A couple of weeks ago, the President of the USA, was given permission to use a drug called REGN-COV2, which was created by an American pharmaceutical company called Regeneron. None of this relates specifically to this particular drug, but it does serve as a catalyst for discussion about how we can save lives in the Isle of Man – and globally – while also creating new jobs here in the Isle of Man.

British writer Tom Chivers wrote about this:

If the drug is safe enough to give to President Trump, then it seems bizarre that it is not safe enough to use elsewhere; and if it’s not safe enough to use elsewhere, then it’s bizarre that it’s safe enough to give to President Trump. So either the FDA is denying people the use of a safe and potentially effective drug, or it is endangering the President by allowing him to be prescribed a dangerous one. (Or, more reasonably, it is letting the President make decisions about the level of risk he is comfortable taking which they would not let the general public take.) None of that seems fair, to me.

Why does Trump get to choose if Regeneron works?

Give the people of Mann the same power as that enjoyed by the American President

The Isle of Man has an opportunity here: give people who suffer terminal illnesses the right to try experimental medical treatment that has passed preliminary – but not yet final – testing. In other words, let’s give the people of Mann the same power as that enjoyed by the American President to control their own body.

Such a regime will empower Manx people – and, in time, visitors from elsewhere – to take control of their medical challenges in a manner that is dignified, and which respects their personal moral agency to control their own lives. It acknowledges that many serious terminal illnesses might well be curable by medical science in the future, while also recognizing that current medical approval procedures may be too expensive, and too slow, for too many people who are alive and sick today.  While giving the patients the benefit of hope through the possibility of extending their lives, it also offers significant opportunities for the Isle of Man to become a leader in a 21st century biotech revolution.

The proposal is simple: if you suffer from a terminal illness, the Manx Government should allow you to make an informed decision to take advantage of experimental medication. This will be experimental medication that has passed preliminary testing, but has not yet fully completed the ordinary testing required before widespread use on the NHS.

Patients who suffer from terminal illnesses will need to be protected

Patients who suffer from such terminal illnesses will need to be protected to ensure that they are fully informed of the risks that they are taking, but they should also be aware of the potential benefits.  Patients need to know that there might well be risks, side effects, and that the medicine might not even work, but they are going to be judging those risks in the context of facing a terminal illness. If you are suffering from a terminal illness, some hope is better than no hope.

This offers great opportunity for both Manx residents and also humanity at large.  Under a Manx ‘right to try’ regimen, Manx residents will benefit from having the opportunity to choose such experimental treatment.  Under a Manx ‘right to try’ regimen, of course not everyone will choose to trial such medication.  Under a Manx ‘right to try’ regimen, global pharmaceutical companies will be naturally incentivized to invest in Manx operating facilities, where they can trial their medications on both informed Manx residents who would otherwise die of terminal illness, but also conduct trials on people from across the world who are able to travel to the Isle of Man to pay their own way to take advantage of these options.  Under a Manx ‘right to try’ regimen, we have the opportunity to create a whole industry of jobs that try to prolong lives and try to ease suffering. Jobs that can be attractive to Manx residents, and which offers the Manx community an opportunity to lead the world.  Under a Manx ‘right to try’ regimen, medical science can benefit from more opportunities to trial research, and to conduct world-leading medical research.

Morally, the case is clear

Morally, the case is clear: people suffering from terminal illnesses should have the ‘right to try,’ and to try living, even without obtaining the approval of some anonymous bureaucratic process which might not yet have approved a particular medication.  That much is obvious: individual patients should have the right to make informed decisions about their own lives, and the right to choose how they will be treated.

Economically, the case is also strong: allowing patients the right to make such decisions may invite self-funded medical tourism. This means that people from across the world could travel to the Isle of Man and pay for the experimental treatment of their terminal illnesses.  This may create jobs across a variety of skill levels, both in terms of delivering patient care, but also in terms of world-leading medical research.

As the global population continues to age, this will likely create great economic opportunities for the Manx community to position itself as a lighthouse of medical freedom, medical opportunity and medical leadership.  A recent report from UBS published in Monocle reported that “In the EU, public healthcare spending as a percentage of GSP averages 15 per cent per capita on those aged 66 and older, compared to just 5 per cent for 20- to 65-year olds.”  By allowing individuals from throughout Europe and the world to invest in their own experimental treatment, the Isle of Man has an opportunity to create local jobs, while also relieving other nations from the need to use taxpayer funds.  The income from non-Manx patients could then be use to subsidize the treatment of Manx patients.

This isn’t just a pipe-dream

This isn’t just a pipe-dream: medical tourism is already a real and growing industry.  The same UBS report mentioned above reports that South Korea “has become a regional hub for cosmetic surgery; South Africa offers so-called ‘safari surgery’; and Thailand provides a combination of quality and affordable services, alongside its famous beaches.”  While the Isle of Man might not be able to quite compete with Thai beaches (with all due respect to Fenella Beach!) it has the opportunity to offer a conveniently-located jurisdiction supported by a high-quality and highly-educated Western standard of care.

The people of the Isle of Man would benefit morally, the people of the Isle of Man would benefit economically, and Manx residents would have the opportunity to access otherwise inaccessible medical treatment. 

We would not just benefit from curing disease for Europeans.  Carl Berrisford, UBS’s Chief Investment Officer, commented back in 2018 that he expects the “emerging market healthcare sector to grow at an 8 percent pace annually from 2014 to 2020, double the forecast for overall GDP growth.  China and India are expected to post double-digit growth rates.”  In that environment, the first and strongest argument for allowing patients the right to live remains respect for an individual’s moral agency and their choices.  However, the second argument is that it offers the opportunity to create high-paying and lucrative jobs in an industry that is very likely to grow throughout the 21st century while making the world a better place.

This opportunity doesn’t require taxpayer funding

Best of all, this opportunity doesn’t require taxpayer funding: it merely requires the Manx Government to decriminalize the right to try medical treatments that have not yet been fully approved by the pre-existing testing procedures.  It will require some verification that potential patients are fully informed, and that the experimental medical treatments are based on legitimate science (and not mythical quackery) but this should not be a difficult hurdle to overcome – especially in a future world where we are less restricted by EU regulations after Brexit.

It’s time for the Isle of Man to respect and promote the right to live. Let’s try to make the world a better place.  Let’s try to combat some of the most terrible illnesses confronting humanity.  Let’s give people suffering terminal illnesses every opportunity to have the freedom to flourish and be cured.

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