Ethics Seek the advice of: Cut Health Insurance for Dangerous Activities?


Welcome to Ethics Seek the advice of — a chance to debate, debate (respectfully), and learn together. We select an ethical dilemma from a real, but anonymized, patient care case. You vote in your decision within the case and, next week, we’ll reveal the way you all made the decision. Bioethicist Jacob M. Appel, MD, JD, may even weigh in with an ethical framework to enable you to learn and prepare.

The next case is tailored from Appel’s 2019 book, Who Says You are Dead? Medical & Ethical Dilemmas for the Curious & Concerned.

The U.S. government is worried concerning the healthcare costs of people engaged in purely volitional high-risk behaviors corresponding to motorcycle riding, hang gliding, and bungee jumping. While injuries from such activities aren’t all that common, they often prove very costly.

“Senator Cheapside” has proposed laws to stop all government-run insurance programs, including Medicare and Medicaid, from paying for healthcare costs resulting directly from these activities. He has identified 92 other activities to not be covered as well — starting from amateur beekeeping to illegal drag racing. “If you must be insured for injuries you acquire while engaged in high-risk activities,” he says, “you must purchase private insurance to cover your costs.”

Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board on the Icahn School of Medicine at Mount Sinai in Latest York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.

Try a few of our past Ethics Seek the advice of cases:

Stop Life Support for a Tax Break?

Prescribe Pills Off-Label for Pilot’s Peak Performance?

Forced Weigh-Ins for Hospital Employees Fair?


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