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    In the words of Ian Dury and the Blockheads, there are indeed “reasons to be cheerful” about the English dementia strategy. We need a strategy, but we need to think about the imperative for “the cure” while appearing to neglect finer details of care. Furthermore, the actual quality, as well as quantity, of diagnosis merits scrutiny. The need for a strategy Our English dementia strategy has some key prongs from the clinical perspective – prevention, diagnosis, care, support, palliative care/end of life approaches and cure. How these components are balanced has practical implications for funding and resource allocation. Underpinning this […]
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    Within the Osier paradigm, doctors have generally accepted accountability in two directions; to their professional colleagues collectively, and to their patients individually. In each case, accountability has been at two levels: a formal level of official complaint, disciplinary action or litigation; and an informal level of custom and expectations. Because in Osier’s time doctors had so little influence on the outcome of illness, accountability for outcome was not possible. Even the traditional Hippocratic rule ‘primum non nocere’ (above all, don’t harm) was not enforceable; desperate fear condoned desperate remedies; so doctors were encouraged to add substantial risks from treatment to […]
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