Should "Bed Blockers" be left to die?
That is the question now being mulled over in the United Kingdom, according to The Sunday Times:
The Sunday Times
March 26, 2006
Doctors call premature babies ‘bed blockers’
Sarah-Kate Templeton, Medical Correspondent
PREMATURE babies who require months of expensive intensive care in neonatal units have been labelled “bed blockers” by one of Britain’s royal colleges of medicine.
The Royal College of Obstetricians and Gynaecologists (RCOG) says the huge efforts to save babies born under 25 weeks are hampering the treatment of other infants with a better chance of survival and a healthy life.
If the British change their national health system's policy and allow such premature babies to die, they would be the second European country to make such a choice:
It would shift Britain towards practice in Holland, the only European country that accepts such babies should die. One paediatrician opposing such a change described it as “involuntary euthanasia”. However, Susan Bewley, chairwoman of the ethics committee of the RCOG, said: “I would prefer that every baby could be treated, but we cannot get away from the fact resources are not endless.”
Alongside the probabilities of survival with medical attention, the costs are outlined in the article:
About 800 babies are born each year under 25 weeks. Medical advances mean about 39% of those born at 24 weeks now survive, and 17% of those at 23 weeks. A normal-term baby is born at 40 weeks.
The cost of treating very premature babies is high. A neonatal intensive care bed costs about £1,000 a day and very premature babies can require intensive care for four months.
Research to be presented at the Royal College of Paediatrics conference shows babies born at 25 weeks or under cost almost three times as much to educate by the time they reach the age of six as those born at full term — £9,500 a year compared with £3,900.
Professor Sir Alan Craft, president of the Royal College of Paediatrics, said: “Many paediatricians would be in favour of adopting the Dutch model of no active intervention for these very little babies. The vast majority of children born at this gestation who do survive have significant disabilities. There is a lifetime cost and that needs to be taken into the equation when society tries to decide whether it wants to intervene.”
Sometimes the ability to do something presents dreadful choices when that ability has both limits and high costs. (Here is a description of the limits of our abilities as manifested in survivors' disabilities.)
What price can be placed on a human life?
If it were an adult, the answer need not come entirely from society. The adult who needs medical care could answer the question when he decides what proportion of his own earnings to set aside for the costs of his care. Differences in ability (but not willingess) to provide for one's own care could be equalized by society's subsidy.
Who could answer for a prematurely born child?
There seems to be no easy answer, yet a society may not be able to afford to do everything for everyone.
For countries that have adopted "socialized medicine" as their method of paying for care, the answers must come from the majority of citizens through their government.
I wonder how the question will be answered in the U.S.A.
We already have a substantial degree of government-funded medical care for the elderly, so will that be the first group for whom the question must be answered here?