Some people's lives are less worth living than others. No one likes to admit to thinking such a thing, but our commitment to the ideal of equality of respect is tested by our attitudes toward the disabled. The issue has been raised for the second time this month by that barometer of the psycho-cultural health of the nation,
Big Brother. The winner of the programme's £70,000 prize, Craig (a man so temporarily famous he needs no surname), says he will donate it to a fund to help to pay for a heart-and-lung transplant for his best friend's cousin, who has Down's syndrome and has been refused treatment on the NHS.

Some people's lives are less worth living than others. No one likes to admit to thinking such a thing, but our commitment to the ideal of equality of respect is tested by our attitudes toward the disabled. The issue has been raised for the second time this month by that barometer of the psycho-cultural health of the nation, Big Brother. The winner of the programme's £70,000 prize, Craig (a man so temporarily famous he needs no surname), says he will donate it to a fund to help to pay for a heart-and-lung transplant for his best friend's cousin, who has Down's syndrome and has been refused treatment on the NHS.

As with the awful dilemma over the conjoined twins known as Jodie and Mary, the case highlights the ambivalence of common views of disability and the value of life.

Of course, the NHS does not do anything so crude as to deny life-saving operations to people with Down's syndrome on the grounds that their quality of life is less than that of others. The calculation that is usually made in such cases attempts to be value-neutral, in that it is based on life expectancy. Because Down's syndrome is associated with heart and lung defects, people with it tend not to live as long and so are accorded lower priority in the waiting-lists for costly transplant operations.

However, that comes close to penalising people for their disability. That cannot be acceptable. In assessing priorities for NHS waiting-lists, any calculation based on life expectancy should treat people with congenital life-shortening conditions as if they did not have them. Otherwise, there is a risk that doctors are in effect deciding that the lives of the disabled are worth less than those of other people.

Let us hope that the unlikely publicity given to Craig's friend's case prompts a re-evaluation of the rationing system.