Allocation of resources--to treat or not to treat, and who shall beg the question?

Two separate clusters of events in recent months have spurred public discussions over the questions of how and to what degree the public should be involved in resource allocation decisions. In England, a group of physicians unilaterally decided to deny bypass surgery to heavy smokers, and in the United States, uninsured parents of conjoined twins elected to seek separation of the twins despite heavy odds against their survival, raising questions of whether health care reform will stymie such decisions in the future.