Search
Recent Posts
- ChangingAging.org Redesign -- Please Bookmark!
- Disaster in Buffalo
- Power Up Friday
- Blanchard WinsDays
- Kevin Frick writes...
- Monkhouse Monday
- Getting Closer!
- Blanchard WinsDays
- Power Up Friday
- My Pick for Health and Human Services
- Understanding Health Care Reform
- Facts Are Stubborn Things: Social Security Edition
- Monkhouse Monday
- Localism is Coming
- Krugman Can't Wait...
Recent Comments
Category Archives
- AGING 100
- Aging
- Culture
- Dementia
- Eden Alternative
- Erickson School
- Green House
- Health Policy
- Longevity
- Media
- Rockets
Monthly Archives
- February 2009
- January 2009
- December 2008
- November 2008
- October 2008
- September 2008
- August 2008
- July 2008
- June 2008
- May 2008
- April 2008
- March 2008
- February 2008
- January 2008
- December 2007
- November 2007
- October 2007
- September 2007
- August 2007
Subscribe to this blog's feed
AnnouncementsBlog Data
« Blanchard WinsdDays | Main | Twittering »
November 14, 2008 |Permalink |Comments (1)
Power-Up Friday: A Staggering Question of Health Care Ethics
In the latest issue of Health Affairs, medical technology is highlighted and many questions are raised. A study from Stanford reports that even though the use and cost of MRI and CT scans have increased dramatically since 1995, there is little evidence to suggest that there has been an impact on overall health care or mortality outcomes.
The explosion of medical imaging technology since my medical school days is absolutely staggering. Nevertheless, our infatuation with the latest and greatest machines sometimes keeps us from critically examining just how useful they are in the larger scheme of things. With increasingly tough economic questions being asked, these types of studies will put our health care practices under greater scrutiny in the days to come.
Nowhere is this more important than in the care of older adults. Changing medical conditions and life expectancy put even further constraints on the usefulness of diagnostic testing, as comfort and quality of life concerns begin to overshadow the ability to cure disease. A recent task force on colon cancer screening, for example, has recommended it not be done routinely in people over 75, and similar guidelines for prostate cancer suggest that people with a life expectancy of fewer than ten years not be screened.
The point is that we need to look at each individual in terms of their own situation, their prognosis and life goals, before blindly walking through the available diagnosis and treatment options. This requires practitioners to know their patients well and to initiate values-based discussions with each person before deciding how to proceed. These conversations alone may serve to cut the cost of health care dramatically.
Here's a great quote from A. L. Caplan (speaking about nursing homes), which is even more true 18 years after it was written:
"...ethics concerns not only questions of life and death but how one ought to live with and interact with others on a daily basis. The ethics of the ordinary is just as much a part of health care ethics as the ethics of the extraordinary. For the resident, the small decisions of daily life set the boundaries of his or her moral universe."
-- Al Power
Comments ( 1)
The Toronto Star just finished a series on aging this past week, by Judy Steed. A very interesting series of articles that you might be interested in: