Should We Cut Up Chuck?
This is a hypothetical posed by Bryan Caplan at Econlog:
The “Cut Up Chuck” Case: A homeless guy named Chuck comes into the ER with a treatable leg wound. But instead of treating his wound, Dan the ER doctor realizes that Chuck’s heart, lungs, liver, and kidneys are all healthy and in fact are all matches for five patients upstairs who are at death’s door and in need of donor organs. So Dr. Dan cuts up Chuck, passes out his organs, and saves five people who otherwise would have died. Question: Did Dr. Dan do the right thing?
My judgment: If you’re a libertarian, the answer is straight forward. But if you are a utilitarian, or a redistributionist or a Rawlsean welfare stater, to say nothing of a modern liberal/progressive, it’s less clear.
Cut up Chuck? How could you?
Interesting hypothetical. And I see that it links back to a philosophy text. A real book? Or notes for classroom discussion?
How is redistributing Chuck’s organs any different in principle from redistributing the product of Chuck’s labor? Both acts implicitly treat Chuck as a means to someone else’s end rather than as an end in himself. Both acts deny that Chuck has a right to pursue his own happiness.
Chuck, the guy that gets dissected in this hypothetical, so five other people can live is described as homeless. What about the five organ recipients? What is their worth to society? Moreover, what if Chuck is a gifted entrepreneur who employs hundreds of people and the five people awaiting organs are homeless? Would it make any difference if Chuck is elderly (or has a dread disease with a short life expectancy) and the patients awaiting organ donations are young? Instead of a ratio of 5-to-1, the number of life years saved might be 20-to-1 or greater.
I agree that redistributing Chuck’s organs is more final than redistributing his income and his wealth. But it does seem to me merely a matter of degree.
Once you postulate that Chuck’s role in life is to sacrifice for others, the moral issue is lost and the only issue left to discuss is how great is Chuck’s sacrifice going to be.
I know what I’m having for dinner tonight!
Dan was probably violating the law, so that’s an issue too. Assuming we are in a desert island and there are no other available organs for the five patients, I would go with the utilitarian choice.
So, Dr. Dan, will the DA charge you with murder 1? Will you plea out to a lesser charge?
I don’t want Dr. Dan or rgomes in the ER if I come in. This example, as with any number of others one could propose, for a liberatarian like me, shows the poverty, the moral bankruptcy, of the utilitarian position. Its the difference between Rothbard or Locke and Epstein.
My question: How was Chuck planning to pay for his leg injury? If he’s using the public system, he’s effectively taking resources away from others that might have benefited. So, in a way, you might say that he is consuming the organs of others.
I’m starting to think I should have gone to law school…
How harshly I judge Dr. Dan depends on whether my name is chuck; or if I’m one of the five guys awaiting an organ donation. If I’m Chuck, I’m going to be pretty steamed about the redistributive justice. However, if I’m one of the five guys needing an organ, I’ll probably wait until I feel better before explaining to Dr. Dan how wrong his decision to cut up Chuck was.
Implicit in this with respect to Dr. Dan is the (fallacious)notion that the physician’s primary responsibility is to society or some greater good. Many otherwise reasonable people don’t understand that the physician’s (like the attorney’s) fiduciary responsibility while he is ministering to Chuck’s injury or illness, is to Chuck.
No one would expect a lawyer to place society’s interests above those of his client, yet people (e.g. hospital administrators and government bureaucrats and even the AMA) expect physicians to do so by, for example, choosing a less expensive and probably somewhat inferior treatment over a more expensive one.
No man has the right to determine another man’s fate.
If people don’t want to treat Chuck’s leg injury for free then they shouldn’t. Murder is something all together different.
Take this case to the extreme, as it was in Larry Niven’s science fiction stories. Chuck runs a red light. Lots of people needing organs match his. New drugs make all organs transplantable. As a result, traffic court is nothing more than three wolves and a sheep voting on breakfast.
Some situations require bright line answers.
Actually Linda, if Chuck walks into an emergency room with an injured leg, money or no by law he has to be given treatment.
The organ problem is a temporary problem. Give it 100 years and the technology will be there to grow new ones.
Laws can be changed. And EMTALA does not require treatment if the injury is not one that is life threatening or has the potential to compromise future functioning.
artk, how can I give it another 100 years if I don’t think I’m going to be around in 100 years. And if I have a need for an organ, it’s likely to arise long before then.
I’m tempted to think that in 100 years, it will just be something else that even more expensive.
I kinda think ERs should have a covercharge. $100 just to walk in the door. A doctor on duty can agree to waive the charge, but should be encouraged not to. That should stop drug seekers and other people who use the ER for nonemergent issues “I’d had this back pain for 3 months.”
I would like to see some hospital adopt a policy of kicking out patients who make some nonemergent claim like that.
Unfortunately, defensive medicine and lawsuits as they are, you don’t want to be held liable.
In regards to chuck. In a free society the hospital or doctor would be free to not treat him, without fear of reprisal, and chuck would be free to keep his life.
That is the society I’d rather live in.