Saturday, August 08, 2009

Utilitarian Ethics

Utilitarianism is the idea that the moral worth of an action is determined solely by its contribution to overall utility: that is, its contribution to happiness or pleasure as summed among all persons. It is thus a form of consequentialism, meaning that the moral worth of an action is determined by its outcome: put simply, the ends justify the means.

As applied to medical decisions, a Utilitarian would decide if treatment for another person contributed to the overall good of society. Would treatment extended be better allotted to another person? Would the expense of treatment be better spent on other endeavors? Would the time allotted to the afflicted person be a benefit to society at large -- and by further extension, would that benefit to society be greater or lesser than if that treatment was diverted to another, similarly afflicted person?

Medical Utilitarianism is exactly: Determining the utility of the person in need of medical attention, then providing or withholding treatment based on that entirely subjective assessment.

Our Democrat-heavy congress has included a section in the new stimulus bill that would put Utilitarianism in the forefront of medical treatment. A new bureaucratic department, the National Coordinator of Health Information Technology, will monitor and 'guide' treatments to make sure your doctor is administering appropriate and cost effective medical care - as will be dictated by the federal government.

Hospitals and doctors that are not 'meaningful users' of this brave new system will face (currently undetermined) penalties. The determination of what a 'meaningful user' is will be left to the discretion of the HHS secretary, who will be empowered to impose "more stringent measures of meaningful use over time" (HR 1 EH, p511, p518, p540-541). Will your doctor, and the administration at the hospital at which he or she has privileges, be willing to buck the system to treat you? Are you willing to bet on their dedication to the Hippocratic oath? Perhaps more tellingly, are you willing to bet your parents, siblings, spouse, child, grandchild, neighbors, co-workers, tribe, etc.'s continued existence? Because that's exactly what's at stake here.

Just how useful are you and all the people that you know?

Do you smoke? You will be placed much further down on the list of treatment recipients than pretty much everyone else in the country.

Are you fat? Just above the smokers on that list, chunky.

Diminished mental capacity? Well, that's not very useful, is it?

Handicapped? Not much you can do that an able-bodied person couldn't do better.

Criminal? Mmmmm, how criminal? Do you think antisocial thoughts? Do you own a gun? How many deductions do you take on your W2? It's counterproductive to expend time, money and energy on social criminals such as you.

Here's a thing: I'm a pretty useful person, for now. To toot my own very useful horn, I'm pretty darn smart, and I work in 'critical infrastructure.' I'm reasonably able-bodied. I'm friendly, clean and thrifty. I have produced only one child, and thus have not overburdened our fragile planet with extraneous life. I am far enough off from retirement that I could probably get a kidney if I really needed it. I'm looking pretty good for rationed healthcare right this minute. My parents, however, would be dead today under that plan.

Under that plan, my beautiful, funny, insightful, volatile, amazing daughter would be permanently disabled; my grandson, who is a beacon of light, would have been allowed to die at birth; my sister, the nurse, would have been dead in childhood.

In fact, if the bureaucrat deciding my 'appropriate care' when I was a teenager had a beef with the military (and what are the odds of that?!), as a military dependent I would have been very expendable and then very dead at the age of fifteen. (I was a particularly useless teenager, anyway.)

A similar trajectory can probably be plotted for each and every one of you -- unless you are a celebrity, or a politician, or a member of a protected political class. Are you one of those kind of special, valuable people? No? So very, very sad for you.

Here's a little info our politicians better know about me: I don't value my life anything like I value the lives of my loved ones. I don't value my life more than certain bedrock principles.

Here's my promise: If this plan is passed into law and in any way harms anyone that I love, I will hunt down the bureaucrats involved in that harm and kill them in clever and inventive ways -- I'll leave it the reader to decide if I mean that metaphorically. Remember, though, I am extremely smart and I could absolutely do it and get away with it.

Further, again if this plan is passed into law and in any way harms anyone that I love, I'll go after the politicians who voted for this abomination. For those who can reason, it should be apparent that it is very, very difficult to stop a person who is friendly, clean, thrifty, smart, and willing to die in the pursuit of justice.

And I am not alone, Congress. We are legion.


Blogger Machinist said...

This whole concept is against the fundamental concept of our Republic. Our rights to life are birthrights as Americans, not privileges to be rationed by the government.

As the high quality of of our medical care has made it hard to sell socialized medicine, especially with the horrible failures in Canada and England coming to light, this seems to be a means of making private care as bad as public care. If paid care is no better you might as well get free.

The idea that politicians think they are qualified to make life and death medical decisions and that we will trust them not to abuse our medical records is risible. Ask Joe the Plumber about privacy.

I was explaining this gambit to Elena last night. She may be no genius but she saw through this POS fast enough.

2/11/2009 10:07 PM  
Blogger BrendaK said...

Hey, Mac -

This whole stimulus disaster has been just awful, but I think this health care grab is the worst thing of all. I believe it is an absolute evil.

I don't think enough people are paying attention, and it is so disheartening.

2/11/2009 11:34 PM  
Blogger Machinist said...

I agree with you, Ma'am.

I told Elena I was not ashamed of my country but I'm embarrassed to be part of an electorate that could become such sheep to such loathsome scumbags.

2/11/2009 11:38 PM  
Blogger Machinist said...

I fear there are many other surprises hidden in this 700+ page pile.

2/11/2009 11:40 PM  
Blogger Machinist said...

From some of the more brazen abuse I wonder if the politicians haven't decided that by the next election we will no longer have enough power to remove them as long as they have the support of the Democrat machine and their "community organizers".

Both Obama and the Dems in Congress and the Senate seem to think that rather than electing them to represent us we elected them rulers over us.

2/11/2009 11:45 PM  
Blogger BrendaK said...

Y'know, I was absolutely astounded that some of the Obamacolytes seemed to think they had elected a king.

I am more astounded that Obama and the Democrat Choir seem to think the same thing.

I never would have expected it, but this is looking more and more like a putsch. Fatwa and I are starting to worry about the long knives.

2/11/2009 11:57 PM  
Blogger Machinist said...

They will have to disarm us first, though I know they have already made the first moves on that front.

I have trouble believing that these incompetents could try to organize such a thing but then I wonder how many people dismissed the SA as clowns. They certainly looked like a bunch of cheap thugs.

Unfortunately, even ham handed moves could do a lot of lasting damage and the political machine certainly knows how to manipulate a dependent and ignorant populace. They have lots of practice. I think we will have elections in the future, I'm just not sure how much real say we will have in them.

2/12/2009 12:05 AM  
Anonymous Anonymous said...

The Carl Drega approach, eh Brenda? It’s getting a lot closer to that time to make that decision to opt out of society.


2/12/2009 1:03 PM  
Blogger Machinist said...

We go from inalienable rights and public servants to unaccountable bureaucrats deciding who has enough value to the government to be allowed to live.

Quite a journey!

2/12/2009 2:27 PM  
Anonymous Anonymous said...

Freedom and liberty; high ideals and government as a necessary evil, to safety, security, and the nanny state. All in a little more than 200 years. Yeah, quite a journey, Mac, but what was that first step that set us down this path?


2/12/2009 2:46 PM  
Blogger Machinist said...

Hi, Sven. I'm no expert and my education is lacking but I would say it was either when we turned away from the constitution in the thirties to embrace socialist programs or earlier when we imposed an income tax. As far as I know the income tax around WW1 was the first time the government owned our time, effort, and creativity and could call it in as they pleased. Prior to that the government charged fees for services and this limited the size of government as we could often forgo those services if the fees were too high. The only claim on our service was to provide military service when needed in time of war. The idea that the government owned us like slaves and only needed to share some portion of our time and labor with us was a fundamental change in our relationship. It was then that they became the master and we began to serve them.
I would love to see Paddy's or John the Baptist's take on this.

What do you think it was, Sir?

2/12/2009 3:33 PM  
Anonymous Anonymous said...

It’s a question that I don’t have an answer to, Mac. It’s the boiling frog analogy and does it matter when the fire was first lit? We’re in the pot and the water is real warm. From my perspective, it started with Lincoln and his flawed logic that states were not allowed to secede. From there, it was all downhill as the federal government grew in size and power; income taxes, decreasing state’s rights, FDR and the New Deal, etc.
What Brenda has pointed out here is a logical extension of the policies and practices of the federal government and limited resources. It just happens to be tied to the health industry. And if it doesn’t pass here and now, it will get passed sooner or later considering the direction America is moving. You don’t like it, I don’t like it, Brenda doesn’t like it; but it’s coming.
When I gaze at all the books in my office or on the shelves or in bookcases scattered throughout the house, the one I keep coming back to is The State vs The People: The Rise of the American Police State. Claire Wolfe and Aaron Zelman. Published in 2001 but still timely. If you haven’t read it, it’s one to get.


2/12/2009 5:08 PM  
Blogger Machinist said...

Thank you, Sir. I will look for it.

There are always people waiting to pick up power when someone puts it down. Perhaps the American people have decided that the power over their own lives and the responsibility that goes with it is just too heavy a burden to bear, and prefer to sell their honor and freedom and that of their descendants' for a treat and a shiny prize today. How very sad.

I wish I could think of any time in history when a people have started this far down this road and managed to turn back. I really can't. Perhaps 1994 was our last chance.

2/12/2009 5:18 PM  
Blogger BrendaK said...

Thank you both for your insights, Sven & Mac.

Now that this piece of shite stimu-palooza has passed, I'm going to be taking my and my family's medical records with me (out of the Dr's hands) right up until the Health Nazi's get that computer program running.

In thinking about how successful the gov't has been with tracking databases to date, it may be a few/several/many years before it even works -- since I dare to dream that Obama is a one-term pony and that the Democrats will loose big next mid-term election cycle, this medical abortion they've dreamed up may never come to pass.

2/14/2009 12:49 PM  
Anonymous Anonymous said...

You raise an interesting point:

Would this legislation fall afoul of the Americans With Disabilities Act? It ostensibly prohibits discrimination based on a host of disabilities. Oh that's right. The Federal Government is exempt.

Sorry for the false alarm.

8/12/2009 10:56 PM  
Anonymous Anonymous said...

heard you're getting hitched - hopefully your new hubby likes to fuck you in the ass, thus minimizing the chance that you mutant genes will be spread.

Or maybe you like to suck cock so much he doesn't need to ever dump a load in your herpes infested snatc?

9/10/2010 12:35 PM  
Blogger Fatwa Arbuckle said...

The preceding puerile vulgarity courtesy of Deb Frisch - well-known failed academic, failed comedienne and failed speller.

Google it!

9/10/2010 1:14 PM  
Blogger BrendaK said...

Now, now, Debbie. I know that it has always been your greatest disappointment that I simply would not date you.

The news of my impending marriage is clearly a devastating blow to you, and I hope you won't have to resort to the Absinthe again to numb your pain.

Maybe another quiet stint in the clink would be of some benefit to your mental well being? Oh, wait...who's that uniformed stranger wading through your weed-infested yard?!

Yay! Prison Vacation time again! Maybe you'll finally get a date on a Saturday night! Of course, Large Marge isn't rumored to be all that gentle...

9/10/2010 2:04 PM  

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