A philosphical question bound to regress to name-calling and flames - page 5

Here's a discussion for you -- and bear in mind this does not reflect any particular personal belief: Does health care in general do any good for our species? By saving people from horrible... Read More

  1. by   sjoe
    BT writes: "I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50). And as for spending a million or two to keep any one person alive, no matter what the medical problem -- I don't get it."

    I agree completely (and I also am over the age of 50), and would impose other significant limits on our healthcare system (such as eliminating all subsidies for IVF, treating the predictable consequences of smoking, excessive ETOH consumption, IV drug use, obesity, among other things). Someone has to have the courage to say "enough." We need to recognize our limits instead of continuing to base our decisions on stale sentimentality and wishful thinking. When the country gets around to looking for a healthcare czar to do so, I volunteer myself (though I don't expect to be around THAT long).

    The inability to recognize that our resources, healthcare and otherwise, are finite is to be living in a daydream. We in the US are already ripping off most of the rest of the world's resources just to maintain our present living standard and still we are leaving more and more of our own citizens behind for the benefit of those who already "have," not to mention those people who live in most other countries. IMHO.

    And for those who believe that I am mistaken, cruel, and/or wrong-headed, then YOU pay for all this stuff if you want to, but count me out of paying for it (in taxes and insurance premiums). Put YOUR money, time, and effort--not mine--where your mouth is.

    (Trying to bring the title of this thread "A philosphical question bound to regress to name-calling and flames" into fruition.)
    Last edit by sjoe on Dec 13, '02
  2. by   purplemania
    The Bible says if it is within your power to do good to someone then do it. That is enough for me. I still think God is in control no matter how much we do or don't do.
  3. by   BellaTerra2002
    Come on, Stargazer. That's not at all what I meant, and you know it. We're not going to let anyone die from something that is considered routine or even almost routine health care. And not only do I still stand by what I said, I agree completely with Sjoe.

    We simply cannot keep EVERYONE alive, no matter what the cost. (Of course, that's not even a consideration for those without insurance. Let them get a terminal illness and they're dead, most of them, and I know that for a fact, because I've seen it over and over.) Even with people with good insurance, we need to learn and accept when to let me them go. The doctors can't keep seeing a death as a failure, and relatives can't be allowed to keep comatose Grandma Sara in the end stages of cancer in ICU for three days while Grandpa comes to grips with the fact that she's going to die -- or already brain dead. And we certainly can't afford to keep everyone in the US who needs dialysis on it. That was one of the biggest healthcare dollar mistakes we ever made. And why should be keep Uncle Jake who is 60 and with terminal lung cancer (whether or not he smoked) alive for another five years, with chemo, meds and surgeries?? And as for the 10-year-old girl with any type of currently terminal cancer, perhaps all we should do is make life as comfortable as possible while she dies.

    Many years ago our county had a Roman Catholic priest in his 40s who decided to stop dialysis and allow nature to take its course. My god, what an uproar. People accused him of committing suicide, for gripe's sake! But the Bishop tried to explain that it was perfectly within anyone's right not to be treated for a terminal condition, quasi or absolute. And the priest died.

    We see death as 'The Enemy' rather than something that happens, irrespective of age. We don't have a God-given right to live to a ripe old age. And we don't have a right to rob another of minimal healthcare while we're using too many healthcare dollars to prolong our lives for a few more years simply because we're afraid to die.
  4. by   Vsummer1
    Originally posted by BellaTerra2002
    I have seen many situations in which technology has overridden our humanity.

    I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50).

    I have a GF in her middle 60s who has been fighting breast cancer now for over a year. I know I will never do that because I've thought about it long and hard. She's had a good, long life (and so have I). Neither she (nor I) are making contributions to society that society can't live without. Perhaps it's time to 'move on' and make room for someone younger.
    I think your humanity on this is questionable, technology or no. Think about it: I was 10 years old when my parents were 50. So, someone decided 50 is too old to contribute to my upbringing, so let them die of cancer and not treat it. I think that is INHUMANE.

    I think you need to look at this a bit differently and look at INDIVIDUALS. Maybe you had your kids when you were young so you think YOU have nothing more to contribute. So be it, go ahead and choose to die. My 50 year old parent had a LOT to contribute.

    Ever see the movie Logan's Run?
  5. by   sjoe
    BT writes: "Many years ago our county had a Roman Catholic priest in his 40s who decided to stop dialysis and allow nature to take its course. My god, what an uproar. People accused him of committing suicide, for gripe's sake!"

    A good illustration of how far "Christianity" has gotten away from the person who is supposed to be their ideal example.

    I suppose the same people would have berated JC for choosing "suicide" since he didn't even bother to defend himself against the authorities. If his death was an example of something useful, it was that hanging on to staying alive is NOT the primary consideration, but that it's value pales when contrasted to things like "meaning," for example.

    Our present, costly, and often sadistic focus on "keep them alive no matter what" flies directly in the face of this lesson, but these people seem blind to such obvious logic.
  6. by   duckie
    Personally, I do not think age even has an issue in this discussion. My reasoning.....until last week we had a person in our facility that is 106, yes you read it right, 106 and was still living on our assisted living unit, caring for theirself, ambulating all over the building without the asisst of a walker and we're talking a multi floor complex here. This person took a fall and now is in healthcare, where is goes from here is up to God. Age is not the issue, it is quality of life. If you save my life, will I lay in a bed, urinate and deficate myself, drooling and having to be fed either per tube or another human....if so, let me go. But if there's a GOOD possibility that I can dance at my great grand daughters wedding, have at it and let's keep it ticking. Family members need to be more educated to think with their mind and not be selfish about letting go when the outcome serves no purpose but for them coming to see a body laying ina bed once every six months so they don't have to feel quilty. Death is NOT the worst thing that can ever happen to us, selfish relatives are. Yes, it hurts to loose thoses we love, I'm an expert on loss, but I would rather free my loved one up from this earthly pain and promise to meet them again someday and have a reunion when we are all happy and painfree.
  7. by   BBFRN
    Originally posted by sjoe
    BT writes: "I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50). And as for spending a million or two to keep any one person alive, no matter what the medical problem -- I don't get it."

    I agree completely (and I also am over the age of 50), and would impose other significant limits on our healthcare system (such as eliminating all subsidies for IVF, treating the predictable consequences of smoking, excessive ETOH consumption, IV drug use, obesity, among other things). Someone has to have the courage to say "enough." We need to recognize our limits instead of continuing to base our decisions on stale sentimentality and wishful thinking.



    And for those who believe that I am mistaken, cruel, and/or wrong-headed, then YOU pay for all this stuff if you want to, but count me out of paying for it (in taxes and insurance premiums). Put YOUR money, time, and effort--not mine--where your mouth is.

    (Trying to bring the title of this thread "A philosphical question bound to regress to name-calling and flames" into fruition.)
    Please don't take this as a flame, but on the other side of the coin, didn't Hitler carry this kind of philosophy? I realize that he didn't let nature take its course when he put all those people with malformations,genetic disorders,etc. in concenration camps along with the Jews, but where do we draw the line with this? It's too heavy for us as a civilized entity to decide this, and Dr.'s have to uphold the Hippocratic Oath, don't they? Darwin brought up this question already, and still, the question lingers as to who is qualified to decide whose life is more valuable than another's? I know I'm not, nor do I want that kind of responsibility. When I'm treating a patient, their insurance (or lack thereof) is none of my business or concern. A person's lack of money doesn't make them a less valuable person. And as far as taxes, the U.S. Income Tax rate is still fairly low compared to other countries.
  8. by   abrenrn
    What seemed like extraordinary measures yesterday are routine today.
    At one time, any type of surgery was extraordinary.
    If an attempt to treat is combined with a desire for knowledge, we move forward. If we don't treat, we can't learn. If we only want to move forward, we lose our humanity (as in concentration camp "research").

    Question is, can the patient accept the price (money, pain, inconvenience) of the treatment? Do they want it? If they have the resources and the desire, I feel obliged to recommend treatment.

    Was this a flame? It didn't feel like it as I wrote it, sometimes I'm told otherwise.

    Just curious.
  9. by   BBFRN
    Originally posted by abrenrn


    Was this a flame? It didn't feel like it as I wrote it, sometimes I'm told otherwise.

    Just curious.
    Heehee, welcome to the club. I now feel obligated at times to add a non-flame disclaimer.
  10. by   baseline
    I just have to say that technology and ethics unfortunately don't always move in the same direction, and although I have enjoyed reading many of the ideas shared here, the only opinion I choose to render is about age. My Mom is 86, bowls on 2 leagues, reads a couple of books a week, and is bright and continues to give to society. IMHO society is better for her presence.
  11. by   BBFRN
    Originally posted by baseline
    I just have to say that technology and ethics unfortunately don't always move in the same direction.
    I agree. Look at the Human Genome Project. It started out innocently enough, and now the Insurance companies are beginning to look into having people genetically tested to determine genetically precipitating factors in whether a person should be covered for certain illnesses.
  12. by   hoolahan
    I loved what VickyRN said, and agree with all of it, and I also like Karosnow's thoughts very much and agree with them.

    I wouls like to add my comments on health care being better for the rich, oh yes it is!!

    Take Christopher Reevs for example. Do you think your or I would have the same opportunities for such amazing physical therapy, and research studies, and being in on the best new meds?? Not in a million years.

    When I was 22 and worked in a med/surg ICU, frequently taking care of quads after C1-2 transection, I decided I would NEVER want to be in their shoes...DNR.

    But then I had children, and the thought of not being able to see them grow up ripped me up, and I decided even if I had to be Christopher Reeves in my WC at their soccer games, I wanted to be there for them.

    Now I have changed my mind again. I have seen them grow into fine young people, they still need lots of nuturing and guidance, but somehow if I died tomorrow, I would feel like they would be OK. And the LAST thing I would want now is to be such a burden, like Mr Reeves, by having to have family wipe my ass. What kind of a life is that to leave to your children? I wonder now how could I have ever had such selfish thoughts to want to stay alive like that.

    Many would argue Mr Reeves life is productive, etc... I just do NOT see it that way, and wouldn't choose that for MYSELF at all. I don't fault him for his choices, but I would not want it for me.

    I guess it all depends on where you are in your maturity and if you are able to make a conscieous decision for yourself. What about the 22 yr old who is in a vegetative state, when their parents die, who is going to care for them??

    I do not belive we can say over age X nothing further can be done. But I do believe that uneccesaary interventions should not be done, even if someone wants it, say if a pt is filled w CA, they should NOT be resusitated and should be offered excellent pain management. Cardiac surgery on people w cardiomyopathy shoud not be done just so a hospital can make money. Treatment must be necessary, curative, and ethical. Those who don't fall into that category need access to palliative measures.

    In cases like Mr Reeves where he would die if resus is not attempted, and the extent of the damage isn't known at the scene, that is a hard call. Once treatment is established, pulling the plug is another story, that is like playing God, but not allowing unecessary Rx to start at alll, like not even intubating someone w terminal CA, that is where we maybe need to start.

    I don't know if this made sense. Maybe I have even contradicted myself, these are just my rambling thoughts on the subject.
    Last edit by hoolahan on Dec 14, '02
  13. by   sjoe
    igflamini--you are making a very big mistake to drag Hitler into this discussion.

    Didn't he also sponsor and pay for many "medical experiments" on human beings "in the name of science and better medicine"? (Some of this data, by the way, was found to be medically useful by the allies after the war ended.) These were experiments that often created substantial suffering, as does much of the "treatment" we administer on critical care, surgical, ortho, etc. wards each and every day to "subjects" who don't have the physical and/or mental ability to refuse.

    Not to mention the simple fact that squandering our healthcare dollars and services in the ways that we do precludes providing basic healthcare for people who would otherwise live much longer and healthier lives, but who don't happen to have insurance or qualify under a given government program. (Let alone the rest of the 6 billion people on the planet.)

    and later "who is qualified to decide whose life is more valuable than another's? I know I'm not, nor do I want that kind of responsibility. When I'm treating a patient, their insurance (or lack thereof) is none of my business or concern. "

    and still later "Look at the Human Genome Project. It started out innocently enough, and now the Insurance companies are beginning to look into having people genetically tested to determine genetically precipitating factors in whether a person should be covered for certain illnesses."

    Not surprisingly, you will NEVER SEE the others, since they didn't make it through the door. These decisions are already being made, primarily based on economics. If you want to continue surrendering these choices to bean-counters, so be it. You don't like the way it is presently being done (by insurance companies, etc.) but you don't want to take any of the responsibility for doing it yourself. I, for one, am willing to take responsibility for helping to make them, when, as I said, I am the healthcare czar.

    Hoolahan--your thoughts made good sense to me, and I have no problem at all with Superman going through whatever he wants to go through, so long as HE is paying for it (which is the case), not the rest of us. I certainly wouldn't choose to live that way, whether I could pay for it or not, but just as certainly I wouldn't expect anyone else to pay for it, regardless..
    Last edit by sjoe on Dec 14, '02

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