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<p class="MsoNormal">04-Healthy Ethics</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">"Trust me we know what's good for you dad and we'll always
do the (ethical) right thing".</p>
<p class="MsoNormal">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?<span style=""> </span>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.
"</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Ethics are not fixed and can be skewed by "moral hazard",
the punishment we get or cause for doing good deeds.<span style=""> </span>Moral hazard occurs when there are more beneficiaries to death
than life.<span style=""> </span>The value of a "Quality
Adjusted Life Year" (QALY)[mathematically derived value of a year of perfect
health]<span style=""> </span>for a patient determines if an
HMO or public payor will contribute and how much towards a medical good or
service.<span style=""> </span>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<span style=""> </span>from cervical cancer is too low.<span style=""> </span>Then a "sensitivity analysis" can be<span style=""> </span>done and criteria which modify the
accessibility are developed so that the adjusted QALY value<span style=""> </span>is reduced to an acceptable number, usually
less than $50,000/QALY saved.</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">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<span style=""> </span>it's a blessing to see them
free of pain and suffering.<span style=""> </span>"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.<span style=""> </span>The moral hazard is that the
last year of life is extraordinarily expensive.<span style=""> </span>The payor saves by being able to redistribute the savings to
other covered services or shareholders.<span style="">
</span>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.<span style=""> </span>Saving $5-30,000 by
socially accepted forms of<span style=""> </span>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.<span style=""> </span>Canada's "progressive licencing" for new
pharmaceuticals is a step towards managing this hazard.</p>
<p class="MsoNormal">( <a href="http://www.newscientist.com/channel/health/mg19826523.800-canada-to-release-trial-drugs-to-patients.html" target="_blank">http://www.newscientist.com/channel/health/mg19826523.800-<span class="nfakpe">canada</span>-to-rele<br>
ase-trial-drugs-to-patients.html</a><span style=""> </span>).</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">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.</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">Some say taxpayer paid universal medicare creates an
incentive to act irresponsibly because the safety net will catch you.<span style=""> </span>Cost shared coverage of preventative care
should yield savings over the total life-cycle of a patient.<span style=""> </span><a href="http://www.fightaging.org/archives/001479.php">http://www.fightaging.org/archives/001479.php</a><span style=""> </span>briefly considers<span style=""> </span>the economic costs Vs benefits of the longevity dividend </p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">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.<span style="">
</span>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<span style="">
</span>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 (<a href="http://ieet.org/index.php/IEET/more/anissimov20080513/">http://ieet.org/index.php/IEET/more/anissimov20080513/</a>
).</p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">The wealthiest 1 percent of USA households<span style=""> </span>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.</p>
<p class="MsoNormal">This is more than the combined wealth of the bottom 90
percent.<span style=""> </span>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 (
<a href="http://ieet.org/index.php/IEET/more/cebys08/">http://ieet.org/index.php/IEET/more/cebys08/</a><span style="">
</span>) for some and QALY limited access for everybody else?<span style=""> </span></p>
<p class="MsoNormal"> </p>
<p class="MsoNormal">My next piece will provide details of life extending
therapeutics which have a wide range of accessibility, cost and<span style=""> </span>proof of efficacy.<span style=""> </span>Some have been available for years and some are years from the
commercial market.</p>
<p class="MsoNormal">This series was meant to help you plan for the future based
by developing your own personal pro-health and longevity strategic action plan.</p>
<p class="MsoNormal"> </p>
<span style="font-size: 12pt; font-family: "Times New Roman";">You may send your feedback attention "Pharmer Mo" at
<a href="mailto:extropian.pharmer@gmail.com">extropian.pharmer@gmail.com</a></span><br>