Choosing who to treat

Are all lives equivalent? It's a thorny question, and the answer depends entirely on the philosophy involved. The egalitarian approach says that yes, all lives are equal, and that it's unfair for some to be considered more important than others. Utilitarians, on the other hand, have no problem with the idea of sorting because not all are equally valuable. Modern medicine plays with these ethical questions.

Since the Napoleonic wars, when battle methods became increasingly violent, doctors have begun to reflect on the question of primacy. Dominique Larrey, among others, was one of the first to realize that amputations, for example, should be performed as a matter of priority, as they were easier and less damaging in the long term than waiting to perform them. During the Second World War, Winston Churchill urged doctors to prioritize the use of penicillin by soldiers most likely to return to the front. As a result, the antibiotic was used more with those who had caught gonorrhea than with the more seriously wounded.

From the first dialysis tests to covid-19, the medical world has been faced with sometimes agonizing choices about which patients to treat. Médecins sans Frontières, for example, goes to certain parts of the world to treat particular crises, to the detriment of other therapeutic needs. This is part of its reality.

The problem is not so much sorting according to medical factors that erase socio-economic differences, as choices that accentuate them. For example, making a particular drug a "luxury" product when it's not that expensive to produce. This sorting (whether conscious or not) by the pharmaceutical and medical world is far more problematic than that of patients.

Running time: 19min21