Comments on: So who gets the liver? http://emonk.org/2009/03/so-who-gets-the-liver/ a many-brained bioethics blog Sun, 17 May 2009 21:26:42 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: ckeathley http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-546 ckeathley Sat, 18 Apr 2009 03:13:25 +0000 http://emonk.org/?p=79#comment-546 Interesting comments. I find it interesting that the presumption is that the sighted person should get the organ because he would contribute more to the global community. What if the sighted patient is a derelict and the blind man is governor of New York? Does that change the answers? How about a Solomonesque approach: split the organ and give a portion to each recipient. The liver is a multi-lobed organ of which we only require a portion. Interesting comments. I find it interesting that the presumption is that the sighted person should get the organ because he would contribute more to the global community. What if the sighted patient is a derelict and the blind man is governor of New York? Does that change the answers? How about a Solomonesque approach: split the organ and give a portion to each recipient. The liver is a multi-lobed organ of which we only require a portion.

]]> By: Giovanna Iannone http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-61 Giovanna Iannone Sat, 28 Mar 2009 00:29:08 +0000 http://emonk.org/?p=79#comment-61 This is what bioethics is all about. Should the blind man, who has suffered all his life with a disability, suffer and die more because of a defect he couldn't have helped in the first place? If it were my decision, the blind man has suffered enough and I would in fact give him the liver. The fact that he is blind and sometimes considered less useful in our society shows how we want to eliminate all those different than "normal". Plus, the man with vision may be able to find another liver easier than he thinks. This is what bioethics is all about. Should the blind man, who has suffered all his life with a disability, suffer and die more because of a defect he couldn’t have helped in the first place? If it were my decision, the blind man has suffered enough and I would in fact give him the liver. The fact that he is blind and sometimes considered less useful in our society shows how we want to eliminate all those different than “normal”. Plus, the man with vision may be able to find another liver easier than he thinks.

]]> By: Andrea Kalfoglou http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-26 Andrea Kalfoglou Tue, 17 Mar 2009 21:36:51 +0000 http://emonk.org/?p=79#comment-26 Just in case you are dying to see Wikler's video on 200 kidney donations video: http://fliiby.com/file/70866/f07o0egn1a.html Just in case you are dying to see Wikler’s video on 200 kidney donations video:

http://fliiby.com/file/70866/f07o0egn1a.html

]]> By: Ashley Mrva http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-23 Ashley Mrva Mon, 16 Mar 2009 22:25:01 +0000 http://emonk.org/?p=79#comment-23 Talk about the quintessential bioethics question!! I hate to to say it (I really hate to say it!) but it does make more sense in a Darwin world to give the liver to the person who will better our evolutionary progress. However... Where do we stop? Let's forget UNOS all together and say, maybe the person who is more kind should get the liver. Or, the person who is prettier. Or maybe even the person who is smarter. These all seem to have the same justification as sight. It's the age-old question... where do you draw the line? Talk about the quintessential bioethics question!!

I hate to to say it (I really hate to say it!) but it does make more sense in a Darwin world to give the liver to the person who will better our evolutionary progress.

However…

Where do we stop? Let’s forget UNOS all together and say, maybe the person who is more kind should get the liver. Or, the person who is prettier. Or maybe even the person who is smarter. These all seem to have the same justification as sight. It’s the age-old question… where do you draw the line?

]]> By: admin http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-14 admin Mon, 16 Mar 2009 14:41:08 +0000 http://emonk.org/?p=79#comment-14 No, you're right. I do believe that we are obligated to save the sighted person and let the blind person die--in the idealized case. I just wanted to add my real-world policy point to the discussion to point out that this answer of mine does not lead to an obvious real-world decision. It should guide policy (assuming the policy-makers agree with me) but that doesn't make it easy to implement. What about the case of the two people who need a liver, identical in every way except that one tells funnier jokes? Is there a threshold of utility difference, below which a coin-toss is the better answer? My intuition: there is no threshold (in the idealized case). You should always kill the guy with mediocre jokes. --John Bohannon No, you’re right. I do believe that we are obligated to save the sighted person and let the blind person die–in the idealized case. I just wanted to add my real-world policy point to the discussion to point out that this answer of mine does not lead to an obvious real-world decision. It should guide policy (assuming the policy-makers agree with me) but that doesn’t make it easy to implement. What about the case of the two people who need a liver, identical in every way except that one tells funnier jokes? Is there a threshold of utility difference, below which a coin-toss is the better answer? My intuition: there is no threshold (in the idealized case). You should always kill the guy with mediocre jokes.
–John Bohannon

]]> By: rnadler http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-13 rnadler Mon, 16 Mar 2009 14:22:42 +0000 http://emonk.org/?p=79#comment-13 Ah, well - the pragmatics of the situation are one thing. But suppose we're *really interested* in the "extrapersonal moral truth" of the matter as to which action is right - assuming that there is such a thing. Which is to say, we want to know what we *should* do, not just the best thing to do given the information constraints. Now the case you gave resigns us to an arbitrary choice by stipulation, rendering the moral fact of the matter flatly beyond our reach. But in the former case? Can't we start trying to determine just which of them it would be "better" to keep alive? Or, phrased more carefully, in the first case does the theoretical (however remotely so) possibility of arriving at the truth obligate us to resist the cop-out of the coin flip? Ah, well – the pragmatics of the situation are one thing. But suppose we’re *really interested* in the “extrapersonal moral truth” of the matter as to which action is right – assuming that there is such a thing. Which is to say, we want to know what we *should* do, not just the best thing to do given the information constraints. Now the case you gave resigns us to an arbitrary choice by stipulation, rendering the moral fact of the matter flatly beyond our reach. But in the former case? Can’t we start trying to determine just which of them it would be “better” to keep alive? Or, phrased more carefully, in the first case does the theoretical (however remotely so) possibility of arriving at the truth obligate us to resist the cop-out of the coin flip?

]]> By: admin http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-12 admin Sun, 15 Mar 2009 19:32:25 +0000 http://emonk.org/?p=79#comment-12 Imperfect information. That's what makes it different. Imagine the same life-saving liver dilemma. But now it stipulates that "one of the two people contributes slightly more to the global burden of disease than the other, but there isn't a clear way to determine which it is." Wouldn't you flip a coin in this case? That's the real world. --John Bohannon Imperfect information. That’s what makes it different. Imagine the same life-saving liver dilemma. But now it stipulates that “one of the two people contributes slightly more to the global burden of disease than the other, but there isn’t a clear way to determine which it is.” Wouldn’t you flip a coin in this case? That’s the real world.
–John Bohannon

]]> By: rnadler http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-11 rnadler Sun, 15 Mar 2009 18:01:16 +0000 http://emonk.org/?p=79#comment-11 I'm in agreement with most of your post, John. However, why the coin flip? I've never been impressed by the morally palatable veneer of controlled chance. Yes, it forces us to divest our own interests from the decision making process, but it doesn't supply any better of a justification for action. Normally we feel that people *shouldn't* suffer on account of chance. What (besides moral-psychology quirks in us) makes this case any different? I’m in agreement with most of your post, John. However, why the coin flip? I’ve never been impressed by the morally palatable veneer of controlled chance. Yes, it forces us to divest our own interests from the decision making process, but it doesn’t supply any better of a justification for action. Normally we feel that people *shouldn’t* suffer on account of chance. What (besides moral-psychology quirks in us) makes this case any different?

]]> By: admin http://emonk.org/2009/03/so-who-gets-the-liver/comment-page-1/#comment-10 admin Sun, 15 Mar 2009 16:33:26 +0000 http://emonk.org/?p=79#comment-10 I would give it to the sighted person and let the blind person die. But I don't see a clear way to translate this into policy. Try to imagine a real-world situation where such a policy would have no negative side-effects. Why stop at blindness? When deciding between the lives of two people who are the same in every way except one inch of height, the same logic applies: Kill the short guy. After all, the slightly taller person will be able to reach the top shelf in the grocery store to help others get food. Or how about two people, one of whom tells slightly funnier jokes? The difficulty of translating these thought experiments into real-world policy is that no two people are ever identical except for a single characteristic. We differ in infinite ways. How should we weigh the relative importance of those differences? The best thing to do, in the real world, is to flip a coin. --John Bohannon I would give it to the sighted person and let the blind person die. But I don’t see a clear way to translate this into policy. Try to imagine a real-world situation where such a policy would have no negative side-effects. Why stop at blindness? When deciding between the lives of two people who are the same in every way except one inch of height, the same logic applies: Kill the short guy. After all, the slightly taller person will be able to reach the top shelf in the grocery store to help others get food. Or how about two people, one of whom tells slightly funnier jokes? The difficulty of translating these thought experiments into real-world policy is that no two people are ever identical except for a single characteristic. We differ in infinite ways. How should we weigh the relative importance of those differences? The best thing to do, in the real world, is to flip a coin.
–John Bohannon

]]>