Ever Again

Britain's National Institute For Health And Clinical Science, or NICE --now there's an Orwellian acronym if ever there was one-- has published a document, Social Value Judgments, putting forth the guidelines by which the National Health Service will decide how to allocate resources. If I were queen for the day I'd compel everyone to read it before being allowed to vote; this is where nationalized health care takes you. Inevitably, inexhorably. Nationalized care means rationed care, and these are the principles of rationing. Here are just a few niceties:

Rejection of the "rule of rescue." Meaning: you are expensive and no one's going to try too hard or spend too much to save your life.
There is a powerful human impulse, known as the 'rule of rescue', to attempt to help an identifiable person whose life is in danger, no matter how much it costs. When there are limited resources for healthcare, applying the 'rule of rescue' may mean that other people will not be able to have the care or treatment they need.

"Nice recognises that when it is making its decisions it should consider the needs of present and future patients of the NHS who are anonymous and who do not necessarily have people to argue their case on their behalf…The Institute has not therefore adopted an additional 'rule of rescue'."

Doctors from now on are to be people capable of ignoring the most fundamental moral instinct? That'll turn out well!

(NICE has already gotten in trouble for rejecting medicines from the US & Europe than can double the life expectancy of kidney patients. Too expensive for "just" 6 months of added life.)

You may not be healthy enough to live, and we reserve the right to keep you that way.

The main health outcome measure that NICE uses is the quality-adjusted life year (QALY). A QALY is a unit that combines both quantity (length) of life and health-related quality of life into a single measure of health gain. NICE uses the QALY as an outcome measure because it takes into account not only the increased life expectancy from an intervention, but also the quality of the increased life. In addition to recognising that much of healthcare is concerned with improving people’s quality of life, it also reflects the value judgement that mere survival is an insufficient measure of benefit; and that the expected quality of life years gained also needs to be considered.
Translation: each year of your life a dollar value (well, a pound value) and the government won't treat you beyond that cost if it decides --it, not you-- you are life not worthy of living. At the same time that NICE decides whether you are healthy enough to live, however, it also reserves the right to deny you the most effective care when good enough care will do; it's not aiming to restore you to health.

Your faith is not going to save you: The Citizens Council emphasised the importance of individual choice and of respecting individuals’ values, cultural attitudes and religious views. However, it recognised that it might sometimes be necessary to limit individual choice in the interests of the population as a whole.

And you will comply with the government lifestyle experts. There's lipservice given to treating fat people and smokers,

unless the behaviour is likely to continue and can make a treatment less clinically effective or cost effective, then it may be appropriate to take this into account.
You're supposed to take that to mean a person who refuses to quit smoking won't get a lung transplant or an alcoholic who won't seek treatment won't get a liver transplant. But look at the health guidelines for people with high cholesterol: the government can require you to eat two portions of oily fish per week or deny you service? How would that be evaluated? Furthermore, often the guidelines are based on bogus and faddish "science," but that's another story.

I could go on, but will let you Read all about it, with links to press coverage in the UK, from a British nurse. She sums it up:

The entire world should care about what this disturbing document forewarns. It is the most palpable document in recent history to bring the same bioethical dilemmas, on the moral claim of personhood and quality of life versus the interests of the state, that were raised in the 1920s.