Does health care in general do any good for our species?

Does health care in general do any good for our species? By saving people from horrible illness and poor lifestyle choices, are we encouraging a weaker human species by going against natural selection processes?

Discuss at will.

[rncountry]

I just have to throw this in for Don M. being Scottish and all. I absolutely agree with the idea that education and healthcare make a society stronger. But what I really wanted to say is that it struck me particularly that Don would say this. Why? Because the Scots have a long, long tradition of public education, or at least a basic education for the public. Does that make sense. In the 1600's Scotland was one of the most poor and considered the most backward of the European countries, then something amazing happened. In large part due to the Presbyterian church, the Scots learned to read, and read they did. By the late 1600's Scotland had the largest reading population of all of the European countries. Nearly 70% of Scots could read. This led to the Scottish enlightenment, producing great philosophers, physicians, attorneys etc... people came from all over Europe to be educated in Scottish universities. The writing of John Locke and his rights of man deeply influenced the founding fathers of this country and the idea of a Republic formed with democratic principals. Adam Smith and his captialist ideals are the basis of the West's economy. Education is capable of leading people to astonding abilities. So what does that have to do with the original question? Everything. As we are able to become more learned we will be able to make better choices, more informed choices. I would bet every single one of us have experienced at least one case where we believed it would be much more humane to have let our patient have basic end of life care instead of the full gamet available. The way to allow people the ability to have death with dignity and release from pain is through educating not only ourselves but our friends, our family, our community. It has not been so very long ago that families had to go to court in order to get their loved one's off a vent because we had an ill concieved notion that to do otherwise was "killing" the patient. The idea of patient rights is very young, and in time it will mature. The ability to make those choices have not always come easily. The nurse who started hospice lost her job because she helped a woman go AMA so she could die at home as was her wish. We have gotten we have because of education though. Is healthcare a right? I don't know about that so much as I believe the mark of a civilized society is how well they take care of the members of it's society that cannot take care of themselves. The vast majority of healthcare dollars are spent on end of life care, and not always wisely. When Western societies, not only America, is willing to accept that death is part of life than perhaps we will see some changes, but that will also take education. The vast majority of my dying patients have fear of pain, it has been the rare patient that I have had anyway who fear death.

To the original question, though, I would say yes, it weakens society. Not in a genetic way, because those patients have already passed on their genetics. But because we are willing to spend sometimes an obscene amount of money on the patient who is G-tube fed, unable to talk etc... while we have children in the beginning of their lives that will not get the care necessary to become strong productive members of society. I suppose that sounds cold, but I know for myself, when I am old I would much prefer the limited resources go to those that have a life yet to live. I do not mean that anyone who is ill should not get the many chances we have to save them, but there is a point in which it no longer is saving the person, but only the body. And in that therein lies the difference. Even if it was one of my children I would do as much as possible to get care that would make a difference to their lives, but if there was very little hope I believe it is a much more loving gift to be able to take care of them with the most love and reverance a person can have for another but to let them go rather than prolonging their lives filled with pain.

And Don, kudo's to the Scots!

[abrenrn]

Kudos to the Scots, too. Thanks, BTW, I did not know most of that. I love to learn new stuff.

I guess healthcare comes down to: resources, distribution and education.

At the prison system I worked in, all HIV patients were expected to sign a DNR at DIAGNOSIS!! I may be too liberal here, but sometimes a couple of days on a vent will get an otherwise stable patient through a pnuemonia. A DNR at end-stage, completely different. Some of these HIV inmates were in for things that, well, there but for the grace of God.

Lots of ethical dilemmas. I agree. I certainly think there is no such thing as too much education.

[JohnnyGage]

I was thinking about this the other night while watching "Maternity Ward" with my wife. A woman has too narrow of a pelvis for lady partsl birth, despite her best efforts, and had to have a c-section. It seems to me that in the past, both she and the baby would have died, thus ending her genes for a narrow pelvis. If c-sections were never done it situations like this, we could assume that eventually, all women would have pelvises wide enough for natual birth.

Having said that ... evolution by definition takes a long, long time. It is likely that the effects of this no-c-section philosophy wouldn't become evident for at least half-a-million years. It seems stupid to not save two lives (mother and child) in a case like this just to promote an evolutionary change that won't directly affect us or anyone we can conceive of.

[$0.02 deposited per request.]

[DIPLOMATICRN4HIRE, MSN, RN]

There are many ways were I can see the natural selection has been hindered

I have also seen were many have a shallow gene pool that sadly contiues to breed.

We have created our own Super Bugs , which I think is our punishment for not allowing natural selection to occur.

We try our best in Medicine to play God and yet we have learned that Only God is God. Only He can make the final decision.

Just my thoughts

Zoe

[brianpribis]

hmmmm, survival of the fittest or natural selection really isn't an issue unless you an unthinking animal. The thing that does make us different is that we can look past the outside and hope for a better inside. Yes, it has its drawbacks, some Hittlers, Mansons, etc. get helped as well, but how many people have been saved who really did somehting for us all? How many great scientests, doctors, nurses, artists, writers and so on were saved by the technology? We save and nurture because people are people and not because they are stronger. That is what makes us humans, that is what makes us nurses.

Oh, and although Darwinian theory sounds nice, look at pictures of the killing fields and the results of the holocaust and tell me they deserved to die because they were weaker. All of a sudden in light of reality Darwin sounds like and ape.

Good question though!

b--

[CRNAorBust]

Does health care in general do any good for our species? By saving people from horrible illness and poor lifestyle choices, are we encouraging a weaker human species by going against natural selection processes?

I don't believe health care does any such thing. People are people. Some of us make better choices than others. Some of us make really BAD choices. All the health care system CAN do is tell them which choices are better for them. It';s up to the individuals to decide if they believe it. This will ALWAYS be the case. That's why I don't believe government or any other institution can MAKE a person or group of persons do ANYTHING good or bad for themselves. And thats' why when government or other institutions TRY all they do is create a new set of criminals and red tape to contend with.

How many of us have patients who are non compliant with meds? Who think poorly about how to behave and wind up with HIV, Hep C, have drug abuse problems etc. Many people come from poor environments and no amount of health care will be able to FIX that.

And its interesting to read this topic because we don't say we have euthanasia in the US but in FACT we DO! My father was in a nursing facility for rehab a few weeks past. He was not attended to properly and wound up with severe dehydration. Obviously at 92 that KILLED HIM. His kidneys shut down, had a K level of 7.0 and Cr of 3.4. then the docs in the ER put in a Central line and he got a small pneumo, Plus sepsis in the blood and the kidneys. The only thing keeping dad alive at that point was Levophed going thru his system. His BP was so unstable that they wouldn't move him to another floor. The doctor asked me what his wishes were. I said "to stop the Levo!" They did and he was gone in one day. But how many others who know little about such matters would hang on to mom or dad in hops of saving them? Health is and always will be about choices. That's what LIFE is about. In lieu of that, I say health care does nothing to extend lives directly. They give us Options to ponder and either correctly follow or not follow.

[mattcastens]

Quote

Originally posted by Stargazer

Well, I just checked in with this thread for the first time in several days and I must say I'm bitterly disappointed there's been no name-calling or flaming yet. Geeze. Promises, promises.

I know! What happened to AllNurses? Has everyone gotten civil? It must be just to impress Santa.

Actually, I've been really enjoying what people have written. Since I started the whole thing, I should probably clarify that I don't belive the premise that I introduced, but I think it's an interesting question.

[BBFRN, BSN, PhD]

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.

[BBFRN, BSN, PhD]

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.

[rebelwaclause, ASN, RN]

Originally posted by sjoe

igflamini--hopefully as you bridge your way to become an RN you'll have time to squeeze in a course in logic.

Ooooo....Don't go there! A "class" DOES NOT make a logical person, just as much as becoming an RN doesn't either!

[BBFRN, BSN, PhD]

Originally posted by sjoe

igflamini--hopefully as you bridge your way to become an RN you'll have time to squeeze in a course in logic.

??? Sjoe, why do you say things like this? I have already taken a course in logic- I do have another degree. Why do you assume simply because I am presently an LPN that I am uneducated? That was an unnecessary comment. And BTW, wasn't it you who said on another BB that you were in favor of universal healthcare? And as someone in their 50's, are you planning on refusing Medicare should the need arise, based on your philosophies voiced here?

[Stargazer]

Well, it's a bout time. Took almost 6 pages for this thread to start living up to its title, even if the bone of contention IS a bit off-topic.