, Volume 35, Issue 3, pp 473-474

Life, Liberty, and the Pursuit of Quality-adjusted Life-Years after Pancreatic Cancer Surgery

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The citizens of the United States hold in their core consciousness the beliefs formulated by the men who signed the Declaration of Independence in Philadelphia in July 1776: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” What happens, however, when my pursuit of happiness interferes with your liberty? A large step is taken in a human being’s moral life when it becomes clear that the universe is not in harmony, that there exist irremovable conflicts of values that are an intrinsic element in human life. The inevitable clash that comes when my liberty interferes with your pursuit of happiness parallels the conflict in medical ethics when a patient’s autonomy conflicts with fairness and medical justice. It is commonplace, to paraphrase the British philosopher Isaiah Berlin [1], that neither equal access to medical care nor eff