[ExI] Longevity Dividend Course OP-ED Assignment 04

[Morris Johnson]

04-Healthy Ethics



"Trust me we know what's good for you dad and we'll always do the (ethical)
right thing".

I know you mean well, but if what you deem ethical and right for me is
blocked by legislation or regulation; will you let me die?  The Readers"
Digest thesaurus of synonyms calls moral, decent, virtuous, upright, proper,
fitting, correct, just, fair, aboveboard and kosher "ethical" and
underhanded, shady, improper, unfair, lowdown, nefarious, unbecoming,
unseemly, indecorous, immoral and indecent "unethical. "



Ethics are not fixed and can be skewed by "moral hazard", the punishment we
get or cause for doing good deeds.    Moral hazard occurs when there are
more beneficiaries to death than life.   The value of a "Quality Adjusted
Life Year" (QALY)[mathematically derived value of a year of perfect health]
for a patient determines if an HMO or public payor will contribute and how
much towards a medical good or service.  For example a simple vaccination
for HPV when allowed under medicare can have a $100,000 /QALY value if it is
deemed that the population based average risk of death  from cervical cancer
is too low.  Then a "sensitivity analysis" can be  done and criteria which
modify the accessibility are developed so that the adjusted QALY value  is
reduced to an acceptable number, usually less than $50,000/QALY saved.



Ethics of institutionalized Ageism is demonstrated thusly: If a youth dies
it's a loss of potentially productive life ; If a frail elderly person dies
it's a blessing to see them free of pain and suffering.  "Living Wills" are
spun to be a way for the frail or terminally ill to relieve health care
providers of the need for heroic or long term end of life palliative
measures.  The moral hazard is that the last year of life is extraordinarily
expensive.  The payor saves by being able to redistribute the savings to
other covered services or shareholders.  In 2008 in Saskatchewan when 43.7%
of every tax dollar went to healthcare, the average cost of all the health
care goods and services was $4,360 per person.  Saving $5-30,000 by socially
accepted forms of  passive euthanasia VS allowing expensive experimental,
risky heroic long shot measures which may provide insights into how to
better treat the next person show how ethics and moral hazard can collide as
an ethical conundrum.  Canada's "progressive licencing" for new
pharmaceuticals is a step towards managing this hazard.

( http://www.newscientist.com/channel/health/mg19826523.800-canada-to-rele
ase-trial-drugs-to-patients.html<http://www.newscientist.com/channel/health/mg19826523.800-canada-to-release-trial-drugs-to-patients.html>
).



Our culture does not allow "honor killing" within families or maintaining a
one child policy and selecting for that child to be a son by killing newborn
girl babies however, a Seattle Washington man ,Timothy Garon, who used State
Law approved medical marijuana to ease his pain from advanced hepatitis was
knocked him off the elegibility list for a liver transplant and left to die
recently.



Some say taxpayer paid universal medicare creates an incentive to act
irresponsibly because the safety net will catch you.  Cost shared coverage
of preventative care should yield savings over the total life-cycle of a
patient.  http://www.fightaging.org/archives/001479.php  briefly considers  the
economic costs Vs benefits of the longevity dividend



Let me set out some of the common arguments against enhancing adult
longevity as set down by George Dvorsky in his presentation to the "securing
the Longevity Dividend" meeting.  George states that critics contend that
death has value by giving meaning to life, providing for the need for
morality, allowing for self-sacrifice, preventing excessive risk aversion,
making beauty exist and providing a vital imperfection. Some  say that it
would be cost prohibitive, people would have unequal access and that
distribution would be unfair. Some say the motivations are questionable, are
of no known social good, produce anti-social behavior, there are more
pressing concerns for society to deal with (global security and geopolitical
gamesmanship) and that individual actions are against the collective best
interest (http://ieet.org/index.php/IEET/more/anissimov20080513/ ).



The wealthiest 1 percent of USA households  household income averages 190
times the national average , own 34.3% of the nations wealth and include the
Forbes 400 whose 2006 wealth was 1.25 Trillion dollars.

This is more than the combined wealth of the bottom 90 percent.  Power and
money trump ethics so how does the rest of society manage the moral hazard
of undeniable access to lifespan enhancing and extending and enhancement
therapeutics ( http://ieet.org/index.php/IEET/more/cebys08/  ) for some and
QALY limited access for everybody else?



My next piece will provide details of life extending therapeutics which have
a wide range of accessibility, cost and  proof of efficacy.  Some have been
available for years and some are years from the commercial market.

This series was meant to help you plan for the future based by developing
your own personal pro-health and longevity strategic action plan.


You may send your feedback attention "Pharmer Mo" at
extropian.pharmer at gmail.com
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