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The future of Wellbeing

| by Victor Cherubim

( January 4, 2014 – London –Sri Lanka Guardian) Cambridge researcher Aubrey de Grey argues that “ageing is merely a disease – and a curable one at that”. Humans age in seven basic ways, he says all of which can be averted. While others maintain that the longer we can live, the more we value our lives and the more precious life becomes. Yet others state there are an infinite number of things one would like to do and see, but only so many one can find time and resources to achieve.

What is living longer mean?

Ordinarily for ordinary people it is living fuller for longer. It is not trying to eliminate old age but trying to get more out of the one life one has and that you need more years in that life to reach optimal fulfilment.

Medical advances in the post genomic age confront us in modern healthcare. Exploring the impact and the potential of rapidly developing technologies as applied to health and medicine, is a study by itself. With so many innovations, cybernomics ,bionics, nano technology, etc., medical knowledge is fast changing.

Medicine is evolving daily, monthly; yearly. To some extent medicine or rather therapeutic medicine is not evolving, but revolutionising itself. Genetic testing is starting to offer the chance of far more precise targeted treatment based on new knowledge of who is likely to benefit. From providing a platform for expert commentary and analysis, to tailoring the drug therapy at a dosage that is most appropriate for an individual patient, to increasing the potential benefits of the efficacy and safety regime of medication, healthcare is now powered by tools, tests and even apps, that bring diagnostic information right to the patient’s bedside, a new dawn at the least, in treatment.

The other day I was told by a friend that when he visited his GP for a check up he was prescribed a drug called “Nitrofurantoin” capsule as an antibiotic. But having been warned of immunisation to antibiotics, he visited the Emergency Department at his nearest hospital where the Consultant prescribed him a specific type of bacteria drug called “Ciprofloxacin”.
The reasoning was that “personalised medicine” was more important in treatment. The point at issue is that generally doctors have had recourse to treat patients with “broad spectrum” antibiotics, whereas hospitals are now very particular in prescribing, “specific and Personalised Medicine”.

What is happening today from random controlled trials, personalised medicine is assisting to shape the future of medicine. No two cancers are the same so even patients with tumours in the same part of the body, may respond differently to treatment.

We are noticing perhaps due to many factors including cost, population explosion, life expectancy and digital medicine, which “it has to be the right drug, to the right person at the right time”. Gone are the days of anything but the right treatment, for the wellbeing of patients.

We are learning that most diseases are caused by a complex interplay of genetic and other factors such age, lifestyles, hormones, medications, environment and other contributors. It is
no longer an acceptable practice or is ethical to prescribe any drug, to any patient.

In the first instance, the medical profession is slowly by surely recognising that impersonal, wide spectrum drugs are in many cases too expensive to say the least, the wrong treatment, to the wrong patient. This takes into account recent genomic, genetic and other data explosion in a clinical context.

With so many other advances in health care, of course quality of life is becoming an important consideration. But the sanctity of life and the duty of care in my opinion is paramount.

What then is life?

The battle over life and death, of even the most recent medical ethics case to catch the public’s attention is for serious consideration. Promoting good and avoiding harm are serious ethical questions of medicine. It is of course a difficult balance. We, in this instance are asked, both as individuals involved and our society in general, to make moral judgments about the appropriateness either to maintain or withdraw life sustaining treatment.

If we take the easy route of taking refuge in the so called “concept of suffering” involved, we naturally run into buffers. Many do not have the breath of understanding about the different types of brain injury. Coma, brain death, vegetative state, minimally conscious state are all separate and distinct conditions which a patient may pass through, but it is my firm belief that we as a civilised society should work with what we have and try to make it better.

This to me is the meaning of living.

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