Comments on: Why is it so hard to die? http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/ Sun, 20 May 2012 12:29:45 +0000 http://wordpress.org/?v=2.7 hourly 1 By: dblacklock http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-935 dblacklock Sat, 05 Dec 2009 20:17:49 +0000 http://www.thinkoob.com/?p=243#comment-935 The nurse at the nursing home notes the decubitus ulcer on the patient's lower leg. The patient has something wrong with every organ system, is bedridden and on tube feedings, has not had a thought in years, and has contractures in all muscle groups. The nurse is obligated to call the PA who makes rounds every day. The PA feels obligated to tell the internist who makes rounds every month. The internist decides that her only hope is amputation and feels obligated to call the surgeon. The surgeon was obligated to see what the family wanted done. The family, who lives 500 miles away, says, "do what you can." I was in the OR when the surgeon was holding the leg and joked, "It's pretty sad when you get off the specimon and can't decide which part to throw away." DB The nurse at the nursing home notes the decubitus ulcer on the patient’s lower leg. The patient has something wrong with every organ system, is bedridden and on tube feedings, has not had a thought in years, and has contractures in all muscle groups. The nurse is obligated to call the PA who makes rounds every day. The PA feels obligated to tell the internist who makes rounds every month. The internist decides that her only hope is amputation and feels obligated to call the surgeon. The surgeon was obligated to see what the family wanted done. The family, who lives 500 miles away, says, “do what you can.”

I was in the OR when the surgeon was holding the leg and joked, “It’s pretty sad when you get off the specimon and can’t decide which part to throw away.”

DB

]]> By: kara http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-272 kara Wed, 28 Jan 2009 03:37:12 +0000 http://www.thinkoob.com/?p=243#comment-272 Just because something takes place in a healhcare setting, doesn't make it healthcare. Staying alive is a religious decision and shoukd not be subsidized by the government. Botox, though not a religious decision, takes place in a healthcare setting but it's also a matter of personal choice, not a matter of healthcare. I vote for the 'controversial" option Just because something takes place in a healhcare setting, doesn’t make it healthcare. Staying alive is a religious decision and shoukd not be subsidized by the government. Botox, though not a religious decision, takes place in a healthcare setting but it’s also a matter of personal choice, not a matter of healthcare. I vote for the ‘controversial” option

]]> By: barrymd http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-147 barrymd Fri, 02 Jan 2009 14:39:47 +0000 http://www.thinkoob.com/?p=243#comment-147 your blog raises the economic issues squarely. I Your make a supposition in your recommendations that changing the economics or reimbursement would change the provision of services. However, the sensitivity of the issues in my earlier email make adoption of policy and social acceptance difficult. your blog raises the economic issues squarely. I Your make a supposition in your recommendations that changing the economics or reimbursement would change the provision of services. However, the sensitivity of the issues in my earlier email make adoption of policy and social acceptance difficult.

]]> By: healthcareconsultant http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-144 healthcareconsultant Thu, 01 Jan 2009 14:38:07 +0000 http://www.thinkoob.com/?p=243#comment-144 Barry raises a good point. Abortion is about the life of the fetus. One must respect that both sides of the debate have deep passions about it even if in complete disagreement. Here, though, we aren't talking about someone's life. We're talking about extending the death process for a few more days or weeks. And I have no objection if peopel wwant to do that . I just don't want to pay for it. It has nothing to do with health care and shouldn't be in the basic policy I buy unless I want it separately. Barry raises a good point. Abortion is about the life of the fetus. One must respect that both sides of the debate have deep passions about it even if in complete disagreement. Here, though, we aren’t talking about someone’s life. We’re talking about extending the death process for a few more days or weeks. And I have no objection if peopel wwant to do that . I just don’t want to pay for it. It has nothing to do with health care and shouldn’t be in the basic policy I buy unless I want it separately.

]]> By: BarryMD http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-142 BarryMD Wed, 31 Dec 2008 14:50:38 +0000 http://www.thinkoob.com/?p=243#comment-142 The issues here are like the value issues in the abortion debate. However, they really are different. There is much more pain and suffering and futility in the death process. The argument that uses Thou shalt not kill" is horse manure. Even the scripture identifies exceptions some of which are as difficult and more questionable than turning of the respirator (like war, the death penalty for certain crimes, and self defense). Rabbinic Midrash (teaching) is great on this. Ethical principles are often the clash of several values. There is clearly a point where it is more cruel and unjust to prolong the life. The issues here are like the value issues in the abortion debate. However, they really are different. There is much more pain and suffering and futility in the death process. The argument that uses Thou shalt not kill” is horse manure. Even the scripture identifies exceptions some of which are as difficult and more questionable than turning of the respirator (like war, the death penalty for certain crimes, and self defense). Rabbinic Midrash (teaching) is great on this. Ethical principles are often the clash of several values. There is clearly a point where it is more cruel and unjust to prolong the life.

]]> By: healthcareconsultant http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-136 healthcareconsultant Sat, 27 Dec 2008 12:21:08 +0000 http://www.thinkoob.com/?p=243#comment-136 I think you could do just the first two and shine a light on "futile care" in the USA. I think we are spending way too much on futile care and that money could be redirected. Those two ideas are easy ways to reduce this amount. I think you could do just the first two and shine a light on “futile care” in the USA. I think we are spending way too much on futile care and that money could be redirected. Those two ideas are easy ways to reduce this amount.

]]> By: lostwifetoo http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-119 lostwifetoo Sat, 20 Dec 2008 13:39:00 +0000 http://www.thinkoob.com/?p=243#comment-119 someone could write a book on it - step in where the states are failing - on how to handle the last days of caregiving. An author could say stuff that a nurse couldn't say someone could write a book on it - step in where the states are failing - on how to handle the last days of caregiving. An author could say stuff that a nurse couldn’t say

]]> By: joe_keith http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-98 joe_keith Wed, 10 Dec 2008 14:46:21 +0000 http://www.thinkoob.com/?p=243#comment-98 I have been through this personally with my mother. She could not possibly have wanted to die like she did but the most you can do is take someone off life support, which we did and which she wanted. BUt she didn't die and seemed very uncomfortable. Even speeding it up by 3-4 days via physician-assisted suicide would have been a blessing. And, yes, a cost savings I have been through this personally with my mother. She could not possibly have wanted to die like she did but the most you can do is take someone off life support, which we did and which she wanted. BUt she didn’t die and seemed very uncomfortable. Even speeding it up by 3-4 days via physician-assisted suicide would have been a blessing. And, yes, a cost savings

]]> By: alewis http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-97 alewis Wed, 10 Dec 2008 13:47:54 +0000 http://www.thinkoob.com/?p=243#comment-97 Make it even easier -- just specify that the form document for the advance directive, which contains checkoff options, have an additional option of physician-assisted suicide, so someone can elect it right on the advance directive. The "rules" for it would be patterned after Oregon. Make it even easier — just specify that the form document for the advance directive, which contains checkoff options, have an additional option of physician-assisted suicide, so someone can elect it right on the advance directive. The “rules” for it would be patterned after Oregon.

]]> By: healthcarereformer http://www.whytheheck.com/2008/12/09/why-is-it-so-hard-to-die/comment-page-1/#comment-95 healthcarereformer Wed, 10 Dec 2008 12:09:56 +0000 http://www.thinkoob.com/?p=243#comment-95 one wonders how adamant Terry Schiavo's family would have been about keeping her alive if they had been paying the bill instead of the rest of us. Society has an interest in keeping us all healthy. That is why public healthcare exists, but it has no interest in keeping people alive a few more days or weeks. That is a "private good" not a public good like healthcare. one wonders how adamant Terry Schiavo’s family would have been about keeping her alive if they had been paying the bill instead of the rest of us. Society has an interest in keeping us all healthy. That is why public healthcare exists, but it has no interest in keeping people alive a few more days or weeks. That is a “private good” not a public good like healthcare.

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