Helen MacDonald

It involves economics.

It involves values.

It's very complicated.

And one of the reflections that I had listening to a lot of the messages that we get from the UK government is that we keep hearing that they're acting on the best science.

And that's really the thing that's guiding them.

And my conversation with Julian really made me think more deeply about whether that's enough.

And sort of cynically, it feels wrong.

Nice to be able to maybe pass the buck to science if you get it wrong.

But I wish that we heard a little bit more from officials about some of those other factors that Julia mentioned.

I think the point for clinicians, which struck home for me, was this thing about the national guidance.

And I have a massive conflict of interest here because I wrote an opinion piece of a few weeks back sort of saying that I think that this is needed, particularly on these ethical issues.

And just being sure that if there are guidelines being made that do triage or ration the

that the evidence has been considered, these aspects of discrimination and what is legal has been considered, the ethics has been considered.

We didn't hear in that clip from Julian, but he did encourage clinicians to escalate their concerns both locally and more broadly nationally if necessary, if they felt uncomfortable around some of the changes that were being proposed in care around the pandemic.

Yeah, I think it's also about trust as well, isn't it?

And public trust.

And I think if you're having an open conversation with the public around, are you likely to benefit from this treatment?

You just need to make clear that that's what's behind this guidance.

And that's different to the situation that Julian and I were talking about in the podcast, which is what happens when,

when there isn't enough of something, and you might have to then start rationing and triaging.