http://www.timesonline.co.uk/tol/life_and_style/health/article6719226.ece
There are two different questions here, so I'd like to see if we can discuss them individually. The first is a very pragmatic question, and the second is a more moral (or, perhaps, at least normative) question about this young man's behavior itself.
The first question is given that there is a dearth of organs, and a huge waiting list, how (and whom) do you deny organs to? On some level, we have to prioritize and triage, our organ recipients. This can be almost purely based on chances of survival, long-term benefit from the organ, and whether the person has a high chance of destroying the new organ. In this case, my sense is that given that this person has been an alcoholic for nine years, giving him a new liver would be like giving a new heart to a fat guy who's had five heart attacks. Whether it's a disease or not (and I believe both are), is irrelevant; the fact that the same thing that killed the original organ will kill the new one is the only salient detail. While we can all feel sorry that he fell in with a bad crowd and basically ruined his life, can we really justify bumping someone else down the list to save his life without complete, one-hundred-percent sure, proof that he won't go back to drinking?
The second question is based on the premise that we have an infinite supply of organs, and that to help this young man would not prevent us from helping anyone else (so, similarly, ignore cost): would you want to save him then? There's a concept in economics and social science called "moral hazard" (which, ironically, has nothing to do with any sort of moral code). Moral hazard is, fundamentally, that when you decrease the costs of a behavior, or increase the rewards, it encourages the behavior; you get more of what you subsidize, for better or for worse. The sanest example is that when you give tax breaks to people who own houses, more people will buy houses. The most extreme example is that when you provide healthcare without it costing the people using it, they'll use it more (which is debatable, but not relevant to this question).
So, the argument goes: if we save this kid by giving him a new liver, we create a moral hazard about underage drinking (and binge drinking), that they can do it with no consequences, since someone else will step in and save them. This, of course, is a normative judgment that underage and binge drinking are "bad" things which we don't want to encourage.
So, here are my questions:
Do you save this young man, given the limited organ-related resources?
Would you save him if we had unlimited resources?
There are two different questions here, so I'd like to see if we can discuss them individually. The first is a very pragmatic question, and the second is a more moral (or, perhaps, at least normative) question about this young man's behavior itself.
The first question is given that there is a dearth of organs, and a huge waiting list, how (and whom) do you deny organs to? On some level, we have to prioritize and triage, our organ recipients. This can be almost purely based on chances of survival, long-term benefit from the organ, and whether the person has a high chance of destroying the new organ. In this case, my sense is that given that this person has been an alcoholic for nine years, giving him a new liver would be like giving a new heart to a fat guy who's had five heart attacks. Whether it's a disease or not (and I believe both are), is irrelevant; the fact that the same thing that killed the original organ will kill the new one is the only salient detail. While we can all feel sorry that he fell in with a bad crowd and basically ruined his life, can we really justify bumping someone else down the list to save his life without complete, one-hundred-percent sure, proof that he won't go back to drinking?
The second question is based on the premise that we have an infinite supply of organs, and that to help this young man would not prevent us from helping anyone else (so, similarly, ignore cost): would you want to save him then? There's a concept in economics and social science called "moral hazard" (which, ironically, has nothing to do with any sort of moral code). Moral hazard is, fundamentally, that when you decrease the costs of a behavior, or increase the rewards, it encourages the behavior; you get more of what you subsidize, for better or for worse. The sanest example is that when you give tax breaks to people who own houses, more people will buy houses. The most extreme example is that when you provide healthcare without it costing the people using it, they'll use it more (which is debatable, but not relevant to this question).
So, the argument goes: if we save this kid by giving him a new liver, we create a moral hazard about underage drinking (and binge drinking), that they can do it with no consequences, since someone else will step in and save them. This, of course, is a normative judgment that underage and binge drinking are "bad" things which we don't want to encourage.
So, here are my questions:
Do you save this young man, given the limited organ-related resources?
Would you save him if we had unlimited resources?
