Published March 06, 2013
Let me be very clear: I did not go into medicine to decide who lives and who dies.
I went into health care because I wanted to heal, to comfort, to educate and to study the illnesses that afflict my patients. And I don’t need a crystal ball to know when a patient is extremely safe or when he or she is going to die.
So I am somewhat confused as to the purpose of this new ‘mortality index.’ A new study from the University of California, San Francisco with funding from the federal government revealed 12 specific items physicians can use to help them determine whether costly screenings or medical procedures are worth the risk for patients unlikely to live 10 years or more.
Using a point system, the different factors include an individual’s age, weight, smoking habits, previous cancer diagnoses, whether or not he or she gets winded easily, and more. The more points a person has, the higher the chance of dying within the next decade.
As I read about this new index, one thing I found particularly amusing was a quote from one of the study’s authors, which stated that this index was not meant to alter a patient’s lifestyle. So the way I read this is that doctors using this point system will decide what patients may or may not get in terms of their future medical treatment – and that’s not right.
As to which doctors will be using this system, I cannot say for sure. Are these doctors going to be doctors in family practices and in rural America, or are these doctors going to be physicians employed by the insurance industry or perhaps federal medical boards like Medicaid and Medicare? It’s a question I’m curious about.
I know a lot of my critics will say, “Well, don’t you realize we are wasting medical dollars in unnecessary testing?” Or others will argue with me and say that perhaps we are treating many older patients with unnecessary procedures, because some physicians are money hungry and are just making the patients suffer more.
All of these are legitimate criticisms. However, creating a mortality index is not the answer. Patients have to be treated with respect and be given opportunities when there is the slightest sign of hope. I know that socialized medicine is the hope for many politicians in Washington, but independent physicians must individually balance the risk to benefit ratio of recommending testing for their patients on their own, as well as thinking about the ethical dilemma that they’re facing.
Ultimately, using a score card makes us less human and disrespects the sanctity of life.