Is it time access to free NHS care was age limited?

theoretica

As researchers keep inventing and improving more and more treatments, many of them very expensive, the potential cost of giving the best possible treatment to everyone will become even more astronomical than it is now. I feel the NHS has a current strange mix of decisions on what it will and won't fund and needs a lot more clarity, and perhaps acceptance from everyone that it can't afford many things. However, I agree that simply age is a very poor way to do it.

BobQ

theoretica wrote: »

As researchers keep inventing and improving more and more treatments, many of them very expensive, the potential cost of giving the best possible treatment to everyone will become even more astronomical than it is now. I feel the NHS has a current strange mix of decisions on what it will and won't fund and needs a lot more clarity, and perhaps acceptance from everyone that it can't afford many things. However, I agree that simply age is a very poor way to do it.

Some of the treatments that are developed actually save money.

Jack_Johnson_the_acorn

Cakeguts wrote: »

The problem with the elderly argument is that it seems that it is fine to withdraw treatment from an elderly person who isn't going to get better because they are old but it is not fine to withdraw treatment from a child who is brain damaged and not going to get any better. I can't see the difference. People are people you can't morally have different rules just because someone is young or just because someone is old. Either you treat them both equally and give the care or you treat them both equally and don't give the care. A son or daughter has as much right to treatment for a parent as a parent has for a child.

The child hasn't had a life yet. The old person has......


How are you struggling to comprehend this?

ukcarper

Jack_Johnson_the_acorn wrote: »

The child hasn't had a life yet. The old person has......


How are you struggling to comprehend this?

But if the argument is that the quality of life is so bad that life is not worth living, which its seems to be surely age is irrelevant.

antrobus

theoretica wrote: »

..I feel the NHS has a current strange mix of decisions on what it will and won't fund and needs a lot more clarity, and perhaps acceptance from everyone that it can't afford many things. However, I agree that simply age is a very poor way to do it.

Is NICE doing something wrong? They even have a standard for 'End of life care for adults'. I believe that they also have one for children as well.

https://www.nice.org.uk/guidance/QS13

westernpromise

Socialists have a very poor quality of life too. They are eaten up and corroded with lifelong envy. Wouldn't it be kinder to just euthanise the lot of them for their own benefit?

antrobus

ukcarper wrote: »

But if the argument is that the quality of life is so bad that life is not worth living, which its seems to be surely age is irrelevant.

NICE uses QALYs - quality-adjusted life year - in its calculations.

QALYs are calculated by estimating the years of life remaining for a patient following a particular treatment or intervention and weighting each year with a quality-of-life score (on a 0 to 1 scale).

https://www.nice.org.uk/glossary?letter=q

Obviously, since death is inevitable, the younger you are the more QALYs you are likely to have.

Windofchange

I can tell you as an NHS clinician that treatment is withdrawn weekly from people of all ages. There is however at times quite a lengthy legal process that has to be followed - you can't just go around turning off machines, and in reality that isn't quite what happens anyway much as the films would have you believe. The issue around end of life care is complex. Some families will fight you tooth and nail to keep their loved one alive, others are more accepting and agree to withdrawal of treatment - it can however still take months for someone to actually die as you can't administer a lethal injection etc. It can be painful and horrible to watch. As much as palliative medications take the edge off things, they aren't perfect.

Where you can plan for termination of life then it can be managed better - in the case of a chap with motor neurone disease for instance he has written clear instructions as to what he does and doesn't want doing to him when the time comes. Where the problem lies is that most people don't turn up to hospital with instructions as to what they want.

You cannot legally discriminate based on age. As the situation stands therefore, you cannot prioritise the wellbeing of an infant over that of a 90 year old. Does anyone remember the recent case of Mr Lai?

http://www.dailymail.co.uk/femail/article-4129600/Hospital-documentary-puts-bed-shortage-spotlight.html

Should an elderly patient have been kicked out of hospital to free up the bed for his life saving operation? Is his life more important that a 90 year old? It's a very interesting moral dilemma and one that is a common question in medical / AHP ethics exams.

Related to all this, I am a strong supporter of euthanasia. I think it gives back control of death to the terminally ill. Imagine knowing you are going to die sometime in the next year but not when. Why not let people go in dignity as opposed to screaming and covered in their own excrement. Why does the individual (with a terminal disease and capacity) not have the right to decide when they have had enough?

As for the original question. No. Limiting health care based on age is stupid. The elderly have been in the spotlight recently, but a lot of our most expensive patients where I work are the drug addicts, the super obese and the chronic conditions such as end stage MS, MND. Would I want my parents told no more medications for you as you've hit 70? Everyone will have their solutions to the NHS crisis, but denying care to a patient population isn't it.

Cakeguts

Jack_Johnson_the_acorn wrote: »

The child hasn't had a life yet. The old person has......


How are you struggling to comprehend this?

http://www.uhs.nhs.uk/Media/Controlleddocuments/Patientinformation/Pregnancyandbirth/Havinganextremelyprematurebaby-patientinformation.pdf

I am not struggling to comprehend anything but quality of life is much more important than quantity.

I would suggest that you read what severely disabled means and then ask yourself what the quality of life is like and whether it is pain free.

BobQ

Euthanasia is the answer, but it needs to be done in as failsafe a way as possible.

We all know that we can make a living will but few do this. I think the NHS could save a lot of resources in the future if people were encouraged to make living wills and declare their view on ethanasia.For example when someone over 60 with no life threatening condition visits their GP, why not allow the GP to raise the issue and offer them an appointment with someone who could facilitate them expressing their wishes ?