As many in the bioethics movement push various schemes to ration health care based on “quality of life” — such as the odious QALY (quality adjusted life year) system beloved of the New England Journal of Medicine — some are pushing back and insisting that health-care coverage and treatment public policy be predicated on the intrinsic equal dignity and moral worth of all patients.
Toward that end, Oklahoma’s governor just signed into law a bill that outlaws such invidious and bigoted discrimination. From HB 2587:
The Legislature finds and declares that:
1. Physical and mental disabilities, age or chronic illness should in no way diminish a person’s right to life, human dignity and equal access to medical care;
2. Historically, persons with disabilities, advanced age or chronic illness have faced discrimination in the health care system, including the denial of access to life-sustaining care;
3. Such discrimination is inconsistent with our society’s commitment to human dignity and the full inclusion of persons with disabilities throughout society;
Such discrimination is now legally prohibited:
An agency shall be prohibited from developing or employing a dollars-per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual’s disability, including age or chronic illness, as a threshold to establish what type of health care is cost effective or recommended.
An agency shall be prohibited from utilizing such adjusted life year, or similar measure, as a threshold to determine coverage, reimbursement, incentive programs or utilization management decisions, whether it comes from within the agency or from any third party.
More of this please, the sooner the better! Considering how shamefully and lethally New York and some other states treated the elderly residing in long-term care facilities during the worst days of the COVID-19 crisis, it is very clear that these laws are desperately needed.