HOW does the NHS keep people alive longer without compromising their quality of life in the process?
That is the dilemma that Richard Holloway has touched on, but it is something that medical leaders in Scotland are already wrestling with through an agenda known as "realistic medicine".
Read more: Holloway says NHS keeping old alive 'when pleasure has gone'
Catherine Calderwood, Scotland's Chief Medical Officer (CMO), admitted last year that modern medicine had led to a tendency among doctors to over-treat patients and urged a shift to "more open and honest conversations" about risks and benefits that might see quality, not quantity, of life prioritised.
Speaking as she launched her Realistic Medicine report, Dr Calderwood said: “I think that doctors are fixers, they want to help but I think we have perhaps overestimated the benefits of some treatments and maybe underestimated the risks and perhaps underestimated the burden of healthcare, so visits to hospital, visits to the GP surgery, blood tests, monitoring."
Read more: Catherine Calderwood talks 'realistic medicine'
No one would choose to live, as Mr Holloway describes, when their "sole purpose in staying alive" without any pleasure or meaning. But it is a difficult balance to strike without the NHS ending up accused of reducing treatment to cut costs.
The Nuffield Trust has estimated that more than two-fifths of national health spending is devoted to people over 65, with an 85-year-old man on average costing the NHS about five times more than a man aged 30.
This sort of data can imply that the elderly are a drain on resources ,which is deeply unfair. It is right they have more say in their care, but Mr Holloway might argue that they should also have more control over their death - and that is an even harder balance to strike.
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules here