running around without family to raise them (but I've seen it during the worst of the AIDS epidemic). You would be better off with 3 of the kids living and 1 adult who is still young enough to care for them. Harsh but true.

I need to read up on the 'trolley' game tonight. I love ethical discussions.

[NastyWoman]

Jan 29, 2021 13:27:40 GMT -5 pulmonarymd said:

We dealt with a similar issue when we had to come up with a ventilator and critical care allocation policy. How do you decide who gets what when resources run out? Difficult problems and decisions. In addition, somehow a policy that needs to discriminate in so way can’t appear to be discriminatory.

As to the question, I think the answer is the middle aged people. Older folks will contribute little in the future. Youngest have only a small chance of dying, so middle aged people would likely benefit the most. From a purely utilitarian viewpoint

But Utilitarianism only gets you so far. It tends to fail when things get personal. I remember years ago when I went back to college for a completely different degree and I had to take a Philosophy class. I shocked many a young soul when we had to answer that question similarly to Oped's thought experiment. If you had to chose and have onevperson killed but that would save everyone in this room, would you do so? In their youthful idealism they all agreed that it would be hard but yes they would make that choice. So this mother of two (then) teens said that if that one person was my son they better be prepared to die. I would choose him over all of ghem any time.

To say they were shocked is an understatement but I wonder what their answers would be today. Over the last 20 years a lot of them will have gone on to have kids of their own...

[pulmonarymd]

Feb 3, 2021 1:08:03 GMT -5 NastyWoman said:

Jan 29, 2021 13:27:40 GMT -5 pulmonarymd said:

We dealt with a similar issue when we had to come up with a ventilator and critical care allocation policy. How do you decide who gets what when resources run out? Difficult problems and decisions. In addition, somehow a policy that needs to discriminate in so way can’t appear to be discriminatory.

As to the question, I think the answer is the middle aged people. Older folks will contribute little in the future. Youngest have only a small chance of dying, so middle aged people would likely benefit the most. From a purely utilitarian viewpoint

But Utilitarianism only gets you so far. It tends to fail when things get personal. I remember years ago when I went back to college for a completely different degree and I had to take a Philosophy class. I shocked many a young soul when we had to answer that question similarly to Oped's thought experiment. If you had to chose and have onevperson killed but that would save everyone in this room, would you do so? In their youthful idealism they all agreed that it would be hard but yes they would make that choice. So this mother of two (then) teens said that if that one person was my son they better be prepared to die. I would choose him over all of ghem any time.

To say they were shocked is an understatement but I wonder what their answers would be today. Over the last 20 years a lot of them will have gone on to have kids of their own...

I agree utilitarianism works in the abstract. Allocation of scarce resources will cause someone to lose out and complain. But we already do it in medicine. Organ allocation for transplant is the prime c as mole. And the process gets overhauled because people do not like the outcome. But the underlying principle is to get the most life-years out of each organ. So there is inherent discrimination based on age and disability. And if you or your family are not candidates, people are unhappy

[thyme4change]

Maybe they should have done it by birthday. Everyone with a January birthday, the February, etc. Or maybe April then August. That would be the best way to preserve a similar breakdown of society - rich, poor, young, old, etc.

I recall a story from decades ago where they transported a bunch of elephants, but the new society of elephants wasn't a normal distribution- missing out on older males. And for years and years the herds were totally dysfunctional because they were missing a necessary element. The older males were responsible for discipline and order, and without them there was some chaos. Same theory as Christians pose about how single mothers and working mothers have screwed up families because God says so.

[pulmonarymd]

Feb 3, 2021 11:22:43 GMT -5 thyme4change said:

Maybe they should have done it by birthday. Everyone with a January birthday, the February, etc. Or maybe April then August. That would be the best way to preserve a similar breakdown of society - rich, poor, young, old, etc.

I recall a story from decades ago where they transported a bunch of elephants, but the new society of elephants wasn't a normal distribution- missing out on older males. And for years and years the herds were totally dysfunctional because they were missing a necessary element. The older males were responsible for discipline and order, and without them there was some chaos. Same theory as Christians pose about how single mothers and working mothers have screwed up families because God says so.

I have advocated for a birthday lottery for the vaccine. Cleaner and will distribute resources more equitably. Just do not get the high risk people preferentially, which is why it wasn't done.

[thyme4change]

Feb 3, 2021 12:37:47 GMT -5 pulmonarymd said:

Feb 3, 2021 11:22:43 GMT -5 thyme4change said:

Maybe they should have done it by birthday. Everyone with a January birthday, the February, etc. Or maybe April then August. That would be the best way to preserve a similar breakdown of society - rich, poor, young, old, etc.

I recall a story from decades ago where they transported a bunch of elephants, but the new society of elephants wasn't a normal distribution- missing out on older males. And for years and years the herds were totally dysfunctional because they were missing a necessary element. The older males were responsible for discipline and order, and without them there was some chaos. Same theory as Christians pose about how single mothers and working mothers have screwed up families because God says so.

I have advocated for a birthday lottery for the vaccine. Cleaner and will distribute resources more equitably. Just do not get the high risk people preferentially, which is why it wasn't done.

I'm really okay with high exposure people getting it first. The question is where that stops.

[Ryan]

I think the lottery would've been the better option just because it takes the ? out of it.  I haven't really even been asking about it, but just within my circle of friends I know the following that have gotten a vaccine:

1) Instacart shopper, does maybe 1 hour per week.  Pretty sure she signed up just to get the vaccine letter.
2) Trained pharmacist that works in CORPORATE, and his wife (assuming it was either just given to her or she got it because she tutors kids).  
3) Guy I know that is a CPA for a small-ish restaurant chain.  I'm assuming he slotted himself in the 'front line grocery" group.
4) My dad was getting his vaccine and lady behind him said that she worked in HR and has a lot of interaction with people because she travels so much.  
5) Guy I know that works for the FAA.  He's a former pilot, used to fly but now does something else and has been working from home for the last 8 months.

You hear enough stories like that and you think, Geez, is this what everyone is doing?  All of these examples clearly fall outside of the definition in our state, but there is probably just enough there to plead ignorance if ever questioned.  

[thyme4change]

Feb 3, 2021 12:59:56 GMT -5 Ryan said:

I think the lottery would've been the better option just because it takes the ? out of it.  I haven't really even been asking about it, but just within my circle of friends I know the following that have gotten a vaccine:

1) Instacart shopper, does maybe 1 hour per week.  Pretty sure she signed up just to get the vaccine letter.
2) Trained pharmacist that works in CORPORATE, and his wife (assuming it was either just given to her or she got it because she tutors kids).  
3) Guy I know that is a CPA for a small-ish restaurant chain.  I'm assuming he slotted himself in the 'front line grocery" group.
4) My dad was getting his vaccine and lady behind him said that she worked in HR and has a lot of interaction with people because she travels so much.  
5) Guy I know that works for the FAA.  He's a former pilot, used to fly but now does something else and has been working from home for the last 8 months.

You hear enough stories like that and you think, Geez, is this what everyone is doing?  All of these examples clearly fall outside of the definition in our state, but there is probably just enough there to plead ignorance if ever questioned.  

Also the Soul Cycle instructor that used her status as an "educator" to get the vaccine. Now that she is fully vaccinated, she is publically repentant. Easy to say when you already got what you wanted and no one can take it back.

[Ryan]

Feb 3, 2021 13:08:50 GMT -5 thyme4change said:

Feb 3, 2021 12:59:56 GMT -5 Ryan said:

I think the lottery would've been the better option just because it takes the ? out of it.  I haven't really even been asking about it, but just within my circle of friends I know the following that have gotten a vaccine:

1) Instacart shopper, does maybe 1 hour per week.  Pretty sure she signed up just to get the vaccine letter.
2) Trained pharmacist that works in CORPORATE, and his wife (assuming it was either just given to her or she got it because she tutors kids).  
3) Guy I know that is a CPA for a small-ish restaurant chain.  I'm assuming he slotted himself in the 'front line grocery" group.
4) My dad was getting his vaccine and lady behind him said that she worked in HR and has a lot of interaction with people because she travels so much.  
5) Guy I know that works for the FAA.  He's a former pilot, used to fly but now does something else and has been working from home for the last 8 months.

You hear enough stories like that and you think, Geez, is this what everyone is doing?  All of these examples clearly fall outside of the definition in our state, but there is probably just enough there to plead ignorance if ever questioned.  

Also the Soul Cycle instructor that used her status as an "educator" to get the vaccine. Now that she is fully vaccinated, she is publically repentant. Easy to say when you already got what you wanted and no one can take it back.

That is the thing that is interesting about all this.  All of these people just volunteered that they got the vaccine and they didn't really seem to think there was anything wrong about it.  They said "Oh yeah, Joe is in 1b because he's a pilot" and I'm thinking "yeah, but he sits at home and does zoom calls all day.  I think it says pilot and flight crew, implying that you actually fly commercial airplanes currently".  

So these are people that I would consider very normal and they are saying it outloud.  There are probably a whole bunch of people that are doing the same thing and keeping their mouth shut.