the latest NHS reforms

[eFestivals]

What do we do about the massive ticking timebomb of dementia?

we get to realise that extending people's lives to sit in a chair and dribble isn't really an improvement of anything.

Yeah I know, it won't happen. But I can dream.

[5co77ie]

Good to know that the latest thing doctors had responsibility for - ordering the right stocks of flu vaccine worked out so well.

[5co77ie]

What do we do about the massive ticking timebomb of dementia?

[llcoolphil]

we get to realise that extending people's lives to sit in a chair and dribble isn't really an improvement of anything.

Yeah I know, it won't happen. But I can dream.

[worm]

we get to realise that extending people's lives to sit in a chair and dribble isn't really an improvement of anything.

Yeah I know, it won't happen. But I can dream.

[eFestivals]

Doesn't really answer the question though does it, unless you're suggesting we terminate life for those with dementia. Ive regularly said I see no point in prolonging life simply for the sake of it, but given that dementia isn't a life threatening condition but does need support, we still have to work out how we cope with it

I'm not suggesting that we terminate the lives of those with dementia.

I'm suggesting that limited medical help is given to people long before they get to the point where they'd suffer from dementia, for the purpose of shortening people's NATURAL lives. The more we try to keep people alive for as long as we can, the more we dig ourselves into deep shit that gets harder to extract ourselves from again.

It's all very admiral to want to try and extend people's lives for as long as we can, but there's much more for society to consider than just that. We are where we are - with all the extra problems that's bringing - because we've only been making the narrow consideration of what medicine can do for individuals, and have been totally ignoring the wider effects of that policy.

[diddly-dee]

I'm not suggesting that we terminate the lives of those with dementia.

I'm suggesting that limited medical help is given to people long before they get to the point where they'd suffer from dementia, for the purpose of shortening people's NATURAL lives. The more we try to keep people alive for as long as we can, the more we dig ourselves into deep shit that gets harder to extract ourselves from again.

It's all very admiral to want to try and extend people's lives for as long as we can, but there's much more for society to consider than just that. We are where we are - with all the extra problems that's bringing - because we've only been making the narrow consideration of what medicine can do for individuals, and have been totally ignoring the wider effects of that policy.

[worm]

I'm not suggesting that we terminate the lives of those with dementia.

I'm suggesting that limited medical help is given to people long before they get to the point where they'd suffer from dementia, for the purpose of shortening people's NATURAL lives. The more we try to keep people alive for as long as we can, the more we dig ourselves into deep shit that gets harder to extract ourselves from again.

It's all very admiral to want to try and extend people's lives for as long as we can, but there's much more for society to consider than just that. We are where we are - with all the extra problems that's bringing - because we've only been making the narrow consideration of what medicine can do for individuals, and have been totally ignoring the wider effects of that policy.

[worm]

But where do you think it's reasonable to start? If someone aged 60 develops TB do you suggest not bother giving them antibiotics as this would prolong their 'natural' lives before they get dementia. It's fine in the abstract to argue for what you're advocating but when you start drawing lines in the sand as to choosing who can live and who can die then it's pretty problematic. Surely a comprehensive health service (or even societal control mechanisms) where through either education or legislation people are kept healthier (and economically productive) for longer into their lives would be a more progressive system?

[eFestivals]

But where do you think it's reasonable to start? If someone aged 60 develops TB do you suggest not bother giving them antibiotics as this would prolong their 'natural' lives before they get dementia. It's fine in the abstract to argue for what you're advocating but when you start drawing lines in the sand as to choosing who can live and who can die then it's pretty problematic. Surely a comprehensive health service (or even societal control mechanisms) where through either education or legislation people are kept healthier (and economically productive) for longer into their lives would be a more progressive system?

I'm not saying it's going to be an easy thing for society to settle on where the line is drawn - but the line is going to be drawn anyway eventually by circumstances (after all, we can't afford to support a huge number of non-working people). So we might as well make the decision for ourselves, rather than have it made for us by those circumstances.

While we might be able to get a few more economically productive years out of people than we do now, ultimately it simply won't be enough to cover the costs. We're struggling to pay for the situation as it is now, and even without any further progression in medical treatments from what we have now, the situation will be unsustainable once the current medical knowledge has worked it's way right thru the age range of the population.

Trying to pretend that it's something we can find a way around as you've done here is kidding yourself. So we might as well start to have the grown up conversation that needs to be had about it right now, and avoid getting ourselves even deeper into the mire.

[eFestivals]

With that in mind, my point would be that knowing that the NHS's philosophy is to provide a service of the best possible treatment to the patient in relation to the extension and quality of their life is imperative.

it's all very well having pie-in-the-sky wishes, but someone has to pay for it.

Are you happy to pay 95% tax for all of your productive life, so that you can sit in a chair dribbling for 50 years and have the care and treatment necessary for that, after your ability to be economically productive has gone?

Edited January 20, 2011 by eFestivals

[5co77ie]

Good to know that the latest thing doctors had responsibility for - ordering the right stocks of flu vaccine worked out so well.

[eFestivals]

It's all a bit Logan's Run to me.

It is.

But it';s coming whether we like it or not. If we don't choose it for ourselves - with the fair operation of such a policy too - then it gets chosen for us by circumstances, and where those circumstances result in some people getting more f**ked over than others.

(Anyone thinking from those words "ahhh, but I'll be one of the alright ones" has a brain that's as useful as a peanut).

[diddly-dee]

I'm not saying it's going to be an easy thing for society to settle on where the line is drawn - but the line is going to be drawn anyway eventually by circumstances (after all, we can't afford to support a huge number of non-working people). So we might as well make the decision for ourselves, rather than have it made for us by those circumstances.

While we might be able to get a few more economically productive years out of people than we do now, ultimately it simply won't be enough to cover the costs. We're struggling to pay for the situation as it is now, and even without any further progression in medical treatments from what we have now, the situation will be unsustainable once the current medical knowledge has worked it's way right thru the age range of the population.

Trying to pretend that it's something we can find a way around as you've done here is kidding yourself. So we might as well start to have the grown up conversation that needs to be had about it right now, and avoid getting ourselves even deeper into the mire.

[worm]

Are you happy to pay 95% tax for all of your productive life, so that you can sit in a chair dribbling for 50 years and have the care and treatment necessary for that, after your ability to be economically productive has gone?

[worm]

But it's coming whether we like it or not.

[eFestivals]

I really can appreciate the logic of your argument, but on the basis of the rationale employed would you be willing to, for instance, accept the euthenasing of, say, all mentally or severely physically disabled people at birth if it meant that those with their faculties could, say, be allowed to live an extra 3 months from, for example, 75 and a half instead of 75 and a quarter?

I'm not remotely suggesting the killing of people at birth, or even the withdrawal of treatment from them. I believe that everyone should have an opportunity to live their life.

But at the same time, I recognise that the decision won't be mine to make. It would be a decision for society as a whole, and society might take the option to give oldies an extra 1/4 year as you've suggested as a possibility.

[eFestivals]

No, but I don't need to.

What I am happy being is assured that the NHS would be obliged to help me if I were to fall ill. If it weren't, then I'd probably be inclined to revolt along with 95% of the rest of the country.

PMSL - for your wishes to be in place, there will ultimately have to be a 95% tax rate for all of your life.

Which is going to have those "95% of the rest of the country" revolting first? A 95% tax rate, or bumping off oldies in some manner? There's only one answer, and it's the answer (you say, as does everyone else) you don't like.

Yet as someone said in this thread or another within the last few days, if we leave dealing with this for too long, then it's going to take turkeys voting for xmas, as the number of oldies increases sharply - and if we get to anywhere near that situation, we'll be truly f**ked, because those oldies will basically enslave the rest to keep them alive.

[llcoolphil]

I'm not suggesting that we terminate the lives of those with dementia.

I'm suggesting that limited medical help is given to people long before they get to the point where they'd suffer from dementia, for the purpose of shortening people's NATURAL lives. The more we try to keep people alive for as long as we can, the more we dig ourselves into deep shit that gets harder to extract ourselves from again.

It's all very admiral to want to try and extend people's lives for as long as we can, but there's much more for society to consider than just that. We are where we are - with all the extra problems that's bringing - because we've only been making the narrow consideration of what medicine can do for individuals, and have been totally ignoring the wider effects of that policy.

[worm]

and, of course, what you actually mean is shortening poor people's natural lives, because you can bet your arse if you can afford to pay for it, many people would.

[worm]

PMSL - for your wishes to be in place, there will ultimately have to be a 95% tax rate for all of your life.

[eFestivals]

People have often led perfectly normal, healthy lives before the onset of dementia - and continue to live physically healthy lives after it. The chances are there hasn't been direct intervention to prolong their life in the first place. So where do we go back to? No treatment after the age of 50 beyond the palliative? 45?

Shortening people's natural lives? Are you sure? That seems the antithesis of what healthcare should be about in the vast majority of circumstances - and, of course, what you actually mean is shortening poor people's natural lives, because you can bet your arse if you can afford to pay for it, many people would.

I recognise that wealth would become a factor, and I don't have an answer to that. Then again, if kid is seeing daddy dribble away his inheritance in the harder times ahead of us, then perhaps it might impact differently to what you and I are expecting.

And I realise that some dementia sufferers had lived previously healthy lives. My suggestion wouldn't target any particular illness tho, so the effect would be across all of those people beyond the age-line (where ever that might be) - the point of it would be to not extend lives beyond their natural ability once past that line, so that there were fewer oldies overall, so that the financial burden of supporting them wasn't more than the economically active people could or would bear.

I'm not remotely suggesting "shortening people's natural lives". I'm suggesting that people's natural lives aren't artificially extended to the extent that they are currently (and which is forever extending further as things stand).

I realise that what I'm suggesting is "the antithesis of what healthcare should be about", at least, with the current view of it we have. But only when you show me the bottomless pit of money that is able to sustain that view of what healthcare should be about do you have a valid point.

Edited January 20, 2011 by eFestivals

[eFestivals]

And before we can even consider that, what exactly is a natural life?

an easy question.

One that isn't being artificially maintained, by drugs or machines.

[eFestivals]

Wrong. For my wishes to come true I have to be assured by the NHS that that is what they are attempting to do.

That's only the answer to a part of the consideration. It is not everything.

The NHS can only give an assurance like that if it is certain of the finances to provide it. At this moment it cannot give the assurance you want, and it's ability to provide the current services into the future is reduced further still.

But if you want to stick to only considering the part you want to - most normally considere3d to be a person burying their head in the sand, or denying reality (that's you that is) - you go ahead with your stupidity. You know even now that what you're suggesting is at best ridiculous and at worst impossible.

Edited January 20, 2011 by eFestivals

[worm]

an easy question.

One that isn't being artificially maintained, by drugs or machines.