The Martian: How much is a person worth?

The Martian: How much is a person worth?

Recently,  I saw The Martian, a movie about a man accidentally abandoned on Mars.  The movie is about the struggle for survival, the marshaling of forces to allow the survival of that one man,  the sacrifice of  compatriots and the politics of rescue .  

Cancer patients, and the people who care for them, can feel like they are abandoned on Mars. The feelings elicited by this movie are similar to those we, who care for cancer patient patients feel. When do we call the situation hopeless?  When do we give up?  How much can we put into the effort for one patient?  How much can we spend?

In the movie there is no limit. Billions of dollars are spent,  scores  of people work without rest, people give up years, in the prime of their lives, to attempt to rescue a single man.  In our real, medical world the money, the time, the energy are all limited,  The resources are shared by thousands of patients. This places every part of the medical system in the position of distributing a limited, precious resource.  The doctor must balance the chance of benefiting the patient against the cost to the system, which could mean denying another patient an equal or better chance.  Doctors differ in their approach to this problem.

How can we do any less than our best?   Our efforts are not like those in the movie.  They are not as good as they should be.. The basis for saving the Martian was adoption of a nonstandard strategy, a strategy that would work, in theory, but was not a usual approach.  A methodology that involved unanticipated expense and sacrifice.

Currently, the pressure to follow standard procedures is almost overwhelming.  Deviation from such standards  risks the label of malpractice.  Obtaining insurance coverage for a treatment that is not recommended in guidelines, or for a problem that deviates from the FDA  approval parameters is a Herculean task - and getting harder.  .

Knowledge and Resources are always limited. The Martian was rescued, he beat  the odds. It is very expensive and difficult to take on the odds... sometimes it works.