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

[RNed]

Yes, it does good for society. However, there needs to be an ethical, moral and healthcare discussion on how much money and services should go to support those that, by study, we know will have poor or bad outcomes. Too much money is spent on the last days of life because our society fails to accept death.

Healthcare has continued a mission statement to postponed death at all costs and has spoonfeed this as "good" to society without open and honest dialog. It attacts anyone who would limit funding as immoral, unethical and without compassion. In other words you are a bad person if you do not continue to fund the medical machine. This is an unfair statement and used to keep the funds flowing.

Medicine is a double edged sword. It has its good and its bad. However, because we can, does not mean we should.

Society is served with good medicine, but like anything else to much can be a bad thing.

[legsmalone, RN]

I don't know if it leads to a weaker species, but the number of patietns I have seen in my short career has a nursing student (!) has led me to wonder if all the technology we have developed to extend the quantity of human life is really worth it, we take patients who are by all definition "on their way out" and fix one thing and expect everything else to come back? A classmate of mine just watched a friends family grapple with this. The friends grandmother was a chronic renal patient, moving into failure and had an episode of chest pain. Angio is done, she needs CABG times 4, sugery done, and she never fully makes it back. She languishes between ICU and telemetry for a month and a half before she passes on. Hard on the patient and I think harder on the family having to decide if they should institue a DNR or let her code for the third time.

And this isn't even dealing with all the genetic diseases that used to be life enders at young ages that no longer are....

Oh what a tangled web we weave...

[researchrabbit]

Well, that depends on whether or not "good for our species" is strictly a physical observation and not a spiritual or moral one.

Plus there's the whole intelligence issue. Does physical ability correlate with intelligence? and (in the world as it is today) is intelligence or physical ability more important?

I never liked eugenics. :) I say let 'em all live and God (or your preferred higher power, fate, or what have you) sort it out.

[eltrip]

My goodness, what a great question! I'm going to have to think on this one for a while.

[kelligrl]

Yikes, that's not deep for 9 am or anything... I think it's a double edged sword. On the one side, we have the means to save people from diseases (whether through treatment or vaccination)that years ago wiped out thousands, some of them young healthy, and productive. So in that sense, what a miracle. And I think that researchrabbit has a good point, that is, it depends on your view of stronger. If we're talking the Rock stronger, then medicine in many cases is bad (as we're allowing physically weaker people to survive when they otherwise wouldn't). If we're talking Steven Hawking stronger (the man has astounding intellect) then it's not as easy to make a call.

On the other side of that sword is the place I'm sure WE'VE all seen, the elderly, frail bedbound person, sometimes not even A/O, who relies on the 36 meds a day he/she's given via G-tube to keep their body functioning at a level that keep them "alive" (if that's what you want to call living). Is this good, just, right? IMO, no. In a case like this, there is no quality of life. Shyt, this person can't even tell you that they don't want all this crap done/given to them, because in their mind it's 1939, and they're 10--when they're awake, that is. Someone else is making that decision for them. But then, who am I to say they shouldn't have the right to decide as they have? That's where it get sticky, who gets to make the call?

As for the poor lifestyle choice folks--shyt howdy that's a can of worms....:chuckle

[canoehead, BSN, RN]

I think that about 50% of the time we are working to extend a productive life. End of life care doesn't proceed soon enough. Vegetative souls could be more comfortable and their familys might be more productive if they were allowed to pass away naturally. IMHO if you are over 80 years old and you arrest that should be all she wrote. The chances of getting them back are surely only 10-20% max, and then 1-2% of getting out of the hospital.

[oramar]

That we do all kinds of expensive treatments on people who are really to close to death to benifit from them. At the same time there are many people being denied health care that could benefit from it because they don't have the money to pay for it. There is a point we will eventually reach where we will try to keep everyone alive for ever and the whole ecosystem will come crashing in on our heads because resourses have limits. At that point, this discussion will become moot because no one will be alive to have it.

[RN2B2005]

Personally, and flame me if you will for this, I don't think healthcare is a universal right. Is it in the best interests of a civil society to provide healthcare on a more or less universal basis? Yes, because it's in our best interests to make sure that 'herd immunity' is cultivated, that people don't die and rot on the streets, but not because it's a right. A duty, yes, but not a right.

Similarly, I am always irritated by the prescription drug pricing debate--it never occurs to ANYONE that until fifty years ago, most of these drugs didn't exist. The drug companies have every right to pocket as much money as possible off of the medications--just as if they'd invented an expensive racecar instead. This is what funds future research into future drugs. Just because the Porsche 911 exists and might make me a happier person doesn't mean I have a right to own one, or that the Porsche company or the government should subsidize my purchase.

*donning flameproof Nomex jumpsuit*

[jemb]

I have seen many situations in which technology has overridden our humanity.

[SmilingBluEyes]

if it's wholistic, respecting the person and his/her dignity as well as wishes above others' egos and other impediments, then yes, it can and does do good. unfortunately politics, HMO's, and so many other things do get in the way of that. I just wish we would all move faster toward practice under a wholistic, respectful model that recognizes death is NOT AN OPTION ONLY BUT A REALITY and learn when to let GO!

[researchrabbit]

When I was a nursing student, we were given our patient assignments the day before. A brief history, prognosis, medications, etc.

My assigned patient was on a vent, had been for 6 months, paralyzed from the neck down due to a progressive neuromuscular disease which eventually reverses itself (but it takes more than a year).

I thought, "Why is her family putting her through this? What a waste!"

But then I met her. One of the most totally alive people I have ever met. Flaming red hair (dyed), great attitude, constant visitors, smart...she had kept a journal since she was 16 and continued to journal (I recorded some of her thoughts for her). Brilliant mind, great writer...

what a waste to have let her go early! And she WANTED to live, wanted life, wanted to be with the people she loved (she got better and eventually went home, btw).

So, how would you ever pick who is expendable and who isn't? I wouldn't care to have that job and I can't think of anyone I know who'd be good at it...

[JonRN]

Good thread. I have asked and answered myself many times on this topic. In a teaching hospital, I think a lot of the codes etc. were for training purposes, as were some of the surgical procedures done there. I doubt seriously that the "powers that be" would ever admit to this. So how else are they going to train Dr.s and nurses? Doesn't this thing perpetuate itself, i.e. train a doc to be good in a code situation, and he/she is going to save more people that shouldn't have been saved in the first place. It is truly a can of worms, and a question that needs much further exploration from ethics committees etc. No flames here, it is a question that needs an honest answer before the whole country is bankrupted trying to save those who don't even know they have been saved.