The Australian medical Association claim that older people are being refused access to surgery in public hospitals.
Where, I ask, is the evidence to support this claim? In making treatment decisions, a range of factors are taken into account.
Even in a utopian world of unlimited health resources, the most expensive, interventionist treatment is not always the most appropriate type of medical care.
Patients (both old and young) are frequently best managed without expensive high technology treatment available in ICUs.
As part of my research and to facilitate a more open debate about the rationale for life-saving treatment decisions, I asked doctors and nurses who should, and who should not, be admitted to an ICU.
They identified four main reasons for not admitting a patient to ICU. These reasons were: patients own choice not to be treated in an ICU, underlying disease, poor prognosis and unlikely to survive the ICU admission.
The decision to deny access to life-support technology implies an awareness of the limitations of medicine and a respect for the natural progression of life. Life-saving interventions maybe neither warranted nor indeed wanted.
First published as a letter to The Age in 1998
