Alfie and the Failure of Medical Ethics
26th April 2018
The case of Alfie Evans once again brings to light the ethical and moral landmines that are promulgated as governments intrude further and further into the personal lives of its citizens.
Young Alfie suffers from a so-far unknown and undiagnosed congenital ailment that has left him in a near-vegetative state since late 2016. As such, the officials of the UK’s National Health Service have brought it upon themselves to hasten the death of the child … for his own well-being.
If you think that is sarcasm … it is not. The Royal College of Pediatrics literally made that argument this week. And that would be bad enough except for the fact that there is no medical or moral reason for their conclusion. So far, there is little to no medical evidence that the child has been suffering at all.
Well, that is not totally the case. The child did suffer over the last 24 hours … after NHS physicians removed his ventilator and then for hours refused to provide any ancillary support to reduce his difficulty as he was gasping for air and suffering from dehydration. In short, the physicians themselves have caused more suffering than any decision the parents have recently made.
This debate could have been avoided if the UK had taken up the Italian government’s offer to fly Alfie to Rome and provide him with any care he required. With the blessings of the Pope himself, Italy even granted Alfie citizenship on Monday. Italian diplomats further offered to evacuate him by military air ambulance to an Italian hospital for treatment and, if needed, end-of-life care.
The UK government said “No thanks.”
The key fact here is that when government provides your health care, government makes your medical decisions, even to the point of deciding whether you live or die. When government provides your health care, health care has become what economists call a ‘public good’ (think military defense or law enforcement) and, as with other public goods, attempts to enforce a government monopoly on the provision of such goods. When government provides a service, the constant inclination is to make it a government monopoly and to de-legitimize other potential providers, even when the ‘good’ in question has historically been adequately supplied by non-government providers. Look at the history of homeschooling — in some countries, like Germany, it is actually illegal to homeschool your children.
UPDATE: The Sad Case of Alfie Evans: A Sordid Lesson in Government-Controlled Health Care
UPDATE: The Lesson of Alfie Evans