Medical Utility Judgements and Rights

Part of the International Library of Ethics, Law, and the New Medicine book series (LIME, volume 22)

I have been arguing that medical utility can compromise an egalitarian approach to patient selection for Resources. It can place differential value on lives according to their degrees of prospective medical benefit. I think that an egalitarian approach should object to the negative impact that medical utility judgements will have on elderly candidates. This age-biased impact is arguably unfair because it conflicts with equality of opportunity.

I want to question whether a patient selection process that aims to maximize medical utility can securely incorporate rights that may protect against age bias. Medical utility can involve value judgements about diminished capacity for social life or clinical judgements about diminished capacity for medical benefit. These judgements are conflated easily in the context of a social interpretation of life. My concern is that greater attention should be paid to devising a means of avoiding the contaminating influence of social value judgements, especially at the first stage. My assessment will cover the attempts by Sumner and Griffin to secure rights in a consequentialist framework.

I will then address two objections to my argument that basing selection on the age-biased impact of medical utility is unfair. The first is Daniels’ cohort argument that denies that age-based preferences are discriminatory the way race or sex-based preferences are. The second claims that the elderly are already receiving a disproportionate and growing share of health care services, which they consume unfairly at the expense of younger persons.


Elderly Person Health Care Resource Moral Foundation Medical Utility Ideal Observer 
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© Springer 2004

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