INTERNATIONAL/QUALITY: The Brits are in court over “how much is enough?”

Well I was up late late last night working on some client stuff and am about to head back to that meat grinder, but for now consider this….

You may (unfortunately) remember the Terri Schiavo incident.  The Brits are playing this rather differently.  Here we’re keeping people alive who want to die (or at least we’re keeping some people who want to die alive). In the UK the issue of the NHS continuing to treat people who are going to die but who want all the stops pulled out anyway is ending up in court. Traditionally this process played out in the UK in a "stiff upper lip" way, mostly controlled by the medical profession.  Now the government is being explicit that it feels some medical care is a waste of resources. Pretty interesting stuff, because of course they are right, and the same thing is going in here but no one has the cojones to point it out.  But with the baby boomers about to hit Medicare and the Federal budget in the pocketbook, and way too much excessive care of the nearly dead going on in America’s ICUs,  the day when this discussion starts here will come.

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  1. I agree, and have had this conversation a few times with folks. To be frank, it’s a national discussion I’m absolutely terrified of. Because in the US we tend to resolve it with “well, if you’re well-off to rich, than fine. But if you’re poor…”
    Foolishly, I persist in believing that we should work a little harder on a policy solution that’s less “screw the poor.” I think the answer lies in a legal right to continue care regardless of ability to pay, and in serious investment in palliative care programs to spur a cultural change in which patients are really helped to make this decision for themselves. Probably changes in medical training as well.
    Of course, there’s a snowball’s chance in hell of an actual planned approach to this–perish the thought of actually preventing crises instead of running around like chickens with our heads cut off when they strike!

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