Dignity, Disability, and Lifespan

Abstract

In the Paraplegia Case, we must choose either to preserve the life of a paraplegic for 10 years or that of someone in full health for the same duration. Non‐consequentialists reject a benefit‐maximising view, which holds that since the person in full health will have a higher quality of life, we ought to save him straightaway. In the Unequal Lifespan Case, we face a choice between saving one person for 5 years in full health and another for 25 years in full health. Frances Kamm has recently unfurled an Equal Respect Argument in an effort to support the position that while we ought to give each person a 50% chance of being saved in the Paraplegia Case, we are morally permitted to save straightaway the person who would live longer in the Unequal Lifespan case. The article tries to show that a Kant‐inspired account of the dignity of persons is far more successful than Kamm's argument in supporting this position. The Kant‐inspired account owes this success to its conceiving of respect for persons not primarily as respect for their pursuit of what is of value for them, but rather as respect for the value in them.

Necessities versus ethical considerations – the realities of COVID-19 and the moral strain they enforce on society

“…Saving more lives and more years of life is a consensus point across some expert reports (5,6,7). It is consistent both with utilitarian ethical perspectives that emphasize population outcomes and with non-utilitarian views that emphasize the paramount value of each human life (13). So what about our rights in this pandemic context?…”

COVID-19: instruments for the allocation of mechanical ventilators—a narrative review

“…Although the application of criteria based on the utilitarian approach is more frequent, it is also possible to identify in the instruments [ 17 , 21 , 22 , 26 , 31 , 32 ] criteria based on the egalitarian approach that argues that all people have incomparable value. From this perspective, no one has more or less value than anyone else, and neither does this value increase or decrease based on their quality of life related to health, personal satisfaction or well-being, intelligence, talent, or instrumental value [ 80 ]. Egalitarianism is based only on the consideration of need and rejects the consideration of the probability of survival, longevity, or quality of life typical of the utilitarian approach [ 64 ].…”

Press release the fairness of ethical decisions related to the allocation of medical resources within the COVID-19 pandemic

“…1 Pravedna alokacija ovih etičkih vrednosti i principa zahteva prilagodljive etičke okvire u zavisnosti od raspoloživih resursa i organizacije sistema zbrinjavanja. 2,3,4,5,6,7,8…”

“…4,10 Dobrobit za sve (utilitarizam) je istovremeno u skladu sa etičkim principima koji naglašavaju značaj za sveukupno, kao i sa neutilitarnim pogledima koji favorizuju vrednost svakog ljudskog života pojedinačno. 3 Postoje brojni načini uravnoteženja između spašavanja više života u odnosu na broj godina preživljavanja 5 , ali bez obzira koji je vid balansa izabran, on se mora primenjivati dosledno. Limitiranost vremena i informacija u COVID-19 pandemiji čini opravdano davanje prednosti tome da se maksimalizuje broj preživelih pacijenata uz razuman životni vek, uz maksimalno poboljšanja dužine života kao podređenog cilja, gde bi prioritet trebalo usmeriti na povećanje broja pacijenata koji će preživeti tretman sa razumnim životnim vekom.…”

“…Primena vrednosti maksimalizacije benefita lečenja značila bi, da ljudi koji su oboleli, ali sa šansom da se oporave imaju prioritet nad onima koji se ne bi oporavili uprkos tretmanu, kao i oni koji bi se oporavili i bez lečenja. 3,5 Maksimalizacija benefita lečenja je jedan od najvažnijih činilaca u pandemiji, što podrazumeva i povlačenje pacijenta sa respiratora i izmeštanja iz jedinica intenzivne terapije (ICU) kako bi se obezbedilo mesto i dala šansa drugima sa većom mogućnošću preživljavanja -ovo je opravdano i pacijenti bi trebali biti svesni ove činjenice već pri prijemu u ustanovu. 8,9,10,4 Svakako, povlačenje sa respiratora i izmeštanje iz ICU pacijente koji su stigli ranije kako bi spasili one sa boljom prognozom je izrazito psihološki traumatično za kliničare -u pojedinim zemljama neki kliničari ovo mogu i odbiti.…”