Saturday, October 12, 2013

Not there yet....

Our efforts at healthcare are aimed at returning people to pleasurable, productive lives. But in determining who receives what healthcare we only terminally consider quality of life. Elsewise the healthcare available and provided depends very much on geography. 

Further in those quality of life assessments people do not expressly consider pleasure, but rather an absence of pain, the ability to eat, to mobilise, to socialise and to sleep. These activities are intrinsically pleasurable but not necessarily so and where they are pleasurable the pleasure is variable.

As far as productivity is concerned, assessments are necessarily retrospective. In disease, treatment seeks to return one to a premorbid state, but such states are never calibrated and so we rely on our very fallible memories to decide whether or not we function as we did before. So, treatment aims to return the capacity for productivity, but no-one would argue that someone who has gone through three cycles of chemotherapy has the same intellectual capacity as previously. The same could be said of someone who has recovered from a serious heart attack or stroke even if such recovery seems remarkably complete. The point here being that all serious illness and the chemicals and procedures we use to return human bodies to functional status have costs in intellectual performance. I know that the activities of daily living do not need or demand a towering intellect but it is nevertheless true that such towers lose both breadth and height in serious illness. Most times irrecoverably so.

I say all this because despite the remarkable and dramatic strides that the technologies of healthcare have made, contemporary healthcare remains very crude in it's diagnostics and it's treatments. We know that we will be able to do better but we are far from implanted cybernetics and designer babies.

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