The basic science and ethics are on our side. But we failed to deal adequately with the inevitable political component, which is now the only major barrier to progress.
In the UK context, removing that barrier requires either a major shift within the medical establishment and a willingness to confront and dethrone the PACE/BPS faction, or a change of government to one prepared to acknowledge serious sustained policy failure on this issue, the appalling consequences of it, and force a more scientific and ethical policy upon the recalcitrant medical establishment.
(Hint: Take the first option, medicos. Regard it as a necessary therapeutic purgative to relieve serious scientific and ethical constipation. An unpleasant and humiliating experience to be sure, but you will feel much better afterwards. Your patients certainly will.)
Until then the PACE/BPS crowd will continue to hold the main political cards and nothing will fundamentally change in the UK, which makes it very difficult for rest of the world too.
In the UK context, removing that barrier requires either a major shift within the medical establishment and a willingness to confront and dethrone the PACE/BPS faction, or a change of government to one prepared to acknowledge serious sustained policy failure on this issue, the appalling consequences of it, and force a more scientific and ethical policy upon the recalcitrant medical establishment.
(Hint: Take the first option, medicos. Regard it as a necessary therapeutic purgative to relieve serious scientific and ethical constipation. An unpleasant and humiliating experience to be sure, but you will feel much better afterwards. Your patients certainly will.)
Until then the PACE/BPS crowd will continue to hold the main political cards and nothing will fundamentally change in the UK, which makes it very difficult for rest of the world too.