A well written (IMHO) article that I would like to share:

http://www.linkedin.com/pulse/i-know-you-love-me-now-let-die-louis-m-profeta-md?trk=pulse-det-nav_art

I can absolutely relate to its content as I am taking care of my 97 year old Mother at home. Fortunately, we have discussed such issues in advance and I know how she wishes to be treated.

It is a great article and points to the developments in medicine that can be used as a curse or to heal depending on where you are in your life.

I agree that "the new norm" is something society has to talk about.

I work in palliative care now and a lot of discussions center around the goal of care. More often, patients will say that they decline certain measures like artificial nutrition, chest compression or intubation but the family will intervene. And then there is the whole idea of how to pay for staying at home. Nowadays where people may not have children or other family close by, survive family or friends due to high age, or are estranged from anybody in the community, they may not have anybody to take care of them. Some can afford to pay privately for care but that is the minority. For the ones who qualify for Medicaid there is always the nursing home if they can not stay at home anymore. But there are a lot of people who do not qualify for Medicaid but who just get by and do not have the financial means.

Our society needs to talk about end of life and have a dialogue about how we want to live the end of our life and die...

Excellent reporting by the PBS Show FRONTLINE on the above mentioned issues and available to view online:

FRONTLINE gains access to the ICU of one of New York's biggest hospitals to examine the complicated reality of today's modern, medicalized death. Watch Full Episodes Online of FRONTLINE on PBS | Facing Death

Medical advances have enabled an unprecedented number of Americans to live longer lives, but this new longevity has unintended consequences. With families more dispersed than ever and a healthcare system overburdened, many experts fear that we are on the threshold of a major crisis in care. Watch Full Episodes Online of FRONTLINE on PBS | Living Old

I love this! It mirrors my own opinion perfectly! There comes a time when you have to say "Enough is enough." Many people are unable to do this, and I understand how they feel. I truly do. But, as medical professionals, we should know better! The medical profession is supposed to be all about patient rights and patient dignity. There is no dignity in the way we treat our senior family members. It's all about how much money can be made from insurance and family members not wanting to let go! Please, please let's allow these people to have the dignity and peace they deserve in their final days!

I keep thinking I'm going to write an article one of these days about just how Frankenstein we can be these days. I had one patient for three nights straight who had no pulses in her arms and legs, we could only doppler her femoral pulse, and the only palpable pulse was a 1+ carotid that I had to dig for. We couldn't get a blood pressure reading for a whole shift because nobody could get an arterial line and there was no extremity with pulses, so we couldn't even doppler a systolic. I just checked a carotid pulse every now and then to make sure her heart was still beating, that the rhythm on the screen wasn't just PEA, because of course the patient was a full code. Not that compressions would have done anything at that point.

I brooded over that for months. We've gone beyond just giving people the ability to breathe, to eat, and to pee - we can literally sustain a brain dead corpse with no pulses for days, maybe even weeks, maybe even longer than that. That one only died because we withdrew care on her. How much longer could that have gone on if the family was more stubborn? It's awful to think about. We've gone way past sustaining life and sustaining quality of life and have gone into full blown reanimation of dead people at this point with how good our drugs and machinery are. Sometimes it really bothers me.

I keep thinking I'm going to write an article one of these days about just how Frankenstein we can be these days. I had one patient for three nights straight who had no pulses in her arms and legs, we could only doppler her femoral pulse, and the only palpable pulse was a 1+ carotid that I had to dig for. We couldn't get a blood pressure reading for a whole shift because nobody could get an arterial line and there was no extremity with pulses, so we couldn't even doppler a systolic. I just checked a carotid pulse every now and then to make sure her heart was still beating, that the rhythm on the screen wasn't just PEA, because of course the patient was a full code. Not that compressions would have done anything at that point.

I brooded over that for months. We've gone beyond just giving people the ability to breathe, to eat, and to pee - we can literally sustain a brain dead corpse with no pulses for days, maybe even weeks, maybe even longer than that. That one only died because we withdrew care on her. How much longer could that have gone on if the family was more stubborn? It's awful to think about. We've gone way past sustaining life and sustaining quality of life and have gone into full blown reanimation of dead people at this point with how good our drugs and machinery are. Sometimes it really bothers me.

There are things worse than death.