> Unfortunately the trade-offs don't go away, and we haven't figured out a way of making these trade offs that doesn't feel horribly statist (so called "death panels")
These already exist. Donor organs are a scarce resource and there aren't enough to go around, so some person(s) has to decide who lives and who dies. People already regularly die in the United States because it is uneconomical to have Level I/II trauma centers within emergency response distance of the entire country.
People have very different ethical standards for how people should act in advance planning scenarios versus in the moment. I think most people agree with the unreasonableness of arranging to have an on call neurosurgeon in a small town in the middle of nowhere. But I think people would have a very different reaction if the same neurosurgeon refused to skip a day of teaching medical students to instead walk across the hospital and carry out a 12 hour brain surgery on a 90 year old patient with dementia who will be dead from lung cancer in two months anyway.
I think people will just have to get over it. There aren't alternatives.
