[BostonCard]

c'mon teejers, I was hoping for a better response from you than "condescending" and "psychobabble."  but I'm sorry you took it so personally.

Sorry to disappoint you; but I'm not sure what other kind of reaction you'd expect (and I thought it rather restrained).



As to MT, I'm saying that the public at large's reaction (and more importantly, those setting policy) would be different if otherwise healthy 20-50 year olds were dropping like flies.  My take is probably different from yours - if I'm interpreting your "all lives are the same" statement - inasmuch as deciding policy under only "number of lives saved from early death" cannot be the only consideration in making policy.  You have to weigh that against the damage inflicted in your effort to "save the most lives" and then draw the lines based on what you think is the least overall "harm" to society.  It's a messy, complicated, imperfect process.  



As for "equality of persons," that sounds nice, but decisions are made all the time based on factors that distinguish persons.  One example that comes immediately to mind is organ transplants.  My understanding (and it may be mistaken) is that it's not a first-come, first-serve process; but rather, factors such as life expectancy with new organ come into play.  It sucks if you get passed over and that's not equal treatment.  And even in the pandemic, we're not seeing "equality of persons" when it comes to rules and regulations.  It absolutely sucks that my mom is cooped up in an assisted living facility that will not allow her to, among other things, see her own family members.  [We were only recently allowed to schedule one-person, in-facility visits].  Everybody else gets to go about their business and social outings as they see fit.  Where is the equal persons treatment there?

Transplant allocations are a fraught topic, but you are correct that (at least for lung transplants, which I know) they no longer happen on a first-come, first-served process, something that changed in 2005 when it became clear that the old system (which had been first come/first served) was not optimal and created perverse incentives by encouraging patients to get on to the transplant list before they needed a transplant.

The current system is based on a lung allocation score, which you can read about here: https://unos.org/wp-content/uploads/unos...atient.pdf

The score was devised to, as the UNOS brochure states "The lung allocation score estimates the severity of each candidates’ illness and his orher chance of success following a lung transplant."  Age is a factor, but mostly because it gives kids and teenagers an advantage over adults.  That's because generally young small, young lungs will to some extent grow to fit an an adult chest cavity, but adult lungs can't "shrink" to fit a kid's chest, so the LAS gives kids higher priority for pediatric lungs than adults.

The bigger issue, however, is that generally lung transplants aren't offered to those over 65 (though that is changing at some centers).  It relates mostly to the fact that outcomes in those above 65 are generally worse than those under 65.

BC

[BostonCard]

c'mon teejers, I was hoping for a better response from you than "condescending" and "psychobabble."  but I'm sorry you took it so personally.

Sorry to disappoint you; but I'm not sure what other kind of reaction you'd expect (and I thought it rather restrained).



As to MT, I'm saying that the public at large's reaction (and more importantly, those setting policy) would be different if otherwise healthy 20-50 year olds were dropping like flies.  My take is probably different from yours - if I'm interpreting your "all lives are the same" statement - inasmuch as deciding policy under only "number of lives saved from early death" cannot be the only consideration in making policy.  You have to weigh that against the damage inflicted in your effort to "save the most lives" and then draw the lines based on what you think is the least overall "harm" to society.  It's a messy, complicated, imperfect process.  



As for "equality of persons," that sounds nice, but decisions are made all the time based on factors that distinguish persons.  One example that comes immediately to mind is organ transplants.  My understanding (and it may be mistaken) is that it's not a first-come, first-serve process; but rather, factors such as life expectancy with new organ come into play.  It sucks if you get passed over and that's not equal treatment.  And even in the pandemic, we're not seeing "equality of persons" when it comes to rules and regulations.  It absolutely sucks that my mom is cooped up in an assisted living facility that will not allow her to, among other things, see her own family members.  [We were only recently allowed to schedule one-person, in-facility visits].  Everybody else gets to go about their business and social outings as they see fit.  Where is the equal persons treatment there?

Transplant allocations are a fraught topic, but you are correct that (at least for lung transplants, which I know) they no longer happen on a first-come, first-served process, something that changed in 2005 when it became clear that the old system (which had been first come/first served) was not optimal and created perverse incentives by encouraging patients to get on to the transplant list before they needed a transplant.

The current system is based on a lung allocation score, which you can read about here: https://unos.org/wp-content/uploads/unos...atient.pdf

The score was devised to, as the UNOS brochure states "The lung allocation score estimates the severity of each candidates’ illness and his orher chance of success following a lung transplant."  Age is a factor, but mostly because it gives kids and teenagers an advantage over adults.  That's because generally young small, young lungs will to some extent grow to fit an an adult chest cavity, but adult lungs can't "shrink" to fit a kid's chest, so the LAS gives kids higher priority for pediatric lungs than adults.

The bigger issue, however, is that generally lung transplants aren't offered to those over 65 (though that is changing at some centers).  It relates mostly to the fact that outcomes in those above 65 are generally worse than those under 65.

BC