Discussion on Whether The Use of Public Funding for Life-saving Drugs is Acceptable

As time continues to tick away, technology and medicine continue to evolve beyond their current limitations. With the evolution of technology and medicine, individuals now have access to life-saving treatments and drugs to disorders that were once without a form of treatment. Some disorders such as have put up a challenge to find an effective treatment which is not limited by cost. Spinal muscular atrophy, which is a “genetic disorder characterized by weakness and wasting (atrophy) in muscles used for movement” (U.S. Library of Medicine, 2018), is an example of one of these cases. For years spinal muscular atrophy has been without an effective treatment leading to the suffering of many. In recent years researchers have found a significant breakthrough in the form of a drug known as Spinraza. Spinraza is a “prescription medicine used to treat spinal muscular atrophy (SMA) in pediatric and adult patients” (Spinraza, 2018). This scientific breakthrough has the potential to impact the lives of many. However, merely finding a treatment is not the only problem that needs resolving. With the discovery of effective drugs such as Spinraza, there comes an astronomical cost. In the case of Spinraza, the drug can cost families up to 700k in their first year of treatment and 300k each year afterwards. The cost of life-saving drugs such as Spinraza is one that is one that may leave a hopeful recipient empty handed. In response, the Province of British Columbia t has decided to step in and cover the cost of these treatments via the usage of public funds. In this paper, it will be argued as to why public funding for proven life-saving drugs such as Spinraza is acceptable and why it should be mandated from Utilitarian and Deontological perspectives. When making decisions of such importance, higher powers need to take into account the ethics and values of using large sums of public funding to treat minority populations. 

By allowing the use of public funding for the treatment of spinal muscular atrophy, higher powers demonstrate the importance of the ethics and values of helping individuals in need. This directly corelates with why utilitarianism defends the action of using public funds to provide for those with spinal muscular atrophy and other disorders. Utilitarianism is the valuing of the “greatest good for the greatest number” (Holland, 2015), so a utilitarian would argue that the government should value the overall utility (“Regarding, happiness, pleasure, and freedom from pain” (Holland, 2015).) of its citizens. As the British Columbia Provincial government allocates these resources, it demonstrates that it believes in the fulfillment of ethics. One important thing to consider is how there is a drug in circulation which has the potential to save many lives if financial help is provided to those who need it. This alone demonstrates the importance of why the theory of utilitarianism supports the idea of utilizing public funding for the purposes of fulfilling the needed distribution of drugs. Providing aid to those who would benefit from it would increase the overall pleasure to the parties involved, satisfying the key goal of utilitarianism. If public funding is readily available to aid others, then by the notion of rule utilitarianism, which states that the act performed is followed by a set of rules in which it yields the greatest utility (Holland,2015), it is now a decision that clearly favours one option over the other. The presented options are to utilize the available funds to save lives or to leave those to suffer and potentially be in the face of death, then it becomes evident what is the most ethical option is for the use of these public funds. Jeremy Bentham, a philosopher and founder of utilitarianism (Holland, 2015), said it is the job of pain and pleasure “alone to point out what we ought to do, as well as to determine what we shall do” (Snyder, 2018). By following Bentham’s lead, the only ethical option is to allow the usage of public funding into allowing the accessibility of high cost drugs. Going beyond the views of rule utilitarianism, act utilitarianism also would further support the funding of life-saving drugs via public funding as well. “The goal of act utilitarianism is to ensure that the full potential of utility is met with the set of consequences that are taken” (Holland, 2015). The median family income as of 2014 in British Columbia was $76 770 (Statistics Canada, 2018). Using the example of Spinraza and its 700k financial commitment, it can be seen how the average family would be unable to financially support the use of life-saving drugs. Act utilitarianism would support the idea of allocating public funds to aiding financially constraint families to get access to life-saving drugs. This would ensure the utility of those who had no other means of access to these life-saving drugs. Looking at each individual case of patients requiring a certain high cost drug, all of them would need the distribution of high cost drugs to truly satisfy having upmost utility. Placing this high value on the utility of all is of highest priority and the most ethical, as not providing any form of aid in accessing life-saving drugs would be an immoral action. Comment by harneet sandhu: Reword this, it sounds weird

When deciding on using public funding for access to treatments of specific disorders, an important question to ask is how the money provided will be utilized. In the case of life-saving drugs such as Spinraza, it becomes more of a duty than a choice to publicly fund the accessibility of what is required. The idea of this being a duty is supported by Immanuel Kant’s theory of Deontology. Deontology is the ethical theory based on “the rightness or wrongness of actions, rather than the consequences” (Holland, 2015). Deontology places heavy value on the ethics of morality, and only following morally right actions. In accordance to this theory, the action of refusing to allow the allocation of public funds to supply high cost drugs would be considered a morally wrong action. This central idea pulls in line why Deontology respectfully defends public funding of expensive drugs. A Deontological argument against not utilizing public funding would be that it is a morally incorrect action because an individual is being put in harm due to the decisions of others. Any decision that is subjects’ others to distress is not morally correct, so Deontology supports the idea of public funding in this manner. This is further supported by the universality principle which is idea of only acting in accordance to a rule or action which would be universal law without consequence (Holland, 2015). This is detailed by the concept of refusing to help someone even though the means to help them are readily available. By allowing public funds to be used to purchase life-saving drugs, the morally correct action of saving lives and aiding others is being upheld. Deontology works in accordance with utilitarianism as both can advocate for utilizing public funding for life-saving drugs and they provide the most utility as well as serving as the most morally correct option. Comment by harneet sandhu: Get rid of is Comment by harneet sandhu: Should be that means

Although both deontology and utilitarianism have strong supporting evidence in favour of the ethicality of using public funds for life-saving drugs and treatments, there can still be a point made of whether this valuing on the morally correct decision is the most optimal choice available. In this particular circumstance, utilitarianism and deontology focus in on the central idea of helping individuals through doing the most optimal and morally correct action. In spite of this ethical option, some may raise the argument that the size of those benefitting from the use of the public funds may not be completely warranted. In the example of Spinraza, allocating millions of dollars a year on only a select few individuals may be more detrimental in the long run than if the funds were designated elsewhere. It is estimated between 500-2000 people live with spinal muscular atrophy in the United Kingdom (TreatSMA, 2018). The United Kingdom has population of approximately 66 million people (Worldometers, 2018), approximately 1.8 times more than Canada’s population of 36 million people (Worldometers, 2018). Assuming that Canada’s ratio of those with spinal muscular atrophy is equivalent to that of the United Kingdom, it can be hypothetically estimated that there could be as low as 277 cases of spinal muscular atrophy in Canada. If spread equally amongst the Provinces, a hypothetical number of cases in British Columbia could be 23 individuals. If all 23 patients were utilizing public funds to aid in the payment of Spinraza, it could be costing the government upwards of 16 million dollars in it’s first year of treatment alone. Due to this extremely high cost, some may bring up the valid argument that covering the costs for these expensive drugs and treatments may be too much of a financial commitment for treatments that would only be assisting a miniscule percentage of the population overall. Instead, these adversaries may vouch for public funds be used in other alternative ways that will benefit a much larger percent of the general population instead.

In response to this critic of the ethicalities of covering drug expenses, one would be directed to enlighten the opposer in what is truly the value of a human life. Following in the footsteps of Immanuel Kant, a German philosopher and founder of deontology (Snyder, 2018), the formula of humanity provides assists in providing ethical reasons as to why the simple idea of money is not what is the most valuable. The formula of humanity says to treat others as an end rather than a means (Snyder, 2018) and that “humans are the one inherently valuable thing” (Snyder, 2018). Following this philosophy of Kant, it can be argued that no amount of money can be quantifiable in comparison to the value of a single human life. This is representative how it does not matter how much money is used by higher powers to cover the cost of life-saving treatments, as the value of the money being spent pails in comparison to the value of the potential lives being saved. By acknowledging this, it is shown how covering the costs of these drugs serves as both an appropriate and ethical use of public funds as increasing the lifespan of those with life threatening disorders is worth far more than the financial cost it entails or the other potential uses.

The debates on whether or not the use of public funding for life-saving drugs is the most optimal use will continue to be tinkered with as time goes on. Despite this, there are still many reasons supporting the action of providing financial aid to those who require it for life-saving treatments. Both Utilitarian and Deontological views list several reasons supporting the ethics of utilizing the public funds, such as the principals of universality, utility and the morally correct decisions. Although the counter argument could be made that these life-saving drugs and treatments are far too much a financial commitment to make in regards to optimal use of public funds, the argument can still be effectively countered when discussing the monetary value of a human life in comparison to real world dollars. As medicine and technology advances, so too should the use of public funds for those in need of the life-saving drugs and treatments. Nothing is more inherently valuable and ethical than saving and helping human lives.