COVID 19 In the Era of Social Justice EssayPLCY 340 Fall 2020 First Paper Instructions: In 1500-2000 words, answer one of the following questions. Papers must use a recognized citation system – e.g. Chicago or MLA – and must be double-spaced throughout. Papers are due September 20th at 11:59pm. Papers should be submitted electronically (in .doc or .docx file format) to the course website via the “Assignment” portal. If students cannot do so for some unforeseen reason, they may submit their paper to my email address: email@example.com. Students need not use sources that are not course readings. But, if students make empirical claims in their papers, they should cite a legitimate source – e.g. an academic study. Late papers will be penalized 3% per day, including weekends. Students are responsible for submitting the appropriate file to Sakai. Late penalties will not be waived in cases where students submit the “wrong file” to Sakai. 1. To fulfill the mandate of the Cameron Gulbransen Kids Transportation Safety Act of 2007, the National Highway Traffic Safety Administration, as of May 1, 2018, requires the installation of rear-view video systems in all passenger cars, trucks, multipurpose passenger vehicles, buses, and low-speed vehicles with a gross vehicle weight of less than 10,000 pounds. The purpose of the regulation is to reduce the risk of “back-over” crashes involving vulnerable populations (young children, the elderly, people with disabilities). The benefits of the regulation are estimated to be between $344-396 million (save 13-15 lives/year; prevent 1,125-1,332 injuries/year; and prevent $10-13/vehicle in damage). The costs of installing the cameras are estimated to be between $546-620 million. What is cost-benefit analysis? What reasons might government agencies have to use this decision procedure to evaluate policies/regulations? If the National Highway Traffic Safety Administration relied solely on cost-benefit analysis to decide whether to implement the regulation in question, what would it have done? Was the National Highway Traffic Safety Administration morally justified in passing the rear-view video system regulation? Why or why not? Be sure to defend your answer. The purpose of this assumption is to have you focus on the ethical dimension of the case. 2. Suppose you are a policymaker responsible for allocating resources and setting spending priorities for North Carolina’s Medicaid program. You’ve been granted an extra $20,000,000, and with this funding, you can either: 1. 2. Offer 50 children/year a highly effective live-saving treatment for pediatric cancer, yielding 3750 total QALYs, or Offer 25,000 adults suffering from mild depression* a highly effective course of psychotherapy – e.g. talk therapy – yielding 25,000 QALYs. Cancer Treatment Psychotherapy Expected Net Benefit (QALYs) 1 0.2 Duration (years) Cost/Treatment ($) 75 5 400,000 800 * Adults with mild depression can typically manage their day-to-day activities, but usually with little enjoyment. They may also experience symptoms such as difficulty sleeping, difficulty focusing, tiredness, negative thoughts, and feelings of sadness, among others. What is cost-effectiveness analysis? What is the motivation for using cost-effectiveness analysis to prioritize healthcare services? How would you decide this question if you employed cost-effectiveness analysis? Is cost-effectiveness analysis a just procedure for prioritizing health care services? Why or why not? Does priority to the worse off offer a more just approach to the prioritization of health care services for Medicaid recipients? Why or why not? If so, which version of priority to the worse off is most defensible? Why? Be sure to defend your answer. 3. If more North Carolinians are infected with COVID-19, hospitals may need to start rationing care, including access to ventilators, ICU beds, and critical health staff. Suppose the North Carolina Secretary of Health and Human Services asks you to devise a plan that North Carolina hospitals may use to ethically set priorities among patients who need access to critical care in order to survive. What would you advise hospitals to do? To devise your plan, please work through the following questions. What is utilitarianism? How would a utilitarian set priorities among patients needing care? How might a utilitarian approach lead to older patients having a lesser chance of receiving care than younger patients? How might a utilitarian approach lead to people with co-morbidities – i.e. people already suffering from other chronic illnesses such as type 2 diabetes – having a lesser chance of receiving care than people without co-morbidities? Are these two consequences fair? Recall too that because of the social determinants of health, people with co-morbidities may be more likely to be low-income and racial minorities. On the whole, is a utilitarian approach to setting priorities just? If not, what is a just approach? Firstcome first-served? A Lottery? Priority to the worse off? To answer this question, it might be helpful to use the following table which outlines some typical patients hospitals are likely to encounter. Patients in need of a Ventilator Age Comorbidities Race/Ethnicity Socioeconomic Status Chance of Survival with Access to Ventilator Jack 45 Black Low-income 40% Frances Andrew Mary Alex 25 75 55 40 Obesity, type 2 diabetes None None None Chronic lung disease Life Expectancy (if treatment successful) 70 Latino White Black White High-income Middle-income High-Income Low-Income 80% 50% 80% 40% 80 80 80 70 4. The U.S. Food and Drug Administration is responsible for regulating tobacco, and evaluates regulations using cost-benefit analysis. In 2014, the F.D.A. decided to discount the benefits from reduced smoking – e.g. fewer early deaths and diseases of the lung and heart – by 70% to offset smoker’s loss of pleasure from smoking less or quitting altogether. What is hedonism? How does the F.D.A.’s discounting decision reflect a partial commitment to hedonism? How might the F.D.A. evaluate the costs and benefits of tobacco regulations differently if it employed a preference satisfaction account of wellbeing, in particular, an endorsed and informed preference satisfaction account? In accordance with which account of wellbeing should the F.D.A. evaluate the costs and benefits of tobacco regulation? Why? Be sure to defend your answer. Evaluation Guidelines The purpose of this paper is for you to provide a reasoned defense of a position on the above question. Your paper will be evaluated in accordance with the following guidelines: 1. Thesis: Does the paper advance a clearly formulated thesis? Is the scope of the thesis appropriate? Or, does the paper set out to accomplish too much or too little? 2. Understanding and Reconstruction of Text/Positions/Arguments: Does the paper demonstrate a comprehensive understanding of the text/arguments/positions under discussion? Does the paper support its interpretation of the text by appeal to textual evidence? Does the paper reconstruct the positions/arguments under discussion in a systematic way, making clear the way in which the different components of the argument/position fit together? Or, does the paper only present a superficial understanding of the text/arguments/position? Is the paper fair to the positions/arguments under discussion by reconstructing them charitably? Or, does the paper reconstruct the arguments in a way that fails to recognize their strength. 3. Strength of Argumentation: Does the paper present strong arguments to support its thesis? Does the paper consider possible objections to its position? Or, does the paper present arguments that invite immediate objections or that commit fallacies? Do the thesis and arguments of the paper consider the complexity of the issue under discussion? Or, does the paper advance claims that are overbroad or too general? 4. Organization: Is the paper well organized? Is its structure apparent to the reader? Does the paper proceed in a rational fashion? Does the paper contain a helpful introduction and conclusion? 5. Clarity of Expression: Is the paper clear? Does the paper use simple language and grammatical sentence structure? Does the paper define the concepts that it introduces? Grades A Paper: An “A” paper will defend a clearly formulated and tightly focused thesis. It will be clearly written and will be organized in a rational and coherent manner. It will demonstrate a strong grasp of the material under discussion and will reconstruct the arguments under discussion in a systematic way. It will support its thesis with strong arguments that do not invite immediate objections and that appreciate the complexity of the issue under discussion. As well, it will consider well thought through objections to the positions that it defends. B Paper: A “B” paper will defend a clearly formulated thesis. Though appropriately focused, the thesis may be either too narrow or too broad. It will be well organized and clearly written. The paper will demonstrate a good grasp of the material under discussion, but it may not do so entirely comprehensively or systematically. It will support its thesis with good arguments; however, these arguments may need work in a number of respects. C Paper: A “C” paper will demonstrate an adequate grasp of the material but will not present it in a comprehensive or systematic way. It will have a thesis, but the thesis will lack focus, either being too narrow or too broad. It will present arguments to support its thesis, but these arguments will require more thought and consideration. D Paper: A “D” paper will demonstrate a very minimal understanding of the material and will fail to engage with it in a critical way. It is poorly organized and is difficult to follow. F Paper: An “F” paper will demonstrate very little grasp of the material and will fail to engage with it in a serious or critical way. It will fail to provide a complete answer to the assignment. …
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