THE COST of saving “impaired and extremely premature” babies should be considered against rising pressures on Australia’s healthcare system, according to a Geelong academic.
Deakin Law School’s Dr Neera Bhatia has written a book asking whether some lives are “too expensive to treat”.
“Just because we can save these babies born at 23 weeks, does it mean we should, knowing that finite public resources could be spent on other patients, children and even babies born at a later gestational period and are likely to make a greater health improvement?” Dr Bhatia said.
“The main premise of my book is that the allocation of finite healthcare resources should be a serious consideration in end-of-life decision-making for this select group of patients. With an ageing population and limited healthcare funds, these difficult questions need to be asked and answered.
“I am not saying exclusively that these babies should be not kept alive. Rather, I am asking if we are doing the right thing by saving babies that are going to require a lifetime of ongoing health care given the fact that we have many competing priorities putting pressure on limited health care budgets.”
Dr Bhatia said rapid advancements in technology and medical science were saving extremely premature babies even though they were still “overwhelmingly subject to severe disability”.
“We are able to save babies from death but not yet from disability.
Dr Bhatia said the issue was “polarising” but needed “open and honest discussion”.
“These are hard and very uncomfortable discussions to have but necessary.
“Some will disagree with my contention, some will agree and others will say they share the same opinion but would never say it out loud – perhaps this is to be expected given that talking about putting a price or value on life is so taboo in society.
“But the reality remains that end-of-life decisions need to be made in some circumstances and should be made on more rational grounds by attempting to put some of the associated emotion aside.
“What I am suggesting, and it is a suggestion is that end-of-life decisions for impaired and extremely premature infants should be driven by a more-objective, transparent and tangible approach. In this regard, resource allocation and quality of life should be important considerations.
“In the book I argue that at the very least such end of life decisions should be guided by a better authoritative legislative framework. While I am not suggesting introducing specific laws on this issue, some guidance or framework is required.”
Dr Bhatia hoped that her book would begin a public conversation so that eventually “end-of-life decisions would not be such a shocking consideration when the issues do arise”.
“End-of-life decisions for critically impaired infants are generally made by consultation between doctors and the parents and in rare circumstances with the intervention of the courts. However, more-open discussion about how finite resources are allocated and the corresponding quality of life for extremely premature babies would potentially lead to more sound policies and decisions that also have the interests of wider society in mind.
“Unfortunately, with limited health care budgets these hard questions have to be asked. While saving tiny babies from death may be considered by some as a moral duty or a benevolent act, we do not have limitless healthcare resources to provide these infants with the lifelong care and support that they require.”
