Editor's blog Wednesday 17 November: Paternalism - not just an NHS thing

The report by Johnathan Brown in today's independent about the Burke and Hare-type exploits of a pathologist associated with Sellafield nuclear power station is a sobering reminder that unacceptable paternalism is by no means confined to the NHS alone.

It is clear that West Cumberland Hospital colluded firmly in these activities. Which even in the mid-1980s, which appears to have been the peak, would properly have been regarded as unacceptable by pathologists other than the van Velzen lunatic fringe. The activities of British Nuclear Fuels Limited's chief medical officer Dr Geoffrey Schofield are particularly unsavoury.

The issue is of course consent. I fully understand the medical argument that once the tissue, flesh, organs and bones no longer contain life, the important part of a person is gone.

In principle, I pretty much agree: I've repeatedly told close family that (after checking carefully that I am actually dead), they can put me out with the dustbin, or preferably do something more environmentally-friendly. I won't care, because the part of me that is me won't be in that body any more.

But I also accept that the people left behind will (hopefully) have an emotional response to my not being in this body any more, and may want to do the ritual wooden box in turf thing. Like I say, I will be dead: I don't anticipate minding much what they choose to do.

As long as they get to choose.

Healthcare can seek objectivity, peer-reviewed evidence, dispassionate analysis. All these are good and needful things. But it repeatedly errs and fails when it does not stop to think about what the patient (or their family or carer) experiences, feels and thinks. Too often, the healthcare industry simply doesn't ask.