Every vaccination lights another candle against the darkness; the complexity of pandemic ethics

Last week we heard that Glastonbury is to be cancelled for a second year running. I’m not surprised, and I don’t suppose many others would have been either. It must have been a very difficult choice to make. Indeed, according to Michael and his daughter Emily (Eavis), they have tried every which way to keep it a possibility, but to no avail. Going to Glastonbury has long been on my bucket list of things to do before I die (more of which later). It is one of the iconic festivals that I have yet to get to, and I have in my time, been to many. I was a teenager in the 1970s and enjoyed many a Summer of Love at a variety of famous music festivals, all of which, for me, at least, were illicit-drug-free experiences. Glastonbury has always been one of the first festivals to take place each summer and over the years has become increasingly complex to arrange and set up.

Whilst the next Glastonbury festival is now planned for the Summer of 2022 (and all the weekend long tickets have been sold) I am still hoping that some music festivals will happen later this year. However, as I was thinking about what initially felt like a lost opportunity to do something that I had wanted to do for a long time, it made me reflect on what I now think is really important. The Covid pandemic has possibly made lots of other folk also think about what has really become important in their lives.

It was this pause for reflection that led me to thinking about whether I still had a bucket list of things I still wanted to do. Apparently, it was one Justin Zackham, a British screen writer, who is credited with first using the term ‘bucket list’. He wrote the screen play for the 2007 film The Bucket List, in which two terminally ill men decide to try and do all the things they have written down on a ‘what to do before I die list’. It’s a great film and if you haven’t seen it, you can download it from Amazon (and other streaming services). Be warned, you may need to have a box of tissues handy in places. Trust me when one of the men (Edward) meets his granddaughter (who he didn’t know he had) for the first time and crosses off ‘kiss the most beautiful girl in the world’ from his bucket list, you will be reaching for the tissues.  

Much of the film is about the different places in the world they have wanted to travel to and see. Travel to far flung places is often a point of friction in our house. I have been fortunate through my time working at the university to have travelled all over the world, whereas J has not been able to afford to do so and would dearly love to. These days the idea of travel, particularly long distance travel, holds absolutely no appeal for me. Travel does not appear on my ‘bucket list’ at all apart from a promised postponed honeymoon to the Holy Land. I’m sure J and I will find a way to accommodate both our ambitions. But of course, the choices we make over whether to travel or not are relatively straightforward and will eventually be resolved through a comprise.

As we were able to see last week, in health care, making the right choice can be a difficult thing to do. There was a challenging example of this in the assertion by Lord Sumption, a former Supreme Court Justice, that he did not accept that ‘all lives are of equal value’. To say this sparked controversy would be an understatement. At a time when many healthcare professionals are increasingly faced with making decisions as to who might receive critical care, I’m not sure starting a public debate on ethical decision making in this way was totally appropriate.

Dear reader, please don’t misunderstand me. I think ethics, and in particular healthcare ethics, are more important now than they have ever been. The pandemic has brought into clear view what I think is one of the most difficult aspects of our current political, organisational, and everyday clinical decision making. Ethical decision making should be about doing what is right and good for the greatest number of people (within resources) but knowing what that might be is extremely complex.  

Last week I had my Covid vaccination. It was simple, painless and TBH, brought me great relief. I was vaccinated as part of the vaccination programme at one of the hospitals I’m a Non-Executive Director at. Thankfully the hospital vaccination hub has almost completed vaccinating all of my colleagues there, as well as nearly all those people living in our local community who are aged over 80 years of age. I’m not, by any stretch of the imagination, a front line member of staff. Due to my age and the recommendation made by NHS England/Improvement, I shouldn’t really be eligible for my vaccination until the end of February. My hospital, like many others I suspect, who are delivering the Pfizer vaccine, are making best use of the rather unreliable available supplies to get as many people through the door and vaccinated as possible. As my #earlyrisersclub friend Deb noted: ‘every vaccination lights another candle against the darkness’. Getting my vaccination made me feel grateful, but also guilty.

I would rather have given my place to my wife J, who is not destined to get her first jab until the end of April. On the basis of doing the most good to the greatest number of people, personally, I would have liked to have seen the vaccine go to all those working in keyworker roles: teachers, policeman, nurses, bus drivers, doctors, fireman, ambulance workers, supermarket staff and so on, first. Without them being available to keep the rest of us safe, cared for, warm and protected, society as we know it would probably grind to a halt under the pressures of the pandemic. Politics rather than science prevailed and a different priority vaccination programme was put in place. 

It is our children and young people who will feel the impact of the pandemic more than any other group in society. Protecting their future health and wellbeing is crucial. Acquiring and maintaining reasonable health (and I know what you are going to ask, what does reasonable mean?) is the precondition to successful engagement in society and human flourishing. If you want to know more, why not get hold of a copy of Norman Daniels’ book: ‘Just Health, meeting health needs fairly’. Like the film Bucket List, it was also published in 2007. There are no easy answers to ensuring we are all ethically sound in our decision making and the choices we make in helping others. The last words go to Michael and Emily who suggest: ‘one thing last year taught us is that fundamentally we all need human connection’. Whatever decisions and choices we are faced with making, now and in the future, let’s try and make sure we keep this thought in mind. When communicating and connecting with others, kindness matters.