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How can the fair innings argument for the distribution of healthcare resources be fair when there is no natural limit to the human life span? In this paper, I argue that for the fair innings argument to justify the redistribution of healthcare, away from those who live longer than a "fair innings" towards younger members of society, it must be grounded on the concept of a natural life span. Yet, current gerontological thought implies that the human life span is limited only by the developments of and access to successful biomedicine, which I argue removes the grounds upon which the fair innings argument justifies its redistribution of healthcare resources.
THE FAIR INNINGS ARGUMENT
The National Institute for Health and Clinical Excellence (NICE) has been criticised for the way it decides the fair rationing of healthcare in the UK. In particular, it has been criticised for over emphasising the effectiveness of medicines at the expense of equality in the distribution of healthcare. One suggestion for balancing the trade-off between equality and effectiveness is to apply the fair innings argument to the problem of the fair distribution of healthcare. 1
The fair innings argument, as it is described by Harris 2 and Williams, 3 maintains that every individual is entitled to live for a normal span of years. A fair innings, the normal life span, is the number of years that constitute what is considered to be a reasonable length of life. If a fair innings is approximately 80 years, to die aged 90 is to live longer than one could reasonably expect; the extra years lived beyond the normal life span are a bonus. In contrast, to die aged 30 is to die prematurely and so suffer the injustice of not having a reasonable share of life. Central to the fair innings argument is the belief that to live for a reasonable length of life is the entitlement of every individual. In addition, Williams observes the fair innings argument is not simply concerned with the number of years that it is fair for a person to live but also that these years are healthy years. 3
The fair innings argument maintains that healthcare resources should be redistributed to ensure, in so far as it is possible,...