MIT OpenCourseWarehttp://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 - 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 first 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 offers 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 differ 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 different 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