Doctor, heal thyself

Published: Monday 15 December 2008

Who does the health system help really? It has victims in both poor and rich countries

the elaborate system of public health care, with all its medicines, interventions and doctors, has been developed on a simple premise: to help people. But more often than not it ends up doing the opposite. Examples abound. One of the latest is that of 13-year-old Hannah Jones of Britain, who decided to forgo a heart transplant because she did not believe it would improve her condition. She was being treated for leukaemia when her heart developed a complication requiring a transplant. Refusing treatment, being fully aware of its fatal consequences, is a difficult decision. People in the uk were concerned how wise it was to leave a decision of life and death to a 13-year-old while doctors, who recommended the transplant, were probably only concerned about the possibility of a malpractice suit if they did not suggest the difficult procedure. The system that was refined with the belief that it would help people could not convince Hannah.

There are other examples of the health system failing. Across the Atlantic, in the us, little Hannah Poling became autistic after she was vaccinated against the disease, raising a question: Do vaccines really help? The link between the vaccine and autism validates parents refusing to vaccinate their children.

Both cases are from the developed world where people, owing to social security, have a choice that is not dictated by affordability. People in these countries are in a position to either accept or reject a public health service. Developing countries do not offer that luxury to vast sections of their population. There is no question of rejecting a service because the public health system is just not there; it exists only in government documents and files. The result is that newborns, children and mothers die easily preventable deaths and shoot up the country's infant and maternal mortality rates. They die because there is no doctor or clinic in the vicinity. In developing countries, it is the callousness of the system that kills.

Ergo: Everyone is a victim of the health system--the rich as much as the poor. The need, therefore, is to devise a health system as if people mattered. Poor people do not need a consensus on the ethics of refusing treatment. They need treatment. The government needs to figure out how to do so.

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