[John]
We should focus more on Quality of life, rather than quantity. That's
the most efficient use of our medical resources, imo.
[Arlo]
Platt's assumption is that the distribution of health services will
always lead to some living and dying, that we cannot provide adequate
health coverage to every single person equally; some will always be
left out. (This may be a valid assumption, of course)
Every single first-year ethics student is given some variant of the
"you have nine pills and ten sick people" question, "how would you
propose to determine who gets the pills and who is left to die?"
Answers, of course, range from chance (draw straws) to quantifiables
(age, net economic worth) to more difficult qualifiables (cultural
importance, intelligence) to contests (physical, scholastic).
I think its undeniable that "economic worth" has been the leading
determinant of this distribution in the capital economies of the West
(before "socialistic" policies were adopted). Imagine that back in
the last 1800's this question (9 pills, 10 patients) was asked, and
imagine that a son of Andrew Carnegie was one of the patients, and
another was a son of Joe the Miner. Who do you think was nearly
certain to get one of the pills? The son of Carnegie, of course.
Social policies were adopted by societies that began thinking that
economic worth should be leading (or sole!) determinant of "who lives
and who dies". Some policies adhered to quantifiables (e.g., in times
were vaccinations were in short supply, the old and the young would
receive preferential treatment over others- a poor senior citizen
would receive a vaccination before a wealthy middle-aged person), or
urgency (a poor, but sicker person would receive an available
transplant before a wealthy, but less sick person).
Would the MOQ support an entirely economic-based valuation of "who
lives and who dies", of who gets those nine pills and who is left to
go without? Would the MOQ say that those pills should go to the nine
people able to pay the most for them? If not, how would the poorest
person on that list have a chance at a pill over the nine wealthier persons?
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