When does the sanctity of life lead to medical waste?

A true story.
There was a patient that arrived in the ER with acute abdominal pain. Imaging revealed air in his abdomen, indicating a perforated bowel. The patient had a very complicated medical history, the most outstanding component of which was a late-stage glioblastoma multiforme tumor. This is the worst kind of brain cancer you can get. It is inoperable, highly resistant to chemo or radiation and has a prognosis of 3-8 months without treatment from the time of diagnosis. Median survival is 14 months with treatment.

So the question for doctors in the ER, the patient and his family members is: what, if anything, should be done about the bowel? Normally this would require an operation to remove the damaged bowel or suture the hole. But any kind of surgery carries complications - which are compounded in this patient's case considering his illness and current anti-cancer medications - and bowel surgery in particular can result in the patient requiring tubes to assist in feeding or defecation. Plus there is the financial cost. Is any of this worth it for someone who has a terminal disease and is expected to die in 2 months?

You might say, well, that's up to the patient. But you might also say, unless that patient is going to pay for the operation out-of-pocket then it is not entirely up to the patient because we, as a community, are going to being paying. Say the operation and hospital fees amount to 50K. Is it ethical to spend this sort of money - public money, let's say - on a terminal patient rather than say a non-terminal patient, or child? Plus we need to consider the health care costs in case their are complications (remember, he is high-risk). We like to pretend that economics don't, or shouldn't, matter when it comes to medical treatment. But they always do impinge.

A last nugget to ponder.
The patient was on a new type of chemotherapy call Avastin which targets a chemical messenger involved in the formation of new blood vessels. Tumors love to make new blood vessels as they grow, so attacking their supply of nutrients and oxygen has shown to be an effective strategy. In some cancers. Avastin is indicated for only a few types of cancer, namely colon. There is little to no evidence that says the drug works against the kind of brain tumor this patient had. Avastin itself is very expensive. A year's course including medical fees is around 200K. Wow! Now, that, is some serious money to drop on a dying patient when there is no evidence it will change his prognosis. On the other hand, there is no evidence to say it won't.

[Update Actually Avastin costs up to 44K for a 10-month treatment, but that is the medication alone, not including the hospital stays and support. Some people have complained to Genentech about the price]

You can find situations like this every day in every hospital. I know it sounds cold-hearted to suggest that this is wasted money, but money spent on a dying patient is money not spent on a living one. Always think of kids, who are, unfortunately, the most under-insured demographic in the country, but who have the most to gain from medical intervention and the most to give back to the public if those interventions work.