Saturday, December 19, 2015

The luck of the draw

We never ask to be born.  We appear on this planet, and for a good chunk of years do not even have the legal claim to make our own decisions.  It is one heck of a random occurrence, which I have addressed in many posts over the years, like here.  This randomness of existence and the advantages or disadvantages that we are born into, raised in, and grow up to, determine most aspects of our lives.  Addressing this randomness becomes a moral issue.  As the comments in the previous post show, well, there can never be any single moral compass to guide us.

One aspect of the randomness in life is longevity itself.  A mere check with Wikipedia reveals the tremendous variation among countries when it comes to average life expectancy at birth.  Take Chad, for instance:
In Chad the average life expectancy at birth is about 50. Children who survive childbirth — and then malnutrition and diarrhea — are likely to die of pneumonia, tuberculosis, influenza, malaria, AIDS or even traffic accidents
Note the different hurdles a typical kid in Chad has to overcome before he is lucky enough to reach my current age.  Notice there is one major disease missing in that list: Cancer.  Why?  Because it takes time for cells to mutate and become malignant.
In fact, cancers of any kind don’t make the top 15 causes of death in Chad — or in Somalia, the Central African Republic and other places where the average life span peaks in the low to mid-50s. Many people do die from cancer, and their numbers are multiplied by rapidly growing populations and a lack of medical care. But first come all those other threats.
Cancer, in other words, is almost a rich person's disease because only the rich live long enough to begin with.  Most men in the decades past, for instance, did not suffer from prostate cancer because they rarely ever lived long enough to suffer that curse.

In the affluent countries, if one is lucky enough to be accidentally born there, it is a story that is different from what happens in Chad.  The report looks at Jimmy Carter's cancer treatment:
How different this is from the United States, where oncologists are working to rid a 91-year-old former president of metastatic melanoma, one of the deadliest cancers. One of Jimmy Carter’s drugs, a new immunotherapy agent called Keytruda, has been priced at $12,500 a month, in addition to the cost of his surgery and treatment with computer-guided radiation beams.
Carter's treatment is not all that exceptional.  Octogenarians undergoing heart surgeries is not news anymore, even though the treatment is at a considerable cost.  All because of the randomness of existence in an affluent country, as opposed to being born in Chad where cancer or heart trouble is the least of the health worries in life, as the following map shows.


It is a moral question of whether or not one ought to be concerned that, for instance, a typical citizen of Chad has to fight the ultimate fight for life all because of the randomness of where we are all born.  Addressing even one aspect of the randomness--longevity--requires redistribution of income, which apparently won't be an easy sell.

So, given that I have won the ovarian lottery, why should I really care about all these?  A verse from the old country says it best for this atheist:
Vaishnav people are those who:
Feel the pain of others,
Help those who are in misery


Anne in Salem said...

Perhaps you won the ovarian lottery so you can lead by example by keeping the less fortunate - the less-lucky in the birth lottery - in full view and reminding those who forget to remember.

Thank goodness for those who feel the pain of others and help.

Sriram Khé said...

Yes, thank goodness for those who are out there to help others not because they have to but because they want to ... which is why I keep donating to MSF, whose people go to conditions that they can easily avoid by staying put ...

Mike Hoth said...

Many of our deaths come from rich people problems. The globally poor don't die of car accidents at the rates we do, and you've just mentioned cancer. Check a map of diabetes and you'll find a similar trend. We free ourselves of the easily cured killers only for mortality to respond by killing us with our own wealth.

Sriram Khé said...

Yes, we might be able to gain a few more years (even if it is nothing but the drooling nineties!) but eventually we have to face the existential crisis--we are mortals with our own expiration dates.

Ramesh said...

Number of moral questions actually. I am less concerned about the randomness of it all, as compared to the the ethical questions you raise.

By the way, a few claps for featuring one of the most haunting of songs, sung by the nightingale herself. A favourite of Gandhi, you might have added. Picture Sabarmati Ashram , circa 1940, to the strains of Vaishnav Janato .....

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