Medical Ethics PHIL 148 @ Binghamton University, Sum 11


Debate: Health Care & Justice (Yes)

Question: Is it moral for the government or individual hospitals to provide limited resources on a first come, first serve basis?

Yes, I believe it is moral for the government or individual hospitals to provide limited resources on a first come, first serve basis.  Well first off, I feel that it is necessary to define what exactly "limited resources" are.    I believe limited resources include measures and procedures that utilize more than the usual time and money.  For example, a heart transplant is something I would refer to as a limited resource.  Besides measures and procedures, a limited resource can be an organ as well; some examples would the heart and the kidney.  A limited resource can also be a vaccination of some sort in order to prevent the flu.  Keeping this in mind,  I believe that the government or hospitals are morally sound in providing these limited resources on a first come, first serve basis, because the people that they are given to actually need them.  If a patient is next on the waiting list for a heart transplant and a heart is found, then that patient deserves to undergo the operation and obtain his/her new heart.  If only 1,000 vaccinations for the bird flu are available, then the first 1,000 to show up at the doctor's office are entitled to receive them.  Some may argue that what if another individual who needed it more comes later and finds that they are not available.  They would say it is wrong to give the vaccinations to the last 100 people who were healthier, and instead, the vaccinations should have been saved for dire cases.  This may have some truth; however, what guarantee do we have that the last 100 people wouldn't have contracted the flu if they hadn't been vaccinated.  What if the last 100 lives had just been saved from the vaccination?  How do the government and hospitals decipher whether the treatment or procedure should go to the patient who presently really needs it or the future patient who may really really need it?  Both institutions are comprised of only human beings that are just trying to fulfill their daily obligations in their occupations.  These people are not gifted with the ability to foresee future patients and then use that future knowledge to withhold treatment for patients in the present who don't necessarily need it as much as the future patients do.

Let's take a look at ethical perspectives.  Kantian deontology states that people have duties whether they be perfect duties or imperfect duties.  The hospital's perfect duty is look after its  patients.  In this case, the hospital's perfect duty is to administer the limited resources to those that need it in the first come, first serve basis.  By doing so, the hospital's actions are considered to be moral.  The hospital also has an imperfect duty to think about future patients who the limited resources might benefit more than the present patients; however, by transgressing this imperfect duty, morality is still sustained.  Virtue ethics values the character of the individual.  When a physician is administering limited resources to patients on a first come, first serve basis, he is displaying virtue ethics.  The physician is caring for the patient by doing all in his/her power to restore him/her back to health and so is morally carrying out his job.  He/she knows that the patient is need of the limited resource.  The patient is next to receive whatever treatment or procedure that he/she is entitled, and so the physician administers the limited resource to that particular patient to the best of his/her ability.   By this, the physician has the right actions coupled along with the right intentions which is a mantra that is preached in virtue ethics.  Care ethics tells us that the health care professionals need to administer to both the psychological and physical needs of a patient.  In this case, the psychological needs are dependent on the physical needs of the patient.  The physical needs of the patient is dependent on the limited resource that that patient is entitled to in order progress towards a healthier being.  By providing these limited resources to patients on a first come, first serve basis, the physician is carrying out an important stipulation in care ethics.  Utilitarianism states that resources should not be wasted and should be used efficiently.  These limited resources are going to individuals who need them in order to carry on with their lives and won't be wasted.  By holding onto these resources and saving them for future patients rather than administering them to present patients who need them and are entitled to them now, there is actually a high chance of the resources going to waste which is frowned upon in utilitarianism.

The best analogy I can think of is a queue for the restrooms in a restaurant.  Sometimes, the line is long and is filled with people who need to use the bathroom for various purposes.  Yes, some people may need to do more important things than others; however, there is a line that has been established and needs to be respected.  Everybody needs to wait their turn on line so that some sort of order is maintained.  Let's say there's no queue to the restroom, should an individual think twice about using it if they have to?  Should that individual think that their purpose in the restroom is not as important as someone else's future purpose might be, so they should wait for the next individual to use the restroom under that assumption?  Absolutely not.  If that happened, then the individual would be standing outside the restroom all day and would never go in.  Nothing would be accomplished.



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