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Strange, the strikethough on the word "negro" isn't showing in your quote, but it is in my post.
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Apr 4, 2015 12:59
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I hosed up quoting it because of the way nested quotes work. Let's all agree that it's there.
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Apr 4, 2015 13:02
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TheImmigrant posted:Look up the word 'triage.' Then grow up, lifeless muppet. Organ allocation is not triage in the sense it is used in medical practice. Even if it were, do you believe that priority should be given to patients of higher social and/or economic status (criminal record status) during triage?
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Apr 4, 2015 13:11
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Hodgepodge posted:Even if it were, do you believe that priority should be given to patients of higher social and/or economic status (criminal record status) during triage? A competent General vs a Private, both in a warzone? The General. Letting the Private die will arguably result in a greater number of lives saved long-term. Michael the Average Teenager vs Billy the Violent Juvenile Delinquent? Sorry Billy, society won't miss you as much.
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Apr 4, 2015 13:19
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How is a medic supposed to evaluate a general's competence to know whether to let him die or not? If the medic can tell you that Ridgeway would handle the Korean War better than MacArthur, maybe you've got him in the wrong job?
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Apr 4, 2015 13:24
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Zo posted:
Nope. Dude survived two years after a heart transplant and was living a vigorous and active (criminal) lifestyle, which puts him above ~20% of other heart transplant patients. You don't get to do that without being in compliance with your medical regimen, which means that he retroactively turned out to be a good candidate for organ transplantation. The hospital was wrong, in hindsight, to deny him an organ based on the health criteria that they actually follow, and not the hosed up moral and racial calculus that most people seem to be engaged with.
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Apr 4, 2015 13:27
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so the hospital made the right call from the beginning. It's almost as if we should let medical professionals do their job, instead of having religious advocacy groups pressure them into doing dumb things. Crazy thought.
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tumblr.txt posted:To throw an extreme example your way: Patient A is an 85-year old chain smoking serial-killer. Patient B is a 30 year old genius who has won multiple Nobel prizes. They both need a lung transplant to survive, but there is only one set of lungs to go around. Age and chain-smoking are medical factors, but assuming that there was no net difference in their chances of surviving after the transplant, then they are both simply patients. As a doctor, one takes an oath to treat patients in a certain way, including fairly and without prejudice. The express point of such an oath is to provide a statement that one will not make special exceptions to the principles of medical ethics on the basis of their own judgement. quote:Do I think it's ethical for doctors to step in and say it's idiotic to give them to patient A, so therefore patient B gets her life saved? Absolutely. Taking a "all life is special, let's flip a coin to see who wins the lungs" view is foolish in a world with finite resources. So, you think that it's okay for a doctor to personally decide whether or not to provide life-or-death care on the basis of their (your) judgement that it would be "idiotic" to do otherwise? quote:don't think it's a basic human right to be entitled to a finite and desperately needed resource. Practically it is impossible, otherwise we would not have waiting lists. Is it lifesaving medical treatment? If so, it is a basic human right. You can fail to provide a basic human right on the basis of limited ability, but the question here is now to allocate that ability. An allocation based on human rights necessarily excludes social and economic considerations, such as criminal records. quote:Giving the heart to someone who isn't going to throw their life away would arguably result in greater benefit to human life. How does a doctor decide who is going to "throw their life away" and who is not? How should one decide what the relative worth of one life is, compares to another? Do you believe that this decision could be made on the basis of a juvenile criminal record?
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Apr 4, 2015 13:36
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tumblr.txt posted:A Senator vs Joe the sheet-metal worker? Other concerns should probably be the deciding factor. Okay, but most hospitals aren't going to ask the kind of questions they'd need to know that you shouldn't be admitted, resuscitated, or treated, so in the interim...
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Apr 4, 2015 13:38
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Apparently he was decent at taking those meds which was the reason they denied him in the first place, so in retrospect it was wise to give him a second chance on that issue. Of course in retrospect it was also a bad move to give him the heart, but for a different reason than the one given for the original rejection. Its a shame no one can legit predict the future because it would have saved the life of someone who would have used that heart well, but alas thats not possible and "we shouldn't have given' 'im that 'art cuz sometimes black kids do things that are loving retarded" (which is the subtext of this news story, lets be honest) doesn't cut it as a rejection reason. Would have been REAL useful to have a crystal ball on this one. The doctor could just go, "OH! The crystal ball tells me he's going to waste it. No dice on this one." As it is I think the kid still deserved a second chance in relation to his peers that also deserved a second chance, even though he has now proved himself not worthy of it. That's one of the things about second chances: you're always taking a risk with them. But it's still worth it to give them, whether you're talking about chances for better behavior or the more lifesaving kind. Some goon has now been through TWO sets of a stranger's lungs. Not by any fault of his own, the first transplant set just crapped out on him. poo poo happens. Even the medical part of this procedure isn't an exact science. It's something of a gamble whether or not your patient is also a black rulebreaker. Having transplants done or not on the notion of perceived merit is an absolutely terrible idea and drat near inhuman.
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Apr 4, 2015 13:39
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tumblr.txt posted:A Senator vs Joe the sheet-metal worker? Other concerns should probably be the deciding factor. All I'm getting from this is that you want decisions to be made based on your gut evaluation of worth, combined with a vague utilitarianism. As a principal, though, you seem to think that both human rights and other attempts at acting in a principled and fair manner should be secondary to preconceived and unexamined markers of social worth. Hodgepodge fucked around with this message at 13:58 on Apr 4, 2015 |
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Apr 4, 2015 13:47
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Hodgepodge posted:Age and chain-smoking are medical factors, but assuming that there was no net difference in their chances of surviving after the transplant, then they are both simply patients. As a doctor, one takes an oath to treat patients in a certain way, including fairly and without prejudice. quote:The express point of such an oath is to provide a statement that one will not make special exceptions to the principles of medical ethics on the basis of their own judgement With one organ, there may be multiple patients. The medical profession has to pick someone. By giving it to one patient, they are deciding not to provide life-or-death care to the others. Since some patients have to forgo this care anyway, why not give it to the most deserving cause? quote:An allocation based on human rights necessarily excludes social and economic considerations, such as criminal records. quote:How does a doctor decide who is going to "throw their life away" and who is not? How should one decide what the relative worth of one life is, compares to another? quote:Do you believe that this decision could be made on the basis of a juvenile criminal record?
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Apr 4, 2015 13:53
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tumblr.txt posted:So the serial killer with 5-10 years of life left should have equal access to the organ a Nobel prize winner with 60 years left, and letting the Nobel prize winner die due to a coin-flip is only fair. Gotcha. The team of experts made a decision based on the likelihood of his taking his medication. By that metric, they absolutely made a mistake in their initial evaluation, because the transplant was a resounding success and the kid took his meds. They don't use a metric of "social worth", which is why you are allowed to be prescribed medication. Furthermore, if you believe that you can clearly discern who is worthy to live and to die, why not put that into practice?
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Apr 4, 2015 13:56
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Effectronica posted:The team of experts made a decision based on the likelihood of his taking his medication. By that metric, they absolutely made a mistake in their initial evaluation, because the transplant was a resounding success and the kid took his meds. They don't use a metric of "social worth", which is why you are allowed to be prescribed medication. How do you feel about Mickey Mantle receiving a liver transplant?
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Apr 4, 2015 14:06
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TheImmigrant posted:How do you feel about Mickey Mantle receiving a liver transplant? Sticking a liver in a corpse wont make it come back to life, dude
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Apr 4, 2015 14:09
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TheImmigrant posted:How do you feel about Mickey Mantle receiving a liver transplant? They looked at the medical criteria, they decided to try and save the patient's life, they failed because his cancer had been malignant for some time. Too bad. You could argue that they made a mistake there, but I don't think the two situations are at all comparable. Anyways, what's your medical background? Moonlight as a surgeon in between trips to the Golden Triangle?
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Apr 4, 2015 14:12
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Effectronica posted:The team of experts made a decision based on the likelihood of his taking his medication. By that metric, they absolutely made a mistake in their initial evaluation, because the transplant was a resounding success and the kid took his meds. quote:Furthermore, if you believe that you can clearly discern who is worthy to live and to die, why not put that into practice?
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Apr 4, 2015 14:15
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tumblr.txt posted:The Heart is now dead, a mere 2 years after the transplant. A great success indeed. That's not because of the reasons they used to initially reject the transplant in the first place. That's not what I asked. You believe that you can clearly discern who deserves to live and who does not deserve to live, judging by your posts in this thread. Never mind that the metric you're using would necessitate your suicide, why aren't you going out and putting this into real practice instead of engaging in passivity?
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Apr 4, 2015 14:17
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Effectronica posted:That's not what I asked. You believe that you can clearly discern who deserves to live and who does not deserve to live, judging by your posts in this thread. Never mind that the metric you're using would necessitate your suicide, why aren't you going out and putting this into real practice instead of engaging in passivity?
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Apr 4, 2015 14:20
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Effectronica posted:They looked at the medical criteria, they decided to try and save the patient's life, they failed because his cancer had been malignant for some time. Too bad. You could argue that they made a mistake there, but I don't think the two situations are at all comparable. Mantle was a clearer case of mistaken medical judgment (he received a transplant the day after going on the list), but the hospital's reversal of their initial decision about Stokes' transplant was a mistake as well. quote:Anyways, what's your medical background? Moonlight as a surgeon in between trips to the Golden Triangle? My medical background is probably no more or less than that of any of the other bloviators on this thread. You sound jealous of being able to travel. Jealousy will eat you up, son.
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Apr 4, 2015 14:21
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tumblr.txt posted:You are a lunatic, and I'm glad your obvious mental illness should prevent you being able to buy firearms. Ah, unable to deal with the fact that you were wrong about why they rejected the transplant, you avoid dealing with it. Then you avoid dealing with the consequences of believing that you can determine who deserves life and who does not. Finally, you avoid the cold truth that when it comes to social value, your life is probably a net negative.
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Apr 4, 2015 14:21
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Effectronica posted:You believe that you can clearly discern who deserves to live and who does not deserve to live, judging by your posts in this thread. Normal people would be embarrassed to post something like this.
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Apr 4, 2015 14:22
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TheImmigrant posted:Mantle was a clearer case of mistaken medical judgment (he received a transplant the day after going on the list), but the hospital's reversal of their initial decision about Stokes' transplant was a mistake as well. No, it wasn't. The medical judgement in the reversal was completely sound, because he was healthy, physically active, and was obviously taking his meds. The medical judgement did not involve "This kid is likely to commit crimes in the future" or else it was not triage. quote:My medical background is probably no more or less than that of any of the other bloviators on this thread. Ah, you realize that claiming both legal and medical expertise would stretch credibility beyond belief. A good sign.
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Apr 4, 2015 14:24
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tumblr.txt posted:So the serial killer with 5-10 years of life left should have equal access to the organ a Nobel prize winner with 60 years left, and letting the Nobel prize winner die due to a coin-flip is only fair. Gotcha. I noted age as a factor and addressed it. quote:With one organ, there may be multiple patients. The medical profession has to pick someone. By giving it to one patient, they are deciding not to provide life-or-death care to the others. I mentioned that you can fail to provide medical service on the basis of inability. In order to determine who receives treatment you draw up a list based on medical factors (of which there are many) and otherwise allocate organs on a first-come-first-served basis. quote:You're playing with words here. Practically a "human right" that many people go without due to finite resources is no right at all. Maybe it should be, but until we have replicators, we have to decide who gets what organ. If we have to make that decision why should it be made blindly, with no attention paid to the benefit (or determent) to society for a given choice? I've already defined how it is a human right. That is not "playing with words." We intentionally make them "blindly" because it is not appropriate for a doctor, or even a society, to value one life over another when it comes to medical treatment. For example, if a doctor strongly believed that Christians contribute more to society than anyone else, would you be cool with hearts being allocated on the basis of church attendence?
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Apr 4, 2015 14:25
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Effectronica posted:No, it wasn't. The medical judgement in the reversal was completely sound, because he was healthy, physically active, and was obviously taking his meds. The medical judgement did not involve "This kid is likely to commit crimes in the future" or else it was not triage. Yes, it was. Mantle and Stokes shared a high risk of premature death due to lifestyle. quote:Ah, you realize that claiming both legal and medical expertise would stretch credibility beyond belief. A good sign. Yes, some of us are aware that we are not omniscient. Give it a try - maybe take a break from Posting and get a passport. You know, meet some Furriners. It couldn't hurt your Posting.
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Apr 4, 2015 14:28
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TheImmigrant posted:Yes, it was. Mantle and Stokes shared a high risk of premature death due to lifestyle. Lifestyle factors cannot be and are not a major consideration in medicine, in large part because the natural conclusion of using them is that the rich get healthcare and the poor get gently caress-all, along with other unjust outcomes. For example, lifelong chain-smokers still receive treatment for lung cancer and emphysema rather than putting them automatically into category 2. quote:Yes, some of us are aware that we are not omniscient. Give it a try - maybe take a break from Posting and get a passport. You know, meet some Furriners. It couldn't hurt your Posting. A normal person would be embarrassed to post something like this.
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Apr 4, 2015 14:30
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tumblr.txt posted:A Senator vs Joe the sheet-metal worker? Other concerns should probably be the deciding factor. lol
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Apr 4, 2015 14:34
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Effectronica posted:Lifestyle factors cannot be and are not a major consideration in medicine, in large part because the natural conclusion of using them is that the rich get healthcare and the poor get gently caress-all, along with other unjust outcomes. For example, lifelong chain-smokers still receive treatment for lung cancer and emphysema rather than putting them automatically into category 2. We are talking about a limited number of organs, not generic treatment. I'm sorry if the distinction eludes you, but if that is the case I suggest you take up an activity more commensurate with your intellect, like fingerpainting.
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Apr 4, 2015 14:35
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TheImmigrant posted:We are talking about a limited number of organs, not generic treatment. I'm sorry if the distinction eludes you, but if that is the case I suggest you take up an activity more commensurate with your intellect, like fingerpainting. There's actually nothing that says that organ transplants are special, especially in the ideas in this thread people like you and "tumblr.txt" have been espousing. Triage, for example, applies to all medical care, because all medical care is inherently finite. Besides, treatments for lung cancer and emphysema are often extensive and expensive and take up a lot of resources that could be freed up by leaving smokers to die. Hell, there's a constant shortage of blood, but apparently that's not sufficient reason to deny it to people in risky lifestyles. Organ transplants are very limited, but that's not a difference in kind.
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Apr 4, 2015 14:39
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TheImmigrant posted:Yes, it was. Mantle and Stokes shared a high risk of premature death due to lifestyle. This is not the reason Stokes was denied. And Mantle had already given up drinking long before the transplant. His post-treatment lifestyle did not contribute to his heath. Giving him a liver was a medical decision based on his current health, not on what they thought he might do in the future.
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Apr 4, 2015 14:42
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Effectronica posted:There's actually nothing that says that organ transplants are special, especially in the ideas in this thread people like you and "tumblr.txt" have been espousing. Triage, for example, applies to all medical care, because all medical care is inherently finite. Besides, treatments for lung cancer and emphysema are often extensive and expensive and take up a lot of resources that could be freed up by leaving smokers to die. Hell, there's a constant shortage of blood, but apparently that's not sufficient reason to deny it to people in risky lifestyles. Organ transplants are very limited, but that's not a difference in kind. Yes, the difference in degree of shortage makes the difference one of kind. The shortage of transplant organs necessarily means that some people who could be saved by a transplant must die. This isn't the case, at least not in the everyday US, with generic medical treatment or blood transfusions.
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Apr 4, 2015 14:45
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TheImmigrant posted:Yes, the difference in degree of shortage makes the difference one of kind. The shortage of transplant organs necessarily means that some people who could be saved by a transplant must die. This isn't the case, at least not in the everyday US, with generic medical treatment or blood transfusions. Are you sure about that? http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ quote:Nearly 45,000 annual deaths are associated with lack of health insurance http://www.organdonor.gov/about/data.html quote:However, an average of 21 people die each day waiting for transplants that can't take place because of the shortage of donated organs. e: additional context Bel Shazar fucked around with this message at 14:52 on Apr 4, 2015 |
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Apr 4, 2015 14:48
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Bel Shazar posted:Are you sure about that? Those people are mostly poor and/or black though, so according to my moral calculus if we spend money on them they'll just waste it. We should be cutting taxes instead.
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Apr 4, 2015 14:50
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TheImmigrant posted:Yes, the difference in degree of shortage makes the difference one of kind. The shortage of transplant organs necessarily means that some people who could be saved by a transplant must die. This isn't the case, at least not in the everyday US, with generic medical treatment or blood transfusions. No, it doesn't. There are plenty of procedures and medicines, "generic medical treatment", that are so limited in availability that they cannot be made generally available and some people who could be saved by them must die. There are also regular blood shortages which force the cancellation of elective surgeries, which in turn leads to people dying. This is also just looking at the rich countries. There is no difference in kind, you just want to have one so that you don't have to reconcile your opinions.
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Apr 4, 2015 14:50
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Bel Shazar posted:Are you sure about that? That is about deaths due to lack of health insurance, not shortage of medical care. It's definitely an issue, but not they one we are discussing here.
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Apr 4, 2015 14:51
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Effectronica posted:No, it doesn't. There are plenty of procedures and medicines, "generic medical treatment", that are so limited in availability that they cannot be made generally available and some people who could be saved by them must die. For example?
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Apr 4, 2015 14:51
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TheImmigrant posted:That is about deaths due to lack of health insurance, not shortage of medical care. It's definitely an issue, but not they one we are discussing here. So... your argument is that the inability to get medical care doesn't equate to the inability to get medical care?
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Apr 4, 2015 14:54
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Bel Shazar posted:So... your argument is that the inability to get medical care doesn't equate to the inability to get medical care? No, that is not my argument.
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Apr 4, 2015 14:57
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TheImmigrant posted:For example? Orphan drugs are probably the quintessential example. Paroxysmal nocturnal hemoglobinuria, which affects between 7000-14000 people per year, is treated with Soliris, which costs over $400,000 a year to administer, and bone marrow transplants, which are risky. Both are limited in effectiveness, as well. The majority of people with the disease cannot access treatment, and it has a high fatality rate. People die every year because of this.
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Apr 4, 2015 15:05
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Hearts for all! Why do we keep warring against other nations if not to secure a reliable organ supply courtesy of our vanquished enemies?
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Apr 4, 2015 15:07
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Bel Shazar posted:So... your argument is that the inability to get medical care doesn't equate to the inability to get medical care?
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