Ageism in services for transient ischaemic attack and strokeBMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38961.641400.BE (Published 07 September 2006) Cite this as: BMJ 2006;333:508
All rapid responses
John Young raises the question of Ageism in his editorial commenting
"Ageism will always prosper when resources are inadequate for the target
Hmm, is this really Ageism, or is it application of a cost-benefit
analysis ? Spending the limited resources where the greatest benefits will
I suspect most "Ageism" in the system is based on the belief that the
greatest benefit over cost is obtained by a subconscious estimation of
something like Quality Adjusted Life Years. There may be a further
subconscious estimation of the economic contribution a patient may make.
Doesn't sound too bad - so let's have a proper debate about how to measure
benefit reasonably dispassionately.
The main problem I see is a failure to face up to reality : we cannot
provide a perfect health service; resources will always be inadequate;
what we really need is transparency in admitting this and a fair system
for allocating what resources are available.
My guess is that the situation will get worse. Health care costs will
rise as research produces more treatments. I'd also guess that the money
available will reduce as world resources become stretched - I believe the
recent rises in energy costs are indicative of what we will face in the
future. We may need a fairer system much sooner than we hope.
Yes, there may be discrimination within our system. Yes, it may be
unfair. Before we can deal with that, we must face up to the reality of
resource restrictions, recognize the (potential) need for rationing, and
devise fair systems for implementing it.
Too politically unpalatable ? OK - that vision leads to a future with
continued pointless efforts to expose and deal with "unfair"
discrimination, when the disease is much more fundamental.
Competing interests: No competing interests