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The consultation: consumerism and healthcare

O’MAHONY: Patients are being exposed to futile interventions

Consultant gastroenterologist Seamus O’Mahony tackled Western society’s attitude to death in The Way We Die Now. His new book – Can Medicine Be Cured? – critiques consumerist attitudes to healthcare. He talks to Tim Tonkin

Medicine had a golden age which I caught the very end of. This was roughly from the mid-1930s to the mid-1980s. During this time, medicine and medical science gained huge prestige and a vast medical-industrial complex emerged as a result.

My central thesis in this book is that this medical-industrial complex’s main goal is its own survival and continued dominance.

In a way, medicine has become almost a pseudo religion. The huge advances during the golden age helped to create it. The medicalisation of life and death, which was what [the philosopher] Ivan Illich and various other people argued against, has to a great extent happened.

There appears to be almost a conspiracy among their doctors and their families to not have the ‘difficult conversation’ with people at the end of life. This is one of the reasons I wrote The Way We Die Now.

I felt that people were exposed to unnecessary and futile technological interventions right up to the very end. Many people were at the end of life in acute hospitals in situations where they didn’t know they were dying.

I’m not blaming doctors directly for this. The whole culture and atmosphere of acute hospitals makes it very difficult for professionals to have these conversations, and very often families put pressure on doctors not to have these difficult conversations with patients.

‘Personalised medicine’ will be incredibly expensive and accessed mainly by the rich. It’s another construct of the medical-industrial complex. If we simply applied fairly and evenly what we already know on a global scale, medicine would be transformed.

The foot soldiers in medicine need to rebel against things such as the excessive emphasis on targets and metrics. I think we need to return to core values. Medicine is not about curing all diseases and increasing longevity indefinitely, it’s about easing the path of people from the cradle to the grave and making the conditions of human life more tolerable.

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