Saving Lives and Respecting Persons

Article excerpt

IN THE DISTRIBUTION of resources, persons must be respected, or so many philosophers contend. (1) Unfortunately, such philosophers often leave it unclear why a certain allocation would respect persons, while another would not. In this paper, we explore what it means to respect persons in resource allocation--specifically in contexts in which scarce, lifesaving resources must be distributed.

As a way of grounding our discussion, we focus on two sorts of cases. We assume in both that our task is to allocate a life-saving resource between different persons. In helping these persons (or a subset of them), we are not discharging a duty of beneficence. Each person needs and wants to get the resource. But since the resource is scarce, we cannot make it available to all. Each person has a claim on the resource in the relatively weak sense that it would be wrong for us to refrain from giving it to her on morally arbitrary grounds (e.g., because we do not like her) or on grounds inappropriate to the context (e.g., because she is not a close friend). Finally, no person in our cases is morally responsible for her need of the resource in any way that would affect her claim on it.

In our first case, we have one indivisible life-saving drug and two patients who are identical in every relevant respect except that one of them is 20 years old and the other one is 70 years old. The patient who does not get the drug will die. If the younger person gets the drug, she will live for many years yet; if the older person gets the drug, she will die of natural causes in a few years. We call this the different-age case.

Most people would agree that the drug should be given to the 20-year-old patient. One consideration in favor of this choice is that giving the drug to the younger patient does more good: since she will live longer, saving her life creates a larger benefit. Another consideration that many people find relevant is that the older person has had a longer life: she has already had her "fair innings." It would be unfair to the younger person to deny her the chance of a full human life, given that the older person has already had such a life. (2)

It is not immediately clear, however, that giving priority to the younger person is compatible with the idea of respect for persons--at least in the sense of treating the two patients with the equal concern and respect that is morally owed to them. Assuming that both patients want to be saved and they both have a claim on the drug, it seems that we show less concern for the older person and we respect her wish to go on living less than the wish of the younger person. Giving priority to the 20-year-old seems to involve not treating both patients with equal concern and respect, although it seems to be the recommended course of action on both benefit-maximizing and fairness grounds.

In our second case, we have to decide whether we save one person or five persons from certain death. Perhaps there were two traffic accidents, and one person was injured in the first and five persons were injured in the second. All the accident victims have immediately life-threatening injuries, and they are alike in all relevant respects. We can, however, reach only one of the accident scenes. If we save the one person, the five persons in the other accident will die; if we save the five, the one person will die. We call this the different-number case.

On benefit-maximizing grounds, we should save the five. But some philosophers argue that it would be unfair to give no chance to the one person at all: if we did that, we would fail to show proper respect for her--perhaps because her claim is not taken into consideration at all. On this view, benefit-maximizing and fairness considerations point in different directions. others argue that it is possible to save the five persons while giving no chance to the one person without failing to show proper respect for her--perhaps because her claim is taken into consideration just as much as those of the others, but it is outweighed by them in one way or another. …