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Conceptualising age

by on October 16, 2012

Widespread media coverage of accusations of age discrimination by the NHS in respect of lifesaving surgery, following the change to the law to prohibit age discrimination in the provision of goods and services.

As reported in this piece in The Guardian, health professionals are said to be too quick to decide against offering surgery because of “outdated assumptions of age and fitness”. This follows a study by the Royal College of Surgeons, the charity Age UK and communications consultancy MHP Health Mandate.

What’s particularly interesting, from our research perspective, is the inter-play between two conceptualisations of age which are also prominent (and problematised) in the age and work literature. Apparently in decisions about surgery, chronological and biological age are being conflated which “means decisions may not always be made on the basis of a comprehensive and objective assessment but on a series of assumptions about fitness in older age”.

It will be interesting to see how work practices in the NHS and other health service providers address this issue.

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One Comment
  1. Paula Fitzgerald permalink

    This topic is very deep and wide-ranging.

    At a very basic level, from an HR angle, it begs a simple question: if some NHS doctors still make assumptions based on “(lack of) fitness in older age”, why are we expecting HR professionals and employers to make decisions about employees or candidates thinking in a more holistic manner? Are our expectations realistic?

    Furthermore, would healthcare professionals grappling with ever shrinking budgets find the medical equivalent of “I am sorry.. but you are overqualified for the job” to circumvent potential age discrimination scenarios?

    On a different note, it is interesting to see how much focus is placed, and life/death decisions appear to be made based on elderly care cost. Comparatively little, however, appears to be discussed surrounding the costs of deliverying care for younger but perhaps obese, alcoholic, smoking, and/or drug addict patients. A brief article written by Dr Levin et al (2008) from the Cardiology Department at Vanderbilt University, Nashville, Tennessee, USA attempts to uncover this. In Dr Levin’s striking paper: “An Image, A Thousand Words, Hundred of Thousands of Dollars…” he reveals that implanting 2 heart assisting devices to a 26-yeard old patient with a high body mass index, suffering from an end-stage cardiac condition, costs in excess of USD$250,000. This amount does not include hospitalisation in intensive care (100 days), medicines, and ancillary nursing expenses derived from the main interventions.

    However, why is that spending USD$250,000 on a high body mass 26-year old with a life threatening cardiac condition and poor quality of life does not appear a waste, but spending the same amount on a 70-year old may be? Who is making these decisions? and How are these decisions made? It would appear that, in some reported cases, not even the patient’s family was properly informed or even notified of unilateral medical decisions.

    Clearly, this is only the tip of the iceberg.

    Hopefully with ‘revalidation’ (every 5 years) becoming a reality for UK medical professionals, perhaps these wide-ranging and highly sensitive topics may become part of a compulsory syllabus. At the same time, I wonder how academics and HR professionals working in the healthcare industry may be able to assist to bring about a more holistic thinking and approach to treating patients. Particularly in light of the fact that, sooner or later, we will all be touched by this problem.

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