I've been teaching Biomedical Ethics (PHIL 3319) for 19 years (about every third year) and have contributed to the scholarly literature in the field. Some people call it "bioethics," for short. Although philosophers contribute to the field, they are not alone. It's interdisciplinary. It lies at the intersection of many professions and occupations: philosophy, theology, law, medicine, biology, and various social sciences (such as economics). Here is a New York Times story about one of the leading philosophers in bioethics, Daniel Callahan.
For the most part, it's an honest report. I do think that Callahan is disingenuous when he says that rationing occurs whenever the demand for some commodity or service outstrips supply. By this logic, Cadillacs are rationed. Okay, but that's not the sense in which people are opposed to rationing or think rationing bad. What people oppose is rationing by agents of the state, who have authority over us. Rationing is acceptable in time of war, for example. People understand that it is temporary; that the war will eventually end and various commodities will once again be distributed by market forces.
Americans are opposed to rationing of health care because they don't want government bureaucrats making judgments about who gets what. Insurance companies are not the same as government, which has a monopoly of force. If you don't like how your insurance company treats you, you can find another insurance company or go without insurance. If you don't like how your government treats you, you can't find another government or go without government.
Addendum: In the New York Times story, it says that Callahan, now 79 years old, recently had "a life-saving seven-hour heart procedure." Imagine the expense of this procedure. Now read this essay of Callahan's, in which he says this:
Given all those obstacles, I believe we need to confront three questions. The first is a matter of the philosophy of modern medicine: is there an obligation to keep the elderly alive as long as possible, regardless of the cost of doing so? I would argue that, in the face of such economic pressure, there is a duty to help young people to become old people, but not to help the old become still older indefinitely. A more reasonable goal is maintaining a high quality of life within a finite lifespan.
One may well ask what counts as “old” and what is a decently long lifespan? We can generally agree that the present Medicare and Social Security eligibility criteria of 65 years is quickly becoming outdated. My own answer is that someone is old when it can be said that he or she has had a “full life,” by which I mean enough time to do most (though not necessarily all) of the things that a life makes possible: education, family, work, and so on. As I have listened to people speak of a “full life,” often heard at funerals, I would say that by 75-80 most people have lived a full life, and most of us do not feel it a tragedy that someone in that age group has died (as we do with the death of a child).
Is the man a hypocrite? You decide. By the way, this gives me an idea. Anyone who agrees with Callahan should sign a legally binding document saying that, because of the expense, he or she should not be given life-saving medical treatment after the age of 70 or 75.
Keith Burgess-Jackson, J.D., Ph.D. 