What is a fair share of life? Do the young deserve life more? Has someone who dies young been wronged in any way?

Is it more tragic when people die young? If you have two patients and only one ventilator, who should be treated and who should die? Has the elderly patient “already lived their life?” And what is a “fair share” of life anyway?

Dying young

It’s an old problem, but the coronavirus crisis has yanked it out of the philosophers’ drawers and into the news: should we let elderly patients die in order to benefit the young?

So you have this doctor standing there in his hospital ward, and he has two patients in front of him, but only one ventilator. The one patient is, say, 80 years old, the other 20. How can he make sense of this situation? How can he decide?

There is an argument called the Fair Innings Argument, and the idea is that some people have already had their fair share of life. So you’d assume that there is such as thing as a fair share of a human life, let’s say seventy years. If you get more than seventy years, that’s good for you, but since you’ve already had your fair share, everything beyond that is valuable and good and you should enjoy it, but it is not something you are entitled to. While other people might not yet have had their fair share. So that 20-year-old is missing 50 years to complete his fair share of life, and because these 50 years are missing, he would somehow suffer an injustice if he died right now. Something would have been denied him that the other patient already had.

So if you believe that argument, you’d say, I prefer to give my limited resource, my medicine, my ventilator, my nurse time to the younger patient, just because they still haven’t enjoyed their fair share of life. So it becomes a matter of justice. It seems more just to give these resources to the younger patient. But is this true? And is the Fair Innings Argument really a good argument?

We’ll use ideas from a paper by Michael Rivlin (Why the fair innings argument is not persuasive. BMC medical ethics. 1(1):E1, 2000).

A life’s fair share

So the question is: is there something like a fair share of life? 

The first thing we can do to answer that is to ask: What does it even mean to have a fair share of something? Where does this concept of a “fair share” come from? We might …

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