Medicine, Health Care and Philosophy publishes article by Dr Sean Sinclair

Dr Sean Sinclair considers various principles which might explain our intuitive obligation to rescue people from imminent death at great cost, even when the same resources could produce more benefit elsewhere.

The article, titled Explaining Rule Of Rescue Obligations In Healthcare Allocation: Allowing The Patient To Tell The Right Kind Of Story About Their Life, aims to explain our intuitive obligation to rescue people from imminent death at great cost, even when the same resources could produce more benefit elsewhere.

Dr Sean Sinclair offers a new account in terms of narrative considerations. We value life stories that follow certain patterns, classic patterns which are reflected in many popular myths and stories. We are particularly averse to depriving people of the opportunity to follow some such pattern as they approach death. This means allowing them to sort out their affairs, say goodbyes to family and friends, review their life, or come to terms with death itself. Such activities carry a lot of meaning as ways of closing our life story in the right way. So, for someone who has not been given much notice of their death, an extra month is worth much more than for other patients.

Finally, Dr Sean Sinclair reviews the UK National Health Service's end of life premium, which gives priority to patients with short life expectancy. He argues that it falls short in terms of such considerations. For example, the NHS defines its timings in terms of how long the patient can expect to live as at the time of the treatment decision, whereas the timings should be specified in terms of time from diagnosis.