Is it wrong to prioritise health workers or public figures during Covid-19?

Alaa Daoud and Ezio Di Nucci.

Over 100 health workers have died because of Covid-19 in the UK alone. Sixty-one and counting medical doctors (not including other health workers) have died in Italy in March 2020 alone from Covid-19, and 1 in 6 hospitalized Covid-19 patients was a health worker.

Health workers are justifiably concerned about their own health and safety as they put their lives at risk to help others. As a result, some health workers abstained from work at a nursing home in Australia after an outbreak. These concerns have led to reduced willingness to work among health workers and to their abstaining from work to protect themselves and their families, which 24% of physicians found ethical in a survey. The recognition of health workers by giving them preference may therefore be necessary to discourage absenteeism among them, protect them and recognise their risky work.

Different forms of compensation on top of their usual pay have also been mentioned. It is widely agreed that health workers should be given priority to promote and reward their value in saving others. Ten policies in the US also give priority to health workers. Bear in mind if health workers are incapacitated, all patients will suffer, and the health system may collapse. This is not to say that the life of the health worker is more worthy, but that the health worker has a higher instrumental value to society by saving others. The theory is that, health workers have the potential to play vital instrumental roles after recovery, especially if the pandemic is expected to last for much longer. Not to mention that providing healthcare is seen as a morally laudable activity and thus more morally deserving of compensation. But the latter is an independent argument, based on individual desert rather than the success of anti-pandemic efforts.

Our rules: Benefits differ in rank as some benefits are more desirable than others e.g. a greater benefit is given priority over the lesser one. So, the benefit of the whole society is given priority over that of a group, and the benefit of the group is given priority over that of individuals. Similarly, preventing collective harm is given priority over avoiding the individual harm.

Our recommendations: The health worker shall only be given priority over the average person if her presence is of the utmost importance to save the lives of others. This prioritisation is easily explicable in terms of our rules. First, since the benefit of the group is given priority over that of the individual. Second, if the avoidance of their loss means prevention of public harm, then it’s given priority even if it means enduring individual harm (lesser harm). Similar rules should apply to public figures. No public figure has a different priority from the average person except those with crucial functions during the pandemic, as the benefit of society is given priority over that of the individual. Keeping in mind, that is, that if the government is incapacitated, the whole society would suffer.


Authors: Alaa Daouda and Ezio Di Nuccib,c


aDepartment of Clinical Medicine, Faculty of Health and Medical science, University of Copenhagen, Denmark

bDepartment of Public Health, University of Copenhagen, Denmark

cCentre for Medical Science and Technology Studies, University of Copenhagen, Denmark

Competing interests: None declared.

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