News that heavy drinkers are to be considered for liver transplants led to a predictable flurry of comments on national press websites. Many were along the lines of “it’s a waste of a liver”, “why should I fund surgery that just lets them carry on drinking”, or “the NHS shouldn’t offer this to people who have brought it on themselves”.
The less responsible media (yes you, Daily Mail) didn’t bother to mention that the NHS Blood and Transplant pilot scheme will involve only 20 patients and is designed to assess the benefits or otherwise of offering transplants to people with severe alcohol-associated hepatitis in some fairly tightly defined circumstances. But then, the image of hordes of rampaging drunks storming transplant centres across the UK and stealing livers from “deserving” recipients will attract more comments and clicks.
There are some aspects of healthcare that will raise debates about whether finite NHS resources should be spent on them – and treatments for conditions related to alcohol, tobacco or drug use top the list. But if you start making judgements about whether people “deserve” treatments, where do you draw the line?
Did I deserve a knee operation to repair damage sustained while skiing? Should someone who falls and sustains a fracture while drunk pay for their own treatment? And what about IVF – should the NHS fund that? It’s not like there’s a shortage of babies is there?
In a world of infinite demand for healthcare and finite resources, decisions about who receives treatment involve hard choices and inevitable losers. But these decisions should be based on evidence of costs and benefit rather than moral judgement.