IOM DHSC & MANX CARE

[Non-Believer]

1 hour ago, Gladys said:

Not that I am volunteering either myself or any other individual(s) to be sacrificed, but is the current health and climate crisis, worldwide, due to over-population and increasing longevity?  Perhaps, this is the time for a look at this kind of debate?

There's far too many in the DOI offices.

[Gladys]

13 minutes ago, Two-lane said:

The global warming/pollution problem is proportional to the never-ending increase in the (industrialised) world's population. But stabilising or reducing the population is not something that is discussed.

[In terms of pollution, whatever the IoM does is less significant than a butterfly flapping its wings on the far side of the universe. Plus or minus one gas-powered power station in the world is irrelevant. I think that the people here who are promoting green schemes are more interested in their own egos than the health of the less-well-off part of society. Keeping people warm/healthy over winter is far more important than reducing gas consumption by an amount that immeasurably small in global terms. Electricity is essential to life, and what should be of concern is that the IoM is not susceptible to a single-point failure of the electricity supply. ]

The increase in population due to better health care is insignificant compared to the gov.'s intention to increase the population by 20,000 people.

If the environmentalist here want to set an example to the rest of the world, they should be promoting the stabilisation or reduction of the population.

If the 20,00 people don't come here, what will happen to them? Not my problem. Setting an example is more important.

Wrong thread, but who cares - it's only ManxForums.

I was thinking more globally, really.  It is an abhorrent discussion, I accept that,  and definitely ethically challenging. But is one that needs to be had and not just by environmentalists. 

It is also about channelling funding to keep one sector alive to the detriment of others and even those in that sector. It is about accepting that death is a natural consequence of living, at what point do you say the quality of life we can give you is minimal?

Millions are diverted to that kind of research which may be better spent  enhancing the lives of younger people who have their life ahead.

We just seem to be on the hook of longevity being good, when really we should be accepting that death is inevitable and a natural outcome.

Personally, and this is counter to the macro view I was trying to explore, the moment I become unable to communicate with my family or deal with my own body, I would like to go, not be kept alive for years because it was possible.  

Years ago the criticism of doctors was that they were playing god by deciding who and how they would treat people.  Now my question is whether they are still playing God  by trying to treat everyone.  

Sorry Wrighty, I know this is a hard one, ethically, and I do not expect you to respond. 

 

[Apple]

9 minutes ago, Gladys said:

We just seem to be on the hook of longevity being good, when really we should be accepting that death is inevitable and a natural outcome.

All things die.

You are right that this debate, and the relevant related issues, do need to be explored more generally as more and more people become aware of the options for making decisions about how they die whilst still able to choose. Isn't Dr Allison working on this and as part of the intended Capacity legislation ?

[Wavey Davey]

5 minutes ago, Apple said:

All things die.

You are right that this debate, and the relevant related issues, do need to be explored more generally as more and more people become aware of the options for making decisions about how they die whilst still able to choose. Isn't Dr Allison working on this and as part of the intended Capacity legislation ?

Quality of life is the main issue. Once that’s gone there is little point in hanging around. 

[Two-lane]

9 minutes ago, Gladys said:

We just seem to be on the hook of longevity being good, when really we should be accepting that death is inevitable and a natural outcome.

Personally, and this is counter to the macro view I was trying to explore, the moment I become unable to communicate with my family or deal with my own body, I would like to go, not be kept alive for years because it was possible.  

There is nothing wrong with longevity - here I am!

As for the second point, I more-or-less agree. A little while ago my neighbour, a lady of certain years, told me that some years before I arrived the neighbour on the other side had ended his life with a shotgun after being diagnosed with terminal cancer - I assume he did not want the pain, suffering, and impact on the family. The medical fraternity of course would not help in that course of action.

On the one hand we have Allinson using up time and effort promoting euthanasia (of which I might be in favour), and on the other hand saying nothing about trying to ensure those who want to stay alive, do so - the time I heard this was when the cyclist was killed at St Johns in a (in my opinion) totally preventable accident. But then again no MHK was critical of the DoI actions there, nor any say anything about the half-arsed prom. non-pedestrian crossings.

Allinson seems more concerned with making the front page of Time magazine (driving force of abortions/ euthanasia), than looking after the interest of the electorate.

This ended up as an anti-Allinson diatribe - what a surprise. Could be worse - maybe Mad Uncle Ronnie could get un-banned.

[In fact, I think I might write a letter to my children - If the worst happens and I'm just a vegetable, just turn the switch off. Save electricity. Don't worry about organ donation - they are already passed the use-by date.]

[Apple]

4 minutes ago, Wavey Davey said:

Quality of life is the main issue. Once that’s gone there is little point in hanging around

For us olderly people that maybe true, but as recent court cases have demonstrated it may not be quite so easy to determine the 'Rules" we apply to ensure consistency. Capacity legislation and the Right to Die initiatives should ensure that.

Going back to @Gladys point about overpopulation that is the point Sir Richard Attenborough is constantly warning people about and the impending crisis of running out of resources to sustain our global population and it naturally follows about money being used to look to prolonging life for those with, say, chronic conditions that have little chance of any improvement in their quality of life.  I may have misunderstood her post (apology if I have) but it is I think a salient point.

[Numbnuts]

12 hours ago, Apple said:

The Health of the Nation document makes it clear that health promotion has to go hand in hand with other lifestyle choices and political / social initiatives and changes. One thing is clear is that an element of choice and self responsibility plays a large part.

It is already being effective to some degree. Look at the number of people out walking, riding bikes, taking up sports, marathons etc all in search of prepping to staying healthier for longer.

In my view this document (after revamping and updating) should be available to everyone in GP surgeries, hospital clinics etc. I don't understand why it isn't. 

This approach is good , and one I've led all my life, but it also brings problems later. I'm 68 now , played loads of sport and coached sport throughout the years and now have the 'after effects' of that lifestyle with really bad  osteoarthritis in my ankle and both knees starting to trouble me with the same. While I wouldn't change anything I've done sporting wise it is galling when my GP tells me it could be up to 5 years to get my ankle sorted. Having never touched alcohol till in my mid 30's and never smoked my suggested healthy lifestyle I always led has a downside too. As I said I don't regret anything and been lucky as never had a operation or spent a night in hospital but as I said there can be a downside .

[Gladys]

It is more fundamental than that. It is more about as a general philosophy should life expectancy be extended beyond its natural bounds? 

I absolutely agree that having a choice on how you do depart is, to me, a fundamental right.  It is the ultimate self-determination. 

But my debating point is more about whether medical science should be diverting resources and expertise to prolonging life, when over population seems to be the road to extinction or at least a miserable existence?

It all sounds a bit bonkers, I accept that, but it is something that we need to face up to and decide. 

[Wavey Davey]

2 minutes ago, Apple said:

For us olderly people that maybe true, but as recent court cases have demonstrated it may not be quite so easy to determine the 'Rules" we apply to ensure consistency. Capacity legislation and the Right to Die initiatives should ensure that.

I know now the point at which I’d call it a day. If I lacked capacity to call that then I’ve left clear instructions to my close family to act on their own judgement. At the end of the day if I’m three sheets to the wind I won’t know what’s going on anyway. 

[Apple]

22 minutes ago, Gladys said:

It all sounds a bit bonkers, I accept that, but it is something that we need to face up to and decide. 

It's not bonkers @Gladys.  Its valid point.

Medical research into age related health problems can often produce insights into other conditions - see the latest outcomes for Parkinson's disease and also early dementia being reversed, yes reversed, by new treatments and new methods to deliver medications etc.  There are lots of philanthropists who also donate huge amounts of their own money into conditions that affect them and those close. (BillGates, Elton John etc)

At the risk of expanding the debate then should we consider the research into children being born with potentially life long (expensive) needs for care and treatments or is that too slippery a slope ?

The day we stop looking for solutions could be the day we accept that things can't be improved. There has to be a better way though.

Edited September 23, 2022 by Apple

[wrighty]

1 hour ago, Gladys said:

 

Sorry Wrighty, I know this is a hard one, ethically, and I do not expect you to respond. 

 

It is hard, but these conversations need to be had. I’ve been at a conference all week, and today’s meeting was about the latest research into fragility fractures and how best to treat patients who suffer them with the aim of prolonging their lives. The research methodology and the people doing this are very impressive indeed, and you’d certainly want them on your side.

However, I often treat patients and fix them up to prolong their lives, but do think have I done anybody any good? Is another 6 months of bewildered existence in a nursing home better than dying? I don’t think it is, but all the guidance/pathways/lawyers/medical regulators/coroners/religious authorities say it is. So we keep doing it. It’s not what I want to happen to me, and I’ll do whatever I can in my twilight years to make sure it doesn’t. 
 

Another example I heard today. My daughter is a police officer (not here, in a large UK city) and they took a call from a nursing home asking them to investigate an unexpected death. In a 105 year old. Fortunately the sergeant taking the call fended it off, as there were no obvious suspicious circumstances such as a smoking gun. But seriously? At that age it’s almost unexpected that you survive the night. 
 

I don’t know the answer. It’s probably better education and understanding of what a frail, dependent existence is really like, combined with greater autonomy over one’s future. We should certainly continue medical research though, but perhaps (and I’ll get shot down for this - ageism is not acceptable) concentrate on childhood cancers and young adult suicide prevention, along with many similar other examples, rather than strategies to keep 90 year olds alive until they’re 91.

As for the other end of the age spectrum - congenital life limiting conditions - I’m certainly ‘pro-choice’ rather than ‘pro-life’, but recognise that ethically it’s even more difficult to say anything at all. Legislating against 1st cousin marriage/procreation might be something though - this is another unspoken issue in certain areas of the UK that seem to have a higher rate of recessive genetic conditions. 

[Roger Mexico]

17 hours ago, wrighty said:

Legislating against 1st cousin marriage/procreation might be something though - this is another unspoken issue in certain areas of the UK that seem to have a higher rate of recessive genetic conditions. 

As far as I can see first cousin marriage in itself doesn't make much difference: Put differently, a single first-cousin marriage entails a similar increased risk of birth defects and mortality as a woman faces when she gives birth at age 41 rather than at 30.  Unless you're going to ban women from getting pregnant over the age of 40 as well. 

A bigger problem is more when small communities don't marry outside themselves over generations, so even in there is no first cousin marriage, couples are likely quite closely related genetically.  But that would be almost impossible to legislate for.

[littlebushy]

Foxdale?

[wrighty]

2 hours ago, Roger Mexico said:

As far as I can see first cousin marriage in itself doesn't make much difference: Put differently, a single first-cousin marriage entails a similar increased risk of birth defects and mortality as a woman faces when she gives birth at age 41 rather than at 30.  Unless you're going to ban women from getting pregnant over the age of 40 as well. 

A bigger problem is more when small communities don't marry outside themselves over generations, so even in there is no first cousin marriage, couples are likely quite closely related genetically.  But that would be almost impossible to legislate for.

I didn’t read the Wikipedia article that you used as your reference before I posted. But what I was getting at, without spelling it out, is further down in that article - colleagues tell me that the rate of birth defects in certain immigrant communities is very high. Suppressing cousin marriages would reduce that. Comparing that practice to 41 year olds having a higher risk than 30 year olds…really?

[Roger Mexico]

9 minutes ago, wrighty said:

I didn’t read the Wikipedia article that you used as your reference before I posted. But what I was getting at, without spelling it out, is further down in that article - colleagues tell me that the rate of birth defects in certain immigrant communities is very high. Suppressing cousin marriages would reduce that. Comparing that practice to 41 year olds having a higher risk than 30 year olds…really?

So it seems.  My point was that banning cousin marriage doesn't automatically solve the endogamy problem.  The article also mentions the Amish who do ban it and yet still have high rates of birth defects.  Of course most of such communities are religious-based and as well as preventing 'marrying out' that might also mean that women carrying a foetus with defects are less likely to seek termination.