Private virtues, public detriment: allocating scarce medical resources to the elderly

Churchill reviews Norman Daniels' Am I My Parents' Keeper (Oxford University Press; 1988) and Daniel Callahan's Setting Limits (Simon & Schuster; 1987). Both books present their authors' reflections on one of the most pressing problems of social ethics, how to allocate health care resources to the elderly in a climate of scarcity. Churchill first analyzes Daniels' response to the problem, the "prudential lifespan account," by which health care rights might give persons legitimate claims to services at one stage of their lives but not at another. This approach is contrasted with Callahan's "return to virtue" argument, which rests upon two major claims, one about the appropriate ends of medicine and the other about the meaning of old age. Churchill discusses both works within the context of the problematic relation in the United States between private and public goods, and between individual and social well-being.