What doctors want (and what they don’t)...

Dr Barry Condon

“If I was very ill and had a lot of suffering and I was comatose I wouldn’t want to be maintained or sustained. I wouldn’t like to be resuscitated just for the sake of keeping me alive. That would be something not fair to those around me, to be looking at somebody lying there and probably no hope of a full recovery.

“I wouldn’t burden anybody to have that task in hand. Going to extremes to keep a person alive, taking up valuable space in hospital — you have to have a proper perspective.”

* Dr Barry Condon is a Cork-based GP

Dr Harry Barry

“I feel strongly about prostate cancer. I’m concerned we’re doing a lot of PSAs and the problem is the test is very insensitive. For myself, I’d have to decide is it worthwhile having a PSA done regularly because there really are a lot of false positives. Only one out of every four positive PSA tests turns out to have cancer.

“There are two forms of prostate cancer — the more common is slow-growing and the other is rarer and more aggressive. Part of my problem with the PSA test is that at the moment it’s too non-specific. It’s not picking up the really aggressive cancer yet — it would be a very worthwhile test if it did.

“If I were diagnosed with the non-aggressive prostate cancer, I feel I wouldn’t have surgical or radium interventions because, though there would be a percentage chance that it could shorten my life. The reality is many people with this cancer go for years before it causes them any significant problems.

“If it were me, personally, I’d be very concerned about the side-effects of treating this cancer — incontinence and sometimes impotence. These are very common side-effects and while sometimes temporary can be permanent. My attitude would be that my quality of life would be so affected that it wouldn’t be worth it to me. I’d rather take my chances than have the procedure done. If it were the aggressive form, I’d probably be more open to intervention.

“PSAs cause a lot of unnecessary worry but it’s an individual thing — each man must decide: ‘Do I really want to know if my PSA is up?’

“It’s important to say that I’m stating this at a personal level — this is what I would do for myself. At a medical level, the advice is for men aged between 50 and 70 to have a PSA.”

* Dr Barry GP, is the author of the Flagging series on mental health and board member of depression support organisation Aware

Jack Shanahan

“This is a very complex question to answer. In future, depending on my general state of health, there may be several medical procedures I wouldn’t want done on me.

“The reality is what I would view as part of my living will. Hopefully, I have a good few decades left but at what point would I not want to get medical interventions? The first is if I got senile dementia or Alzheimer’s and I’m in a situation where I’d need fulltime care. I would insist on a Do Not Resuscitate Order — it means if I got a heart attack I wouldn’t be resuscitated. I wouldn’t want CPR in those circumstances.

“It’s all about what value you place on human life — if I’m effectively gone, if the personality that was Jack Shanahan is gone, at that stage I feel there would be very little to be gained in prolonging my life, when the natural course would be that I’d die in that situation.

“There are also certain cancers with a very low treatment success rate. If I had one of those, I’d rather go down the palliative care route than have a few last miserable months getting chemo. It wouldn’t add to the quality of my life in those last months. But this is my feeling now — it could be different if I was in the situation.”

* Jack Shanahan is a Kerry-based pharmacist

Professor Damian McCormack

“In general, I would avoid cosmetic surgery, especially aesthetic cosmetic surgery. As a surgeon, I’m familiar with the unpredictable risks that come with surgery and anaesthesia. I think they are inevitable, occasional risks, therefore surgery should only be undertaken when there’s good medical reason. In my personal opinion, some aesthetic cosmetic surgery doesn’t qualify.

“I think the private cosmetic clinics popping up all over the place are dangerous. There’s a growing danger, with the emphasis on private surgery, that these risks aren’t emphasised to the patient.

“Small stand-alone private clinics especially can be unsafe.”

* Damian McCormack is an orthopaedic surgeon.

Dr John Ball

“I definitely wouldn’t take sleeping tablets. I like to be in control of my own body’s rhythms. Nobody ever died of lack of sleep. it’s something you should catch up on yourself.

“Lack of sleep is a warning to put other things in process – like exercising properly and eating healthily. I think tablets don’t address the core issue of people’s sleep problems: it’d be like telling somebody to have a drink to help them sleep.

“The part of my body I’d least like somebody to operate on would be my eyes. But that’s more phobic than rational. The eyes are so precious and you’re so dependent on them. I certainly wouldn’t let anyone near them for any aesthetic reason — it would have to be an emergency.”

* Dr John Ball is a Dublin-based GP and spokesperson for the ICGP.

Dr Mark Murphy

“I would caution the use of the general check-up in its current format. The modern vogue for screening for conditions before they occur may not be benefiting patients. It may just be over-diagnosing and harming them.

“Unless I had a specific symptom such as a lump or a pain, I don’t think I’d be getting blood investigations done when I feel perfectly well. Doing so wouldn’t prevent me from becoming unwell in the future. It just generates anxiety and medicalises normality. It creates patients out of normal people, it creates disease and causes over-treatment and that causes harm.

“It has become increasingly clear that — for an asymptomatic adult — many of the investigations that can be done may create results that have no clear significance. I believe the best way of preventing ill-health has to do with lifestyle factors — keeping active and eating a healthy diet.”

* Dr Mark Murphy works as a GP registrar in Sligo Town and is chair of the Non-Consultant Hospital Doctor (NCHD) Committee of the IMO

Dr Donn Brennan

“I wouldn’t take statins and this comes out of my personal experience. I had elevated cholesterol, with the ‘bad’ cholesterol being quite high.

“According to medical thinking, I should have considered going on statins because the belief is that you cannot bring your cholesterol down by more than 10% by lifestyle changes. But I’ve brought mine down 30%. It was a very strict diet but I didn’t need it to be so strict. Now, I keep my bad cholesterol low on a relatively easy diet. I’ve cut out animal protein quite a lot. I have milk only in tea. Otherwise I avoid dairy and animal fats and I take more exercise than I used to do.

“I’ve subsequently encouraged my patients to do the same. Quite a few who would have gone on statins got their cholesterol down by lifestyle and dietary changes.

“We’re rushing to drugs before adequately adopting natural strategies of health promotion. The overall consequence is we’re becoming a nation of drug addicts. By 2009, the Government was spending four times more on its drug bill than in 2000.

“All patients should of course get the advice of their doctor and in relation to taking statins should listen to their doctor’s advice. I’m not advocating people give up their statins but they should talk with their doctor about health promotion and lifestyle and dietary changes.

“The prevention of heart disease isn’t about taking a tablet but about having less stress, stopping smoking, taking more exercise, improving diet and enjoying good quality social connections.”

* Dr Donn Brennan is a GP and Ayurvedic practitioner

Dr Micheline McCarthy

“I wouldn’t be comfortable with a junior doctor doing a procedure on me if they’d been working for more than 24 hours. Whether I wanted them to do the procedure would depend on the length of time and the intensity of what they’d been doing over the previous period of time.

“I also wouldn’t choose to have a bone marrow biopsy unless there was a good indication for it.

“That’s no reflection on the procedure itself, which can be quite a comfortable procedure and the test can be quite necessary, but it’s a very large needle and knowing there’s this big needle would make me uncomfortable — as a child I always hated having my blood taken.”

* Dr Micheline McCarthy, NCHD based in Tallaght Hospital

* These are the personal opinions of individual doctors. Consult your own doctor if you have concerns about your health.

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