As we live such spoiled and pampered lives in the West, and as we’ve pushed death far out of sight so that 85% of people now die alone in anonymous beds in distant hospital wards, we’ve utterly lost perspective, as this unfortunate article indicates. The reality is that no matter what lengths the medical profession goes to, and no matter what level of hysteria the general public embraces, the old and the sick are going to die. The only questions are: when, and at what cost.

All health care systems suffer from the fundamental mismatch between limited resources and potentially infinite demand. Thus all health care systems must ultimately face the harsh reality of choice. Should we spend the time and money on Auntie Mabel’s hip replacement now that she’s 98 and will likely die within the next few months, or should we spent that time and money on replacing the kidney of Suzy, who’s eleven and with luck has a long life ahead of her? It’s no good screaming that Auntie Mabel deserves just as much care as Suzy, or that any system failing to provide that care is immoral, or that the system is “culling” Auntie Mabel.

Therefore any argument based on a failure to understand the fact that even in a nation spending 100% of its GDP on health care there would still be the need for choices and tradeoffs, is merely an argument that relies on misguided emotion alone. And that’s never a satisfactory basis for making any sort of decision whatsoever.

Oh, and we also need to remember that even if a nation expends vast time and resources on “saving” the old and the very sick, they will, actually, still die in a few weeks or months from now. Because we all die, no matter how many silly TV shows we’ve watched in which heroic doctors save the lives of people who in reality would have presented DOA. We need to learn to accept the reality that each of us will die, not retreat into childish postures of denial that lead to very confused and incoherent thinking.