Cheap, managed death

For most of medical history doctors have had ethical and financial incentives to keep their patients alive. Preserving life as long as possible was, until recently, the automatic, unquestioned response by a physician to serious illness. In many systems of medical care the longer a patient was kept alive the higher the fees earned by the medical attendants; while even in systems such as the NHS, where prolonged illness was expensive for the hospital, no one questioned the obligation to preserve life.

Two quite separate developments in the past 10 years or so have now changed that picture, and some voices in …