Exam 4: Should We Ration Health Care for Older People

Brody asserts that there are two principal ethical arguments for waste avoidance in medical interventions and health care. What are these two arguments, and what are your thoughts about their implications, if taken seriously?

Daniel Callahan argues that people should live out their "natural" life spans of approximately 80 years, and then they should be allowed to die.

Callahan argues that the primary role of elders is to serve the young and the future.

Is Daniel Callahan cruel and hard hearted, or is he instead courageous and far-sighted in his willingness to advocate a controversial idea? Discuss.

How much money would be saved by Callahan's proposal to ration high-technology medicine on the basis of age?

Public entitlement programs for the health care of older adults should be used to relieve suffering but not to extend life through the use of life-extending technology.

What do Perry and Butler mean by an extended "health span"? How do they propose extending not just the life span but also the "health span"?

According to Ubel, the need to ration health care resulted in managed care; in other words, managed care did not create health care rationing.

Callahan argues that it is acceptable to withhold treatment from older persons, but it is unacceptable to collaborate with patients who want help in ending their lives.

Describe precedents for rationing health care that have taken place in other countries. Would there be support in the United States for rationing health care on the basis of age? Explain.

According to Brody, in the United States, ethical debate is now shifting from rationing health care to the avoidance of waste.

Alternative approaches to rationing health care that would improve the efficiency of the health care system include which of the following?

A "tolerable death" is one that can occur at any age due to causes that are beyond the control of medical care.

Callahan's proposal for age-based rationing assumes that care for older patients in their last year of life is expensive because of high-technology, life-sustaining medical treatment.

What is Ubel's position on rationing health care? Do you agree or disagree? Explain.

For Hentoff, Callahan's proposal becomes a "decent proposal" when Callahan suggests that age-based rationing won't go into effect until all older adults have access to long-term home care or nursing home care.

Hentoff argues that Daniel Callahan's proposal to ration health care on the basis of age is class-biased.

According to Callahan, people should be allowed to live out their "natural life spans," after which time they should be allowed to die.

Brody asserts that interventions that prolong life and those that relieve suffering are not easily made at the bedside.