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How much work should we expect a person to do to keep another person alive? At a certain point, our obligations to another person have to end. At what point do

How much work should we expect a person to do to keep another person alive? At a certain point, our obligations to another person have to end. At what point do we fault someone for not putting in work to delay someone else's death? Obviously, withholding immaterial support is ethically deplorable. If it costs $1 of medicine to cure a child's life threatening illness and give them a high probability of living a typical human lifespan, you'd be a monster to not help. But what if it costs $100,000 and has a low chance of healing them? Or $10,000,000, with no probability of them ever leaving the hospital room, and their use of the room and machines will mean 10 additional deaths that could have been prevented? I think we should be biased towards life over money because it's more humane and we'll probably learn useful things along the way that improve care in the future, but even with that overweighting, at some point it looks like a bad trade-off.

margalabargala 3y ago
We as a society make a significant distinction between declining to provide something in the first place, and choosing choosing to take back something someone already possesses. To wit: > At what point do we fault someone for not putting in work to delay someone else's death? That isn't what is happening. I'm faulting someone for putting in work, to expedite someone else's death. Sure, there's all sorts of math you can do to justify things either way. You can say "oh but it'll cost ten gajillion dollars and the equipment could have saved an entire ethnic group from extinction", as though you have as much certainty about hopeful future hypothetical benefits as you do about the person dying. On the other side you can say "oh for someone age 16 a week is the same proportion of their life so far as 3.5 weeks for someone aged 55, so if we can keep the 16 year old alive for another week that's better than keeping a 55 year old alive for 3 weeks". It really all comes down to the difference between action and inaction, between causing harm and declining to prevent harm. Is someone who pushes someone in front of a bus no worse than someone who sees a bus coming at someone and doing nothing to warn them? That's a hard sell.
- datadrivenangel 3y ago
  That's what makes it such a fascinating ethical issue! Action/Inaction is an important distinction for ethical frameworks and our intuition, but this situation is so difficult to reason about because it forces us to ask when triage/lifeboat ethics apply. Even more tricky because the obvious solution to triage/lifeboat/trolley ethical problems (avoid getting into them) doesn't make sense here because the technology can save so many people! How many lives can we ethically save in exchange for putting doctors and biophysicists into trolley problems? Entropy is why we can't have nice things.
- toast0 3y ago
  > We as a society make a significant distinction between declining to provide something in the first place, and choosing choosing to take back something someone already possesses. To wit: >> At what point do we fault someone for not putting in work to delay someone else's death? > That isn't what is happening. I'm faulting someone for putting in work, to expedite someone else's death. My understanding is someone on ECMO needs continuous monitoring and infusions of things. You could put in work to proactively remove them from ECMO, hastening their death. Or you could stop putting in the work to continue the treatment and let what happens happens. Are those equivalent? Maybe the machine needs maitenance to continue functioning and you don't do it. Maybe you designed the machine so that it must be disconnected every 30 days, so that the default is death after a month and the doctors have to actively choose to replace the machine every 30 days if death is to be avoided.
silverquiet 3y ago
Seems like a real life trolly problem. I can’t imagine that anyone would be willing to throw the switch on a kid who’s living on the machine though. Even a psychopath who’s done the math and doesn’t feel anything would probably know that just the bad publicity alone wouldn’t be worth it.
will5421 3y ago
> additional deaths that could have been prevented Imagine taking someone off ECMO to save others but they all die too. A bird in the hand is worth two in the bush.

margalabargala 3y ago

We as a society make a significant distinction between declining to provide something in the first place, and choosing choosing to take back something someone already possesses. To wit: > At what point do we fault someone for not putting in work to delay someone else's death? That isn't what is happening. I'm faulting someone for putting in work, to expedite someone else's death. Sure, there's all sorts of math you can do to justify things either way. You can say "oh but it'll cost ten gajillion dollars and the equipment could have saved an entire ethnic group from extinction", as though you have as much certainty about hopeful future hypothetical benefits as you do about the person dying. On the other side you can say "oh for someone age 16 a week is the same proportion of their life so far as 3.5 weeks for someone aged 55, so if we can keep the 16 year old alive for another week that's better than keeping a 55 year old alive for 3 weeks". It really all comes down to the difference between action and inaction, between causing harm and declining to prevent harm. Is someone who pushes someone in front of a bus no worse than someone who sees a bus coming at someone and doing nothing to warn them? That's a hard sell.

datadrivenangel 3y ago
That's what makes it such a fascinating ethical issue! Action/Inaction is an important distinction for ethical frameworks and our intuition, but this situation is so difficult to reason about because it forces us to ask when triage/lifeboat ethics apply. Even more tricky because the obvious solution to triage/lifeboat/trolley ethical problems (avoid getting into them) doesn't make sense here because the technology can save so many people! How many lives can we ethically save in exchange for putting doctors and biophysicists into trolley problems? Entropy is why we can't have nice things.
toast0 3y ago
> We as a society make a significant distinction between declining to provide something in the first place, and choosing choosing to take back something someone already possesses. To wit: >> At what point do we fault someone for not putting in work to delay someone else's death? > That isn't what is happening. I'm faulting someone for putting in work, to expedite someone else's death. My understanding is someone on ECMO needs continuous monitoring and infusions of things. You could put in work to proactively remove them from ECMO, hastening their death. Or you could stop putting in the work to continue the treatment and let what happens happens. Are those equivalent? Maybe the machine needs maitenance to continue functioning and you don't do it. Maybe you designed the machine so that it must be disconnected every 30 days, so that the default is death after a month and the doctors have to actively choose to replace the machine every 30 days if death is to be avoided.

silverquiet 3y ago

Seems like a real life trolly problem. I can’t imagine that anyone would be willing to throw the switch on a kid who’s living on the machine though. Even a psychopath who’s done the math and doesn’t feel anything would probably know that just the bad publicity alone wouldn’t be worth it.

will5421 3y ago

> additional deaths that could have been prevented Imagine taking someone off ECMO to save others but they all die too. A bird in the hand is worth two in the bush.