Skip to comments.Principles for allocation of scarce medical interventions (playing God)
Posted on 07/25/2009 12:59:33 PM PDT by dervish
Treating people equally
Hard to corrupt; little information about recipients needed, Ignores other relevant principles
Military draft; schools; vaccination
2. First-come, first-served
Protects existing doctor-patient relationships; little information about recipients needed, Favours wealthy, powerful, and well-connected; ignores other relevant principles
ICU beds; part of organ allocation
Favouring the worst-off : prioritarianism
3. Sickest first
Aids those who are suffering right now; appeals to rule of rescue; makes sense in temporary scarcity; proxy for being worst off overall, Surreptitious use of prognosis; ignores needs of those who will become sick in future; might falsely assume temporary scarcity; leads to people receiving interventions only after prognosis deteriorates; ignores other relevant principles
Emergency rooms; part of organ allocation
4. Youngest first
Benefits those who have had least life; prudent planners have an interest in living to old age
Undesirable priority to infants over adolescents and young adults; ignores other relevant principles, New NVAC/ACIP pandemic flu vaccine proposal
Maximising total benefits: utilitarianism
5. Number of lives saved
Saves more lives, benefiting the greatest number; avoids need for comparative judgments about quality or other aspects of lives Ignores other relevant principles
Past ACIP/NVAC pandemic flu vaccine policy; bioterrorism response policy; disaster triage
6. Prognosis or life-years saved
Maximises life-years produced Ignores other relevant principles, particularly distributive Principles
Penicillin allocation; traditional military triage (prognosis) and disaster triage (life-years saved)
Promoting and rewarding social usefulness
7. Instrumental value
Helps promote other important values; future oriented, Vulnerable to abuse through choice of prioritized occupations or activities; can direct health resources away from health needs
Past and current NVAC/ACIP, pandemic fl u vaccine policy
Include -- but only in some public health emergencies
Rewards those who implemented important values; past oriented, Vulnerable to abuse; can direct health resources away from health needs; intrusive assessment process
Some organ donation policies
Include -- only irreplaceable people who have suffered serious losses
By contrast, the complete lives system combines four morally relevant principles: youngest-fi rst, prognosis, lottery, and saving the most lives. In pandemic situations, it also allocates scarce interventions to people instrumental in realising these four principles. Importantly, it is not an algorithm, but a framework that expresses widely affirmed values: priority to the worst-off , maximising benefits, and treating people equally. To achieve a just allocation of scarce medical interventions, society must embrace the challenge of implementing a coherent multiprinciple framework rather than relying on simple principles or retreating to the status quo.
The shortages here will be self-imposed by the government in order to create social justice.
The use of criteria such as youth and utilitarianism are reminiscent of "Life unworthy of life"
Didn’t see the option that creates a system that has enough physicians to meet the demand.
Oh, forgot, that’s capitalism. Ptui-ptui.
“Rational” allocation can sound compelling or fascist, depending on one’s perspective. However, knowing our politicians the way we do, I think we should expect medical care to be given out like highway funds or tax breaks.
Does anyone know if Obama carries a signed organ-donor card with him?
Based on the sections of the proposed health care deform legislation that I have read to date, I am forced to conclude that "social justice" means preference to underrepresented minorities.
This entire concept of "social justice" is foreign to me. We have a Constitution. That is my idea of justice.
1 - People who work in the private sector except lawyers.
2 - Private sector retirees.
3 - People who work in the public sector like cops or librarians. Appointees and elected officials not included in this category.
4 - Public sector retirees.
5 - People who have been on public assistance (excluding the above retirees) for more than two years.
6- Politicans (if not lawyers).
My categories are based on a persons true worth to society. It is only measured by gainful contribution. People who do not contribute to society go to the back of the line. Professions that cause the greater harm go to the bottom.
If you don’t like it then don’t be a govt employee. Your choice. For the job security you give up preferences. Sorry.... not!
I’ve read this article before. In a nutshell, it advocates allowing infants and old people to die, so that people who are productive to the State’s interests get preference.
I knew the useless eater tagline was coming....
Ramesh Ponnuru is very pro-life.
And the Obama/Emanuel crew is very pro-death. It is spelled out here - let the infants and seniors die. With the way they devalue infants it is easy to see where their unlimited support for late term abortions comes from.
Thanks for the ping!
If anyone wants the full PDF PM me with a direct e-mail address and I will send it to you.
HITLER reborn and the Gestapo applauding.
then click the Google link
not a problem, still if anyone wants I can send the pdf. it’s an open invitation :-)
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