Stop Prolonged and Unnecessary Medical Procedures....(Achieving a consensus on the right care for our elderly)

(This was sent to ST Forum Page but was unpublished.  I think it is relevant in view of the many things happening to our healthcare system : - overcrowding in hospitals; high medical costs; untold pains of both patients and loved ones caused by risky and unnecessary medical procedures)

The medical care of an elderly patient is a complex one involving both clinical and non clinical considerations.This arises from the interactions amongst patient, loved ones and physician  - each with at times differing intentions.  I therefore agree that the highest level of care and comfort should form the paramount basis for any and every decision.  The ultimate goal must be to help patients regain a reasonable level of functions - physically, mentally and emotionally.    

In many surveys, elderly patients have indicated that they wish to spend their time (particularly the final hours at home where care should be made available.  I think it is laudable that finally, efforts are being made to review the use of CPF for palliative care, and more resources (hopefully without too much bureaucratic delays) are being planned to invest in home care training of professionals etc.

The wishes of patients and their primary care givers should always take precedence. These must be determined at the outset. Since the clinical inputs of professionals are important, it is therefore vital that a comprehensive discussion of any recommendations pertaining to medical procedures be conducted before any action is taken. Such discussions should cover clinical as well as post procedural care and living condition. In the event that there is a conflict of opinions regarding the options for the patients - their wishes or those of their loved ones must prevail. This is to prevent decisions that will result in unnecessary pain to the patients, undue anguish to loved ones and financial hardship to the families. 

The advice of physicians while to be respected must be subserved to those of the patients and their loved ones.  Physicians should also be wary not to draw exceedingly alarmist scenarios that present loved ones or patients with only dire outcomes that force their hands on some of these decisions.   

I feel very strongly that patients, their caregivers and loved ones should begin to take responsibility for medical decisions.  I have heard of too many sad cases when these were prevailed by professionals at the expense of the dignity, care and comfort of patients