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Was dealing with justice in our PDS lecture today. How does one ration health care? And we were given an exercise to do during that lecture. Essentially we were supposed to imagine ourselves as members of the board of a DHB facing some serious financial problems and would have to decide which services that would have to be cut, and also be able to give reasons for them. There was the neonatal intensive care unit, anti-smoking education for school children, helicopter rescue service, cataract operations, hospice, CADS, appearance surgery unit, A and E, patient's services, and management to think about. Practically everyone agreed on cutting funds for the management, appearance surgery unit and anti-smoking education for school children. The hospice was a fav for cuts amongst a lot of people, though I thought that was one where there should be not cuts. I thought it cruel to cut funds to it though, even though it's not going to save lives (most of the others that were given the definitely no cuts options were essentially those that would save lives), it would mean a lot of people would have to spend their last days in... pain? That would be a sucky way to go... :(

And apparently there are two primary values relating to justice here. Need and benefit. Both, the lecturers made out, were morally empty on their own. How does one decide whose need is greater? And is it better to have one healthy person or many healthy persons? The answer to that last question seems obvious, but the lecturer gave this analogy - Chuck is healthy, and has seven friends who are in need of organs to save their lives or they'll die soon, AND they each need different organs, all of which Chuck would be able to provide, and once they get the organs they require they'll be perfectly healthy again. So, to maximise benefit, does one kill Chuck and donate his organs to his friends? It's a disgusting thought, but a lot like the one where a Pharm friend of mine related to me -- do you pull the lever to change the tracks so that the train that is coming would not run over your close friend, sending the people in the train to their deaths as the train derails? Or do you let your friend get crushed to mush, and spare the hundreds of train passengers? Hard decisions to make here.

The ethics tutorial was next. More of these sort of questions that take us around in circles, questions to which we know we'll never have the right answer for. Lifeboat will take 8 people, and you've got 17 potential survivors. Who would you choose to take? An interesting thing that came out was that practically everyone scratched out Toni, the drug addict first. Are we right in judging who gets to live based on their lifestyles? I mean, yes, there's no point saving people, giving value to their lives, if they don't even value it themselves in the first place. But when I think of it, it sounds very judgemental of us to do so. And tossing a die to randomly choose people so that we don't appear to be assigning value to peoples' lives may sound like an easy way out, but when one is going to have to live on an uninhabited island with the other 7 people with small hope of being rescued anytime soon, it doesn't seem very practical either...

4 more Renal Physiol lectures to 'look forward' to... *note my sarcasm* I mean, he knows his stuff, sure, but there's no point if the way you present it in such a way that you lose your students along the way :( I'm struggling to keep awake... HELP!

Got my reference letter and certificate at last for the mentoring programme. Yipee!