# Major Moral Dilemma: It Started with Viagra **URL:** \ **Category:** Great Debates\ **Created:** [December 5, 2008, 2:24pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850 "2008-12-05T14:24:07Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![coberst](https://avatars.discourse-cdn.com/v4/letter/c/c37758/32.png) [@coberst](https://boards.straightdope.com/u/coberst)\ **Post date:** [December 5, 2008, 8:09pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/21 "2008-12-05T20:09:43Z")
> [@Ace309](#): > > Chuck, this appears to be the kernel of your argument. I think it’s somewhat ambiguous, but I will assume from the rest of your post that you’re using ‘afford’ in the financial sense, that is, that your argument can be fairly restated as “Society cannot sustain a population of its current size if the average lifespan is extended; a specific example is the cost of medication required to sustain the elderly.” If that’s not a fair restatement, feel free to object. > > My issue with your argument is that it presumes aggregate productivity will remain constant across the relevant time periods. Is there any cause to believe that a longer-lived population will not produce more net benefit, thus justifying the cost of sustaining those longer lives? Do not think that the money spent to allow an elderly person to live another 6 months is a vital question? ---
**Author:** ![coberst](https://avatars.discourse-cdn.com/v4/letter/c/c37758/32.png) [@coberst](https://boards.straightdope.com/u/coberst)\ **Post date:** [December 5, 2008, 8:27pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/22 "2008-12-05T20:27:00Z")
> [@Chief\_Pedant](#): > > I am going to assume that the core concept you are trying to debate is this: It is expensive to prolong life and quality of life, and because it is not cost-effective we should not do it. > > It’s much too late to “begin” a discourse on this, as such a discourse has been going on for many years at both private and public policy levels. > > The only possible solution is to ration healthcare that is paid for out of public funds. Because there is no upper limit to what could be spent on prolonging life and quality of life, this rationing will take place whether we want it to or not; there is an upper limit to public funds and therefore an upper limit to what we spend. > > What is it that you want to debate: Whether it is, in fact, cost-effective, whether there is a moral issue around such rationing, or how we should practically effect it? > > (May I assume you have done your part by giving up Viagra voluntarily?) The problems are how much can we afford to spend to keep an elderly person alive for another 6 months. How can we limit the population of humans on this planet to some reasonable level when we are constantly extending longevity with new medical technology? ---
**Author:** ![Fish](https://avatars.discourse-cdn.com/v4/letter/f/bc8723/32.png) [@Fish](https://boards.straightdope.com/u/Fish)\ **Post date:** [December 5, 2008, 8:49pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/23 "2008-12-05T20:49:50Z")
> [@coberst](#): > > Do not think that the money spent to allow an elderly person to live another 6 months is a vital question? It is a question we deal with every day. However, the answer is not simple. Question: Is the diagnosis of the patient’s ailment certain, or are the doctors guessing? Is there clinical proof that the diagnosis is correct and other diagnoses have been eliminated? Question: Is the treatment certain to work? Example: When confronted with death, patients will often demand risky experimental treatments that have no proven medical efficacy. Who should pay for such tests? Question: Are there complications that make the treatment riskier than usual? Does the treatment have untoward side effects? Example: Suppose the treatment involves a complicated, stressful 12-hour surgery… but the patient is a chronic smoker with emphysema. The patient may not _survive_ the surgery. Or suppose the treatment is a medicine which will damage the patient’s kidneys or liver — you might cure one condition only to exchange it for another, worse condition. Question: Is the treatment one which requires the patient’s compliance and is that patient likely to comply? Example: An Alzheimer’s patient is a poor candidate for an organ transplant, because he (or she) will be unable to remember to take the necessary medications twice daily for the rest of his life. Question: Is the patient’s life more important or less important than the patient’s comfort? That is to say, if the patient can live for 6 more months, but he will be in excruciating pain the entire time and bleeding from both eyes, should we do it anyway? Does the patient _want_ to live for 6 more months in pain? Example: Pancreatic cancer, once advanced, has no known cure. It is also an uncomfortable way to die. In some cases the only treatment is neurolysis (to destroy the nerve centers so the patient can’t feel what’s killing him). How do you spend money wisely for this patient? So, yeah: by extending lifespans we’re crowding the planet and spending money, but on the other hand, we’re learning new things daily and advancing the frontiers of knowledge. Would it really be better to hide in caves, die young, and blame disease on evil spirits? ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [December 5, 2008, 8:53pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/24 "2008-12-05T20:53:34Z")
> [@mswas](#): > > This is the most serious problem with socialized medicince. If people are allowed to retire in their 60s and then we prolongue their lives indefinitely, we’ll bankrupt health care programs. And with our current system rich people live and poor people die. Surely there is a better way of making these decisions than looking at people’s bank balances. ---
**Author:** ![CircleofWillis](https://avatars.discourse-cdn.com/v4/letter/c/54ee81/32.png) [@CircleofWillis](https://boards.straightdope.com/u/CircleofWillis)\ **Post date:** [December 5, 2008, 9:21pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/25 "2008-12-05T21:21:27Z")
> [@Voyager](#): > > And with our current system rich people live and poor people die. Surely there is a better way of making these decisions than looking at people’s bank balances. Pop quizzes. A random subject. First one to finish gets next appointment/prescription. Smart people live, dumb people die. …shit… I got Trigonometry, guess Ill have to study more for my blood pressure pills… ---
**Author:** ![Oakminster](https://avatars.discourse-cdn.com/v4/letter/o/77aa72/32.png) [@Oakminster](https://boards.straightdope.com/u/Oakminster)\ **Post date:** [December 5, 2008, 9:25pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/26 "2008-12-05T21:25:46Z")
A quick google shows the same OP spammed far and wide across the internet. ---
**Author:** ![Bryan\_Ekers](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bryan_ekers/32/183_2.png) [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)\ **Post date:** [December 5, 2008, 9:29pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/27 "2008-12-05T21:29:40Z")
> [@Oakminster](#): > > A quick google shows the same OP spammed far and wide across the internet. Corporate America at work, obviously. ---
**Author:** ![Liberal](https://avatars.discourse-cdn.com/v4/letter/l/848f3c/32.png) [@Liberal](https://boards.straightdope.com/u/Liberal)\ **Post date:** [December 5, 2008, 10:40pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/28 "2008-12-05T22:40:42Z")
> [@Bryan\_Ekers](#): > > Harrumph. Had you read the OP, you would know that there is no Critical Thinking required. Despite that, he posted it at [The Church of Critical Thinking](http://www.churchofcriticalthinking.com/viewtopic.php?p=2622&highlight=#2622). ---
**Author:** ![Rune](https://avatars.discourse-cdn.com/v4/letter/r/e68b1a/32.png) [@Rune](https://boards.straightdope.com/u/Rune)\ **Post date:** [December 5, 2008, 10:43pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/29 "2008-12-05T22:43:43Z")
> [@mswas](#): > > This is the most serious problem with socialized medicince. If people are allowed to retire in their 60s and then we prolongue their lives indefinitely, we’ll bankrupt health care programs. No we won’t because the health care system has always been prioritizing. – if for no other reason, then because there have always been a chronic shortage of doctors and skilled nurses - and health care has not been allowed to balloon out of control. If fact private health care in the USA typically spend a larger portion of the GNP than socialized health care in Europe. What happens around here is that everybody knows we can’t do everything. Ever so often it hits the political agenda and the politicians very reluctantly enter the debate and try to convince the voters that we can indeed do everything, and then refuse to be dragged into any kind of prioritizing because it is very bad to be caught saying we have to choose between heart transplant for these patients or hip replacement for those other patients. It then falls back on the different hospitals and doctors to choose which patients get treated, resulting in a very arbitrary set of ad-hoc guidelines likeable to be changed at the smallest media attention and subject to heavy influence by various pressure groups. Old geezers have very powerful pressure groups, homeless teenage psychiatry patients not so much. So we get a lot of money allocated to the geezer and not so much to the teenager hearing strange voices inside her head. As far as I know, if a guy wants Viagra, he’ll have to pay for it himself. ---
**Author:** ![sailor](https://avatars.discourse-cdn.com/v4/letter/s/a587f6/32.png) [@sailor](https://boards.straightdope.com/u/sailor)\ **Post date:** [December 5, 2008, 11:25pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/30 "2008-12-05T23:25:53Z")
> [@Rune](#): > > As far as I know, if a guy wants Viagra, he’ll have to pay for it himself. Or steal it > [@](#): > > Viagra Stolen! Breaking News! > Hardened criminals on the loose! ---
**Author:** ![Odesio](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/odesio/32/20003_2.png) [@Odesio](https://boards.straightdope.com/u/Odesio)\ **Post date:** [December 6, 2008, 12:26am UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/31 "2008-12-06T00:26:30Z")
> [@Bryan\_Ekers](#): > > Lottery in June, corn be heavy soon. Thank you, Ms. Jackson! ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [December 6, 2008, 1:34am UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/32 "2008-12-06T01:34:14Z")
> [@coberst](#): > > It is obvious even to the most casual observer (no Critical Thinking required) that we must quickly deal with the problem that medical technology has left on our door step. Someone is leaving erections on your doorstep? Eugggh. > [@CircleofWillis](#): > > For a couple bucks more I will clean up the mess…I’ve gotta big bbq pit in the back. :eek: ---
**Author:** ![straight\_man](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/straight_man/32/3027_2.png) [@straight\_man](https://boards.straightdope.com/u/straight_man)\ **Post date:** [December 6, 2008, 3:17am UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/33 "2008-12-06T03:17:14Z")
> [@ITR\_champion](#): > > If the citizens of the USA are not able to deal with this technology, then who is going to participate in the internet discourse? Resident aliens? Damn straight. Anyway, this issue has already been addressed by the ideology of [compassionate fascism](http://www.youtube.com/watch?v=5hOt9UhX4cU). [Warning: YouTube] ---
**Author:** ![coberst](https://avatars.discourse-cdn.com/v4/letter/c/c37758/32.png) [@coberst](https://boards.straightdope.com/u/coberst)\ **Post date:** [December 6, 2008, 12:51pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/34 "2008-12-06T12:51:37Z")
Mine is not so much a question as it is a claim that we face some very serious moral questions that requires answers constructed on a foundation of courage, compassion, and sophistication. How can we stabilize world human population in a moral and sophisticated manner and how do we utilize our resources to best effect that important result? ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [December 6, 2008, 1:25pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/35 "2008-12-06T13:25:57Z")
> [@coberst](#): > > Mine is not so much a question as it is a claim that we face some very serious moral questions that requires answers constructed on a foundation of courage, compassion, and sophistication. How can we stabilize world human population in a moral and sophisticated manner and how do we utilize our resources to best effect that important result? We set general public policies about what we are going to provide as a basic benefit of living in this society. We let the free market stumble through the details. We decide how much total money we are willing to spend collectively on health. We decide where we want to spend that amount of money. We ration healthcare by providing benefits in some areas–we’ll pay for your busted hip–but not in others–you can’t have Viagra every night on my tax nickel. The free market will allow private relationships to extend healthcare availability beyond what is provided by the public coffers. Buy my private prescription plan and I’ll get you that daily Viagra. This is already the way the system works. It is not practical to parse it out much further. ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [December 6, 2008, 3:40pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/36 "2008-12-06T15:40:16Z")
> [@coberst](#): > > The problems are how much can we afford to spend to keep an elderly person alive for another 6 months. You’re not doing much “critical thinking” here. Where is that money going? It’s going to the person’s doctors, nurses and other healthcare workers. it’s going to people who own stock in pharmaceutical companies. It’s going to people in the food/clothing/transportation/utilities industries who are sustaining his life for another 6 months. In short, that person isn’t taking the money and putting it under his mattress; that money is going to a younger, more productive segment of society, which is exactly where it belongs. ---
**Author:** ![Ace309](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ace309/32/1050_2.png) [@Ace309](https://boards.straightdope.com/u/Ace309)\ **Post date:** [December 6, 2008, 4:15pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/37 "2008-12-06T16:15:25Z")
> [@coberst](#): > > Do not think that the money spent to allow an elderly person to live another 6 months is a vital question? More of a viatical question, really. Before we discuss the method of stabilizing the human population, you must first establish that the population needs to be stabilized. The ordinary method of doing this is to offer an argument that we’re better off under your suggestion than without. Do you disagree with the woman in your initial quote who says “Everybody should be allowed to have as much life as they can”? If so, why? ---
**Author:** ![coberst](https://avatars.discourse-cdn.com/v4/letter/c/c37758/32.png) [@coberst](https://boards.straightdope.com/u/coberst)\ **Post date:** [December 6, 2008, 10:19pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/38 "2008-12-06T22:19:48Z")
> [@Ace309](#): > > More of a viatical question, really. > > Before we discuss the method of stabilizing the human population, you must first establish that the population needs to be stabilized. The ordinary method of doing this is to offer an argument that we’re better off under your suggestion than without. > > Do you disagree with the woman in your initial quote who says “Everybody should be allowed to have as much life as they can”? If so, why? A society can spend only a certain amount for health care. Rationing must happen. ---
**Author:** ![mswas](https://avatars.discourse-cdn.com/v4/letter/m/e99b99/32.png) [@mswas](https://boards.straightdope.com/u/mswas)\ **Post date:** [December 6, 2008, 10:50pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/39 "2008-12-06T22:50:30Z")
> [@Voyager](#): > > And with our current system rich people live and poor people die. Surely there is a better way of making these decisions than looking at people’s bank balances. Why must it be fair? Nothing else is fair when it regards the rich and the poor? This is the way it has always been. Why single out health care as the great equalizer? Rich people per capita live longer than poor in every society no matter it’s level of advancement. A rich person can reduce risk by hiring poor people to perform risky labor, they can have a live-in chef to cook healthier food for them that will still be tasty. Why should health care be more populist and egalitarian? There are plenty of things the poor can do to live longer lives, things you might scoff at. Qi Gong for instance helps rebalance the body but because it is based around the notion of Qi, you would scoff, though people who do Qi Gong tend to be healthier. One can eat healthier, rice and beans are the cheapest food there is, much healthier than a cheeseburger. There are plenty of things people can do for their health that costs nothing. Do 100 pushups 100 situps, 100 squats, 100 lunges, and run two miles every day, you’ll be far healthier. What is it inherent about longevity that brings about this egalitarian notion? As medical technology progresses, the choice between life and death for most people will quickly approach cost/benefit analysis. We will always be beset with triage. Better to save 5 people at 20k a pop than 1 person at 150k a pop right? ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 6, 2008, 10:51pm UTC](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850/40 "2008-12-06T22:51:31Z")
> [@Rune](#): > > As far as I know, if a guy wants Viagra, he’ll have to pay for it himself. Unfortunately, most insurance policies cover it - the group ones anyway, which is where my experience lies. It is also covered by Medicare and I wouldn’t be surprised if it is covered by MediCal. Disgusted but not surprised. [Previous page](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850.md?page=1) [Next page](https://boards.straightdope.com/t/major-moral-dilemma-it-started-with-viagra/475850.md?page=3)