MIT OpenCourseWare http ocw mit edu 24 06J STS 006J Bioethics Spring 2009 For information about citing these materials or our Terms of Use visit http ocw mit edu terms 24 06 STS 006 Bioethics R12 TA Daniel Hagen Recitation 12 Rationing Health Care and Valuing Lives 1 Presentation Suhni Chung on rationing health care 2 Is health care rationing necessary and inevitable Ubel yes He considers three arguments that health care rationing is neither necessary nor inevitable Health care is special and shouldn t have any limits set on it We should rst eliminate wasteful practices The problem is the health insurance system which we should eliminate or restructure What does Ubel say to rebut these arguments What exactly is the problem to which health care rationing is a response Is it a scarce resources problem If it is a scarce resources problem what is the resource that is scarce 3 Health care rationing in practice NICE NICE o ers us an example of what a health care rationing system might look like in practice Who objects to NICE and to what parts What do you think of NICE Americans are wary of excessive government involvement in health care Why do you think this is Does the experience with NICE in Britain justify these concerns 4 Presentation Kathleen Clark Adams on valuing lives 5 What makes a life valuable Some cases to focus on In each case you have 100 respirators and 1000 people need them Those who do not receive a respirator will die Who should receive a respirator Case 1 The group is homogeneous The are all the same sex age ethnicity back ground intelligence abilities life prospects etc They all have the same amount of money Case 2 As in case 1 but they do not all have the same amount of money Some have more money than others Case 3 As in case 1 except that they are not all the same age There ages range from 1 year old to 100 years old evenly distributed across ages Case 4 As in case 1 except that they di er in their intelligence Some of the people are rather stupid while others are rather smart Case 5 As in case 1 except the people are of di erent ethnicities Case 6 As in case 1 except there is a range of sex and genders Case 7 As in case 1 except that some people have led and will continue to lead virtuous lives whereas some people have led and will continue to lead vicious lives In each of these cases what features are morally relevant features Why 1