Thursday, December 21, 2017

The Delilah Saunders liver transplant case

The story of Delilah Saunders has been in the news lately. Ms. Saunders is seeking a liver transplant, but cannot get on the waiting list due to a "six-month clean" policy which Ms. Saunders is apparently not compliant with from the news reports.

Saunders supporters are expressing frustration with the policy. Some might think the six-month clean policy is unfair. The liver transplant policy is based on objective criteria, and it applies equally to all. Thus the policy is certainly fair.

Some supporters believe that the six-month clean rule is wrong. Well health care is the provinces responsibility under the constitution. It's for the Minister of Health to establish a liver transplant waiting list policy, and review or revise the policy as he sees fit. Thus the policy as it exists is right per the authority of the Minister of Health.

It would be unethical for the policy to be changed at this point in order to favour one individual, Ms. Saunders, and necessarily bump someone else further down, or effectively off the list (if they die before getting a live transplant). The thing is, erasing the six-month clean rule wouldn't particularly help Saunders. After all everyone else currently shut out of the liver transplant program under six-month clean, however many dozens or hundreds or whatever, would then immediately have precedence over Saunders. These other excludeds have been "waiting" outside the program earlier, perhaps attempting to comply with six-months clean, to become eligible to be on the transplant list.

So the only way waiving six-month clean would help Saunders would be if it was waived for Saunders only, telling the others currently on the outside to go home and get sober for six months while Saunders gets on the list now without having to meet the sobriety requirement. Is that fair or ethical?

One point made in the media by Saunders supporters is the "multiple traumas she has suffered in her life". So yes Saunders has a sympathetic hard-luck story. I will confidently believe that everyone on the liver transplant list, or around the list in six-months clean limbo, can tell a hard-luck story in addition to facing liver failure. So we don't know who, like Saunders, has the most hard-luck story to tell. There seems no obvious way to objectively measure it or use it to prioritize the waiting list.

Basically what Saunders supporters are seeking is for the policy to be set aside in this one case in order to favour a specific individual. Let's follow that through to its logical conclusion. Suppose the policy as it exists is struck entirely and there is no specific policy to get on the liver transplant list, or to move up or down in priority once on the list. What would happen is the list would become based on

  • political connections
  • money
  • bribes and corruption
  • access to mass media (Delilah Saunders)
  • ability to present a hard-luck story in the press, while ignoring other hard-luck stories (Saunders)
  • supporters being able to mobilize campaigns in social media, and public demonstrations (Saunders)

Wednesday, December 20, 2017

Burma and Serbia

The situation with the Rohingya in Burma has been in the news lately. I haven't studied all of the details and backstory, but for the Buddhist in Myanmar to take this action is pretty unexpected. I mean from what I've always heard Buddhism is all about peace and love. So for the Buddhist who I'm told are so peaceful, to be pushed to taking this drastic action, it makes me wonder what must have happened.

So the Muslim Rohingya are being forcibly ejected from Burma into neighbouring Bangladesh. Now Bangladesh is an Islamic nation, an exporter of terrorism as we saw in New York just this week. So it was this accident of geography that gave Burma this option in dealing with the Rohingya issue, that is the option to force them out of their country into an adjacent Muslim zone.

Which brings to the parallels with Serbia. Also recently the old Balkan wars of a generation ago have been in the news. Serb and Croat leaders from back then still going through trials and sentencing. So back in those days Serbia also had Muslim problems in their nation. And Serbia in a way set the example by forcibly removing Bosnian Muslims out of Serbia and into Bosnia and Muslim dominated areas. Serbia, like Burma today, had the option with geography to push Muslim trouble off their land and onto an adjacent Muslim country.

It's interesting the changes in world opinion from a generation ago in the Yugoslav wars to today. Back then it was Serbia is bad, bomb Serbia, stop Serbia. There was no discussion at all about Serbia being Christian, or the threats Serbia was facing that led them to do what they did. Ah simpler times.

Now today with Burma and the Rohingya the outrage is more muted. World opinion is more nuanced. The situation with the Rohingya and Muslim violence is seen as difficult and complex. The actions taken by Burma are certainly harsh with a real human toll, and individual-level injustice. Yet its recognized that Islamic strife is a problem worldwide (Genesis 16:12). Also the world recognizes that it isn't sufficient to tell Burma that mass deporting the Rohingya is not an option, while offering no other solutions.

Saturday, December 02, 2017

The Books Everyone Read

I recently read Anna Karenina by Leo Tolstoy. It was a good book. It held my attention through the 800 pages. It makes you think. Set in the 19th century Imperial Russia, many of the themes are still relevant today.

I'd always meant to read that book. It was one of those books I grew up thinking everyone read. Well I thought everyone read them. So with Anna along with these other titles I've completed in recent years I have finally completed the task to read these books that everyone read.

Atlas Shrugged
Uncle Tom's Cabin
Anna Karenina

There are still some classic books that I've been meaning to read for a long time and perhaps I will get to them. So the reading and learning journey continues.

I have some ideas but I'm not entirely certain what to make of Anna. I'd be interested to hear the views of others who have read it and what they think it is about.