On September 25th, 2010, an article was put out by Associated Press titled “$93,000 cancer drug: How much is a life worth?” The basic story was one of huge medical bills charged to cancer patients for very little return in length of life. Insurance picks up most of the tab, but the money does have to come from somewhere. And so the question, how much is a life worth? If it costs $100,000 to add four months to someone’s life, do you spend it or decide that the gain is not worth the cost? What about $21,500 for 11 weeks? What about $24,000 for 12 days?
An answer to this question can come from at least three points of view: from the cancer patient, from the strangers in the insurance office, from the family and friends of that cancer patient.
If you knew you would only live another 4 months, would you ask your family to give up what would likely be a large portion of their retirement savings? If you knew you would only live another 12 days would you ask your family to give up a significant portion of a year’s salary? Weighing cost and benefit like this, it would be easy to say no. I don’t think I would ask my family to trade in real opportunity for real trouble just so I could die a little later.
If a stranger was tasked with overseeing a fixed amount of dollars that could be spent on helping to pay other people’s medical bills, how does he or she approach the question? He can either give one person 4 more months, or give 4 people 12 more days. He also could do neither and give 100 people prescription drugs that raise the quality of life indefinitely (or years beyond the time scale considered here anyway). He could say that one person’s 12 days aren’t worth the suffering of 100 people for years. The decision does have to be made, after all. There is a fixed amount of resources and an ever growing number of people asking for them.
The third viewpoint is the hard one. Would you spend that money so that the family member you love would live another 4 months, or even 12 days? How would you even begin to think about it? It seems that if the decision is based solely on your emotions, then your own recent history is what determines the fate of your loved one. If you’ve been stressed out about money then the prospect of having to pay such a huge sum is just going to send you into despair. If you have been doing well, then anything is worth the effort of raising the money to help your family member live even 1 day longer. Is one answer correct or does it just depend on the situation?
I’m not trying to set aside quality of life issues. No one wants to prolong someone’s groaning pain by artificial means, but that is not generally what people are asked to do. That is not what the drugs in the AP article do. They give a decent quality of life for the amount of time that is given.
And so, is the value of life really dependent on our emotional state or size of our bank account?
It is most comfortable to say that the value of a person’s life, loved one or stranger, should not be determined by economic reasoning at all. Nor should we have to rely on our fickle emotions to guide us. Each human being is unique and has value that is independent of the power of a dollar. The measuring stick is wrong, like asking for the color of the wind. I think that is why the question makes you feel like you have to disembody yourself from human experience to come up with an answer that makes sense.
What brought this question back to mind was a story tonight on Rock Center with Brian Williams about making end of life decisions along with your family instead of waiting until your family members are the only ones capable of answering. One of the points in the story is that quality of life can be better than quantity of days. It is not a story about euthanasia. Killing yourself is an absurd decision that is made from a place of despair and ignorance. The Rock Center story is one about having the discussion of when to deny treatment in favor of palliative care, and focus on comfort of the person.
The topic of the Rock Center episode seems to be slightly different than the question of cost of care, but another point in the story is that the ultimate cost of care goes down when these decisions are made ahead of time. Rather than the default always being incurring more cost in hospital stays and treatments, many decide on comfort rather than more days to live.
In the Old Testament it always seems so much easier. Abraham just laid down and died peacefully. Jacob gave everyone a verbose farewell and laid down and died peacefully. Moses gave a huge speech and went off into the mountains. It didn’t cost any money at all to die back then. How do we take guidance about answering this question from those types of examples?
Well, for one, the value of life is everywhere upheld and purposefully ending your own life early is everywhere rejected. The bible also reminds us that, for those whose faith is in Christ, this life is not the end and that better things await.
Wait. That’s not helping. It just means you should stay as long as you can, but don’t bother with staying as long as you can because it’s better elsewhere. Those types of tensions are found all over the place when looking in scripture. Each one reminds us that we are not in control. At some point we have to look to God and let him show us when it is time.
So here is my take on the issue. Get the best insurance you can so that cost is taken up in other ways, because we should seek to honor the life of our loved ones even if that life will last only 4 more months. That time with your loved one is worth the cost. But when you come to the limit of what your economic situation in life will allow, don’t feel guilty about seeking comfort over length of stay. God has allowed you to live in the place where you are. He is in ultimate control of when we are called home no matter how much treatment we receive.
The tension and sorrow at these times is real. There is no such thing as an easy and comfortable loss of a family member. It is very easy to second guess after the end of life decisions are made because life is worth whatever cost we can bear. But remember that maybe the death of Abraham, Jacob, and Moses are portrayed in such peaceful manners because that is how it is supposed to be. Quality of life is worth the cost. But as we try and color the wind we can also remember that we are not in control of our number of days.
Asleep On The Phone 