For the latest INSIGHT lecture, held on Zoom, we hear from Reverend Bryan Vernon a senior lecturer in healthcare ethics at Newcastle University. During the lecture Vernon discusses the allocating scarce resources in a pandemic.
The lecture begins with the discussion of the government’s actions in regards to the pandemic, with the major warning of how “it is unwise to claim you are making the right decisions at the right time when hindsight may show why you weren’t”. He links this to the argument being made that says that the consequences of different choices may result in premature deaths.
He makes sure to remind us that with the next argument he does not trivialise death, it is important to note this as he continues to discuss that in other spheres of life, we – humanity – willingly permit a trade-off. For example, road deaths, which are the trade-off of our transport systems. Changes could be made to reduce road deaths, however this would be at great expense.
He goes on to ask a series of rhetorical questions to the audience. “Is your life as valuable as mine? Yes. Is each year of your life as valuable as mine? Yes.” Vernon then states, however, that if he were given an ICU bed in place of you, then the person who decided the bed should be his has infact enhanced the value of each year of his life. This draws in to question the reasons as to why someone would choose one person to recieve the available treatment over another.
A common view is the ‘Fair Innings’ argument. Borne from a cricketing term, this argument dictates that every person should have the opportunity to reach a certain age, with all curative measures being given in aid of this goal. Upon reaching said certain age, that person is deemed to have had a ‘fair innings’ and thus is not eligible for life prolonging treatment over someone who has not lived for the same amount of time; this person would be cared for but not treated.
There are, however, dangers in taking a metaphor too far, for it fails to consider say life-threatening conditions that could severely limit a person’s life expectancy.
The Reverend states that anyone needing an ICU bed to beat COVID-19 has as much a need as anyone else, but to call bed assignments a lottery trivialises life. A system to allocate ICU beds must be easily applied; statistically, this can be done with little hassle if done based on chances of survival and potential years lost. However it cannot account for instances in which someone in far more need does not arrive to the hospital an hour after another, to whom the bed has already been assigned. It seems far too casual to deem this bad luck, thus the Reverend encourages calling it grave misfortune.
In conclusion, a reasoned process can only take us so far – it cannot give us every answer and assign resources easily. Those who don’t want the resources should not have it forced upon them. It is impossible to weigh value of a longer life against the value of a peaceful death. When deciding the best option the ideal is unattainable, the goal is to pick the least worst option. No matter what you believe, a different decision making process could change which lives are saved – but who are we to make that choice?
Last modified: 8th May 2020