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1 The selection problem Nicholas Rescher pointed out in his essay The Allocation of Exotic Medical Lifesaving Theraphy

(1969) is who should be given the priority to receive the exotic lifesaving therapy or ELT. This is a major concern by medical practitioners nowadays because, first, the modern technology has brought medical equipments into their complexity and required experts to be highly trained in using these devices. We all know that there is a scarcity of functional and efficient equipments in some hospitals most especially in suburban areas which now limits the number of patients to be treated with these electronic devices. There are only few facilities with these complex devices like the haemodialysis units that are basically for the ELT and not everybody could afford the expense. Second, the availability of sources for any surgery, like a heart or lung transplant is also limited and is not even sufficient to the number of patients needing the surgery. That is why the selection on who will receive the treatment needs a careful consideration because these are lives that needed to be saved but unfortunately not all have the chance to be. There are selection criteria presented, however, some may seem contradicting to the ethics of the medical profession. The selection process is not just a medical problem but also philosophical like the ethical and moral aspects of life. Reschers proposal on how the selection process should be done is a fair consideration of both criteria in the initial and final stage of the selection mentioned in his essay which involves biomedical, familial and social factors. Using the scoring method in the final stage of selection can at least provide a measurable variable in narrowing down the selection before picking the most eligible candidate for ELT. On the other hand, the proposed acceptable selection process lacks measurement or evidence on the social factors involve. It is difficult to judge a persons achievement, future contribution and value to the society being one of the criteria in the final selection process.

2 Nevertheless, even if Rescher wanted to achieve fair and acceptable selection criteria he admitted that there is no optimal solution. Being that way, a slight unfairness on his proposal is still evident because of the intangible factor, the social side. The relevance of a persons life in the society cannot be solely judged as someone who has contributed or someone who can be of a future asset in the community. It is still inhumane and unfair to allocate ELT to those public icons and let those average people lose their chance to life. To illustrate, two patients suffering from lung cancer need an urgent lung transplant. Considering the criteria, one is a well-known journalist and is a young bachelor and the other is a middle-aged factory worker with two minor children. It is most likely that the young journalist would have greater chances to receive the ELT because of one, his life expectancy is longer and two, his contribution to the society is greater compared to the middle-aged man who has only the family role factor to consider. But we can consider that if the latter has been given the ELT and prolonged his life, his future contribution to the society might seem viable. This type of selection proposed by Rescher is still a matter of chance. Just like what Rescher (1969) stated, It should be recognized that this injection of man-made chance, supplements the element of natural chance that is present inevitably(p. 184). Every human life is essential and must be taken fairly in the hands of those who cure in order to sustain life. These proposed selection system can be fair enough in some cases and may not be acceptable in some situations.

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