January 28, 2013

Just desserts?

The moral psychology of medicine is so old school.  It's distasteful.  It should have been blown away with Sontag's Illness as Metaphor, which took tuberculosis as the disease of moral culpability.  Years later she followed up with an analysis of HIV/AIDS, which was the obvious modern illness comparable to those of earlier times, but more broadly, and more likely to affect the average punter, cancer carries the burden of personal deficiency, blame, or credit.  Even the dead are congratulated for fighting the good fight, to the last breath.  Pity help those who aren't seen to fight, or don't live long enough to demonstrate their grim determination to live on, no matter what, or those who don't have an endless supply of platitudes and thinning smiles.  

There's this whole ugly area of responsibility, punishment and reward.  The human body is the object of moral judgement, just as the state of the planet is used in the same manner against all of human kind.

It's the path that leads directly to calls for charging more to obese patients needing medical care, or to smokers or alcoholics or anyone not eating their broccoli.  It's the exact same path upon which resides the debate around who does and doesn't "deserve" spare body parts. 

Organ transplants, in my view, are no-one's "right", therefore, no-one deserves an organ, period.  Certainly there is no-one, of any age, who deserves an organ transplant more than any other person.  

Given that organs are available, and given there are people in want of an organ, or several, the only grounds for decision making should be medical.  Unfortunately, medicine isn't practiced  in a neat void separated from cultural time and place and doctors are as inept at making moral decisions as politicians - yet both groups persist in doing so.

Questions about who deserves scarce organs will continue, more so as populations continues to age and as the young are increasingly temporarily saved from physical failures.   

The question of who should receive organs should not be a moral decision-making matrix, but increasingly, as with so many areas of medicine, it is.  This recent NYTs article is laden with just desserts analysis.  And that's the problem.


  1. 'Just Desserts Analysis' - exactly the term to describe the approach to smokers in the health system. In Australia, at least. The routine argument 'smokers are a disproportionate burden on the health system' for instance used to justify, well, just about anything.

    Must read some more Sontag sometime. The Baron was talking to me about her last night - something about her argument that the camera was a kind of phallic object!

  2. (Desert has been served, and desserts has been corrected!)

  3. Arrhhh - lost my comment, do'h, do'h!

  4. "Looking at War: Photography's View of Devastation and Death" and "On Photography".

    Likely to be the best musings you'll find on photography, but Sontag surprisingly irrational in her thoughts on the violation of photography.

    An invasion, hence the camera as phallic? I don't recall. (Can monuments or nature be invaded? Her focus is skewed to photo's of humans, which is too narrow.)

    Just remind yourself, if you read the books about photography, that Sontag allowed her girlfriend - Annie Leibovitz - to take many photo's of her in her dying days - those photos were published in one of Leibovitz's books after Sontag's death.

    Go figure.