Re:The value of a life (Score 1)

Those decisions will have to be made. In general, medicine uses the qaly (Quality-adjusted life year) to gauge a medical treatment. As the name might suggest, it considers the quality of life as well as the likely lengthening of life from a treatment.

The idea is that a treatment that helps you live healthy for 6 months might score better than one that helps you live a few years bedridden and delirious.

It's interesting reading all this as someone who works in the industry. In health economics, QALYs are a standard measure. But, when decisions are made in the insurance industry as to whether to authorize treatment or not (at the clinician level), those decisions are often centered around guidelines such Milliman Care Guidelines (MCG) or InterQual. There are actually regulations forbidding utilization review staff from considering financials when adjudicating. One is to simply consider "medical necessity". Of course, what gets covered in the first place is a different matter that also involves lobbies in addition to health economics.

At the patient level, a quality life year can mean different things to different people. So, we can't deny treatments based on what I think (or the insurance company thinks) might be the best quality of life decision. That becomes a patient-values question about what course of treatment they (and their families) want to pursue. When I treated patients at the bedside, this was a common problem. Many patients that clearly qualified for hospice criteria (and should have been on hospice in my professional opinion) chose not to (or their families did). They chose to pursue further "curative" treatment instead. Then, it is up to utilization review clinicians to either grant or deny authorization. Of course, there may be criteria built into the guideline that requires progress to be made or documentation of benefit to the patient -- or approval may just require the presence of a particular condition and level of acuity.