R. franc, sociol., 43, Supplement, 2002, 3-40

Sébastien DALGALARRONDO Philippe URFALINO

Tragic Choice, Controversy, and Public

Decision-making: the Case in France of

Random Selection of AIDS Patients for

Treatment ("Lot-drawing")

The battle for life over death in the treatment of AIDS has come to consist in a hunt for new drugs that will bring about remission. From the time an effective treatment is produced to the time it becomes available to all patients, access to the drug is a life-or-death matter for some. With the appearance of each new drug or set of drugs, the conditions are met for a temporary "tragic choice" situation. Guido Calabresi and Philip Bobbiťs term "tragic choice" (1978) describes a situation where the goods necessary for survival, or avoidance of terrible suffering, exist in insufficient quantity for the members of a collectivity that need them. The situation implies not only that efforts are made to increase the available supply of such goods, but also that the mode adopted for allocating them is "tragic" in that it necessarily excludes some of the individuals for whom the good in question is indispensable.