Map of life expectancy at birth from Global Education Project.

Wednesday, December 03, 2008

That ol' Rule of Rescue

Gardiner Harris in today's Gray Lady has a long piece on Britain's NICE, which we have much discussed here. It's got a lot of good information, but is a bit short on the deep thinking. Unfortunately, here in the U.S. we're going to have to do some of that deep thinking if we're ever going to get our knickers untwisted. Harris begins with a little case vignette:

When Bruce Hardy’s kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British, and the British health authorities refused to buy the medicine. His wife has been distraught.
“Everybody should be allowed to have as much life as they can,” Joy Hardy said in the couple’s modest home outside London.

And he ends with the Hardys as well (just like they taught him to do in J school):

Meanwhile, Mr. Hardy waits. In recent weeks his growing tumor has pressed on a nerve that governs his voice. He can barely speak and is increasingly out of breath. The Hardys are hoping that in January NICE will approve the use of Sutent, allowing Mr. Hardy further treatment.

"It’s hard to know that there is something out there that could help but they’re saying you can’t have it because of cost,” said Ms. Hardy, who now speaks for her husband of 45 years. “What price is life?”

In between is a lot of facts and history (including that Sutent can be expected to buy Mr. Hardy 6 months of life, at a cost of $54,000) but little reflection on Ms. Hardy's moral position. Should "everybody be allowed to have as much life as they can?" Does life have a price? What if we were to answer, as Ms. Hardy would like us to, "yes" and "no" respectively? What would be the logical consequences?

If the British National Health Services -- rather, the British taxpayers -- are obliged to spend the $54,000 to buy Mr. Hardy those six months, what else are they obliged to do? Dare we even ask that question?

1 comment:

roger said...

“Everybody should be allowed to have as much life as they can..."

the "as they can" is the sticky part eh? is the village obliged to use the winter's food supply to keep one person alive for a week, dooming the rest to starve in a month? maybe not the best analogy.

we don't allow the victims of crime, or their families, to exact vengeance. they are too emotionally involved. how can we allow one person to use a hugely disproportionate supply of our group medical resources. maybe still not the best analogy.

we, our country, don't have such a hot record of deep thinking. best get with it as quickly as we can.