Bioethics Study Guide Exam 4 - Final Study Guide Hope...

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4/29/15 Final Study Guide Hope: undervaluing statistical people costs lives One thing that is universally true is that health care systems must operate on a budget. Limited resources must be allocated, but how? Utilitarianism can run up against what is called the “distribution problem” The point of utilitarianism is to allocate the greatest good for the greatest number. Can you imagine a scenario where this might result in a conflict? Example: Suppose the chair of the department was to tell me that the dean wanted to help students in Bioethics. My (exclusive) choices are: 1. Choose 10 people with C or lower on exam 2 and give them each 4 points (40 total points added, 10 people helped) 2. Choose 17 people with C or lower on exam 3 and give each 2 points (34 total points added, 17 people helped) 3. Choose 2 people with C or lower on exam 4 and give each 15 points (30 total points added, 2 people helped) Now suppose you substitute points for “Life years added” and the different exams for different kinds of illnesses. Does that change your conviction about what should be done? Should life years be prioritized or the number of people helped? If you think what matters is the most life years being given (the most points being awarded) you hold the MAXIMIZATION VIEW……in this case you believe that #1 is the best utilitarian choice If you think what matters is helping the most people (even if on average they get a little less help) then we will call your view the GREATEST REACH VIEW If you think what really matters is that those who are helped receive the most significant gains from the allocation of resources then you hold the PER CAPITA GAINS VIEW The Rule of Rescue Usually it is thought that those who are in most in need of help, without which the individual would clearly die, are to be given priority. Hope considers such instances cases of a duty to rescue. A duty to rescue arises when we know that a particular person, without a medical intervention or without a literal rescue party coming to his or her aid will die. Let’s call such intervention Type R intervention. Type R interventions are those that we know will save a particular person (or at least are VERY LIKELY to save a particular person). Dialysis can be an example, although emergency surgery, transplants, and procedures targeted at one individual are also examples. Type R medical intervention is like the duty to rescue. When someone comes in needing dialysis (or else they will die) it seems correct to say that the moral thing to do is to give them dialysis. A Second Type Of Intervention: Statistical Intervention Statistical intervention is different from a duty to rescue. When someone is in a terrible accident or is in a burning house the fire department shows up based on the rule of rescue.
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