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	<title>Comments on: Don&#8217;t treat the old and unhealthy, say doctors &#8211; Telegraph</title>
	<atom:link href="http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/feed" rel="self" type="application/rss+xml" />
	<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html</link>
	<description>Ramblings of an Emergency Physician in Texas</description>
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		<title>By: ssk</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-17612</link>
		<dc:creator>ssk</dc:creator>
		<pubDate>Thu, 23 Apr 2009 20:47:34 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-17612</guid>
		<description>Demented, frail, senile, weak, brittle? You do not have a medical condition, you have a social condition. Please apply for social support. I am sorry, due to funding difficulties we do not offer social support at the moment</description>
		<content:encoded><![CDATA[<p>Demented, frail, senile, weak, brittle? You do not have a medical condition, you have a social condition. Please apply for social support. I am sorry, due to funding difficulties we do not offer social support at the moment</p>
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		<title>By: Freddy Hill</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9525</link>
		<dc:creator>Freddy Hill</dc:creator>
		<pubDate>Mon, 04 Feb 2008 22:31:39 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9525</guid>
		<description>Thanks for the answer.  I did not mean to imply that you made moral judgments during triage, nor that you denied care.  My point is that, given that there are limited resources to be allocate (as you mention in your answer), I&#039;d rather have you the allocation rather than some faceless committee trying to second-guess God.</description>
		<content:encoded><![CDATA[<p>Thanks for the answer.  I did not mean to imply that you made moral judgments during triage, nor that you denied care.  My point is that, given that there are limited resources to be allocate (as you mention in your answer), I&#8217;d rather have you the allocation rather than some faceless committee trying to second-guess God.</p>
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		<title>By: GruntDoc</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9517</link>
		<dc:creator>GruntDoc</dc:creator>
		<pubDate>Mon, 04 Feb 2008 07:58:14 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9517</guid>
		<description>Hmm, I don&#039;t ration care for anyone.  We do triage patients as to severity, but that&#039;s to provide the appropriate level of care to the sickest quickest but eventually getting to them all.

I do not say &quot;Well, you&#039;re still smoking, so no nebulized bronchodialators, no steroids for you&quot;; I will mention that smoking probably isn&#039;t in their best interest at this point, but that&#039;s the most I&#039;d say (and often don&#039;t, they&#039;ve heard it and prefer smoking to living longer).

Triage isn&#039;t care denial, it&#039;s resource allocation, and it&#039;s based on medical need, not moral judgments.</description>
		<content:encoded><![CDATA[<p>Hmm, I don&#8217;t ration care for anyone.  We do triage patients as to severity, but that&#8217;s to provide the appropriate level of care to the sickest quickest but eventually getting to them all.</p>
<p>I do not say &#8220;Well, you&#8217;re still smoking, so no nebulized bronchodialators, no steroids for you&#8221;; I will mention that smoking probably isn&#8217;t in their best interest at this point, but that&#8217;s the most I&#8217;d say (and often don&#8217;t, they&#8217;ve heard it and prefer smoking to living longer).</p>
<p>Triage isn&#8217;t care denial, it&#8217;s resource allocation, and it&#8217;s based on medical need, not moral judgments.</p>
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		<title>By: Freddy Hill</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9516</link>
		<dc:creator>Freddy Hill</dc:creator>
		<pubDate>Mon, 04 Feb 2008 05:20:52 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9516</guid>
		<description>Gruntdoc, I realize that this thread is a bit stale, but its subject is fairly immediate to me, so I hope that this gets read.

You complain about UK&#039;s socialized medicine, but you work in an ER.  You make life and death decisions every day.  You choose to spend part of your considerable but ultimately finite (no offense intended!) brain power on deciding to help patient A first and patient B second.  You do the same thing personally as the UK National Health Service does collectively.  

Is there a difference?

Speaking as a guy that by now is just happy to look at the golf ball from above the green rather than from below, I&#039;m grateful that you and guys and gals like you are around to make that decision, rather than relying on some bean counter somewhere.  

Health care choices must ultimately be economic decisions.  The difference between the UK and US health care is not one of fairness, but one of trust.  Both systems are deeply unfair, but so is life.  All things being equal, though, I want people in the trenches to make the decisions, and not faceless bureaucrats.  In this the American system is (for now) far superior.</description>
		<content:encoded><![CDATA[<p>Gruntdoc, I realize that this thread is a bit stale, but its subject is fairly immediate to me, so I hope that this gets read.</p>
<p>You complain about UK&#8217;s socialized medicine, but you work in an ER.  You make life and death decisions every day.  You choose to spend part of your considerable but ultimately finite (no offense intended!) brain power on deciding to help patient A first and patient B second.  You do the same thing personally as the UK National Health Service does collectively.  </p>
<p>Is there a difference?</p>
<p>Speaking as a guy that by now is just happy to look at the golf ball from above the green rather than from below, I&#8217;m grateful that you and guys and gals like you are around to make that decision, rather than relying on some bean counter somewhere.  </p>
<p>Health care choices must ultimately be economic decisions.  The difference between the UK and US health care is not one of fairness, but one of trust.  Both systems are deeply unfair, but so is life.  All things being equal, though, I want people in the trenches to make the decisions, and not faceless bureaucrats.  In this the American system is (for now) far superior.</p>
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		<title>By: JP</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9494</link>
		<dc:creator>JP</dc:creator>
		<pubDate>Sat, 02 Feb 2008 19:44:48 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9494</guid>
		<description>Careful, bloggers.  The same who put for the idea you ridicule might suggest dispensing &quot;soma&quot; (A. Huxley, Brave New World) to keep the peace.</description>
		<content:encoded><![CDATA[<p>Careful, bloggers.  The same who put for the idea you ridicule might suggest dispensing &#8220;soma&#8221; (A. Huxley, Brave New World) to keep the peace.</p>
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		<title>By: Sam Benjamin</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9470</link>
		<dc:creator>Sam Benjamin</dc:creator>
		<pubDate>Wed, 30 Jan 2008 03:41:29 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9470</guid>
		<description>I think we should withold care from anyne who has not walked 1/2 hour 5 tuimes a day and y the way let&#039;s withold care from anyone who has had a lewd thought or a communist thought or any thought at all. In fact, let&#039;s withold care from everyone and leave insurance cos. to collect premiums but they will no longerneed to disburse any $. By the way let&#039;s withold care from anyone over 45. When Congress votes on this, I have a list of sins that should merit witholding care.</description>
		<content:encoded><![CDATA[<p>I think we should withold care from anyne who has not walked 1/2 hour 5 tuimes a day and y the way let&#8217;s withold care from anyone who has had a lewd thought or a communist thought or any thought at all. In fact, let&#8217;s withold care from everyone and leave insurance cos. to collect premiums but they will no longerneed to disburse any $. By the way let&#8217;s withold care from anyone over 45. When Congress votes on this, I have a list of sins that should merit witholding care.</p>
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		<title>By: Health Care BS - DENYING CARE BASED ON AGE AND LIFESTYLE</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9464</link>
		<dc:creator>Health Care BS - DENYING CARE BASED ON AGE AND LIFESTYLE</dc:creator>
		<pubDate>Tue, 29 Jan 2008 17:39:24 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9464</guid>
		<description>[...] [HT GruntDoc] [...]</description>
		<content:encoded><![CDATA[<p>[...] [HT GruntDoc] [...]</p>
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		<title>By: SeaSpray</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9460</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Tue, 29 Jan 2008 08:42:15 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9460</guid>
		<description>People of ALL SIZES present to the ED with the mantra &quot;I&#039;m broke, fix me&quot;. 

I think that is just wrong! And who decides these things and what is the cut off point? Are they talking elective surgery or life saving surgeries. So overweight people, elderly people, smoking people and drinkers have no value as human beings?  There lives are disposable? Didn&#039;t Hitler think that way?

I don&#039;t condone all the behaviors that go with some of these people but in the mix you have got some real good people that are devalued because of a weakness.  Yes there needs to be accountability but c&#039;mon...we are talking about human beings. They are someones uncle or grandma or brother or child, etc.

Where is Michael Moore  for that article?</description>
		<content:encoded><![CDATA[<p>People of ALL SIZES present to the ED with the mantra &#8220;I&#8217;m broke, fix me&#8221;. </p>
<p>I think that is just wrong! And who decides these things and what is the cut off point? Are they talking elective surgery or life saving surgeries. So overweight people, elderly people, smoking people and drinkers have no value as human beings?  There lives are disposable? Didn&#8217;t Hitler think that way?</p>
<p>I don&#8217;t condone all the behaviors that go with some of these people but in the mix you have got some real good people that are devalued because of a weakness.  Yes there needs to be accountability but c&#8217;mon&#8230;we are talking about human beings. They are someones uncle or grandma or brother or child, etc.</p>
<p>Where is Michael Moore  for that article?</p>
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		<title>By: Eamonn</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9457</link>
		<dc:creator>Eamonn</dc:creator>
		<pubDate>Mon, 28 Jan 2008 20:35:38 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9457</guid>
		<description>It&#039;s only socialized in the sense that it&#039;s available to everyone. There no limits on access to private health insurance, except the ability to pay</description>
		<content:encoded><![CDATA[<p>It&#8217;s only socialized in the sense that it&#8217;s available to everyone. There no limits on access to private health insurance, except the ability to pay</p>
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		<title>By: Matt M</title>
		<link>http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html/comment-page-1#comment-9454</link>
		<dc:creator>Matt M</dc:creator>
		<pubDate>Mon, 28 Jan 2008 15:52:00 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2008/01/dont-treat-the-old-and-unhealthy-say-doctors-telegraph.html#comment-9454</guid>
		<description>Demented, frail, senile, weak, brittle?  You do not have a medical condition, you have a social condition.  Please apply for social support.  I am sorry, due to funding difficulties we do not offer social support at the moment.</description>
		<content:encoded><![CDATA[<p>Demented, frail, senile, weak, brittle?  You do not have a medical condition, you have a social condition.  Please apply for social support.  I am sorry, due to funding difficulties we do not offer social support at the moment.</p>
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