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Elderly patients denied treatment because of age, report claims

Picture: Donald MacLeod

Picture: Donald MacLeod

  • by CRAIG BROWN
 

THOUSANDS of elderly patients are needlessly dying because they are being denied treatment on the grounds of their age, a report has found.

Surgical treatments, which can prolong life and improve living standards for older patients, have been shown to steadily decline as patients get older, the research suggests.

But as the population ages and people are living longer lives, doctors have a “moral duty” to properly care for older patients, according to the Royal College of Surgeons (RCS).

They said that surgeons should no longer look at a patient’s age to assume whether they are suitable for surgery. Instead, their overall health should be taken into consideration, according the report which was conducted by the RCS, Age UK and MHP Health Mandate.

The report – which bases its findings on figures on England and Wales, but which the RCS and Age Scotland say apply to the whole of the UK – found that surgery rates decline for people as they grow older for a number of treatments including breast cancer operations, joint replacements, prostate cancer treatments and hernias.

While the incidence of breast cancer peaks in patients aged 85 and older, surgery rates decline sharply from the age of 70, the figures indicate.

The research also found the number of patients who receive treatment for prostate cancer plummets after the age of 70.

Age Scotland spokesman, Lindsay Scott said financial strictures faced by doctors and health boards meant they were under pressure to take decisions based on the age of the patient, even though they did not want to.

“From a human rights perspective, it is unacceptable that age makes a difference in the treatment of a patient,” he said. “They [doctors] always say that cost takes a role in making these decisions and the efficacy of doing it given the factors involved: how ever long the patient is likely to live, and whether it’s going to make a substantive difference to their quality of life or not.

“But we’ve discussed this with human rights lawyers, who have said that it could challenge decisions made on that basis, and certainly the European Court of Human Rights in Strasbourg does not accept cost as a basis for treating people differently.”

The authors of the report said there are a number of possible explanations as to why older people are not getting life- saving treatment.

Doctors are looking at people’s age to assess whether they are suitable for treatment, instead of their overall wellbeing and fitness, they said.

Discussions with patients about possible treatments could be “limited or ineffective”, they add.

Clinical factors could mean that the risks of treatment outweigh the benefits or patients could decide themselves to opt out of treatments, the report states.

Professor Norman Williams, president of the RCS, said: “This isn’t about surgeons slamming the theatre door on older people. The key is that it is a decision based on the patient rather than how old they are that matters.”

The authors have made a series of recommendations to ensure that older people have fair access to surgery, including ensuring there are no age “cut-offs” which would see older patients denied treatment.

Multi-disciplinary teams, including specialists from geriatrics and other hospital departments, should make joint decisions about treatment, they said.

 

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