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J R Soc Med. 2001 July; 94(7): 370.
PMCID: PMC1281620

Surgical decisions in the elderly

The study by Miss Farquharson and others (May 2001 JRSM, pp. 232-235) is a fitting reminder that doctors should be advocates for the intellectually disabled. A cardiologist whom I greatly admired exemplified this role when he implanted an expensive pacemaker in a demented patient with a history of multiple falls resulting from sinus node disease—justifying his action by arguing that, if this patient fell and fractured his femur or sustained a subdural haematoma, with consequent physical disability, this would vastly compound the mental disadvantage that he already suffered as a result of dementia. The same argument justifies neurosurgical intervention for subdural haematoma in previously active and mobile patients with antecedent dementia. We need always be aware that the demented have human rights, and that the right to physical disability is not one of them.

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