Do we Value Life?
by Dr. David Cook In 2017 the National Institute for Health and Care Excellence (NICE) rejected the drug nivolumab for use in the NHS to treat patients with advanced head and neck cancers. The reason given was that, despite the drug showing positive benefits, it was judged to be too expensive based on the cost per ‘quality adjusted life year’ (QALY). For patients with this disease (and clinicians treating them) this was a hugely disappointing decision and although subsequently nivolumab has been approved for use, at the point of this judgement it must have felt to these patients that their lives were somehow being deemed to be less valuable than those of other patients. Let’s wind forward to today and Lord Sumption discussing the impact of lockdown on society and apparently suggesting something similar, namely, that some lives are less valuable than others. But in both of these cases is this what was actually meant? Are we really assigning a value to a life? Are we really judging that some lives are more valuable than others and so more worthy of saving? To answer these questions, let’s focus on QALYs because these seem to be highly culpable in the crime of ‘life valuation’. Quality Adjusted Life Years (QALYs) are not used to assess the quality of a life and they...
