PT - JOURNAL ARTICLE AU - McLachlan, Hugh V TI - On the random distribution of scarce doses of vaccine in response to the threat of an influenza pandemic: a response to Wardrope AID - 10.1136/medethics-2013-101516 DP - 2015 Feb 01 TA - Journal of Medical Ethics PG - 191--194 VI - 41 IP - 2 4099 - http://jme.bmj.com/content/41/2/191.short 4100 - http://jme.bmj.com/content/41/2/191.full SO - J Med Ethics2015 Feb 01; 41 AB - Wardrope argues against my proposed non-consequentialist policy for the distribution of scarce influenza vaccine in the face of a pandemic. According to him, even if one accepts what he calls my deontological ethical theory, it does not follow that we are required to agree with my proposed randomised allocation of doses of vaccine by means of a lottery. He argues in particular that I fail to consider fully the prophylactic role of vaccination whereby it serves to protect from infection more people than are vaccinated. He concludes that: ‘The benefits and burdens of vaccination are provided impartially and far more effectively by targeted vaccination than impartial lotteries.’ He has shown convincingly that this conclusion can be established in the case of his particular envisaged scenario. However, Wardrope gives no reason to suppose that, in the circumstances that we actually face, targeted vaccination would constitute impartial treatment of citizens in the UK. I readily agree with Wardrope that if it should treat its citizens justly and impartially, it does not necessarily follow that the state should distribute vaccinations of the basis of a lottery. That will be a reasonable thing to do only if certain assumptions are made. These assumptions will not always be reasonable. However, they are reasonable ones to make in the actual circumstances that currently apply.