Intergenerational Justice

It is revealing to consider what form discussions about intergenerational justice might take if the young outnumbered the old. Would such concerns be expressed in terms of setting limits to publicly financed health care for the young? If not, perhaps there is more at stake here than the proportion of old persons compared to young persons within society. If a society would be relatively less willing to curtail resources to younger people, this might suggest that its sense of justice somehow includes the idea that the young are inherently more morally deserving of scarce resources than older persons are. It is unclear that any ethical basis can be found to support such a position.

The philosopher Daniel Callahan argues that it is not unjust to deny persons access to publicly financed life-extending medical care once they reach a natural life span. Callahan's reasoning is that once individuals reach old age, death may be an occasion for sadness, but should also be thought of as a relatively acceptable event. To clarify this idea, Callahan asks people to imagine the death of both an older person and a younger person they know, and to consider how they will feel about their deaths twenty or thirty years after the fact. According to Callahan, while the death of any individual is a loss, we perceive the deaths of young and old persons differently. When viewed in distant retrospect, people continue to feel despair and moral outrage about the death of young persons because such persons were deprived a full and meaningful life. By contrast, over time the deaths of old persons are regarded as philosophically and ethically tolerable because death in old age does not rob persons of living their full or "natural" lifespan.

If these judgments are correct, perhaps society's obligation to prevent the death of younger persons is not the same as the obligation to prevent the death of older persons; perhaps more of its scarce resources should be devoted to preventing premature deaths, and comparatively less devoted to preventing death in old age. Callahan proposes that society can ethically ration publicly financed life-extending health care to people who have reached a "natural lifespan." Most people will reach a natural span of life by age sixty-five, or certainly by their late seventies or early eighties. After this age, individuals remain free to use personal resources to pay for life-extending care in old age, yet society is not obligated, according to Callahan, to devote scarce resources to this end.