Putting a price on the life of a child

DEATH OF JAYMEE BOWEN

The doctor who treated Jaymee Bowen justified the money spent by saying he gave her a "clear year of life".

But assessing the value of life, particularly that of an 11-year-old child, is an immensely complex procedure with many different judgements taken into account.

Martin Slack, senior partner of actuaries Lane, Clark & Peacock said to value a child's life financially was "very difficult. It would be a spurious and very sweeping judgement".

When actuaries assess loss of life or quality of life in accident cases or deaths, the main thing they take into account is the level of income during the victims' working lives, which will have been cut short.

Mr Slack said you would assume that someone would work until they are 60, "so you're looking at, say, 20 years multiplied by an average income of pounds 20,000 a year so it could be a capital value of pounds 400,000."

If a case included medical negligence as well, additional expenses such as nursing and distress would also be taken into account.

"Actuaries can't place a value on an extra year of life for a child. If you had a 25-year-old doing a valuable job it's easier. Suppose an individual had a job contributing an income value to society of about pounds 50,000 you'd say it was worth spending pounds 30,000 on treatment for them to be able to do that job for another year."

The Department of Transport also estimate the value of life. According to their 1994 figures the cost of a casualty in a road accident is pounds 784,000 - which takes into account lost output, medical and ambulance costs and human cost. In 1994 there were 3,500 such casualties.

In the health system economists have attempted to value treatments under Quality Adjusted Life Years (QALY). Health economists gather information on different treatments and look at how many extra years of life are given and the quality of life compared with the costs of treatment. They draw up league tables on the most cost-effective treatment. Therefore pounds 200 given to a GP for treatment to stop a patient smoking would be highly efficient under QALY, whereas hip replacements would come half-way up the scale.

But Professor Chris Ham, of the health services management centre at the University of Birmingham warns against looking at this in Jaymee Bowen's case. "Used in these kinds of cases the data is very limited. There isn't enough to make an inference over rationing ... we would need a proper system evaluating such treatments before you could apply them widely."

Mr Slack agrees. "You can't put a financial value on a child's life. It is a social issue."

He added: "Clearly there are special cases. There is no doubt that the country would be prepared to spend money on a major player such as the Prime Minister or whoever because of the damage that would be caused if they were not available to do their jobs. But when it gets to ordinary mortals like you and me it's more difficult."

The Appeal Court last year overturned a High Court decision that the health authority had been wrong to refuse Jaymee Bowen further treatment.