Intended for healthcare professionals


Maintaining older people's dignity and autonomy in healthcare settings

BMJ 2001; 323 doi: (Published 11 August 2001) Cite this as: BMJ 2001;323:340

Whole system must be looked at to prevent degrading treatment

  1. A J D Macdonald (, professor of old age psychiatry
  1. King's College London, Lewisham Hospital, London SE13 6LH
  2. University of New South Wales
  3. Department of Ambulatory Care, Macarthur Health Service, PO Box 149, Cambelltown 2560, New South Wales, Australia

    EDITOR—Unfortunately, I cannot agree with Lothian and Philp in their article on the dignity and autonomy of older people in the healthcare setting.1 On several occasions I have put forward the view that British health care is failing older patients as a consequence of system-wide abuse of staff, managers, purchasers, and politicians. 2 3 As long as this corrosive, self sustaining culture remains untouched it is impossible to improve the dignity and autonomy of any group, let alone the more disadvantaged ones. What Lothian and Philp call the anecdotal evidence of a continuing, serious problem is already overwhelming and is still growing.

    Recently, a 91 year old family member was finally given a hospital bed after being taken to an accident and emergency department after falling down the stairs. She had fractured three ribs and sustained a severe, immobilising calf injury. She spent eight hours, until 3 am, in hospital A's accident and emergency department on a trolley. She was admitted to a ward …

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