The Price of Life

It is not often that a good news story captures the hearts and minds of Australians. We saw one such story last week with the successful surgery on conjoined twins Krishna and Trishna.

As someone who gets a bit squeamish at the mere thought of invasive medical procedures, I was fascinated by what was being done to give these two children a new start in life.

The twins were joined at the head and Krishna relied on her sister’s kidneys. An Australian woman found them in Bangladesh and brought them to Australia so the risky operation could offer them new hope for a normal life.

In marathon surgery spanning 31 hours, a team of Australian doctors and support personnel managed to separate the two-year-old twins. This involved removing the top of their skulls and microsurgery to ensure the isolation of all shared blood vessels. At the conclusion, doctors, although cautious, deemed the operation a success.

The first of the girls awoke from anaesthesia a day later and Krishna, the physically weaker of the two, opened her eyes and blew a ‘raspberry’ 48 hours after the surgery. Doctors are confident of a full recovery for both girls, both of whom will be forced to undergo further operations in years to come.

Future surgery will involve replacing their plastic ‘upper skulls’ with new ones as their brains and bodies grow. The mere thought of it makes me shiver but I, like many Australians, are in awe of what modern medicine can do.

There is no doubt that the surgery and ongoing care will be very expensive but what price can you put on human life and dignity?

This is a question that enters into the very heart of our health services. If an individual is spending their own money the decision is purely a personal one. However, when public money is being spent, the health and medical services available are determined on a cost-benefit analysis.

This effectively puts a price on human life.

This was brought home to me recently when I was approached by a pharmaceutical company who were keen to get their new product on the Government’s Pharmaceutical Benefits Scheme (PBS). This would result in taxpayers bearing the majority of cost for providing patients with these drugs.

The drugs were designed to stabilise an acute lifetime medical condition that is currently incurable. Left untreated, the patient will die within five or so years. With treatment, a normal lifespan could be expected. I was advised that approximately 70 people in Australia have this chronic condition.

Now here is the rub. The annual cost of treatment was approximately $400,000 per patient, a total of around $28 million every year, for decades to come. It is a lot of money but has the direct result of being able to save the lives of 70 Australians.

I challenged the manufacturers as to why it cost so much and was told about the development process and the need for reinvestment in ongoing research. Although not mentioned, I am sure the manufacturer would also be making a substantial profit along the way.

This gives rise to two questions and both relate to what I would regard as moral issues.

Firstly, if a company has developed a lifesaving drug, is it moral to withhold that treatment or make it effectively unavailable by virtue of cost?

Secondly, in such circumstances, at what level should a government say that the price tag of saving lives is simply too high?As a supporter of capitalism, free markets and smaller government, but also a believer in the sanctity of life, I have found those two questions rather challenging recently.

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