Rationing Māori Life and Well-Being - Who Decides and How?

Associate Professor Krushil Watene - IIRC20
Thursday, November 19, 2020
Aotearoa New Zealand has to date avoided the extreme consequences of COVID-19, which internationally has uncovered how health systems and societies differentially value people and groups. However inequality exists in NZ and many of these values and mechanisms still operate not only within our society and but also within our health system. We will investigate, expose and discuss the ethics of rationing health care in a racialised society - critiquing the use of prioritisation tools in medicine about who gets access to technology like ventilators and ICU.
By doing so it will highlight the health inequities that already exist but which would be exacerbated by COVID-19, and bring into the light issues of relevance to government, health professionals, researchers and communities across Aotearoa.
Ideas about fairness pervade our lives and shape the society in which we live. One prominent view is that society is a collection of individuals working together for mutual advantage. On this view, the value of our lives is largely determined by how useful we are. Such a view often ignores the full range of ways in which we (individually and collectively) enrich each other’s lives. For instance, such views often ignore the importance of relationships in their own right, the importance of love, and the importance of acknowledging our own needs and vulnerabilities throughout our lives. Critical discussion and reflection about fairness within the context of social justice should be centrally about equity across the full range of well-being and justice dimensions -- not least in the distribution of health. To have these discussions, we need to be honest about the role of history in shaping disadvantage for some and privilege for others. We need to be clear about how we begin to enhance our relationships with each other. We need to be courageous enough to re-imagine our lives together. Most importantly, we need to rethink basic assumptions that we take for granted. Instead, we need theories and policies that provide us with ways of equitably navigating the challenges that we face, rather than those that create or reinforce them.