Lord Save Us from doctors making public policy


There's an old bon mot about preferring to be ruled by the first two thousand people in the Boston telephone book than the combined faculty of Harvard, experts that they are in their subjects. And so it is when we've got doctors trying to tell us what public policy should be rather than their sticking to their knitting and trying to treat the diseases that we become prey to:

Cancer is the best way to die because it gives people the chance to come to terms with their own mortality, the former editor of the British Medical Journal has claimed.

Dr Richard Smith, an honorary professor at the University of Warwick, said that a protracted death allowed time to say goodbye to loved ones, listen to favourite pieces or music or poetry and leave final messages.

He claimed that any pain of dying could be made bearable through ‘love, morphine, and whisky.’

Writing in a blog for the BMJ, Dr Smith admitted that his view was 'romantic', but said charities should stop spending billions trying to find a cure for the disease because it was clearly the best option for an ageing population.

It's entirely possible that going out on a wave of whisky and heroin (not a combination we would recommend if you're not planning on going out just yet and yes, gin is worse than whisky in this regard, off what libertines liberals like us know about) having said goodbye and enjoyed those last days is indeed the "best" way to go.

But we're afraid that it's still an insane thing for anyone to say that we should not try to cure cancer. The mistake is akin to that made by so many of the slower thinkers about market interactions. Sure, if there's only one single market interaction then as game theory tells us the incentive is to rip off the other party. But most market interactions are not one off transactions, they're simply a part of a number of iterations of the same transaction. In which case the incentive is to cooperate to mutual advantage.

Looking to cancer the assumption being made is that OK, once suffered from one should simply fold one's tent and steal away into that long dark night. Which is to entirely ignore the fact that as cancer treatments get better it's possible to have a series of iterations. That first, that skin cancer, say is treated and two decades later the luck of the draw brings on, say, colon cancer which may or may not be treatable. The whisky and heroin option taken at that first iteration would then have robbed one of that 20 years of life.

It's entirely possible that cancer is that "good death" but surviving one or two brushes with it before succumbing would be even better. So no, while we might well take a doctor's advice on how to treat a cancer we shouldn't be taking same on whether to investigate treatments or not. To do so would be to succumb to the views of the experts, something that pulling names randomly from the phone book would avoid.