On Medical Futility - by Linda Kim

I disagree with the concepts that Jecker and Pagon present in their article. In both of their "standards" of futility and inhumanity, there's an assumption of what is good and bad for the babies' future. But who is to decide on what is good or bad for a person? Although some of the examples presented where they attempt to justify their standards may be ethical (for that particular case), not every case is the same. In other words, Jecker and Pagon tries to put a concrete "standard" in ethical decision making, but different people have different ethics. Thus, for Jecker and Pagon to set a standard for everyone (for every case) is impermissible. Moreover, they stated in their concluding remarks that "physicians are not required to offer, nor are patients entitled to receive, medical treatments that are futile or inhumane . . . [but] there should [also] be a presumption in favor of family decision making." This also is problematic. I believe that physicians should be required to offer everything they can to save their patients (to live!), and that every person born alive has a right to sustain life, and the parents are responsible to help sustain its life. Moreover, how can anyone even the family decide on what is really good for the baby? After all, when a child is born (or perhaps even when it's in the state of gestation in the mother's womb), they are another human being. One would not make moral decisions for another person. A child may be young and may depend on their parents, but that does not make them a robot to control; even a child has their right to at *least* (but really more) to live *their* life.

Impaired Infants and Medical Futility - by Sarah Jarvis

I believe that the Owenses were wrong in deciding not to allow their baby girl to undergo life-saving surgery. I agree with Englehardt that parents should be the ones to decide whether or not to withhold treatment from an impaired newborn, the parents will be the ones taking the infant home and who will bear the cost and responsibility of raising the child. But I also agree with Weir that treatment should not be withheld unless the child lacks the neurological potential to reach personhood, or that prolonging the child's life would only prolong its suffering. Baby Owens did not meet either of these criteria. She had Down syndrome and therefore it was quite possible for her to lead a relatively normal, happy, productive life. Baby Owens was born in the mid 1970s and perhaps the prospect of DS children leading satisfying lives was dimmer then, but I believe that Robertson is right in saying that the decision to withhold treatment from an impaired infant should not be based on the social cost. And, as Englehardt wrote, if treatment is withheld "one must recognize that death is often not directly but only obliquely intended. That is, one often intends only to treat no further, not actually to have death follow, even though one knows death will follow." But I think the Owenses intent was for death to follow. They were not acting in the best interest of their child, but in their own. When the obstetrician told Dr. Owens that the whole family would grow to love the baby, she replied, "I know . . . And I don't want that to happen. I don't want us to center our lives around a defective child." Not wanting mentally retarded children is understandable, but the Owenses used their baby's duodena atresia as an easy way out. The Owenses let their baby die because they didn't want it, that was wrong.

Against Angell on a Single-Payer System - by Cate Fusco

In the second piece written by Marcia Angell, she argues for a single-payer health insurance system with the basic arguments that it would save the general public money and make insurance more available to everyone. I agree with her on most accounts except one. Unfortunately this country is founded on the ideas that there should be levels of everything so that a person is open to make themselves whatever they want. By levels I mean there is a difference in the type of school you can go to, the brand and quality of the clothes you can buy (Target vs. Gap vs. something more expensive etc and Ursinus vs. Montco). In the system we have now, health care is treated in levels just like mostly everything else that can be bought. If you make something of yourself in life then you will be able to afford more health coverage.

Even if you don't have the money to pay the extra bills (the ones the hospital charged you because the insurance won't cover everything) it's sad that I know this, but as long as a person pays at least 5 dollars a month on those bills, they will not have a credit problem, or have a lean on their house or anything -- and over time the bill is sent to the bill collectors who bug the person for a while until the bill is just written off. Now I'm not soliciting that idea, but clearly if the money was absolutely needed they would take more action into getting it from the patients.

My point is that if we move to a single-payer system the coverage for which everyone can receive is limited, and I would not be able to go to that specialist I needed because she has the best ocular surgical technique in the country . . . or maybe I would but then everyone would be paying for me to go there, and that's not fair to them to pay more than they need to. That's sort of the theory of private health clinics. Those who can afford to go there can, and those who can't get the basic coverage by the government. Maybe I'm completely wrong about the whole idea, but it sounds to me that by changing systems completely, we're eliminating what this country is about.

Paying for Health Care - by Heather Marino

I do not think that we owe health care to Robert Ingram. I understand his position: he is a working individual but makes very little money and has to care for a sickly wife; however, I struggle with the fact that he did not have the foresight to look ahead and acquire some sort of health insurance. I'm sure that there was some point in his life where he was capable of landing some form of job that would have afforded insurance. Additionally, I struggle with the fact that he was trying to run his own business without providing health care for himself. I don't know that people should be able to run their own business if they cannot provide health insurance for themselves. I think it is very unwise and negligent on the part of Ingram. For all citizens with health insurance, they pay into it regularly and draw out of it when they fall ill. In the same way, people without health insurance hope to draw out of that well unfairly. They never have to pay into it but only draw out of it. Is this fair or just? What is the point of troubling yourself with paying for health insurance month after month if when you get ill, you can get someone to pay for you anyway, even if you didn't pay? It seems to me that it is very unfair and we ought to reward those who think ahead. Ingram has not taken the responsibility to care for himself and his wife and must pay the subsequent consequences. In this instance, I do not think it morally impermissible to withhold healthcare from Ingram as he did not pull his own weight in society. Running his own business should have been the last thing on his mind. He should have first obtained a job, even if only minimum wage, just so that he might have health insurance for his wife and himself and then made extra money on the side with his personal pursuits.

Consent v. Conscription - by Matt Meeker

The shortage of organ donors justifies the need to find better ways of approaching potential organ donors, however, the approach presented by Spital and Erin is far too extreme and ultimately immoral. It seems rather strange for the authors to point out that a lack of consent can be solved by simply not asking for consent. Currently consent must be achieved first from the patient and then from the family members of the deceased person. People are most often confronted with the decision to consent when they are at the DMV getting a new driver's license. This demonstrates the first problem with the system; people are not informed of the need and benefits to others of organ donations. There is a popular belief amongst non-donors who believe if they do consent that doctors will not try as hard to save them if they are in an accident. Yet it is very unlikely that this would ever happen. These decisions should not be made at the DMV. The second problem is the need for consent from the family. This should simply not be required except in the case of minors who would donate.

I will concede to Spital and Erin that these solutions will not guarantee 100% organ donation, but even if these changes do not increase organ donation it is still wrong to take organs without any consent. The authors claim that religious reasons are not absolute, however some religions require the body to be intact for movement into the next life and preventing a person from doing so is wrong. Non religious reasons aside, we do put some moral value into corpses, medical school cadavers receive special ceremonies at the end of the year, necrophilia is illegal, as is grave robbing. To some the value of a dead human may be small but to others it is not, and because of this consent should always be required to respect the body and religious beliefs of the deceased person.

Having a Child to Save Another - by Patrick Gasda

In the Alaya case, the family had a child in order to save the life of an older sibling of the child. This was done in all the best intentions to save the existing child’s life. But there are so many risks involved to the new child that many say that it is not worth it to try this method. The other major snafu is that the baby was created as a means to an end rather than the “normal” reasons for having a child. But what are the normal reasons to have a child anyways? When a family wants a child, they decide to for any number of reasons. Having a child might bring risks to the mother, the family, or to the kid being born. The thing is, we all take risks and it is basic part of life. In fact, some might say we need to take risks in order to live a good life. I think it is well within the acceptable amount of risk to have a kid to save another.

Another major concern is if this last ditch effort did not end up saving the other child. Eventually, the new kid would find out, and might live with a bad feeling for the rest of their lives that they failed. They might also feel less human thinking that they were not born out of love or want of another kid (or other “normal” reasons), but instead for some other reason. Maybe they would have bad parents that would neglect the “bad” child or somehow be vindictive against them. I feel this would not happen under normal circumstances because most parents are not this irresponsible. I believe that since people live with their decisions and actions, they would try to the best of their abilities to make the most of their new child. Since now their other is dead, they can start with this fresh kid. Thus, overall, I think that having a kid for the sake of saving another’s life is morally permissible.