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October 7, 2004
When Government Runs Health Care, They Tell You When Your Child Should Die

The Manchester Guardian reports on a family's struggle against Britain's National Health Service to keep their daughter alive. The NHS has decided that Charlotte Wyatt, an eleven-month-old preemie, will never be able to recover from the complications of her birth and want to force a do-not-resuscitate order onto her parents:

The parents of baby Charlotte Wyatt are expected to hear this afternoon whether a high court judge has supported their case for their daughter's right to life.

Darren and Debbie Wyatt from Portsmouth tried to convince Mr Justice Hedley that their 11-month-old child has a right to life. They argued their daughter should be provided with every aspect of medical care available.

Charlotte was born three months premature, weighing only 1lb and measuring five inches. She has already stopped breathing three times due to serious heart and lung problems; she is fed through a tube because she cannot suck from a bottle and she needs a constant supply of oxygen.

Portsmouth hospitals NHS trust argues that resuscitating Charlotte again would lead to further damage to her lungs and cause her further suffering. It has asked the court for an order allowing its doctors not to ventilate her again if she has life-threatening breathing difficulties.

In the government-run health system that the British have used for decades, the choice between life and death doesn't belong to the patient or their family -- it lies with the government. In the case of the Wyatts, the government has decided that it has wasted enough resources on Charlotte and now wants to cut its losses. The only options the Wyatts have to save their daughter is to either sue the NHS to keep it from abandoning Charlotte, or to pay 100% of all medical costs out-of-pocket at the private treatment centers that wealthy British citizens can access.

Just as in the case of viable kidneys being thrown away for the lack of transplant surgeons, the British experience with government-run health care reveals the strange and Orwellian experiences with single-payor systems that a vocal contingent here in America want to impose. A "health" care system that tells young parents that it refuses to keep their daughter alive because it's just too costly to do so, or one that routinely fails to perform transplants because the monopoly doesn't incentivize surgeons to learn the procedure, is not a system that maintains the health of its patients. It's a system that unnecessarily nationalizes a large segment of the economy and ensures that only the most mediocre care will be given to anyone not rich enough to buy better care outright, and completely out of pocket.

In the US, important medical decisions are left to the patients and to their families. We should make sure it stays that way.

UPDATE: The judge has ruled that the NHS can let the baby die:

Doctors caring for a critically-ill premature baby, Charlotte Wyatt, were given permission by a British judge to allow her to die if her condition seriously deteriorates and her breathing stops.

High Court Justice Sir Mark Hedley rendered his decision after parents Darren and Debbie Wyatt, who are expecting their third child, urged him not to give up on their 11-month-old daughter.

I appreciate all of the comments that you have posted, a thoughtful and interesting commentary. Here's where I think those that say this case is not the one to indict single-payor systems are wrong. It is one thing to have a hospital say they will refuse to resuscitate the Wyatt's daughter, or for a private insurance company to refuse to pay for futher treatment. It is another issue entirely when the government forces the Wyatts to pay for the NHS and then usurps the decision for her medical care from the parents, without any realistic option of going anywhere else. Their money has already gone to the NHS.

Let me put it another way. Charlotte Wyatt is a severely ill infant, but she is alive and her quality-of-life decisions belong with her family, not a government functionary. Under a market-based system, the government would never be in a situation to decree that her life wasn't worth the effort to save it; that decision would be made between her doctors and her family, along with whatever private insurance they had. If the Wyatts and their doctors disagreed, they would be free to get medical care elsewhere; the same is true for insurance. That isn't the case in Britain, where all of it is run by the government.

In essence, Britain has a system where the government, not the patients or their families or caregivers, become the arbiters of whose life is worth saving and whose have no worth. And the only time that will be noticed is when the government decrees that the Charlotte Wyatts are to be abandoned regardless of the wishes of their families. Such a utilitarian view of the value of life recalls the slippery slopes that ultimately led to the horrors of the Nazi euthanasia programs and the death camps, the Soviet gulags, and trafficking in slavery that continues to this day.

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Posted by Ed Morrissey at October 7, 2004 5:59 AM

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