School of Public Health

Prof. Bicknell believes the public health for the next 50 years is “The art and science of deciding who lives a longer, less miserable and happier life”. It means public health mission is to increase lives of people (quantity) with less misery (quality). Avicenna an Iranian physician and philosopher (980-1037 C.E.), believed that the quality of life is more important than quantity of life. How do you think if you have only two choices, which one is more important for you, quality or quantity?

BBC world services broad-casted a report yesterday (Jan 19, 2008) titled Bladder surgery ‘not necessary‘. BBC reported from UK: Radiotherapy can be a better option than surgery for people with bladder cancer, being effective while preserving continence, say experts. Doctors typically opt to remove the whole bladder when the cancer is advanced. But work by Cancer Research UK shows this should not necessarily be recommended as “gold standard” care.

Removing the bladder can treat the disease (increasing quantity of life), but it may result in continence problems that the person has to live with for the rest of their life (reducing quality of life). Fred Walker, 67, was diagnosed with bladder cancer in 1983. He had his bladder removed. He said: “I know from my own experience that losing your bladder has a daily impact on your life which for some people could be more devastating than the cancer itself. Body disfigurement and embarrassment caused by having your bladder removed can be quite hard to accept.”

It seems medical care system tries to find the alternative ways to not only increase the lives but also reduce the misery. Living long with low quality or living less with high quality always should be a choice for patients to select. This is the right of patients to answer the question of which side do you like better, the side of quality of life or the option of quantity of life.