IS OLD AGE A DISEASE?

from those who are less deserving. Yet most of us do work with conceptions of the underlying values of our community, the ideals to which it aspires, and most of us are quite capable of identifying those individuals whose lives and characters, in our opinion, most closely personify those values, ideals, and aspirations. Moreover, it may be quite reasonable to suggest that when a community makes substantial resources available for the health care of its citizens, it does so on the implicit(if not explicit) condition that these resources be invested toward the welfare and the betterment of the community. And“welfare” and“betterment” are not necessarily to be identified with an unbending insistence on the principle that every person, every cause, or every possible social need enjoys an equal claim to our limited medical resources.

Let us consider che following hypothetical, albeit extreme, case. Two persons require a heart transplant. One is a respected social studies teacher at an inner-city high school, a woman beloved by her students as a mentor and a confidant and admired by all for the number of young people she has guided to college and to successful living beyond school years. The other is a prisoner serving a twenty-year sentence for the sexual molestation of a five­year-old child. On purely medical grounds, both candidates are found to be equally acceptable for transplantation. Are we entitled to award one of them priority in receiving the heart based on his or her lifestyle, moral record, or“contributions to society?” Even the most liberal among us, if we are honest with ourselves, would admit that we would prefer to award the heart to the teacher on precisely these grounds. To say this troubles us, of course, because of our deeply held commitment to the equality of all persons in the sight of God . We tend to believe it unjust to make decisions of this sort based on an argument that one person is a“better” human

70