Too old to treat?
Offering patients different treatment depending on their age is not always appropriate, argues Patricia King
“Where age is an indicator of benefit or risk, age discrimination is appropriate.”w1 This statement from the National Institute for Health and Clinical Excellence in England and Wales in 2005 provoked widespread concern among charities for older people. Reports of ageism in clinical practice have since reignited the debate about the allocation of resources in the National Health Service. The main problem is ethical: the NHS cannot pour money into every new treatment that research provides for an ageing population; but where should the line be drawn?
Some reports of trials document older people not being referred for investigations or for life saving surgical treatment. For example, a study in the BMJ by Fairhead and Rothwell found that older people were less likely to be referred for transient ischaemic attack and minor stroke than their younger counterparts. Because preventing a disabling stroke is a priority in all age groups, they