Older people in queues for surgery might make way for younger people
BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7353.1544/c (Published 29 June 2002) Cite this as: BMJ 2002;324:1544All rapid responses
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Sir
For a healing profession to even reflect on the merits of favouring
one portion of society over another is shocking; there should be no bias
beit age, sex, colour, creed, chronicity of illness, or whatever; every
effort should be made to tackle as efficiently and effectively as possible
the condition posed by any person as they appear.
Healing has no place for statistical favouritism.
Regards
John H.
Competing interests: No competing interests
Peter A West's response is in the right direction. I guess that at
61 I am starting to be an "older person". If I had to be operated on,
either for my heart or for something else, I would be happy to give up my
place for any of many younger people. But if this were a general rule, I
would likely never get to the operating room, because in a hospital
serving a large population, there would always be more younger people
bumping me out of the queu. A mathematician with a grasp of statistics,
however, ought to be able to figure out a formula by which I would do
something a little more sophisticated than always stepping aside for
younger people. The formula would increase one's chances of being next in
line, in reverse proportion to one's age. But although I would have less
chance than younger people, of getting into the operating room, I would
always have some chance.
Competing interests: No competing interests
Sir,
In commenting on the paper showing that some elderly people
would give up their place in a surgical waiting list for a younger person,
you note two reasons - that they may value themselves less or feel that
they have had a fair innings. But neither of these fully cover the more
obvious reason (to an economist). Surgery, particularly heart surgery, is
a balance between costs or risks and benefits. If I can look forward to
25 years of reasonable functioning, surgery looks a reasonable bet. But I
am only 52. Based on a small sample of elderly relatives, I believe that
some older people are genuinely concerned about the risks and pain of
surgery and view this relative to the benefits. The pain and discomfort
of major surgery seems, at first glance, to be constant with age. So it
may not be surprising that for those who foresee fewer gains, in years of
improved daily living, the chance to leave the waiting list may be
appealing.
Peter West
Competing interests: No competing interests
Re: Ageism, what next?
John P Heptonstall's response is correct for health professionals.
Of course there should be no discrimination. But patients have a right to
step aside for others, if it is voluntary and with no pressure from the
health professionals or from anyone else.
Competing interests: No competing interests