A philosopher, Arras was the chair of the philosophy department at California’s University of Redlands when in 1981 he got an interesting offer to join the clinical staff of New York’s Montefiore Medical Center — as a medical philosopher. He accepted, assuring the public “We do not tell doctors what to do.” Instead, he said, he was there to help doctors figure out what to decide when medical decisions conflicted with moral, ethical and legal questions which, in the past, were often ignored by the medical profession.
For instance, what if there was a flu outbreak, and there was a shortage of vaccine? Who should get it? “Some people apparently believe that if there is a right to health care, then any explicit rationing of health care must be morally impermissible,” he explained. “Nothing could be further from the truth. If we define ‘rationing’ as the denial of potentially beneficial care on grounds other than the welfare of the patient — i.e., on the grounds of cost, opportunity costs, fairness to others, etc. — then health care rationing is both inevitable and morally justified.” He also tackled the ethics of doctor-assisted suicide, among other medical questions. Arras later joined the University of Virginia, where he taught biomedical ethics, was appointed to the Presidential Commission for the Study of Bioethical Issues, and was a founding member of the ethics advisory board of the Centers for Disease Control and Prevention. While vacationing with his family recently, he suffered a stroke, and died on March 9. He was 69.