Our first world health system is bizarre, and I can’t reconcile the contradictions. Basically, we have lots of sick people that need help, and help is becoming more and more expensive. And we are cleverer and able to do more stuff. However, there is always someone out there that is willing to do things another doctor would walk away from.
In Australia, a lot of healthcare is subsidised, and free. I couldn’t make those trade-offs, but I find them perplexing. Given the lack of funding for elective surgery, and hospital beds for the sick, I have trouble figuring out how to reconcile:
- Helping people (even infertile people) make babies
- “Saving” people so they can live as dependents for many years
- Using expensive techniques to prolong life when people’s bodies are failing
- Cosmetic medicine where the outcome is not strongly linked to a change in productivity/mental health etc.
I’m not saying that these procedures are unethical, or should be abolished, I just can’t figure out how a government can fund them in preference to other things. I really have no problem with people choosing to have procedures that they are willing to pay for. I have friends who have experienced all of the situations listed above. I don’t have an issue with a mother choosing to try to deliver all babies in a multiple conception. I would find it hard to follow medical advice in that situation.
But I have an issue with people using the health system to do things they can’t afford to pay for. And they may not even “need.”
I guess these decisions are too hard for me. In the drivers seat, I would probably make the “wrong” decisions in the cases listed above. Maybe it is wrong to chime in on a news article from the other side of the world. But I just would like to say that we don’t always need to do stuff, just because we can.
Excellent post, Dr. Cris! I must say that I really like the way you tied things up:
“But I just would like to say that we don’t always need to do stuff, just because we can.”
You are an inspiration for telling it like it is! Fantastic!
[…] Dr. Cris Cuthbertson Scalpel’s Edge […]
@Moof: That is the only thing I know for sure about this whole situation. Everything else is grey for me, and I am really glad that other doctors that those tough decisions on. I can’t make those decisions.
In general surgery, the decisions are a bit easier for me. The patient arrives witha true problem, often potentially life-threatening (if not straight away). You decide to try or not, knowing that you are also deciding whether they live or not. If you treat the patient – you use no half measures.
I strongly believe your last sentence!