Situation 1: Buying preferential medical treatment
I would like to respond to the question regarding the wealthy patient who pays to change places on the waiting list for a life saving treatment with a poor person who is at the top of the list. It seems to me that there is more at issue than whether or not it is right for the individuals to do this but also whether or not it is right for society to put people in a position to need to have to make this kind of choice.
First, I will address the individual's situation. The poor person is in a position to have a life saving treatment. The scenario does not state whether or not this person has the money to pay for the procedure in the first place. If the poor person has the money to pay for the procedure, then the decision to accept the money in exchange for her place in line is one where she must feel that money is of greater benefit to her children than to have their mother alive. I would have to believe that the only motivation here is a mother's selfless love for her children and the belief that the best chance for their survival and success depended on getting this money. There could not be any other motivation for making this decision.
If the poor person does not have the money needed for the procedure, then she has no other choice. Her place in line is of no value without the money to pay for the treatment. Her choices are to keep her place in the line, only to be turned away since she cannot pay, or to accept the money and hope that this puts her children in a position that they will never have to make the kind of choice that their mother did. In this situation, she will die regardless, so the best she can do is leave something behind for her children.
In either of these situations, I cannot find fault with the poor mother for her choice. Her sole motivations are the well being of her children. I cannot say the same for the wealthy person who makes the offer. I think it is reprehensible that someone would use their money to buy their salvation at the expense of another person's life. One person's life is not worth more than another person's. I cannot blame a dying person from wanting to do everything humanly possible to save their own life, but the k word there is humanly. We are not animals where it is everyone for themselves and survival of the fittest. The better solution to this problem is for the wealthy person to take money and donate it to the hospital so the hospital can afford the staff to insure that everyone who needs the treatment has access to it, This way the money plays a role in the solution but it helps more people and in a equitable manner. While the donation is prompted by the wealthy person's own problem and they are not acting out of completely altruistic motivations, the end result is a net gain for all parties and what we should expect in a civilized society.
The question now is whether society should prohibit this kind of transaction from taking place. Beyond the issue of ethics, there is another problem I have with this situation. Some people might believe that if two people freely engage in a negotiation that involves no one but themselves and involves no harm to others that it should be allowed. But this situation is more than what it appears on the surface. The offer of money is a kind of coercion which means that it cannot be seen as an agreement that is entered into completely voluntarily. The poor person has the welfare of his or her family to consider and this forces him or her to act in a manner that he or she would not do otherwise. For this reason as well as the problem I have with the ethics of the situation, I would have to say that this should not be allowed.
People have the right to sell whatever they choose as long as it is property or services that belongs only to them. I do not believe that anyone has the right to sell or buy another person, which in essence is what this amounts to. No one who is of sound mind or without any other form of duress is willing to sell their life or themselves to another person. As a society, we must protect the sanctity of the human life and spirit. As a society, we also have an obligation to insure that no one should ever be forced to make the kind of decision that the poor mother did. A truly civilized society would find the means to give care to the sick regardless of financial status. If we have the means in our grasp to save a life, I believe we are obligated as members of the human race to offer it to anyone in need.