Monday, January 10, 2011

Dying Old

In The Herald Socialist Courier reads that 50% of the time that people spend in hospital over a lifetime occurs in the 12 months before they die. In a new book, Professor Phil Hanlon, a former adviser to the Scottish Executive, argues the elderly should be prescribed far fewer drugs and given fewer tests and procedures as they reach serious physical decline.

He said: “It is not that I would discard such people. I would simply give them a more human and humane approach, which would use less intensive NHS facilities. The big debating point is: would people die earlier? And the answer I would give to that is we do not know. You might actually live longer if you do not have all the stress associated with going to the hospital for treatment and healthcare-associated infections. We all get to that stage in life where your systems begin to shut down, albeit slowly, and medicine cannot reverse that. If you treat the person as if you are going to reverse that, you actually do them harm and that is what we do at the moment.”

Hanlon, who trained as a doctor, said: “The system is designed to deal rapidly with you, shunt you through and get you off the waiting list. All of that is not human and humane.”

Some estimates, he said, suggest one in five hospital admissions is at least in part caused by previous treatment. He envisages a more open conversation between health professionals, patients and their families about whether fewer tests and treatments would be desirable in what is likely to be their last 12 months of life. Decisions would be made on a case-by-case basis, however, he stressed.

Lindsay Scott, communications manager for charity Age Scotland, said: “As an organisation, we would look at this proposal from a discrimination point of view. It was the idea in the first place with the NHS that from cradle to grave everyone is treated equally.” However, he said some older people would support Mr Hanlon’s ideas. A survey of 300 pensioners in Scotland found 65% supported assisted suicide for people with a terminal illness and 54% would consider it as a means of ending their own lives.

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