Resource Allocation

Question 1

1. criminal justice does NOT equal __________ justice
2. __________ is a reality. What world event has made this clear?

Answer 1

1. distributive justice
2. Scarcity, Covid has made this clear

Question 2

1. what is distributive justice?
2. If the same people benefit every time, this would demonstrate a _________ injustice?

Answer 2

1. • trying to make the decision of who gets what under what circumstances in an equitable manner (allocating appropriately)
     - so that the same people do not benefit every time
2. systemic

Question 3

1. What is Aristotle’s principle of distributive justice?
2. What is the problem with this?
3. T/F: Aristotle intended for this problem to occur

Answer 3

1. principle of distributive justice = equals should be treated equally and those who are unequal should be treated unequally.
2. • issue is that if you decide someone is not equal to you, the excuse of treating them badly is sufficient
     - makes for justifying injustice
     - however, if there is no relevant distinguishing feature on someone, they should be allowed to access the same thing, and if an accommodation is needed, they should be granted it.
3. F. he did not intend

Question 4

1. What is the negative definition of discrimination?
2. what is the other definition of discrimination?
3. what is another word for unintentional bias? What does this mean? Give an example.

Answer 4

1. someone is behaving in a prejudicial way for no valid reason. Acting against someone because of a feature of their
2. evaluating and choosing between possibilities with equal consideration free from intentional bias –> evaluating 2 people and then choosing someone based on an unintentional bias you had.
3. encultured bias = biases that we are unaware of. Walking the other way because you see a homeless man who is actually harmless.

Question 5

What was Alfred Bater’s story? What does this show?

Answer 5

• his family fled germany and came to Canada. He was jewish
• he has amazing grades and applied to all the good universities.
• many schools had quotas (limits) on the # of Jewish people they would accept because they believed that too many could cause disruption in student life.
• he did not get into UofT or Mcgill because they had too many Jewish people. He got into Queens because they did not have a quota
• shows he was made into an unequal

Question 6

What is the problem with current acceptance into Canadian school university programs?

Answer 6

people are discriminated against (someone evaluates choices) based on based academic performances to determine future academic performances.

Question 7

Explain the situation of Emergency care at a hospital and how it is discriminatory (based on eval of choices)

Answer 7

• a person comes in with a cough and a person comes in with chest pain.
• you have to evaluate which is in priority and hospitals normally take those with chest pains first

Question 8

What are 2 morally relevant factors that make people unequal in healthcare?

Answer 8

1. medical need (acuity/triage) = how severe their sickness is
2. likely benefit (% chance of recovery) = if treated how likely are they to recover

Question 9

1. Poor people replicate __________
2. privileged people replicate ____________
3. __________ __________ of health suggests there is a difference in access

Answer 9

1. poorness
2. privilege
3. social determinants

Question 10

1. What is the problem with organ donations currently. What is a fix?
2. what is the problem with the fix?

Answer 10

1. there is a constant organ shortage because people do not get around to signing the consent form, so there are essentially wasted organs.
   a fix would be to make it so that it is an automatic consent unless someone gives negative consent and says no to their organs being donated.
2. how can we be certain that everyone will know how to fill out the form to say NO if they have a strong objection to their organs being donated –> we cannot assume everyone will know how to say NO. (because what if they do not know english)
   therefore this viewpoint on organ donating discriminates and is not equally accessible

Question 11

1. Explain preferential/conditional access to certain surgeries/treatments using an example
2. Is this discrimination?
3. What is the purpose of conditional access? Give an example of its importance

Answer 11

1. Means that you have an illness where the treatment required has some conditions that you must first meet to qualify for the treatment. Ex: a smoker who has been smoking since the age of 9 needs a heart bypass surgery. The doctor puts the condition that the surgery can only be done if the smoker goes 6 months free without smoking before the surgery, otherwise it cannot be done
2. not discrimination because you are not choosing between options of performing the surgery or not. You will perform the surgery but the conditions not being met could mean not qualifying
3. to ensure the surgery or treatment is going to have maximum benefit and that the patient is protected and safe. Ex: can’t do a hip replacement on someone with BMI over 30 because complications could arise

Question 12

T/F: preferential/conditional treatment may have a link to adversely affecting one group more than another. Explain why or why not

Answer 12

T. because with the conditions of the BMI, you exclude people who are obese from getting the surgery, and obesity can be an outcome of socio-economic status/ something out of the persons’ control.

Question 13

What type of problem exists in this case?
covid 19 wipes out the proportionately large population of older people and therefore the elderly were disproportionately absorbing negative effects. The population of younger people lacked resources to help them. So the question of should we continue to help the older population even though they have already lived long lives?

Answer 13

this is ageism

Question 14

What are the 2 types of questions we must ask when considering justice? Explain each

Answer 14

1. substantiative or material questions of justice= these help us evaluate who should receive care first (triage, acuity, % chance of recovery) to see what we value and why we would preserve one life over the other
2. procedural or process questions of justice = how we apply the answer to who goes first. So once we have picked our patient, what application should be put in place?

Question 15

1. The substantiative or material questions of justice consider 3 things of _______, ______, and _________
2. The substantiative questions of justices involves __________ of life and makes us evaluate our ________

Answer 15

1. triage = assessment to determine the urgency of care
   acuity = intensity of care needed
   % recovery = how likely they will recover
2. preservation of life, evaluate our beliefs

Question 16

List the 5 substantiative questions of justice?

Answer 16

1. Need
2. equality
3. utility
4. liberty
5. restitution

Question 17

Answer based on need:
1. _______ is a major impediment to happiness
2. T/F: if you are ill, you cannot live a happy life
3. ________ types of societies have negative effects on happiness
4. ________ should reflect need
5. What is the decider to determine what resources are allocated in terms of need?

Answer 17

1. illness
2. F. being ill makes it more difficult to live a happy life, but it doesn’t mean you will be unhappy
3. egotistic
4. resources
5. acuity = the intensity of the illness

Question 18

Answer based on equality:
1. what is horizontal equality?
2. We should treat like cases _________

Answer 18

1. horizontal equality = equal resources for equal need.
2. alike

Question 19

answer based on utility:
1. What is the principle of utility
2. Explain this using the example of masks

Answer 19

1. do what will yield the greatest result for the most amount of people possible, while minimizing harm
2. masks help to minimize illness, protect those with fetal exposure

Question 20

answer based on liberty:
1. What does liberty have to do with treatment?
2. give an example.

Answer 20

1. liberty bases allocation of resources on who is most deserving. You can disqualify yourself from accessing resources by the decisions you make.
2. You have 2 patients each need a liver transplant to survive and there is only 1 liver that can be used for either. You must choose one and decide based on liberty:
   Patient 1 is 10 years old
   Patient 2 is a 65 year old alcoholic
   –> choose patient 1 because they are more deserving and patient 2 has made the decision to smoke

Question 21

answer based on restitution:
1. What is restitution based on?
2. Give an example

Answer 21

1.access to healthcare should be focused on those who have been historically denied or unjustly treated.
2. Ex: residential schools had a bad history of medical experiments. When Covid 19 vaccine was available, there was hesitation from the indigenous people because of fear of repeated history. So the government had to take extra steps to ensure availability of the vaccine and that it was safe

Question 22

________ are hard to track
________ are easy to track
________ want to be able to track progress

Answer 22

preventions
treatments
politicians

Question 23

T/F: in the distribution of healthcare, there is equal access

Answer 23

F.

Question 24

1. What is the lottery system
2. What is first come first serve system
3. T/F: During a pandemic, allocation by simple lottery is sufficient by itself
4. T/F: first come first serve treats people fairly
5. T/F: first come first serve maximizes benefits of resources available

Answer 24

1. lottery = does not take into account knowledge of individuals
2. first come first serve = does not treat people equally and favours more advantages people in society who have more financial resources or connections
3. F. insufficient unless used in a larger system when allocating between individuals who have similar expected treatment benefit
4. F.
5. F.

Question 25

Should medical professionals be allocated resources over others?

Answer 25

yes. Because they are valuable to society in combating the pandemic. these people are limited in numbers so it is important that they are well and in good health first to treat others

Question 26

Should we give priority to the worst off?

Answer 26

can be relevant in a well supplied resource setting but not in a limited resource setting because we wouldn’t be maximizing benefits if these people were to die post treatment –> we do not know post treatment prognosis

Question 27

T/F: Patients presenting with non-pandemic conditions should not be favoured over those presenting from the pandemic. They should not be treated at all

Answer 27

F. they should not be favoured but should also not be less favoured.

Question 28

What are the 3 requirements for patients possibly needing surgery during the pandemic?

Answer 28

1. should be tested for covid 19 before an emergency surgery
2. planned surgery patients should isolate before and assess for covid 19 before
3. where non operative management is possible instead, this should be done instead