Thursday, December 07, 2006

Mandatorily Mine

[posted by dinah]

My title is a take-off on ClinkShrink's title. I was thinking of commenting on her post, and decided I wanted one of my own.

So Clink talks about the idea of legislation as it effects how health care is delivered. We've already talked about the NHS Blog post on proposed legislation in the UK to mandate psychiatric evaluation (or screening?) of all those entering hospice care. Clink goes on to talk about legislation mandating screening for post-partum depression in New Jersey, and her feelings about legislating health care relationships. See Mandatorily Yours below.

I think the whole world is nuts.

Okay, let me explain. Basically, I believe you live until you die, and that there are only a handful of things that one can control. The biggest, obvious causes of unnecessary premature preventable death are obvious: Smoking and Car Accidents seem to cause a lot of preventable mortality. People, however, want autonomy, and want to make their own choices: no matter how you dice it, smokers want the choice to kill themselves. And while I don't smoke, I do drive, and while I don't drive drunk and I'm reasonably careful, even good, careful, law-abiding drivers are susceptible to death. Last I checked, it's illegal to drive while intoxicated, but this mostly seems to be an unenforceable law.

So what can we control, and should we? What do we, as a society, choose to legislate, and does it make sense? Over forty years after the Surgeon General's warning about the dangers of smoking, we're finally making it illegal in public places. You may be legal to drive after a drink or two, but if you're on your death bike (oops, I meant motorcycle), you may be required to stick a helmet on your head --so much for the wind ruffling through that gel-held hair-- and to buckle your seat belt. Should we go further? Why should you be allowed to stroke out - should we mandate yearly blood pressure screening? Should we make junk food illegal? Please say no! But wait, in New York City, they've passed a law banning trans fats in restaurants ! So you can smoke then have a couple of drinks (keep that level under 0.8) and jump in your car (don't forget to buckle up), but I can't eat a donut?