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Patients 'should not expect NHS to save their life if it costs too much'
The NHS should not always attempt to save someone's life if the cost is
too much, the medical regulator has ruled

By Robert Winnett, Deputy Political Editor
Last Updated: 8:58PM BST 12 Aug 2008

The National Institute for Health and Clinical Guidelines (Nice) has
ruled for the first time that saving a life cannot be justified at any
cost, in a review of its ethical guidelines.

The ruling - made by the board of the controversial organisation -
contradicts advice it received from its own 'Citizens Council' which
offers advice from a representative sample of the general public.

Nice is facing growing criticism over the number of drugs it is now
rejecting which are available throughout Europe and in America. Last
week, it refused to sanction four kidney cancer drugs which can double
life expectancy.

It has now rejected the so-called "rule of rescue" which stipulates that
people facing death should be treated regardless of the costs. The rule
is based on the natural impulse to aid individuals in trouble.

In a report on "social values judgement" the regulator says: "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'."

The ruling contradicts the advice of Nice's Citizens Council, which said
that a rule of rescue was an essential mark of a humane society. The
report said that where individuals are in "desperate and exceptional
circumstances" they should sometimes receive greater help than can be
justified by a "purely utilitarian approach".

Doctors have also criticised the ruling. Tony Calland, chairman of the
ethics committee of the British Medical Association, said: "We would be
opposed to ignoring a rule of rescue when it introduces a degree of
flexibility around extreme cases. So what if you waste a few pounds if
you are doing your best for humanity?"

Nice defended its ruling last night saying that the Citizens Council
provided useful input to its decisions but that the organisation' s role
was to determine how best to allocate the health service's limited
resources.

Nice is facing increasing accusations that it is giving undue weight to
financial considerations - rather than medical benefits - when making
decisions on whether to allow drugs or other treatments on the NHS.
Doctors and patients have alleged that they are treated with contempt by
the organisation and that life-saving drugs are being unfairly denied.

The Daily Telegraph disclosed yesterday that Nice is preparing to offer
patients advice on the medical benefits of drugs that are not available
on the NHS. The disclosure is likely to anger patients who face paying
tens of thousands of pounds for expensive drugs which may prolong their
lives.

http://www.telegrap h.co.uk/news/ 2547393/Patients -should-not- expect-NHS-
to-save-their- life-if-it- costs-too- much.html