This document discusses different views on how to allocate scarce healthcare resources in situations where individual responsibility for health outcomes may differ. It presents scenarios where two patients are in the same health condition but one previously led an unhealthy lifestyle through choices like smoking. Views discussed include: 1) treating all patients the same and focusing only on current health; 2) prioritizing those less responsible for their condition; 3) the view that all outcomes are a matter of luck so past choices should not impact care but incentives could be used; and 4) that people should not be responsible for consequences of choices beyond their control like socioeconomic class. The document examines arguments for and against each view.
This document discusses different views on how to allocate scarce healthcare resources in situations where individual responsibility for health outcomes may differ. It presents scenarios where two patients are in the same health condition but one previously led an unhealthy lifestyle through choices like smoking. Views discussed include: 1) treating all patients the same and focusing only on current health; 2) prioritizing those less responsible for their condition; 3) the view that all outcomes are a matter of luck so past choices should not impact care but incentives could be used; and 4) that people should not be responsible for consequences of choices beyond their control like socioeconomic class. The document examines arguments for and against each view.
This document discusses different views on how to allocate scarce healthcare resources in situations where individual responsibility for health outcomes may differ. It presents scenarios where two patients are in the same health condition but one previously led an unhealthy lifestyle through choices like smoking. Views discussed include: 1) treating all patients the same and focusing only on current health; 2) prioritizing those less responsible for their condition; 3) the view that all outcomes are a matter of luck so past choices should not impact care but incentives could be used; and 4) that people should not be responsible for consequences of choices beyond their control like socioeconomic class. The document examines arguments for and against each view.
● Shifts focus from healthcare to health specifically
● Individual responsibility should play role in health
● Gives scenario: patients in exact same health conditions, only difference is that one is a millionaire ○ Says should NOT give priority to either, when focused on health only ● “Every person’s life has equal worth, and everyone’s health should be equally important.” ● Moral should be to maintain health and promote health among everyone regardless of other factors ● Some people disagree because they want to take health outcomes and individual behavior should be taken into account when considering ○ i.e.) smokers, drinkers, obesity, unprotected sex, etc. ○ Socioeconomic factors correlate with health outcomes ● Scenario: Patient A was a heavy smoker for years, but quit smoking and committed to living a healthier lifestyle. Patient B has lived healthy for their entire life. Both have same health condition now and develop same heart disease and need heart transplant ○ health -related only would say both patients should be treated in the same way; and flip coin for heart transplant ○ Others argue that Patient A should be held responsible for past actions and B should be rewarded ● luck egalitarianism- basically states that inequalities in situation, such as a person’s health, are often unjust because of people receiving bad luck (brute luck) ○ Patient A bad luck is called “option luck” because they chose to practice unhealthy lifestyle prior to getting a disease ■ Not unjust if they suffer consequence because of their choices or bad habits ■ Does not mean A does not deserve health care at all ○ Patient B bad luck is called brute luck (brute defined as “characterized by an absence of reasoning or intelligence”) in short if they can’t help something ■ As a matter of justice they need to be compensated ○ Refute: Abandonment objection- we can abandon those that make bad choices in situations with those subject to brute luck ● Only in scarce medical supply predicament, however, if there are enough supplies can supply to both patients ■ Very harsh ■ Pluralist response- should not abandon because of moral principles such as charity, solidarity, humanism, etc. ● Of abandonment and pluralist this is the most unsatisfactory ● Prioritarianism- the ones that have no control over condition and are in worse situations should have priority ● In treatment, responsibility wouldn’t have impact ■ Responsible for their choices but not for the consequences of them ○ Coin flip for treatment ● All-luck egalitarianism- responsibility of health is from outside of the healthcare, therefore we should have incentives since everything is a matter of luck ○ Everything is a matter of luck ○ Smokers, like A, could be lucky and not get disease or unlucky and get disease ○ People can’t be responsible for their luck, they have no control over it ○ Refute: Ignores fact that some people can partake in risky behavior some of time not all of the time, but still have to pay high tax ■ Even if luck is everything, not all outcomes are beyond control ■ Doesn’t consider difference in responsibilities with risky activities ○ Create Incentives ■ i.e.) tax increase, require insurance ■ For Patient A and B they should still receive same health care, but heavy tax placed on tobacco for heavy smoker ■ Patient A pays compensation for choice prior to circumstance now ● Fair equality of opportunity view- should de discriminative of no one, therefore everyone has equal chance to receive the same health regardless of factors ○ Patient A and B should get same care ○ Refute: doesn’t argue who is responsible ● Should we be responsible for our choices, not consequences from our choices? ○ Choice really isn’t choice because those with lower socioeconomic status tends to correlate with practicing bad habits (i.e. bad diet, smoking, drinking) ○ Didn’t have a say so in what class born into, therefore had no say in lifestyle ○ Triple Jeopardy- 1st low socioeconomic class 2nd more likely to suffer because of their class 3rd given lower priority
Carol J. Greenhouse (Ed.), Elizabeth Mertz (Ed.), Kay B. B. Warren (Ed.) - Ethnography in Unstable Places - Everyday Lives in Contexts of Dramatic Political CH