here’s an ethical question I’ve been pondering for the last two days. In public health, morbidity and mortality is often looked at in terms of “years of life lost” instead of “percent mortality”. (actually, gets more specific as is adjusted for disability, so you might hear about disability adjusted life years – DALY). The reason is because if you only look at percent mortality, you’ll find that heart disease is the number one killer. However, when you think about it, rarely does anyone under 60 die of heart disease. It’s referred to as a degenerative disease – as in, it occurs later in life as things start to break down.
So in public health, should you put resources into heart disease?? If you look at DALYs you find that things like HIV/AIDS and even depression are much higher up the list – mostly because these are diseases that affect young people.
My question is, is it okay to put different value judgements on people’s lives based on their age? Does it matter if a 4 year old dies of diarrhea, a 28 year old dies of HIV or an 84 year old dies of heart disease? In one sense I want to say that it’s right to focus on diseases that kill younger people, as the elderly are going to die anyway… but it doesn’t really sit right with me. And I wonder whether I’ll still be saying this when I’m 70??
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March 3, 2010 at 12:29 am
Anthony Douglas
Return on investment: how much easier is it to prevent death via x in a young person than heart disease in an octogenarian?
So, not a judgment based on ages, or years left, but on ability to affect outcome. Does that help?
March 3, 2010 at 12:43 am
Mark Earngey
Merran,
That’s a fascinating question. And one which isn’t easy to answer anyway.
I’ve got an excellent chapter on this from John Frame’s doctrine of the Christian Life (ethics). He asks whether the sanctity of life demands maximum care at all times? Or, similar to what you’re asking: how do you make priorities with resources when all of life is vastly significant to God?
No quick answers I’m afraid, but I’ll print out the chapters and give them to you on Sunday!
March 4, 2010 at 12:34 pm
Alison Moffitt
This kind of came up recently for me in something I was writing for work. At the moment I am thinking something like this:
As Christians – of course we never discriminate on age. Older people should be cared for just as younger people, because they are just as much loved by and sustained by God as everyone else on the planet.
But at the same time, our medical care for older people should be shaped by what we know in Christ. The life we live now is not all there is to living. Life should not be extended at the cost of everything else.
So I guess it’s about holding those two things in tension. Older people deserve the same medical care as everyone else. At the same time, we should never think that keeping people alive is the most important thing. Of course, caring for people’s health is vitally important, but if it overtakes our hope in a resurrection, then that is stupid.
Yeah, it’s not about who is more useful or valuable. That is a very worldly way of looking at things. It’s just about seeing things through God’s eyes and remember that we all bear his image (even when we are frail and lose the use of our limbs and minds) and we should all ultimately look to Jesus’ ressurection for the restoration of our bodies (not just doctors).