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Medical Ethics: 13 May. Aggregation and Kamm.So much to say and so little time. Sigh.
What we did and didn't showAt most, we gave an argument for the view that the world is worse if more people die than it would be if fewer die. That's simply worse, not worse from any particular person's perspective. That's what Kamm will have shown if she's completely successful.
But Taurek still has an argument: it's unfair to the smaller number of people to always choose to save the greater number of people. We should give each person an equal chance of living instead. He can still stick to this even if he loses the argument that the world can't better or worse from no particular person's perspective.
There's a general point here: what rules should we follow in rationing care? Should we allocate our health care resources so that they save the greatest number of lives? Should we allocate our health care resources so that everyone has an equal chance of having his or her life saved?
What's coming up next is a version of this debate. Some (Singer, McKie, et. al. believe that we should allocate health care resources to produce the greatest number of Quality Adjusted Life Years (QALYs, for short). Maximizing QALYs would mean maximizing the number of lives saved but with extra weight given to higher quality lives over lower quality lives: those who could only live on in a hospital bed score lower in terms of their quality of life than those who could move about normally. Harris, on the other hand, thinks that this would be unfair. His basic position is much like Taurek's.
Read over what Taurek says about the boat and the volcano: it's about how he thinks public resources (the boat and coast guard captain) should be distributed.
Here's a quick summary. There's an island about to be destroyed by a volcano. The island's coast guard boat can save the many people on the north end of the island or the few at the south end. You might think that a publicly financed coast guard should always save the greatest number. But why is that fair to the people on the southern tip of the island?
Of course, not all rationing questions involve public resources (the case of David and the drug was a rationing question). But many of them do.
Of course, we don't have to look too far ahead. Jean beat me to the punch today -- she saw right through to the big issues in rationing health care.
We didn't get to talk about Glover's argument in class today and, given the schedule, we probably won't get to it. Still, you can look at what I would have said.
This page was originally posted on 5/27/98; 12:08:17 PM and was last built on 6/3/98; 2:43:53 PM with BBEdit and Frontier 5 on a Macintosh running System 8.1.