It’s actually a strategy for leaders to want the underlings to stick their neck out, so that they can be sacrificed as a scapegoat when convenient.
(in these bureaurocratic situations, obviously I’m not talking about a leader asking people to murder others and them not being responsible for that).
In this specific case; where's the prosecutorial discretion? If it's coming down from on high, why aren't their names in this article?
> what's difference that makes 'just following orders' suddenly not apply?
I don’t know, but this situation isn’t it in my opinion. It can be fixed with a flick of a pen (or email) by a higher up.
I don't know that that's a useful question in this context. Bureaucracies function in intensely amoral ways. Even ones with a moral mission. You can embarrass the leadership with moral judgments, and that will steer things for at least as long as public scrutiny maintains its attention span. Internally, though, the rules look more like game theory, and the bureaucracy will naturally tend to reject anyone who doesn't want to play the game.
Had the judge not thrown out this case, she'd have another feather in her cap, another headline for the website: "Kim Ogg puts nepotistic, racist, embezzling doctor behind bars!" Doesn't need to be honest, just needs to sound good.
The official statements of the medical associations in the article state: “It is difficult to understand any justification for charging any well-intentioned physician in this situation with a criminal offense.” As there is clearly no legal justification, the only justification in sight is progressive identity politics attacking a "white-adjacent" physician.
Basically, the more categories of historically marginalized people groups an individual belongs to, the more acceptable that person is, the more of a voice they’re allowed to have, and the more laudable it is to favor that person (and the more unacceptable it is to fail to favor that person regardless of the circumstances).
This doctor apparently “failed” to favor the right people. The progressive calculus around the case is all about “who”, and it intentionally excludes what, when, where, why, or how.
The problem she had with his decision was that he was “favoring” certain people in an unfair and illegal way — a conclusion that could only be reached by disregarding every question about the incident except “who”. That approach finds its origin in modern progressivism, where the only truth that matters is “who”.
The DA (she) charged the pharmacist (him), because he favored non-blacks. What is the "who" refer to? What's modern progressivism? What's its origin?
Most of them aren't blind. They know full well they're missing the forest for the trees but they follow through anyway in order to cover their butts and they justify it with "policy is policy" and "I've only got three years until my pension kicks up to the X% bracket".
I think the issue here is that the organization was stupid and unable to use them. And while the doctor’s motives seem virtuous, his wife got a vaccine ahead of schedule.
I think we have to improve efficiency, but not also set up a system where friends and family of doctors get preferential treatment because of proximity.
This whole issue is solved by better inventory management where about to expire doses are used first, not poorly managed so that a healthcare worker has to try to handle logistics directly.
I think the whole case would have been different if he didn’t personally benefit through his decisions by giving a dose to his wife.
If he wanted to cover-his-ass, he shouldn't have given it to her. If he wanted to actually do the right thing, he was doing the right thing.
I think it’s hard to know how much someone tried or didn’t try superficially based on a Times article and the doctor’s story.
The system is so messed up that the director of covid vaccinations can’t even find 9 people to vaccinate in six hours.
It’s very convenient that there was only one dose left for his sick wife. The wife was right to question whether it was right, but more importantly was that they should have considered the perception of the situation.
If something will have the look of corruption, but will result in waste, go for the waste, every time.
It would be easy to imagine a cooked up scheme whereby two vials were opened, instead of using an entire one resulting in a surplus of 10 doses with 6 hours expiry overnight which would mean “I had to give them to my family”.
So imagine if this is left to slide, there is the potential for huge numbers of vaccines to be given to family and friends. The desirability of the vaccine and the deadliness of the virus could also encourage bribes to propagate such schemes.
The whole thing has a very bad look and to trust the people in charge of the program would require a full investigation in order to clear the situation of corruption. Of the officials don’t act, they are at risk of being complicit.
The potential reputations damage from his action is much greater than he realized.
Copy paste this to other scenarios and I think you will find the excuse of “otherwise it would go to waste” a massive vector for all sorts of corruption at every level. How hard does someone try to find someone in need of something will go to waste? How will we ever know? It’s the slippery slope of corruption that poison societies.
Corruption is the deadliest thing in human existence.
Anyone who thinks that this would not happen doesn't know human nature very well. They are welcome to post situations where such excuses haven't been taken advantage of. I'll take lack of replies as acceptance of my point.
In my opinion that makes this, at least in part, a fault of those above him. There should be a standby list with a clear expectancy of urgency. If you get a call at 2am, you either show up or get passed by. Fill it with all the front-line workers in the county or something like that first, then start pulling in the public.
There should be _no_ shortage of people willing to take this, we're just spending so much time worrying about who gets it and not enough time worrying about ensuring that every last dose is effectively used and not wasted.
Edit: Also, I only replied so you would realize that you don't have implicit agreement.
Sure, buddy, you do that. Whatever helps you feel clever.
A doctor driving around vaccinating whoever he can find at their house is clearly not how you want to distribute the vaccine in early December, it's not going to get to the most at risk people as soon as it can and any issues that arise are a huge liability problem unless he can fix it with what's in his car.
At the same time not having any plan or procedure of how to use the remaining vaccines or how to decide if the last batch should be opened is only going to create bad scenarios so you can't blame the person following the instructions for having a bad outcome if that's all you gave.
What's really messed up about this (and probably why the response had to be overly strong) is it was made into a news story about how he maliciously took the vaccines for his own use when really it's a story about how the vaccine rollout procedure wasn't good enough and left him in a shitty situation.
After all, vaccination is not an emergency treatment, so it should be easy to avoid the situation in the article.
If the rules were changed to allow for this, you can easily imagine that some less ethical doctors would decide to break seals just before closing the clinic, and then vaccinating their family and friends because "it would be a shame to waste it".
This is entirely reasonable, but it comes down to - what to do when faced with this situation? True, it's not going to get to the most at risk people, but what's the alternative?
> it's a story about how the vaccine rollout procedure wasn't good enough and left him in a shitty situation.
I wish that people like the administrator who fired him and the prosecutor who charged him would have used better judgement. This logic is not "reasonable" given how extreme the outcome is.
It takes a lot of steadfast effort to go after someone like that knowing that it's going to be a PR nightmare (except perhaps on HN, where people will argue that it was "logical"). This story seems completely insane to me.
No, but it is absolutely what I would want any doctor to do if the alternative was throwing away COVID vaccine doses.
Like, I literally think this should be the standard policy. Do absolutely everything within your power to never waste a dose, ever. If that means getting in your car and driving around town, you need to go do that, no question.
1) everything still happens in a controlled setting
2) fair distribution is still ensured
3) you're not making unrealistic demands of a person who has to give out doses every night to then drive around town without a plan
Obviously none of these are the fault of the guy taking the fall though, it's process work that needed to be done by the people that fired him and charged him. That's why the response is a bit strong, he wasn't the one that created the problem and he seemed to try to talk to anyone he could reach about a better solution. At the same time that doesn't mean this was a good outcome or what should happen.
I.e. if 9 doses have to go to waste to safely improve the distribution process as a whole it's probably better than telling doctors to independently try to take it on the road unplanned.
If two people cancel one morning because, I don't know, a storm knocked down a bunch of trees in their area, and you've tried your future appointments list, do you now have to phone the other six patients and ask them to reschedule too? Or do you have a nurse go out and find two people off the street who want a COVID vaccine, and bring them to the office asap? Remember that the vaccines have a limited shelf-life even in the freezer, and that the ultimate goal is to get shots into arms as quickly as possible.
You can optimize for speed, or you can optimize for equity. I don't think we should throw out equity, but we should lean towards speed.
I wouldn't necessarily object to that particular policy. It's a shame to waste perfectly good medicine in a pandemic, but would we feel the same if he had not found anybody vulnerable who was available, and instead ended up vaccinating his own children, who are fit and healthy? What if, instead, he taken the vaccine vial to Beverly Hills and called up the rich and famous to try and find someone who wanted to be vaccinated?
I think the prosecution in this case is wrong; and the authorities should have prepared well in advance to make use of spare vaccines in a fair way. But the motivation for the prosecution is understandable - a distribution policy exists to protect the equity of society, and bureaucracy is meant to be a guarantee of that equity.
If he can get from Texas to Beverly Hills in six hours, I'm fine with it. Every shot in an arm is a step closer to ending this thing. I'd rather it get couriered to Bill Gates than dropped in a trash can.
If he'd made an honest attempt at offering it to vulnerable people first and couldn't find any takers, then I'd be fine with him giving it to his healthy children.
> What if, instead, he taken the vaccine vial to Beverly Hills and called up the rich and famous to try and find someone who wanted to be vaccinated?
That's worse, but I think it's unfair to offer these as the comparisons to what he actually did - offered it to first responders, healthcare workers, and finally the most vulnerable people he could find, all on his own time, money, and effort.
> * But the motivation for the prosecution is understandable - a distribution policy exists to protect the equity of society, and bureaucracy is meant to be a guarantee of that equity. *
Unfortunately, "equity" is a nebulous term here. The bureaucracy took one look at the list of names, saw a bunch of brown South Asian names and assumed this was unfair - why? Was their net worth written next to them? Could they have taken this step with a latino doctor and all the names were latino names - or with a black doctor?
> a distribution policy exists to protect the equity of society
Not really - the policy was exists in most places heavily favors the most vulnerable, not equitable racial distribution. There is some overlap between those two groups, for sure.
They're not comparisons. They are hypotheticals, intended to explore the range of possibilities that people would allow or oppose.
If people want to argue that the doctor was right to go out and distribute the vaccine ad-hoc, I think they should consider not just the actual result, but also counterfactuals, and whether in those counterfactual cases the actions would still be "justified". By returning to the real events, you're avoiding that consideration.
>Not really - the policy was exists in most places heavily favors the most vulnerable, not equitable racial distribution.
I did not mean "equity" in terms of "equitable racial distribution". I meant "equity" in the nebulous way of "fairness".
I agree that we must consider counterfactuals, but we can still only judge him by his actions, not hypothetical scenarios. Considering counterfactuals should help guide policy, not punishment.
> I did not mean "equity" in terms of "equitable racial distribution". I meant "equity" in the nebulous way of "fairness".
So how do we determine a particular list of recipients was "equitable" or not? While I agree with the idea that equity should mean fairness, I would offer that unfortunately in America that notion begins and ends with "equitable racial distribution".
He didn't create the situation. He just tried to do the best that he could given the situation that he was in.
No, the point I'm making is that his actions were outside of the system we use as a society to ensure fairness. He could still have distributed the vaccine fairly - but he also could have done it unfairly. The concern comes from the lack of due process.
>You’d rather see life saving medicine trashed rather than go into a human being’s arm? How can you defend that position?
This is a strawman, so thankfully I don't have to defend it.
Ultimately, the point is more this one: if you view this with a utilitarian mindset, then you may feel that the ends justified the doctor's means. But the rule of law is deontological, not utilitarian - both because it simplifies decision-making in the justice system, and because it protects people from utilitarian injustice. And from that perspective, the doctor acted unjustly in bypassing policy, even if the outcome was good - and that's what the prosecutor is concerned with.
Citation needed please, the article said that he followed the policy of not letting the vaccine go to waste.
The county prosecutor maintains that policy directed him to act differently, since that is the basis of her case against him. So, from the prosecutor's perspective, he bypassed policy. Since I'm making a point about the prosecutor's motivations, it's charitable to see this from the view of the prosecutor.
But in this case, the policy would still be wrong if it encouraged wasting vaccine that could have been used to save lives.
It's frankly bizarre to see people value bureaucracy over lives.
> In the number of words usually taken to describe an allegation of retail shoplifting, the State attempts, for the first time, to criminalize a doctor’s documented administration of vaccine doses during a public health emergency,” Bynum wrote in his order, adding the prosecutor’s affidavit was “riddled with sloppiness and errors.”
https://www.houstonchronicle.com/news/houston-texas/crime/am...
Honestly? As long as he made a good faith effort to distribute the doses he had available, then hell yeah I endorse him vaccinating any warm body available to him, whether it's his family or not.
Now if he took money in exchange? That should be a criminal offense and he should loose his medical license. But if he walked into a grocery store with an hour left and a rich person just happened to get the shot, so be it, as long as no favor was exchanged.
In my opinion this whole mess is, at least in part, a fault of those above him. There should be a standby list with a clear expectancy of urgency. If you get a call at 2am, you either show up or get passed by. Fill it with all the front-line workers in the county or something like that first, then start pulling in the public.
There should be _no_ shortage of people willing to take this, we're just spending so much time worrying about who gets it and not enough time worrying about ensuring that every last dose is effectively used and not wasted.
The current distribution policy does not exist for the equity of society, it puts the most at-risk first. That makes sense, but it shouldn't be the point at which we draw the line. For herd immunity to take effect, 70%+ of the population must be resistant, so a few people getting the vaccine out of order shouldn't cause this much of an outrage when done without malice.
I agree, but I think if I were in the position of having an extra dose that needed a warm body I'd try to find someone outside my family to avoid even the appearance of a conflict of interest.
At no point should this vaccine be wasted, people have literally given their lives to save others during this pandemic. Throwing away doses because it looks improper is an insult and a disservice to those who have paid the ultimate sacrifice in the service of others.
It's not a popular opinion, but I think anyone who's administering the vaccine should have their immediate family added to the standby list anyways, if not placed in the current phase.
Eliminate the temptation for these people to want to go outside the normal channels to protect your family, and you eliminate the risk of impropriety.
That's not to say it shouldn't be rationed and planned so the high-risk populous suffers though. It's ultimately a contentious line we have to walk, since supply is limited and demand is high, though not as geospatially dense as we'd like in all cases. It makes efficient delivery to those in rural or less well served areas much harder, which brings about intended and unintended inequalities to the front.
I don't understand why people make arguments like this. Throwing them away and giving them to friends and family aren't the only two options. There's a whole swath of acceptable and achievable options.
Giving doses to friends and family is a pretty bright ethical line. I don't think arresting him is the right call. But there shouldn't be much dispute that he acted wrongly here.
With a six hour window, it's unlikely he's gonna be able to invent a fair queuing system on his own, and get applicants to it. The article indicates he tried first with EMS, police, etc. at the vaccination location.
There should be state-wide efforts at this; a "we might call you at 2am to ask you if you can be to the hospital by 3am for a shot" list.
Why would the nurse open a new vial when they know they are about to close? That is very reckless, considering that vaccination is not time critical. That person could just come back tomorrow.
Source: I work at a medical school, and was told this by the doctor managing the vaccination line. He walks up and down the line, counting the number of people who showed up and opens the vials accordingly, but he's not in a position to ask anybody to come the next day. At least with Moderna, it's 10 doses per vial. Even though my employer had sufficient vaccine supply for us, our hospital was overrun with COVID cases in early January and medical staff to actually perform the vaccination was in short supply. The senior medical students were recruited to help out, and even then it would take many weeks to cover our staff. I actually got vaccinated at a different site 30 miles away, but I doubt this is an option available to most people. If you miss your appointment you're screwed.
Nobody expects him to come up with a perfectly fair queueing system on the spot. He should have done that sometime in the 6 months he had to prepare for the rollout. Even if we overlook that, using your position of public trust for personal benefit or for the benefit of your friends is a bright line you are not supposed to cross. And it is a bright line that is there for good reason and should be enforced.
If he were turning away people from the vaccine site and squirreling away vaccines for friends and family that would be a bright line, but that's not what happened here at all.
Please don’t make statements like this, it is against the rules.
“Please don't comment on whether someone read an article. "Did you even read the article? It mentions that" can be shortened to "The article mentions that.”
Go to the nearest grocery store/ Firehouse / police station and give them to front line workers.
(Further, he made house calls to sick elderly people, which is something sorely missing from our existing vaccination strategy.)
He distributed the vaccine to people that knew him (or were in his social network) in the very limited time he had left.
The DA who pursued this should be dis-barred.
With ID, sure. Besides, he's been the medical director of the Covid response for the county since April. His job was to put procedures to handle situations like this in place.
But that's not really the point. The point is that part of his job was to come up with a plan for these situations. And he settled on give them to my friends and family. That's obviously a poor choice fraught with ethical issues. Like I said, arresting him is not the answer but he is not innocent.
The doctor didn't do anything wrong!
This feels like backseat driving/gaming.
For my second shot, I drove out 30 miles in a snowstorm, and waited two hours in line. Other people probably waited longer. Should the last couple of people be turned away after waiting 2 hours because there aren't neat multiples of 10 at closing time? Your solution, while reasonable, optimizes vaccinate utilization but at incredible cost to an unfortunate few.
But if people waiting for 2 hours is common, then turning away the last ones doesn’t seem like a good solution. If they really wanted to they could of course come up with an efficient, low corruption system but they don’t seem terribly organized in the first place.
While reasonable in isolation, I would suggest that this view doesn't account for the extreme scarcity of the vaccine, and the stretched healthcare resources. I mean, while I work 300 feet from our hospital and our vaccine stockpiles, it was quicker to travel to the neighboring county with a lower caseload. As someone who still experienced close to 4 hours standing in line in total & driving over a 100 miles, the situation is pretty dire. Ironically, NY state has been extremely boneheaded in vaccine delivery policy. They didn't allow hospital networks any leniency is how vaccines are administered, but punished them for slow rollout. In the initial two weeks or so, NY state mandated that only COVID ward staff, emergency & delivery staff should be vaccinated. We were done with them in a couple of days, but the state wouldn't allow the rest of medical staff to be vaccinated. It was a ridiculous situation - we had thousands of medical staff waiting & ready to get vaccinated, we had the resources, and we had the vaccine - but the state would not update their policy. By the time they did in mid January, we were already facing the post Christmas & New Year related travel surge in cases and didn't have staff to spare for vaccination. According to me, hospitals/counties should have been allowed to move further down the priority list as and when they had the capacity to do so, rather than requiring the governor to allow it. Instead, we had ridiculous situations like 30% utilization of stocks.
> If they really wanted to they could of course come up with an efficient, low corruption system but they don’t seem terribly organized in the first place.
Agreed, but what's the options available to the last mile staff, like the nurse who opened the vial, or the doctor in question?
Those 30 could simply be the first 30 from the next day.
Unfortunately, the way the system is setup right now, at least from my own experience in NY, is not like this. The appointment itself is treated as sacrosanct, and the time on it is meaningless - it only gets you through the door on that day. You can show up at any time. I think the vaccination starts at 7 AM. Considering how far in advance the appointments are given (months at this point) and how inconveniently many centers are located, it's a tough call for most people.
It probably would be better to have a separate wait list of opportunistic recipients, who say they can show up at an hour's notice at the end of any day. To prevent abuse, the people vaccinated through this waitlist can't exceed 10-20/day. Honestly, let these people be the family members of the healthcare workers at these sites. I have absolutely no qualms with the household of hospital workers get preferential treatment with the vaccine - they're at elevated risk as it is.
The guy is a hero who is going above and beyond what his job requires, and not a criminal.
Give me a break.
The guy started work before dawn. The countdown started after 6 PM. He had 6 hours to find 10 eligible recipients that met the guidelines. Most that he found were strangers.
He gave the last dose to his wife after he had only found 9, and it was after midnight. It is easy to sit in an armchair and say that he should have found someone else. But how?