the end of average life expectancy receives less attention than people in their twenties or thirties, have been widespread. The [NICE] guidelines would run the risk of reinforcing such prejudice.’
It is perhaps understandable that this happens. On the face of it, it seems so much more worthwhile to pour the best (and most expensive) resources the medical profession can offer into treating a nineteen-year-old with all their life ahead of them, if the treatment is effective, than into treating an 89-year-old who is less likely to thrive, and likely to have only a short time of health before some other ailment strikes. Managers and doctors facing a heavy workload and limited resources may argue that choices have to be made and that such prioritising, though undesirable, is simply unavoidable. There is often an attitude, too, that old people have had their ‘fair share’. More poignantly, sometimes doctors who treat old people with all the skill and dedication they would devote to younger patients are forced to accept that they are fighting a losing battle – that they will not be able to keep their patient alive, let alone restore them to good health. When, then, do they stop fighting?
But there is a problem with too much ‘pragmatism’. The NHS is an ideal – the ideal of the best available treatment free to all, no matter who – and it’s an ideal that should notbe sacrificed lightly. For each and every patient and their loved ones, it’s their health and their life that is precious. The ideal of the NHS means we should not be making choices between one person’s health and another’s. Every patient should be treated to the best of doctors’ abilities. If this principle is compromised, it begins to undermine the important and reassuring comfort of knowing that we will always be treated when we are ill; it also begins to place a very difficult burden on doctors to choose who should be treated and who shouldn’t.
Yet the NHS budget is rising by the year and the UK has a population that is ageing. Already over 20 million (more than a third of) British citizens are over 50 years old, and old people are more prone to illness. 55 per cent of 75–84-year-olds have some illness or disability and two-thirds of those over 85 do. It is argued therefore that this increasingly aged population will place more and more strain on the NHS’s limited resources – and the ability of younger people to fund it – and that we need to start recognising this before catastrophe strikes. What this argument fails to recognise, however, is that the old people of today are much, much more healthy than those of former years. That is exactly why we have so many old people. And if there are numerically many more frail 90-year-olds now dependent on the NHS than in earlier times, there are also many, many more very fit people in their 60s still actively contributing to society economically, socially and intellectually. More importantly, a society that fails to look after its old people and hold them in any less than the utmost respect may be said to be sick and in need of treatment.
You have a 3-litre jug and a 5-litre jug. Make 4 litres.
(Mathematics, Oxford)
This problem comes up in the movie
Die Hard with a Vengeance
. At the bidding of the monstrous Simon Gruber (aka Peter Krieg) (Jeremy Irons), John McCain (Bruce Willis) and Zeus (Samuel L. Jackson) are forced to solve this problem in order to disarm a bomb. They succeed just in time. They did it like this (using gallons rather than litres): First they fill the 5-gallon jug. Then they empty 3 gallons from the 5-gallon jug into the 3-gallon jug, leaving 2 gallons in the 5-gallon jug. Then they empty the 3-gallon jug and add the last 2 gallons from the 5-gallon jug. Then they fill the 5-gallon jug and fill up the 3-gallon jug, using just 1 gallon and leaving 4 gallons in the 5-gallon jug.
Et voilá
!
This problem is so simple that you can see the solution straight away, and the
It is perhaps understandable that this happens. On the face of it, it seems so much more worthwhile to pour the best (and most expensive) resources the medical profession can offer into treating a nineteen-year-old with all their life ahead of them, if the treatment is effective, than into treating an 89-year-old who is less likely to thrive, and likely to have only a short time of health before some other ailment strikes. Managers and doctors facing a heavy workload and limited resources may argue that choices have to be made and that such prioritising, though undesirable, is simply unavoidable. There is often an attitude, too, that old people have had their ‘fair share’. More poignantly, sometimes doctors who treat old people with all the skill and dedication they would devote to younger patients are forced to accept that they are fighting a losing battle – that they will not be able to keep their patient alive, let alone restore them to good health. When, then, do they stop fighting?
But there is a problem with too much ‘pragmatism’. The NHS is an ideal – the ideal of the best available treatment free to all, no matter who – and it’s an ideal that should notbe sacrificed lightly. For each and every patient and their loved ones, it’s their health and their life that is precious. The ideal of the NHS means we should not be making choices between one person’s health and another’s. Every patient should be treated to the best of doctors’ abilities. If this principle is compromised, it begins to undermine the important and reassuring comfort of knowing that we will always be treated when we are ill; it also begins to place a very difficult burden on doctors to choose who should be treated and who shouldn’t.
Yet the NHS budget is rising by the year and the UK has a population that is ageing. Already over 20 million (more than a third of) British citizens are over 50 years old, and old people are more prone to illness. 55 per cent of 75–84-year-olds have some illness or disability and two-thirds of those over 85 do. It is argued therefore that this increasingly aged population will place more and more strain on the NHS’s limited resources – and the ability of younger people to fund it – and that we need to start recognising this before catastrophe strikes. What this argument fails to recognise, however, is that the old people of today are much, much more healthy than those of former years. That is exactly why we have so many old people. And if there are numerically many more frail 90-year-olds now dependent on the NHS than in earlier times, there are also many, many more very fit people in their 60s still actively contributing to society economically, socially and intellectually. More importantly, a society that fails to look after its old people and hold them in any less than the utmost respect may be said to be sick and in need of treatment.
You have a 3-litre jug and a 5-litre jug. Make 4 litres.
(Mathematics, Oxford)
This problem comes up in the movie
Die Hard with a Vengeance
. At the bidding of the monstrous Simon Gruber (aka Peter Krieg) (Jeremy Irons), John McCain (Bruce Willis) and Zeus (Samuel L. Jackson) are forced to solve this problem in order to disarm a bomb. They succeed just in time. They did it like this (using gallons rather than litres): First they fill the 5-gallon jug. Then they empty 3 gallons from the 5-gallon jug into the 3-gallon jug, leaving 2 gallons in the 5-gallon jug. Then they empty the 3-gallon jug and add the last 2 gallons from the 5-gallon jug. Then they fill the 5-gallon jug and fill up the 3-gallon jug, using just 1 gallon and leaving 4 gallons in the 5-gallon jug.
Et voilá
!
This problem is so simple that you can see the solution straight away, and the
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