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The potential threat of pandemic influenza is staggering: 1.9 million deaths, 90 million people sick, and nearly 10 million people hospitalized, with almost 1.5 million requiring intensive-care units (ICUs) in the United States (1). The National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Policy (ACIP) have jointly recommended a prioritization scheme that places vaccine workers, health-care providers, and the ill elderly at the top, and healthy people aged 2 to 64 at the very bottom, even under embalmers (1) (see table on page __). The primary goal informing the recommendation was to "decrease health impacts including severe morbidity and death"; a secondary goal was minimizing societal and economic impacts (1). As the NVAC and ACIP acknowledge, such important policy decisions require broad national discussion. In this spirit, we believe an alternative ethical framework should be considered.

