If most would prefer, say, 10 years as a quadriplegic to 4 years of nondisabled life, but would choose 6 years of nondisabled life over 10 with quadriplegia, but have difficulty deciding between 5 years of nondisabled life or 10 years with quadriplegia, then they are, in effect, assessing life with quadriplegia as half as good as nondisabled life... If that judgment represents a rough average across the population, we might conclude that restoring to nondisabled life two people who would otherwise be quadriplegics is equivalent in value to saving the life of one person, provided the life expectancies of all involved are similar. [my emphasis]
Really? What about if we asked people if they'd rather be a man for 50 years or a woman for 100? If people have trouble deciding, does that mean men are worth twice as much?
Very astute. Even in principle, the analysis requires that the people making the comparison be well informed about the choices.
ReplyDeleteA quadruplegic could, one supposes, be well informed about both alternatives. I wonder how Singer would feel about a survey restricted to quadruplegics.
Anonymous Economist
Maybe... but I don't really feel like public opinion polls are a good thing to base ethical norms on. Maybe everyone would rather be blonde and blue-eyed. Maybe they'd say they'd trade a few years of their life for it if you asked them in some survey.
ReplyDeleteBut that doesn't mean that blonde, blue-eyed people have lives that are "worth more", it means we have a society with some fucked up values.
The respectable research in the area isn't simple survey research. It's more structured. The point of the research is not to establish ethical norms, but to discover preferences. Whether or not that's an appropriate way to make decisions about medical care, Singer's broader point is that there has to be some decision about who gets what medical care. There is now, and will be under any system. We might as well discuss how to make the decisions.
ReplyDeleteYeah, but he's using preferences AS ethical norms. As in, if more people say they would prefer to not be quadriplegic, quadriplegic life is worth less and is less worth saving.
ReplyDeleteSure, there has to be a way to make decisions about health care. Deciding whose life is "worth" more seems like an intrinsically bad way to start out, to me. Basing the worth on opinion polls, however complicated, doesn't make it any better.