Two recent news stories caught my eye in the midst of lock down. The first, on the BBC website, was headlined: Blind ‘not vulnerable enough’ for deliveries. You don’t need to read any further to get the gist. It reads exactly how it sounds. A blind couple are not classed as vulnerable enough to warrant food deliveries even though they cannot drive themselves to the supermarket.
But terrible as that may sound, it pales into insignificance when weighed against a Guardian article that opens with this terrifying comment:
Coronavirus patients with a poor prognosis could be taken off a ventilator even if they are stable or improving to make it available for someone else deemed more likely to survive, under guidelines drawn up by UK doctors.
We are now living in a time where we are instituting a sliding scale of deserving vulnerability and a terrifyingly dystopian approach to healthcare. If my pal in his 70s, with COPD and muscular dystrophy, gets coronavirus at the same time as me, he’ll be booted off the ventilator for my sake. That is as horrific for the person taken off the ventilator as it is for the one who must live with the fact that they were allowed to die so they could live. But this isn’t a gospel illustration making its way into all our sermons because the one allowed to die hasn’t voluntarily given up life-saving intervention for the sake of another, it is simply enforced by healthcare providers who determine their life was not as worthwhile. It is deeply troubling that utilitarian ethics remain alive and well.
Rather than viewing all life as inherently valuable, utilitarianism views life as valuable if it leads to beneficial outcomes for most people. Of course, this makes determining the over-70s as more worthy of death a bit of a conundrum because the overall net value of saving some pensioners lives might (by our subjective calculations) lead to more societal value that saving certain fit and healthy younger people who – in the eyes of those who make such judgements – add little to society. On the cold, hard logic of utilitarianism, it surely depends on a multivaried analysis of the person and their impact on wider society as to whether the overall benefit is worth granting them the ventilator or not. Such logic leads inexorably to the conclusion that certain lives are simply not worth living.
If we buy the logic regarding the over-70s, there is little to stop us making decisions on the same ‘chance of survival’ logic should there be certain health conditions that exacerbate the condition among certain ethnic groups. Then, of course, there is always the value of the poor too. Why would we grant a ventilator to a person in receipt of out-of-work benefits – who adds nothing to the economy and would appear to be a drain on society – over, says, a wealthy City of London hedge fund manager whose single tax bill funds dozens of other out-of-work claimants? Such logic would lead us to target certain regions of the UK as more or less deserving of necessary healthcare. The logic is as ill as the virus driving others to employ it.
Medical ethics are clearly complex and, in any healthcare system without limitless resources, inevitably difficult choices have to be made. But the Christian view would always lean toward the saving of life, regardless of whose life it is. Life is not to be valued according to the wider benefit or happiness that it brings to others, nor according to the greatest possible outcome, but is valuable simply because it belongs to one of God’s image bearers.
Whilst the use of ventilators for those who cannot survive over those who might seems obtuse, to determine from the front end that the elderly have had a good innings so we won’t bother trying if there is a younger life to be saved seems more problematic still. The decision must surely be made on the credibility of saving life, not on the ground of which lives we subjectively determine are more worthy of saving.