In his letter ‘Need to measure value’ (therapy today, March 2008), Gavin Robinson comments, reasonably enough, that we live in a world ‘measured by money’ and asks whether we might have to ‘work with the reality and not an idealised world?’
I appreciate that he is trying to be pragmatic, and it’s an argument that might be compelling were it not for the fact that reality is not necessarily quite what it seems. Money is the supposed measure, but if the NHS really were run on purely economic lines, then it would look very different. Economics certainly cannot justify medical or surgical procedures carried out on anyone over the age of 60. Far better to let them die and avoid both the cost of the operation as well as the subsequent care costs, including state pensions. In fact, the health of the nation – and its economy – might be far better served by closing down hospitals and devoting the resources to basic community healthcare, and the promotion of healthy living. Could it be that technology makes medical spending so attractive? There seems to be a parallel with spending on armaments. Technology, whether it preserves life or destroys it, is neat, seductive and easily quantifiable. Living is much messier and harder to define.

Is economic prosperity more important than human happiness? Is prolonging life (or ending it) more important than valuing it? These are economic and moral double standards that need to be confronted. As things stand today, physical existence must apparently be saved – or destroyed – at any price, but the things that make life worth living carry a price tag. If we believe that it’s worth spending money to try and save the life of a cancer patient with no economic prospects, and no guarantee that a prolonged life will bring happiness, then I cannot see why we should not spend similar sums on helping someone towards spiritual, emotional and human fulfilment. If we believe that economics should not be the principle measure of what is important, then it seems to me doubly vital that we do not become apologists for those who both demand that we prove our economic worth, whilst ignoring economic considerations when it suits them.

William Johnston