Simply put, we're up against the law of diminishing returns. We're also facing the reality of several finite resources: money and personnel being two of them.
I'll give several examples:
- should a 95 year-old, but generally healthy person receive a hip replacement?
- how about a 95 year old in poor health?
- should a chronic smoker be given a lung transplant, given that his smoking (a voluntary act, in theory) is the reason for his lung disease?
- should that smoker be given priority over a patient in need of a lung transplant due to accidental exposure to toxic chemicals?
- or over a 35 year old father of two who was severely injured in a car accident?
- what if the 35 year old had caused the accident because he drove while drunk?
Keep in mind that care provided to these people cannot be provided to someone else; care for these people is care that is denied to someone else.
These types of decisions appear in medicine every day, several times a day. There is only so much care that can be delivered, and demand outstrips supply. How do we fairly allocate a scarce resource?
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