Medical Morals

When Politicians / Lawyers / Religious and Medical Ethics Committees are allowed to determine medical questions about when and if treatments should, or shouldn't be applied, then common sense can be a victim.

Medical Decisions Are Often Muddied By Other Considerations

I am not simply talking about the public right to die (assisted suicide) campaigns (which the public actually back, but which our cowardly politicians refuse to legislate for).

No, I am talking about medical treatment decisions that are made daily, but without publicity. For example, if a patient presents with a Cancer or Heart condition that is advanced. The clinical team determine the risk of undertaking an operation which may:

• Save their life i.e. cure them, or offer them a much longer life than they face without the operation.

And weigh this decision against the risk of the treatment killing them, or alternatively that it won't cure them.

However this decision, which should be purely a medical one, and involving mainly the surgeon and the patient, always takes into account many other factors, and these rarely involves the patients views or necessarily their best interests.

The clinical assessment team consider such factors as:

1. The risks of the patient dying on the operating theatre table e.g. more than 50/50 (or whatever figure they use).
2. Whether they can be sued by the patients family, or one of the new breed of ambulance chasing lawyers the UK is infested with, if the treatment fails.
3. What the risk is of the medical team being called before a medical ethics committee, and then warned or struck off if the surgery or treatment is deemed to be too risky e.g. greater than 50/50 chance of a failure, or whatever the figure they benchmark by.
4. Whether parliament, which has a high religious input by people who believe that an invisible power actively determines our fate in some ineffable manner - (which apparently includes giving children cancer or heart conditions that are going to kill them for example - that's ineffability for you.), has laid down any rules about the treatment that can, or can't be offered.

So what should be merely an informed consent decision, between a surgeon and the patient, is layered with concerns that the patient is not aware of. It is also a decision that the patient may have little or no input into, except in some circumstances e.g. where parental or other third party consent is required to proceed.

This can and does lead to the ridiculous situation, where a patient is refused an operation which is deemed too risky, and potentially of offending some religious or social taboo or law, but which if successful could possibly save their life.

Instead the patient is told that they are 'inoperable', and are to be given a certain death treatment instead i.e. palliative care. This because this certain death option somehow doesn't offend any of the non medical considerations, that were part of the decision on whether to treat or operate or not, but obviously is actually the worst decision possible from the patients view point.

Now if anyone can tell me why in any common sense world:

1. Offering and undertaking a high risk operation or course of treatment that offers say a 30% chance of success, but obviously a 70% chance of failure and the possibility of death or accelerated death, is deemed a worse option for the patient than;
2. Refusing them the risky chance of an operation (with a peaceful death on the operating table accidentally thrown in), or course of treatment, and therefore ensuring a 100% chance of certain death?

..... then I would be interested in hearing from you. Because I, for the life of me can't see how the logic of this is arrived at.

In the meantime, this illogical decision to withhold a risky but uncertain outcome operation or treatment, but which nonetheless offers some hope of success, in preference of a certain, but slightly slower, and certainly more painful death, is made everyday.

Our world is definitely insane, when our pets are offered more considerate treatment (including euthanasia), than our fellow human beings. But then again, because many religions don't believe that animals have any souls, they don't interfere in the medical treatment decisions available for animals. The result of this indifference is that we often make more logical and humane treatment decisions for them than for humans.

Where is the sense in that?