The UK's medicines watchdog, know by its acronym of NICE, says the strong human impulse to expend vast resources to save someone — refered to as the rule of rescue — cannot apply to medicine. The decision comes on the heels of a controversial NICE decision last week to reject four new drugs for kidney cancer even though they have been shown to extend life by five to six months. NICE's own citizen's council recommended six months ago that it adopt the rule of rescue as a mark of a humane society.
NICE, however, rejected the idea, saying there just isn't the money and that applying the rule of rescue would deny care to others. "When there are limited resources, applying the 'rule of rescue' may mean other people will not have the care or treatment they need," the NICE report says.
Treatment may also be refused to elderly patients if the benefits are deemed too low or the risks too high.
The British Medical Association has criticized the report, saying doctors have a responsibility to do everything they can for a patient. Says Tony Calland, the BMA's ethics committee chairman: "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?"
Access to care stands to become a growing issue in healthcare as drug companies come up with expensive new treatments and governments must decide which they pay they will pay for. Canadian Medical Association president Brian Day has long warned about this looming problem, made worse by the aging baby boom generation.