Exploring Bioethics - NIH Office of Science Education - National ...

• A con response might be, “The sickest people didn’t necessarily getthe drug, since they might not have lived close enough to go tothe hospitals in Toronto.”10. Transition to a full-class discussion of the criteria the dialysiscommittee used to decide who had access to dialysis. Ask students,“Is it fair to consider one’s social worth—or value to society—as acriterion?”This question will help students assess the fairness of a policy thatconsiders criteria that most people find irrelevant or inappropriate.Students might respond to this question in several ways:• Some might think it is fair because it maximizes the long-termbenefits to society. For example, surgeons are very valuable tosociety because they save others. If surgeons have priority formedical procedures such as dialysis, more people will benefit inthe long run.• Some might think it is unfair because all people are equallyvaluable. These students would find that it is inappropriateto consider a person’s value to society when deciding how todistribute a scarce medical resource.• Still others might argue that some forms of social worth shouldcount, while other forms should not. For example, some peoplemight think it is fair for an allocation policy to give priority topeople like firefighters and police officers so they are available tohelp others. Yet, the same people might think it is not fair for apolicy to prioritize someone with a lot of children over someonewith few or no children.Be sure to add social worth to the criteria on the chart or board if it isnot already listed.11. Engage students in a discussion of the penicillin case and theguidelines of the Committee on Chemotherapeutic and OtherAgents (COC). Use this case to show that a policy is not fair whenit fails to consider relevant criteria.The COC did not consider some key criteria, such as how long a personwould likely live after receiving the penicillin.12. Explain to students that the COC distributed the penicillinprimarily on the basis of how sick the patient was and secondarilyon the basis of advancing scientific knowledge.Be sure to add the criterion “sickest” to the board, if it is not already there.13. Ask students, “Is there anything else that the COC should haveconsidered? Why or why not?”Tip from the FieldStudents might disagree aboutthe meanings of the terms socialworth and value to society. Letthem discuss this briefly, butrefocus them quickly on the largerquestion, Should one considervalue to society when allocating ascare resource? You might want totell them that the committee’sdecision-making process was verycontroversial at the time and stillis today. Some people believethat it was wrong. Others believethat priority should be given tosome people—such as thesurgeons mentioned in Step 10or emergency medical technicians(EMTs)—because they have theability to save many lives.12345Module 3 3-96