Our time of pestilence: Purchasing immunity and ignoring the misery of others

Abstract

Do medical professionals have a moral obligation to relieve the misery of people far away? The world is increasingly starkly divided geographically, into lands of long life and lands of early death. In the wealthy world, we are followers of Herman M. Biggs, who said that "health is purchasable": medical professionals warn of impending epidemics and attend to reducing risk. In the poor world, people live in misery and die in disasters. The word "epidemic" is used to designate perceived threats to the long life of the wealthy, such as obesity, but "epidemic" is not applied to the sources of greater misery, including malaria, tuberculosis, and diarrheal diseases, which are responsible for more widespread mortality. The experience in 2009 with H1N1 flu illustrated the danger of the excessive focus on forecasts of epidemic risk: expenditures for flu vaccine were far in excess of spending for prevention of illnesses that cause greater mortality. In the end, billions of euros were transferred from public funds into private hands, yet flu immunization was irrelevant to the outbreak, and the outbreak was relatively mild. To learn from lessons like this, health professionals should attend to the main purpose of medical science: to make the world better. © 2011 Springer Science+Business Media, LLC.