Brody and Engelhardt introduce the history of healthcare and provide insightful examples of countries that offer socialized medicine, starting with Germany and Britain. This article alone mentions discouragement of treatment to more advanced technology as reasons for healthcare success, but these reasons themselves are not enough to reveal how they are more moral.

I also encourage you to check out this revealing attempt by the Internet (the ever-entertaining Yahoo Answers)  in responding to a related question: https://answers.yahoo.com/question/index?qid=20101119020726AApz3pv

(It is funny picking up on how everyone thinks they are the expert, and answers range from education reform to budgeting to immigrant policies!).

In addition to Germany and Britain, we should perhaps take a look at Scandinavian countries like Norway and to understand more deeply why they are healthier – healthier bodies, and healthier wallets. Their systems are consistently more successful in the big picture.

The Nordic countries are considered to be the best-governed nations in the world (The Economist). Sweden, Denmark, Finland, and Norway are ranked highest overall, taking into account all factors to ensure relevancy to health. These include global competitiveness, innovation, corruption perceptions, ease of doing business, human development, and prosperity. However, these high marks are a result of  subjective perceptions from outsiders just as much as what numbers reveal. As a consequence, people also attach higher levels of morality with the original affairs. By this I am suggesting the US is capable of providing the healthcare everyone deserves, as we are capable of handling large scale economic calibers. While some say we are disadvantaged for having invented Coke and McDonald’s, their global prevalence gives us no grounds to suggest we are doomed to spend more on our health outcomes. Since the basic conditions are met and align with other first world countries, the problem is not that we do not have the means, but that something is holding us back. This is a moral problem. The situation denies what the US government promises its people, and American individuals have been stuck as the victims of this moral dilemma. Brody and Engelhardt ask many questions as to how approach a solution, but answers need to come from politicians and businessmen who must look at this as ethicists. After all, healthcare is where politics and economics collide.

They do not need to start from scratch. It is already established the prevention is cost efficient. The resulting health benefits and lower costs of treating disease, thus ethically serve us. Since prevention is the key to our deserved outcomes, it is, as a result, moral to push vaccinations, limit smoking, and consumption of sugar. While it is not completely mandatory (preserving the freedom also promised by out government), it serves us better than if public health efforts did not get this chance – to have as much influence as for-profit and often illness-inducing corporations. The US needs to take a hint and realize that what works best is investing in prevention, for the sake of its budget and the health and promise to its people.

References:

The Secret of their Success, The Economist. http://www.economist.com/news/special-report/21570835-nordic-countries-are-probably-best-governed-world-secret-their Last Accessed April 7, 2014.

Brody, Baruch A., and H. Tristram Engelhardt. Bioethics: Readings & Cases. Englewoods Cliffs, NJ:Prentice-Hall, 1987. Print.

Julian Savulescu and Richard W. Momeyer’s article “Should Informed Consent Be Based on Rational Beliefs?” gives its readers a fresh perspective on consent not yet addressed by other authors in Arguing about Bioethics, by Stephen Holland, and it is one that happens to be very critical of the different thought processes that arise in choice making and their logical soundness.

This entails dissection of various situations of a theoretical person but they are always somehow placed in an inferior position- the relating of example stories to theory heavily place the decision-making critiques on the patient, in the case of a patient-doctor relationship. The authors do little to provide ways of evaluating the differences between each of the unsuccessful outcomes, and solutions that are reached in this article speak to things that doctors can do better, not patients, lawyers, and others who could benefit from being more self-aware. It is this self-awareness that would in fact solve their three cases of holding false beliefs.

First of all, there is the heavy reliance on Jehovah’s Witnesses as their go-to example (it is not as easily relatable for non-religious people and definitely not a reliable example across universal belief systems) and this shows a weakness in their article on the most general level. This is so as such reliability on only one specific case is in a way “taking the easy way out” and not showing how their perspective is crucial to the success in every case.

The authors provide smaller example situations with characters such as “Author 1” which are better in generalizability but contain gaps still. As these authors proceed to be so critical of the thought-processes described, I too will show that with the same criticism their overall argument lacks a final impression that motivates change.

A first gap occurs on page 329, when they claim more information to patients must be given, and that is must be relevant. A lack of discussion on what is “relevant” is a gap because it is later crucial in their 3 “Author” examples; they demand that the unknowing person somehow should make themselves informed of things they would not even consider possible in their situation in order to make a their beliefs true. Thus it is crucial to understand what relevant information is so that decisions can be both rational and based on true beliefs, and the person can as a result truly be autonomous. It is now clear that a gap would remain without a discussion on relevancy.

As the authors attempt to apply a case of Jehovah’s Witnesses to patient-doctor relationships, they do use useful sub-examples of a character intending to put out a fire. Something interesting they claim in the process, however, is that sometimes people are unsuccessful in their decisions because the do not care to inform themselves. They then say this results in both practical and theoretical failures. I believe this is inconsistent, as this leads to a result of failed thinking, which has practical implications. The authors may want to revisit such examples with a more philosophical eye- by this I mean checking the validity of their statements to ensure their effectiveness. In the world of Logic, a perspective within the broader study of philosophy, it is possible their article has several fallacies. This word at its root “fallare” means “mistake” in latin. In this case, we see fallacies of “begging the question”. In addition, although  contradictions are still valid by definition, any that come up in the article take away from consistency in argument. It is clear how this takes away from its degree of conviction.

The final takeaway of this article is indeed more along the lines of having the patient trying to inform themselves more, as hinted at on the conclusion of page 337.  It is slightly concerning, though, that a concrete guide to doing this is not provided.

Savulescu, Julian. and Momeyer, Richard. “Should informed consent be based on rational beliefs?” Arguing About Bioethics. Ed. Stephen Holland. London:   Routledge, 2012. 332. Print.

Here is a related article I found, and wanted to share for providing an interesting read. I believe everyone in our class can benefit, as it places more context about a topic we are now all much better familiar with; paternalism, among others.

“While this is a welcome development, it should not obscure the fact that there is still a place for old-fashioned paternalism in medicine — though the decision to defy a patient’s wishes or withhold information is one of the trickiest that we doctors face.”