Apologies for the long silence I have had a break in my blogging not because I ran out of opinions and mad cap ideas but due to lack of time, but if you still haven't tired of my notions I'll start to through them out there again :)

Get into the Ethics Debate

It angers me to say that over the past year I feel I have become more cynical and less confident in the “power of the people”, or should I say the vulnerable people and those advocating for them.

I guess the starkest examples of this relate to the removal of discretionary medical cards from seriously ill children, the increasing gap between the rich and poor in our society and the lack of progress in relation to controlling the advertisement and sale of alcohol and tobacco. I’m sure there are many other examples which could be discussed, but these are the particular few which have particularly troubled me.

Dr. Ciara Kelly took the brave stand of publically challenging the HSE in relation to the removal of discretionary medical cards from seriously ill children or those with lifelong conditions and openly condemned giving medical cards to all those under six in light of the financial struggles which still cripple the functioning of the health service in this country. Much has been said and written in relation to these issues and rather than  repeat what’s been said I’ll just provide a link below.

I admire Dr. Ciara Kelly because she stuck to her own personal set of values and the values which she felt are core to her profession as a doctor. She advocated on behalf of the patients and vulnerable people whom she treated, and who quite frankly were dealing with enough without having to prove their need for a medical card to officials in the HSE. She didn’t pull any punches and she also openly used her own situation as an example of the gulf between the level of need which those with a healthy child under 6 and those with an ill child would have. It troubles me to think what would have happened had she and the families affected had not taken this stand in relation to the medical card controversy.

How could elected representatives and the directors of the health service think that it is right to take medical cards from seriously ill children and the families who devote so much of their time and resources to care for them at no cost to the state, plunging them into uncertainty and financial difficulty ? This injustice was compounded by  the introduction of  free G.P care to children under 6, many of whom do not require regular attendance at G.P surgeries thereby over-medicalising childhood and choking up an already stretched system. In my opinion this represents an attempt at appealing to the voting masses and complete abandonment a minority of vulnerable citizens. 

As a non-drinker, non-smoker I may anger people by writing about the might of the alcohol and tobacco industry, however I want to clarify that I don’t have an issue with drinking or smoking per say. To be honest every smoker I know realises that smoking damages their health and wants to give up but struggle to do so and as a person with an addictive personality I don’t underestimate how difficult it is. Similarly I know alcohol and moderate drinking is perfectly healthy and I often wish I did drink as it can be extremely social and I’m sure helps to deal with the self-conscious terror which engulfs me in social situations, nevertheless I doubt my ability to do so in moderation and don’t want to run the risk of developing an alcohol dependency. My issue is with the industries surrounding these substances and the covert tactics they use to market their products, to combat efforts by the government to reduce their availability and to limit their attractiveness. These industries are economically powerful with resources and legal expertise to challenge any well-meaning initiatives from the health service; pedalling on our fears for the future of the economy and the cultural aspects of Irish life we value so much.

Recently published statistics from The National Institute of Cancer Research (NICR) indicate that as a result of  our lifestyle choices incidences of many cancers are rising at an alarming rate, with cigarette smoking and excessive alcohol intake contributing to a significant number of cases. In spite of these alarming statistics behind which lies an enormous human suffering efforts at reducing the prevalence of these behaviours have been vehemently opposed. Consider the resistance to the attempts to introduce plain packaging of cigarettes. This measure, which has been demonstrated to be effective in making cigarette smoking less attractive to young people and so decreasing the number of young people taking up the habit. To me this seems like a no brainer, given the degree of regret many smokers express in relation to ever having started to smoke and the resources which are channelled into smoking cessation services.

In my view anything which prevents young people from taking up smoking is worth it, as the messages on the packages, supported by extensive medical research, state Smoking Kills. I noticed that the main lobby against the introduction of plain packaging appear to be coming from those in the tobacco industry and the legal might which they employ. At a time when we are just emerging from a recession suggesting that the measure may have a negative impact on the economy and force more tobacco sales into the black market is an opportunistic argument , whether it is valid or not. Strangely those who object to the introduction of a measure which has been demonstrated to decrease the uptake of cigarette smoking appear to be primarily from middle or upper social classes, where the incidence of smoking is much lower than that in lower socioeconomic classes. In this debate those whom are most affected by the health implications of cigarette smoking have little voice and are reliant on elected representatives to advocate on their behalf. Somewhere along this path someone is trying to convince us that the economic success of the tobacco industry is more important than health and indeed human life. This isn’t a concept I will buy into and I sincerely hope that the same degree of bravery which lead to the introduction of the ban on smoking in public places, despite claims that it would signal the death knell of pubs and cause wide spread public disorder, is exhibited.

On a similar vein the resistance to  two measures which the WHO has recommended as best buys in terms of improving health , the introduction of minimum pricing of alcohol and banning of alcohol sponsorship of sport have been resisted by industry . The objections centre around it’s impact on sport and on alcohol sales. When we look at the number of huge companies which don’t generate income from a potentially addictive substance which can seriously damage health and limit life expectancy there are many, surely they could fill the breach and facilitate the development of a healthy sporting relationship where it’s enjoyment and disappointed isn’t associated with alcohol.

 For this reason I welcome with hope President Higgins initiative to stimulate discussion and debate around ethics. I fear that as our nation has developed and dealt with the financial setbacks of recent years, we have distanced ourselves from a set of solid values which determine policy and practice seeking to create a just society for all. Perhaps we have developed tunnel vision and lost the capacity to see beyond our own agendas. President Higgins is not alone in his desire to stimulate conversation around the values which underpin both personal and societal decisions in this country and indeed on a global level. Former President Mary Robinson has also asked us to reflect on how our decisions in relation to climate change can and will impact on future generations, encouraging us to look beyond our own time on earth and to make efforts to spare those who follow us from unnecessary suffering which we could have prevented .