1/13/2014 Death Panels and the Kidney Machine Exercise

Back in October, a well-known ministry, which I respect, published an article decrying a high school for using the “kidney machine exercise.” Basically, the exercise is a group decision-making process involving the allocation of scarce resources. In this case, there is a kidney dialysis machine, a set of candidates who are given various characteristics, and a panel (the class) to determine who should get time on the machine. The ministry called this practicing for ObamaCare Death Panels.

Without making any judgment on the Affordable Health Care Act (ObamaCare) and without knowing exactly how or why the high school teacher conducted the exercise, I wrote to the ministry with an alternate view…

You should know that the kidney machine group exercise has been around for at least 40 years. I used it in an Air Force leadership school in the late 70s. It’s a good “rainy-day” activity that involves leadership, group dynamics, interpersonal skills, etc. How are the decisions made? Who dominates the discussion? Can the participants reason with each other with respect or are there one or more bullies? With respect to not wanting to put a value on people based on arbitrary criteria, the option to choose randomly is always there. I observed one group making the decision that way. “I’m not comfortable with this discussion. Can we choose the people randomly?” Everyone agreed.

If you don’t like kidney machine and its association with ObamaCare’s “death panels,” you can do the same exercise and call it the lifeboat problem. There are 10 people in the water, and the lifeboat holds only 5. This was a real-world problem during the sinking of the Titanic, and the honorable men chose to let the women and children go ahead of them. By contrast, 150 Haitians were killed when the boat they were in capsized. The boat had a capacity of 25, and my experience with Haitians leads me to believe they have no concept of “capacity” nor a mechanism for choosing.

People make decisions on criteria of their choosing all the time. For example, I was recently criticized by a fellow believer for going to Starbucks. My friend chooses to boycott Starbucks because of their support of the homosexual rights movement. There are at least two values at work there. One is the value that one should boycott businesses you don’t agree with. This is not a value I share. The second value is that a business’s stance on homosexuality trumps everything else. Also not a value I share. What if I value Starbucks’ commitment to helping poor farmers in developing countries more than I devalue their position on homosexuality in this country?

The real point of the kidney machine (or lifeboat) exercise is for people to have criteria for making decisions (even if one criterion is choose randomly) and be able to articulate their position in a compelling way. Those are skills everyone needs.

And a larger lesson may be, Do we have to continue to provide fuel for those who think that Christians are against everything? Can we try a little harder to exercise 1 Corinthians 13 love? “Love is patient and kind…it is not arrogant or rude. It does not insist on its own way.”

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