TSR Med Students' Society Part III

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I don't obviously.

As for the prof I don't want Whitehall running my life. I don't like the arrogance that comes with telling someone what they must do.

But the arrogance of authority can be countered with the arrogance, so to speak, of autonomy.

That is (with an admittedly simplistic example), if we say the doctor telling the obese patient to get a grip & stop eating is arrogant, then the obese patient sticking two fingers up at the NHS & saying it's their body & their lifestyle choice is also arrogant.

You're right as regards autonomy mind. Disregard for it is, if anything, an incredibly dangerous route to go down, and goes against the whole concept of being 'adults'.

Reply 5261

sidewalkwhenshewalks

this conversation is pretty interesting but i wish it had been spun out to its own thread in the medical students and doctors forum. having more threads would stop discussions getting subsumed in the monolithic thread and it might make the forum thread page checking again.
/rant

Reply 5262

Blatant Troll

My bad dude :colondollar:

Reply 5263

carcinoma

Original post by Fission_Mailed

I've seen my timetable for the first day and we have 3 hours rota'd in the middle of the day to take the freshers to the pub. :awesome:

We have the whole week off, to play with the freshers.

Reply 5264

Medicine Man

Original post by FFCrusader

I'm sure you will :p:

If not, you'll have to suffer the consequences

Just some random F2s that just started there :awesome:

It's quite nice seeing medicine from their point of view :h:

It's by far better than preclinical shizzle with little perspective of stuff in real life

I don't think I would want to face them... :nothing:

Pre clin isn't real medicine - it's a shame I feel I'm better at the fake medicine as opposed to the real thing! :unsure:

Enjoy the shadowing dude! Just come back to London already! :teeth:

Reply 5265

digitalis

OHCM-best book in the world. Got it for 16 quid in a Blackwell's sale and felt wrong paying so little for it. My bank account is not worthy. The only book I read for reference/revision in 3rd year.

Reply 5266

Wangers

trying to sort out a research project with a ****ty computer that randomly chooses not to read guidence documents, access vital supervisor pages or read emails is just not going to work, is it? Fail.

Reply 5267

buzzcat

Original post by crazylemon

I don't obviously.

As for the prof I don't want Whitehall running my life. I don't like the arrogance that comes with telling someone what they must do.

and yet you're studying medicine O_o? arrogance is a prerequisite to a job where you spend most of the time (not filling in forms) telling people what to do...

I respect free will and autonomy, but when decisions effect others' lives (unless they seek private treatment) then we need to take action and stop preaching our long guidelines and statistics that are simply ignored.

It is not fair that a health service set up to provide for all should have to make sacrifices because of our selfish and ignorant society. By all means, smoke, get fat, **** all the hookers you want - but don't come crawling back to the NHS with your NI card in hand like it's a get out of jail free card.

(edited 12 years ago)

Reply 5268

Kinkerz

Original post by buzzcat

and yet you're studying medicine O_o?

I respect free will and autonomy, but when decisions affect other's lives (unless they seek private treatment) then we need to step in and stop preaching our long guidelines and statistics that are simply ignored.

What's your alternative? I'm currently with lemon on this, but I'm happy to be persuaded if you can be bothered.

Reply 5269

buzzcat

Original post by Kinkerz

What's your alternative? I'm currently with lemon on this, but I'm happy to be persuaded if you can be bothered.

I agree you can't force people how to live their lives - but you can force them to make their own decisions though - like how some surgeons won't do certain operations until a patient loses some weight.

As the NHS becomes more fiscally ****ed, we need to force the public to look after themselves. How lazy and stupid has our society become that people turn to bariatric procedures rather than turning away from junk food. We can talk about preservation of free will, but these people don't possess it.

I think we could do with some basic negative reinforcement - if you do something to **** up your own body, you will have to suffer the consequences.

In essence - why should we be there to take their heavy burden when there are others far more needing and deserved?

Sorry if you ere looking for solid suggestions, I don't have any - I'm more of the hippy think tank sat in the corner with sandals on throwing out **** ideas to get the 'creative juices flowing'

Reply 5270

sidewalkwhenshewalks

Original post by buzzcat

Doctors treat people.
If you want to treat society, become a politician.

The medical profession shouldn't become an instrument of paralegal 'justice' for behaviours deemed unacceptable by a small group of (elitist?) people.

Reply 5271

buzzcat

Original post by sidewalkwhenshewalks

I know that you're right, that's the reason we all became doctors and why the NHS is so great - but at the same time I can't help but feel like we're only promoting society to become more unhealthy by not challenging these behaviours

Call me paternalistic but when your faced with morbidly obese kids, someone's got to teach them?

Reply 5272

sidewalkwhenshewalks

Original post by buzzcat

We aren't promoting society to do anything. Where possible we try to prevent these things from happening, but in reality the permissions or lack thereof granted by the medical community do not rank highly in most people's deliberations RE the last slice of cake. Add in the panoply of biases that exist around the subject, and I start to think the whole issue is just being taken out of proportion.

A doctor can if they choose, berate a patient for their vices, and in many cases it is the correct thing to do. Other doctors may choose not to. That discrepancy is perfectly acceptable because the patient can choose to discard the advice. However, once the berating physician is given the ability to discriminate on the basis of vice (beyond what happens currently, where denials are issued on the basis of patient safety) then they hold too much power, and their subjective opinion contravenes the right to health care as mandated in law .

Finally, I'm sure you already know all of this and yet feel how you do regardless. In all honesty, I feel the same way. But I also know that feelings shouldn't take the place of rigour in discussions about policy.

Reply 5273

Blatant Troll

Most eloquently put :holmes:

Reply 5274

Lantana

In complete opposite to the wonderful debate about responsibility you've been having, we need to turn to the more important thing of finding me some smart shoes as one can no longer turn up in trainers which I've lived in for the last 7 years and I don't think motorbike boots will cut it either! I think I must have driven my sister mad by dragging her round the shops today and not ending up with anything.

Ballet pumps seem somewhat flimsy, I'm not wearing heels unless they are wide and tiny as they'll kill my feet and I'd rather not have shoes that remind me of being at school or that my grandmother would wear...

Any suggestions?

Reply 5275

Blatant Troll

I'll take that as a cue to wrap things up... :cute:

Original post by crazylemon

And skiing, rugby and every other risky activity? We treat no self inflicted problems? The whole point of the NHS is free at point of use regardless of your problem. If you want to bar people from treatment let them opt out of NI payments and go elsewhere at the very least. Personally I am not totally convinced that the NHS is the best way to deliver healthcare. No doubt it isn't that worst.

Everything we do affect people. That is inevitable when you live in a society as connected as ours

You point on barriatric surgery. Do you really think a fax tax/withdrawal of healthcare/fine/whatever would help? I would suspect not.
I would rather not make decisions on who is worthy/deserving of treatment. Be they drunk, obese, smoker, junkie whatever. Our system is set up such that all get treated regardless of cause and everyone pays in. I don't think you can expect people to pay twice.

I've come round to your side of the debate (particularly after SWWSW's post), but perhaps the bold was wishy washy. A 'society' where everyone does what they please, when they please, in spite of the consequences & how they affect other people is, by definition, no society at all. Doctors have & always will serve people first and foremost, but the NHS also serves society - it's 'wider social duty' also being detailed amongst it's key principles. Arguably an increasingly individualistic culture blunts its ability to do so effectively ("selfishness"? "arrogance"? I think people are arrogant in their selfishness). Hence my feelings on a sense of duty-imposed limit. However that limit is completely & utterly subjective/arbitrary (as we've both said), goes against the founding principles of the NHS (as you've said), and may dangerously exceed the remit of doctors (as I've said).

...in short - despite my feelings on the matter (a la SWWSW) - I'm inclined to agree with you on this one :h:

(edited 12 years ago)

Reply 5276

carcinoma

In summary, If we all treat our patients as individuals and educate ourselves on the evidence enough, we will make a change even if it is once person at a time.

We can leave changing society as a whole to the education system, with influences from public health.

Reply 5277

Wangers

Original post by crazylemon

Yes, but there is a difference between Rugby - which carries a risk, and smoking, which is a definate harm. Whenever I see COPD patients on the ward totter outside with their oxygen cylinders for yet another fag - you can be as non judgemental as you like - it's still pissing into the wind if people don't want to help themselves.

Reply 5278

Wangers

Original post by crazylemon

You get old smokers. Likely but not definite harm.

The odds might be different but both are measureable risks to health.

No, smoking is still a harm, all you're saying is that it might not be the main factor - but it dosn't help. does it? We consider peoples' actions and attitudes in all oher areas of life - jobs, criminal justice, loans, why not healthcare?

Reply 5279

Wangers

Original post by crazylemon

My point is that many things we do cause harm. Living in cornwall means I get lovely radon exposure. Jobs too. Living in large cities etc.

Because those affect productivity or likeness to pay. Any system of denial wont be based on that.

If someone pays in 20k of NI a year why should they be barred from service for being fat? All you have done is created the potential for another injustice. If you want to deny healthcare fine but you have to then give people the option to opt out. Or they end up paying twice.

Yes, and my point is that people should take responsibility for their actions, and inactions. You cannot be held responsible for Radon exposure, but you can steps to stop smoking - I am not saying we should punish people for smoking, or being fat, but it is reasonable to expect people to make some effort to improve their condition, or at least not willfully continue something which is detrimental to health and treatment. I don't plan to punish COPD patients for smoking - but I would expect them to take nicotine replacement theapy for instance. We cannot afford to pander to the wants of a population who will not take care of themselves - it simply is not viable. And a for paying twice? Well in every other walk of life, if you break something, you replace it - and pay through the nose, it is worth considering as a incentive.