Another statement as if it's true. Why don't you go express the right to healthcare in countries that don't have any? Or maybe imagine living 500 years ago? Healthcare is a privilege reserved for mostly affluent nations. Everybody else is mostly screwed. It's the same with human rights; they are a privilege.

There's an important distinction between thinking everybody should have access to healthcare and everybody is entitled to healthcare.

The ethics of triage:

1. autonomy, patients can decide if they want care or not and if there are options in type of care, select the option of their preference.
2. normaleficence, don't unnecessarily increase risk to harm others or intentionally harm others.
3. beneficence, do what is right for the patient.
4. justice, treat similar cases, similarly, treat dissimilar cases, differently. Justice as fairness.
5. fidelity, patients ought to be able to trust doctors.

How does my proposal fit in? Pretty well I'd say. A doctor is screwed on 2, 3 and 5 anyways, as a choice for one or the other will harm the other, won't do one of them any good and probably will be experienced as a breach of trust by the person on the wrong side of the equation.

On autonomy it's interesting that this is the primary consideration but already three posters are getting hysterical about including patient autonomy exercised before coming into the hospital. That's rather inconsistent if you ask me.

My proposal rests most squarely on a consideration of justice. If you willfully make decisions that contribute to you requiring care and those decisions are proximate causes to you requiring care, then all other things being equal, you are not the priority patient.

Well, thank you for that meaningless statement. And why would that be?

People seem to misunderstand healthcare isn't an entitlement but a privilege. So we can definitely decide to set rules for people to receive that privilege.

These are all mitigated by circumstance. Punishment will almost always be less severe in such cases. — Isaac

Also, this is actually not true. People from lower socio-economic backgrounds are disproportionally sanctioned for breaking laws with less leniency applied. That's in part institutional racism, in part network corruption and part knowing how to deal with authorities (and sometimes even just speaking the language and understanding your rights).

Most laws that are passed disproportionally benefit rich people.

Riding a motorcycle is a conscious choice. — Isaac

Yes, but not a proximate cause of an accident and still considered generally safe, which is why some cars aren't permitted on roads.

You're suggesting that above the value of human life, we should hold the value of 'teaching them that actions have consequences', or the value of creating a more 'deserving' society by weeding out those less worthy of its benefits. — Isaac

I think all lives are equally valuable but for any contributory negligence. I don't see any good reason to prioritise young people over old people, for instance, but I do see good reason to prioritise help if someone culpably has put himself in a particularly dangerous situation. In most cases this choice isn't forced because there's plenty of room and resources available with acceptable waiting lists for non urgent healthcare. But in a triage situation, sure, I don't think someone in a car accident should not be helped because the IC would be full with unvaccinated Covid patients. I'd kick one of those Covid patients off the IC without any guilt.

Your disdain for people who make different decisions than you, regardless of their reasons, shines clearly through your posts. — Tzeentch

It's not disdain to insist choices have consequences. Nor is it novel. That choices should have consequences is clear. And your "but they paid their entire lives" doesn't make them special, so did the 90 year old granny.

Except she got vaccinated.

You keep thinking I would deny health care to unvaccinated people but I've been very clear under which circumstances.

Like it is a game, it is stated that "people should be booted out of the IC." — Tzeentch

Under rather specific circumstances, which you keep happily ignoring. Do you disagree with the examples I gave?

Should doctors treat car passengers above motorcycle riders in a RTA? Cars are a demonstrably safer means of travel and such information is publicly available, so if someone willfully avoids a practice which reduces their risk of hospitalisation, they should feel the consequences, right? — Isaac

No. The difference is when you have a victim of the person exceeding the speed limit and the person who exceeded the speed limit. If that information would be available at the moment if having to decide who to operate first, the moral decision is clear. It's about conscious choices and whether that choice is a proximate cause or not.

Those with learning difficulties will need to be identified (we can't hold them to the same standard of willful disregard), those with English as a second language, recent immigrants, the minorities in culturally oppressive groups like women and older children... All shunted to the back of the queue for refusing advice they barely understood or had little control over? — Isaac

Of course we can and we already do. A learning disability is no excuse for paying taxes late, parking in the wrong zone or not knowing how to lodge a complaint against a government institution. These aren't solved by tweaking the rules but by providing systems of care.

There's nothing sick about it and has nothing to do with revenge. Only an idiot would interpret it that way. But you're probably one of the idiots who didn't get vaccinated and feels personally attacked.

If people wilfully refuse preventive treatment and then get the illness they could've prevented then obviously they ought to move down the line of priorities when doctors have to make decisions about where to commit resources. So if you're a strapping young lad without a vaccination and you need an IC bed and a 90 year old vaccinated granny needs one as well, you both have Covid but there's only one bed, you can most definitely go fuck yourself. If she fell down the stairs and you have Covid and both need the bed you can still fuck yourself. Only when you get into the hospital for something else but Covid should regular rules apply.

That said, I think this should be the case with respect to all vaccinations. Children who can't decide for themselves yet exempted or course.

Yes.
Against.
Against.

The vaccine is available and everybody that wants to get vaccinated can (in Europe and the US, what we seem to be talking about). Vaccination willingness seems to be sufficient to avoid deathly illness. More vaccination might lower hospital admittance and IC use but all that is temporary anyway as the cohorts that would end up in the hospital either die or get immunity through having the disease.

The genie is out of the bottle any way, we're going to have to live with Covid and after vaccination/first infection it really doesn't seem worse than the flu. We'll get plenty of new variants. We shouldn't be living in fear. Living healthily is the best protection.

As much as I hate it, I do believe in the freedom for other people to make stupid choices. We never mandated measles vaccines, which was much, much worse in terms of infection rate and slightly higher death rate but also risk of blindness.

We're too scared.

Also fuck boosters except for the elderly and those with known comorbidities and send vaccines to countries that can't afford them. That will save many more lives than boosters can.

Finally, if a hospital is ever faced with a triage situation they ought to boot unvaccinated Covid patients out of the IC regardless of other considerations like age, likelihood of survival, etc. Some consequences ought to be felt.

EDIT: I also think we should be much quicker in closing off borders if a new variant is detected in another country. Just stop all non-essential travel and require quarantine if you travel from such a country until its clear whether the variant is similar or worse than the existing variant.

Well at least you don't live in Afghanistan.

curious, are you aware when the last time was they had to set up triage because of a "serious" flu?

OK, noted that all you can do is bitch. I'm happy to know I can ignore all your posts from now on on anything to do with politics.

to add to my other post, within a time frame necessary to stave off the worst of the climate crisis and obviously the plan should be feasible not some fairy tale.

Parliament. Representation. It seems you have a lot of problems understanding government as a cooperative endeavour and only see it as an oppressive master. That interpretation is simply lazy.

But let's assume it's right, I've only ever heard you bitch about governments. Lay out how to transition from the type of government we have now, to what you think we need, and then how that new society is going to tackle the climate crisis. I want a plan, not just empty criticisms that we keep wasting time on waylaying. Prove that you're not just an inane ideologue.

Because she understands, apparently better than you, that to effect change you go bother the people with the power to do so.

Well, we’ve all been raised to believe the government will fix our problems, so it’s probably true that people will not collectively mobilize until it is too late. — NOS4A2

Nobody has been raised that way but nice caricature to make yourself feel better I suppose.

Says the guy totally misrepresenting what I said. Maybe next time read first and write later.

Can't read, can you?

Indeed.

You've offered nothing in way of proof about something serious, which you claim is happening in the US. I just like to call it a third world country because it apparently is, where job security is so low, people will prioritise money over other people's lives. And healthcare is apparently at such an abysmal low level they've forgotten what their job is.

I didn't swear unless your delicate sensibilities include "bullshit" as a swear word. I have two close friends who are doctors and neighbours too who work in hospitals. I don't know in which dreadful third-world country you work where the oath doesn't mean anything but they actually work with their oath in the back of their mind all the time and continously do things they personally would prefer not to because their oath requires it. It's not idealistic at all. In an ideal world they'd let fat anti-vaxxers die instead of postponing medical treatment for other diseases because the IC is full.

Funny how you think talking like a street thug makes you think anybody will start believing you. As I thought, bluster and bullshit that ought to be ignored before people start worrying about going to the hospital to get help.

Sure. So send it via PM or it will have to be written off as bullshit. And whistleblower protections exist too. So one wonders why you come here alluding to serious problems without any proof. You'd think patients have a right to know their care isn't prioritised. But I suppose your job is more important than saving lives if what you say is true.

Seems the idea has very limited application but that's no bar for a patent application.

If a computer programmer of reasonable skill can setup what you're suggesting to do based on the above descriptions, then the idea has already been released into the public, which means it's no longer patentable.

Sure, why don't you share the protocol and health region you claim this is the case and I can do some sleuthing to confirm what you say is true instead of taking your word on a policy in clear violation of the hippocratic oath.

I can not speak directly to the treatment of only addicts in ICU with Covid. However (and this will raise a ton of naysayers who will refuse to believe me) the treatment protocols for Covid in the ICU for ventilated patients are designed primarily to reduce the number of viral particles expelled by the patient while ventilated. This is the first time I have ever seen a protocol for patient care that is based on fear of the infectious agent, rather than focused on patient recovery. — Book273

My neighbour is an anesthesist and he's calling this bullshit.

Hanover already is a dinosaur. He's developed a keen sense of when to not speak his mind lest the velicoraptors tear him a second butt hole.

I did find a way to export some things but it's only for specific pages you want to keep. For instance, I'm using the Pocket app so I can read the short stories on my e-reader.

Precisely why I'm against vaccine passports. People make shit choices all the time. I have a stressful job and exercise too little. I'm even aware I should be doing more about the latter but don't give it priority. It's relatively stupid but it's not as if it makes me Satan.

The fact nobody wants to be around philosophers does help.

What they never mentioned was how quickly the virus can circulate among the vaccinated. — NOS4A2

Who are they? Pfizer and Moderna did mention it: they didn't know what the effect was so that would be somewhere between no effect to herd immunity through vaccination and every possibility in between. If by they you mean governments, well, not the first time political decisions aren't fact based, or as I suspect in this case, incorrectly interpreted with a large serving of wishful thinking.

I'm not in favour of vaccine passports by the way but I wouldn't be even if vaccination would lead to herd immunity.

Well if you look at the claims around the phase 3 trial, it's only about the efficacy of the protection of the vaccinated. No discussion about herd immunity at all. This came indeed later, around May, because evidence showed it cut transmission by half and then the delta variant made that news old quickly.

I think it's because a lot of vaccines do result in herd immunity that a lot of people assumed this would be the case as well.

Pretty cool that you are personifying me in your head. I didn't realise I'm that important to you. Alas, you just sound like me reading text. Anyhoo, as to the subject, you're turning it around. Show me one expert that claimed the Pfizer vaccine would halt transmission. There aren't any.

Things like this is what I remember best:

https://medicalxpress.com/news/2021-05-evidence-covid-vaccines-transmission.html

https://www.theguardian.com/theobserver/commentisfree/2021/may/02/vaccinated-people-less-likely-to-pass-covid-on

It reduced transmission but didn't stop it.

What sources are you using for your impression of institutions being clear that the efficacy of the vaccines at reducing transmission was uncertain? — Isaac

Official statements by Pfizer and Moderna at the start of vaccination. I'm not aware of any other communication. And then came the good news that it reduces the rate of transmission of the alpha variant but that came again with the warning that is no guarantee for future variants.

Yes, we're well aware of your ideological stance and the resulting confirmation bias. God forbid fact-based decision making.

When the vaccines were introduced, they made clear the efficacy against the spread of the disease was not certain. Its protection against its effects was. The idea was that if enough people would be vaccinated at least they wouldn't end up in hospitals and cause an overload of the hospital system. When has this aim changed?

In other words, you are complaining about something nobody ever said would be the result of vaccination. Why? Because of your confirmation bias. Thank you for playing.

Thanks.

How sick are they getting from it? Are you less sick when vaccinated? Otherwise we can stop vaccinating altogether and combat the pandemic how they did it in the old days.

If I may interject, I think we are a victim of the slow development of human nature that cannot keep up with the rapid changes resulting from technological inventions and our ability to easily transfer knowledge and cooperate. Our moral intuitions aren't developed to take into account far off risks or other people in the abstract. We pursue impartiality and abstraction by expressing everything in terms of money, which becomes a self perpetuating beast mostly out of our control (the Market) so that we don't have to feel anything about a decision, further divorcing it from morality.

What you're left with is a society that rumbles along with barely a chance to steer it in another direction simply because of its size and complexity and people incapable of making moral decisions most of the time and it's not even their fault.

Smaller failed states are not so significant because as they fail their carbon foot print will fall. — Punshhh

I'd argue failed States are already insignificant where it concerns carbon footprints.

That there is systemic racism still allows for individual experience to deviate from the norm. This is not really the point of the debate. This is a social problem, not an individual one. You're confusing observing those social facts with prejudice and race consciousness and mistakenly believe articulating those observations contribute to said racism.

I'll get back to my original point: not talking about a problem doesn't make it go away.

EDIT: how would you go about resolving the systemic racism that many (most) black us citizens claim they are experiencing?

This man has such-and-such phenotypes, therefor he has this-or-that experience, behavior, beliefs, and so on”, is the logic of racism and other forms of prejudice, and I see no reason to continue using it. — NOS4A2

Black men are telling you about their experiences on an almost daily basis. Describing the world as it is through the eyes of another as a result of listening is not reinforcing racism or prejudice at all, it's learning to understand what the world is like "as a black person" through empathy. If you don't understand what they're going through, you can't help them.

Your ignoring the reality of racism as it exists today does nothing to change it.

This difference in the way of meaning permits the word Brot to mean something other to a German than what the word pain means to a Frenchman, so that these words are not interchangeable for them; in fact, they strive to exclude each other. As to what is meant, however, the two words signify the very same thing". — StreetlightX

This just reads like a contradiction to me. Either it means the same thing because it signifies the same thing or Brot and pain mean different things because Germans and French use them differently because it signifies other things to them.

If this is about the observation that French bread is decidedly different from German bread and that therefore a French person with no knowledge of other types of bread understands pain only to signify French bread then I'm not sure what is new here.

Disclaimer: I don't know shit about the philosophy of language.

There was a white girl and she looked to adults as to what to do with her life. Most adult women were stay at home mums, nurses, librarians and school teachers. Nobody told her she can be anything. Her teacher didn't question why women or mums, nurses, librarians and school teachers. That's just how things were. The teacher thought mathematics, chemistry and physics weren't important to the girl considering where she was going. The girl became a nurse.

There was a black boy and he looked up to adults as to what to do with his life. Adult black men were slaves. The boy became a slave.

There is a white girl and she looks to adults as to what to do with her life. Most adult women still are stay at home mums, nurses, librarians and school teachers. Meanwhile, media portrayal of girls has changed; they are protagonists in stories, heroines, smart and beat boys regularly. Her parents tell her that what she sees isn't the way the world has to be; "you can be whatever you like honey". Her teacher knows what girls usually become but he/she too believes she can be whatever she can be. assume where she'll end up and discovers she happens to be really good at mathematics, chemistry and physics. The teacher also discovers girls learn differently then boys. The teacher changes how she teaches and the girl blossoms. She becomes a mum, with a Ph.D. in linear algebra teaching at university.

If the parents or the teacher didn't realise what the world looked like to the girl, precisely because she is a girl, and actively engaged her to allow her to have a different view from what is, she never would've gotten there (we're not all Marie Curie!).

Now what to do about that black boy? Society and media still tell him he's "less" than white boys. Black men overwhelmingly have lower paying jobs. The only way out seems to be rap or athleticism. Stories with black heroes are rare, criminals are predominantly played by non-whites, in fact, representation of black people is often about race because non-whites apparently are incapable of having universal experiences (notable exceptions exist of course!).

People suggesting to ignore this boy's view of the world by ignoring that he's in fact black are not helping him. If you want to improve his chances, you need to realise what the world looks like to him, as a black boy, and actively engage him (e.g. going the extra mile to undo all the socio-economic damage he grows up in) to allow him to have a different view from what is. And while you're doing that you also need to teach him how to deal with the racist fucks still out there and those that think ignoring that he's clearly black is in any way, shape or form helping to change society for the better.

Not talking about the problem does not make it go away. Slavery didn't disappear because people stopped pretending there were slaves.