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          The (un)ethics of social worth decisions

          George Anesi

          Issue date: 11/14/08 Section: Opinion
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          A social worth decision is one that considers a given set of criteria, consisting of various societal distinctions, used to determine a social ranking among evaluated candidates. In medicine, as elsewhere, social worth decisions may be - and indeed have been - used to ration scarce resources, often to great controversy.

          There are several ways to ration scarce resources, medical or otherwise. Scholarships, of which there is certainly not an unlimited supply (and are therefore scarce), are awarded based on merit - academic, athletic, or otherwise. Transplantable organs - to the dismay of this author - are awarded, at least after certain medical considerations, by chance. Medical care in the United States - to the dismay of many - is more or less awarded based on payment, and thus indirectly via level of education and employment.

          Social worth is perhaps an even more complicated method for rationing than the above in that it takes into account a far broader spectrum of qualities that are indeed far more difficult to quantify. The goal in a social worth distinction, as the name suggests, is to determine a measure of worth to society. Of the many problems that plague such distinctions, perhaps most important is the fact that the easy distinctions are easy and the hard are hard.

          Few would argue, with respect to contributions or worth to society, with the notion that a career criminal pales in comparison to a law-abiding citizen who has worked honestly for his or her entire life. But can we possibly try to make distinctions, for instance, between honest citizens? This very task was attempted in medicine in an effort to solve a problem of scarce resources, and to disastrous consequences.

          The paradigm social worth case in American medicine is that of the Seattle Artificial Kidney Center, which in 1962 had a very limited supply of newly invented life-saving "artificial kidneys" (hemodialysis) and needed a method to determine which of the many medically eligible candidates would receive the treatment.
          Continued...
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            George Patsourakos

            posted 11/20/08 @ 4:48 PM EST

            George Patsourakos
            A social worth decision -- that is, a decision that uses a set of criteria to determine a social ranking among evaluated candidates -- is not a fair way to make a decision. (Continued…)

            Details   Reply to this comment

            Watcher

            posted 12/09/08 @ 5:14 PM EST

            The (un)ethics of social worth decisions have been tested right under your noses and I bet no one has even noticed.

            Does anyone ask where Dr Timothy Kinsella, past CWRU Chairman of the Dept of Radiation Oncology has gone, or why he left?

            Please read the stonybrookpress. (Continued…)

            (1 reply)   Details   Reply to this comment

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            In This Issue

            News

            • A Conversation with Caroline Goulding
            • Don't blow it all at once: financial tips for recent graduates
            • International student session to debut during 2010 orientation
            • Name That Place - 4/23/2010
            • Relay For Life raises $76,000, short of goal but not short of spirit
            • Student Leadership Award Winners
            • Tanning dangers abound as summer approaches
            • What Now?
            • Mass funding successful for some, headache for other organizations

            Sports

            • Case falls to Wooster at Progressive Field
            • Spartan Spotlight: Obinna Nwanna
            • Spartans are optimistic heading into UAA's
            • Spartans extend win streak to six
            • Spartans snap long losing streak
            • The next step
            • Top 10 Spartan stories of 2009-2010

            Opinion

            • 2009-2010 Year in Review
            • Letter to the Editor: Straight Answers to Questions about Greek Life Funding
            • Living - and dying - on your own terms
            • The last hurrah: experiencing senior week
            • What are you doing this summer?

            Focus

            • A final fling for finals
            • Despite an oppressive crowd and disappointing opener, Ben Folds continues to impress on stage
            • MaDaCol performance distinguishes dance as alternative communication medium
            • Parting word of advice: Express yourself
            • Springfest blowout to feature activities, student bands and national headlines
            • The best bars in Cleveland
            • Tri-C Jazz Festival features stunning jazz organ performance, among others
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