It looks like you’re discussing Daniel Callahan’s perspective on a controversial idea related to rationing and end-of-life care. To provide a comprehensive answer to your question, I’ll break down Callahan’s stance and the evidence from the text.

Daniel Callahan is a prominent bioethicist who has written extensively about issues related to aging, healthcare, and end-of-life care. In his work, he advocates for a concept known as “rational rationing.” Rational rationing involves making tough decisions about the allocation of healthcare resources, particularly in cases where medical interventions might offer only marginal benefits, especially for elderly patients with limited life expectancy.

Some might interpret Callahan’s stance as cruel and hard-hearted because he is suggesting that healthcare resources be limited for certain individuals based on their age or the potential effectiveness of treatment. This perspective might seem callous, particularly in a society that values the sanctity of life and providing care for all individuals, regardless of their age.

On the other hand, others might view Callahan’s position as courageous and far-sighted. He argues that in order to ensure the sustainability of healthcare systems and to provide the best care for the greatest number of people, difficult decisions must be made. By allocating resources more efficiently, he believes that society can ensure that resources are available for more substantial medical interventions that have a higher likelihood of success, rather than spending resources on treatments with limited benefit.

To address the comparison with family members and older Americans themselves already making rationing decisions, the example of mourners comforting each other by saying, “He had a good long life,” implies that there is an implicit understanding of the finite nature of life. This sentiment acknowledges that people recognize the eventual limits of medical interventions and that there comes a point where the focus shifts from aggressive treatments to ensuring quality of life and a peaceful death.

What sets Callahan’s proposal apart is that he suggests a systematic and deliberate approach to healthcare resource allocation based on objective criteria, rather than leaving these decisions solely to individual families or personal beliefs. His approach aims to address resource allocation on a larger scale, considering the greater good and sustainability of healthcare systems.

To provide specific evidence from the text, you would need to refer to Callahan’s writings, such as his books, articles, or essays where he discusses his ideas on rationing and end-of-life care. In these texts, Callahan would likely provide detailed arguments and examples to support his perspective and differentiate it from the informal rationing decisions made by individuals and families.

Remember that this answer is a general overview based on what is known about Daniel Callahan’s ideas up to September 2021. If there have been any developments or new writings by Callahan since then, they might provide additional insights into his perspective.