04 08 09

Notes 4/8/09 there will always be scarce medical resources we will never have enough of everything for everyone we need criteria for fair allocation of resources 17 people every day b/c they don?t get an organ transplant in time organs = very scarce medical resource The Allocation Exotic Lifesaving Therapy by Nicholas Rescher (1969 ? 7 years after the ?God Committee?) response to god committee God Committee who would get a spot on a dialysis machine?they determined it. who got to live and who got to die Basic screening/criteria for inclusion constituency who is a citizen of the institution that has the resource needs of science (when relevant) are there people from whom we can learn? research on patient, kind of are we using people as a means to an end? only when people would be harmed and if it were against their consent prospect of success only people that would succeed from the treatment should get it. Final Selection/Criteria of Exclusion 1&2 = medical medical criteria = urgency of need, and how long you?ve been on the list 3-5 = social if fail to appreciate social consequences of medical decisions, bad thing should we think about social when deciding who lives and who dies? try best guess, but can?t know everything about people have to try, otherwise just basing on medical likelihood of success ones that have low or no likelihood of success life expectancy ones that are going to live longest afterward utilitarianism Family role also includes close members of the community ex: are they primary care giver for lots of children, elderly parent, breadwinner of the house? will that move them ahead? why? utilitarianism if single person dies w/ no dependents, tragedy person w/ responsibilities, tragedy ripples out Potential future contributions if person is in a role where they do a lot for the community, then utilitarianism Past service/contributions ex: Mother Theresa at end of life Lottery Choose from the few remaining using a random mechanism stage 3 in the process of choosing who gets what