Saving the Young Before the Old: A Reply to John Harris
Bioethics. 1994 Jan; 8(1): 84-92.
For a distribution of health care resources to be fair, it should consider the consequences for the whole lives of the affected persons and not just how badly off they are at the present moment. Since, other things being equal, a person is worse off if he dies young than if he dies old, it is fair to give scarce vital health care resources to young rather than to old persons. In the paper this ageist view is restated and defended against a number of objections raised by John Harris. According to Harris' so-called anti-ageist argument the only relevant consideration in the distribution of vital health care resources is people's desire to go on living. On reflection, this is highly counterintuitive. Instead, it is argued that both present desires to go on living and possible future happiness should weigh together with considerations of fairness. Both fairness and possible future happiness will in most cases speak in favour of saving the young before the old. A number of other problems for the ageist view are discussed, and solutions are suggested.
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Kappel, Klemens; Sandoe, Peter (1992-10)...We can therefore conclude that either we should go for equality; and in that case QALYs are unfair because they haven't got enough of an ageist bias. Or we should accept consequentialism; and in that case QALYs have ...