this post was submitted on 15 Jul 2026
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Kinda, I think we're in the same zone, but I feel you're kinda glancing off some important points, and also bringing in unrelated concepts.
What if the money spent on the mri could have been spent on alzheimers?
Well, if at the time it was reasonable to expect that the investment in MRIs was the most effective thing to do for society that's fine. That's just a choice made with reasonable expectations of a positive outcome that ultimately turned out to be suboptimal. It isn't reasonable to expect that smoking won't statistically be detrimental to your health. It's a self-inflicted wound, done knowing this was a likly outcome. This is the critical difference there.
Now, as for unrelated topics, you've muddled two distinct ideas: "moral evaluation of actions", and "evaluation of worthiness to recieve care".
If you need an ER doctor to pull a dildo out of your ass, but didn't reasonably expect to demand society to end up having to pay for it, then I see no moral issue, just like if someone forgets thier hair straightener on and thier house lights on fire and the firefighters risk thier lives to rescue you.
If you fully expected to require an ER doctor beforehand, yah, morality issue there. If you light your own house on fire on purpose because you wanted to get carried down a ladder, same deal.
Doesn't mean you don't deserve to be helped. Doesn't imply that you must not, may, or are obligated to feel contempt or whatever. Evaluating the STATE of a moral agent RESPONDING to a moral transgression of another is several steps removed from the ideas of the morality of self-harm in a social collective with finite support resources.
Anyways, long story short... I don't mean to say that the two cases are morally identical. They're both actions that needlessly risk degrading the overall health of your society. I think if you want to frame ONE as a moral issue, they BOTH are.
So, to my original point... I don't know if the public health angle for the moral evaluation is a great one here. I think it's hard to build a consistent and reliable moral model around.
The only reason that I keep bringing up worthiness to receive care is to reaffirm that idea that the hospital is a safety net. That is the only way I think about it. I'm not looking for efficiencies. Its efficiencies do not affect my moral calculus.
If there were enough smokers that the hospital had to triage the issue to focus on some guy's brain tumor, that's fine. That's a budgeting issue. I would also choose the nicer of two people if both were hanging off either end of a bridge.
Would it be nice to spend obesity money on something else? Sure. It can't be, though. It's hard to see obesity and cost as a moral issue when I don't actually view the obese, nor the smoker, nor the drug addict, nor the suicidal, nor the adrenaline junkie, nor the MMA fighter, nor the venomous snake guy as burdens. Every one of these people "should know" that they will cost the medical industry money; they might be the ones to "kill" a guy with a brain tumor. I'm not bothered by this because these are the very people the medical industry is built to serve. It exists for them.
A medical industry that cannot accomodate obesity is one that is failing its own constituents. It is failing to serve its purpose. So, becoming obese, and costing the healthcare system money, is immaterial. It doesn't matter.
But, a guy in the supermarket sneezing on people is a burden. Not because he is straining medical services and indirectly murdering in-care patients, but because there are people in the supermarket who now must be burdened with illness.
So this is what my view comes down to:
This view is useful because it means I am socially equipped to punish people for anti-social and irresponsible medical behavior, but also that I remain sympathetic to victims of the tobacco and sugar industries. And that guy with the snake.
It's also not that complicated, because my problem is chiefly with anti-social behavior.
How does this relate to necrophilia?... I don't know. He probably shouldn't do that.