Tag: drugs

Conversations about Anxiety

This morning, I had a conversation with a friend about anxiety. (It’s good to talk, folks!)

We all experience anxiety to some degree. I know I do. I worry about certain situations and often place far too much emphasis on what others think of me. But I’m gradually accepting that these things are out of my control. So why worry?

My friend, (let’s call her Brenda!), was absolutely fine when she got to mine, though her anxiety had flared up earlier causing her to overreact and behave irrationally. As she put it, she “catastrophized”. The fact she’s aware of this is, in itself, a positive sign.

Brenda has various mental health issues resulting from personal trauma. She takes antidepressants, antipsychotics and is undergoing counselling.

For a LONG time she buried her issues and tried to carry on as usual. This culminated in Brenda becoming very ill and unable to cope with everyday life. It was only at this point that she sought medical support and realised that what she was experiencing isn’t “normal”.

I asked Brenda what happened this morning to cause her to overreact. Her parents have bought a wooden toy kitchen for her son, which wasn’t in the plan. It’s a Christmas present Brenda specifically told her mum not to buy. Not a big deal, you might think. So I asked, “why did it bother you so much?”

Control. The situation was taken out of her control and this triggered Brenda’s anxiety.

She worried her son wouldn’t like it.

She worried he would like it too much.

She worried he might be teased/judged for receiving a stereotypically girly toy.

She worried about the cost.

She worried that he would prefer the toy kitchen to the gifts she has bought for him.

She was overthinking the whole situation. But she knows this. So once her anxiety subsided a little, she removed herself from the situation, went home, shut herself away and had a nap. Anxiety is mentally and physically exhausting!

It’s only through therapy and counselling that Brenda is learning to recognise her triggers, symptoms and manage her anxiety. She can better organise her thoughts, respond to her feelings and differentiate between what is real and unreal.

She summed up her anxiety in one simple phrase ~ fear of the unknown. I’d never thought of it this way. But it makes a lot of sense!

Guest Post | NHS Funding

Resource Allocation: A classic medical ethics topic that often rears its head in the inevitable reality of working in a cash-strapped public healthcare system.

Should the NHS fund this new expensive treatment for a rare disease?

Should the government pay for a new experimental cancer treatments?

Should X procedure be on the NHS, or Y?

The list is endless.

This blog covers a few basic ideas and concepts for you to broaden your understanding of why things are done as they are, enhance your opinion and help you think of the bigger picture.

Utilitarianism

One way of analysing resource allocation is using a utilitarian approach. Utilitarianism describes the moral theory that the most moral action is that which maximises the happiness (or in this instance healthiness) of a population. This seems quite a nice logical and fair systematic approach, but has one major drawback.

How do you quantify the benefits gained from a specific treatment?

Fortunately, Alan Williams, a health economist calculated a measure for doing this – the Quality Adjusted Life Year. This system described not only the length of life a specific treatment can give a patient, but also factors in the subjective quality of that life.

Interestingly, some of the ‘best’ treatments by this system including cataract surgery and hip replacements, owing the massive improvement in life these can bring (even though they are rarely viewed as life extending). However, despite quantifying the ‘best value’ treatments, this system still has its drawbacks.

Firstly, many argue that this system ignores both the old, and the chronically ill. The old will have fewer ‘life years’ per treatment and the chronically ill will have a lower ‘quality of life’ per treatment by this system, and will thus lose priority in this system.

This a great concept to think about as many new drugs are for specific diseases, which are often rare and chronic, or those which affect the elderly. Secondly, ‘quality of life’ is a highly subjective term, and, although this system goes someway to quantify it, the end result is still a subjective rating score.

Egalitarianism

Another way of analysing these topics are through an egalitarian approach. This theory states that resources should be distributed equality unless an unequal distribution would work to everyone’s advantage. However, in reality, there is not unlimited funding and therefore equality of distribution means that expensive treatments (the new drugs often featuring questions) could not justifiably be funded.

This approach does promote a decent minimum standard of care (good for everyone) and some argue that more expensive treatments can be funded elsewhere. For example, charities and private companies could find a place in an egalitarian healthcare system to fund more niche treatments.

Libertarianism

Another viewpoint worth nothing (though one which many, especially in the UK, would be against) is that of libertarianism. This system states that healthcare should follow individual liberties and free market principles – i.e to be privatised. This is an interesting viewpoint to discuss, but, given the many drawback of private healthcare and the NHS in the UK, it’s not one we in the UK really consider.

So, there we have it, a few basic approaches to the classic question of ‘should we fund this expensive new drug’.

This guest blog post is provided courtesy of writer Adi Sen, from the website UniAdmissions.

Disclaimer: The views and opinions expressed in this article are those of the author (UniAdmissions), and do not necessarily reflect the official policy or position of myself or any other organisation.