Our Death-Defying, Death-Denying Society - Page 2

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  1. Aug 20, '12 by
    Quote from TheCommuter
    A national conversation about common issues surrounding death and dying must take place soon. However, in this highly politicized era, I do not envision this happening anytime in the near future.
    Just bringing up the conversation will rain down a fusillade of DEATH PANEL! charges upon your head. Given the prevailing belief system in this country, I wonder why the morbid fear of death prevails.
    lindarn, redhead_NURSE98!, pomegranate, and 7 others like this.
  2. Aug 20, '12 by
    Quote from breaktime
    My point being we, as humans, are willing to suffer to prevent death. If it turned out that lighting yourself on fire allowed you to live longer, we would be living in a world full of charred centenarians.
    The issue is not about suffering. The issue is about taking extraordinary measures (which often cause great suffering) when there is no realistic chance of a recovery.

    There is also the issue of families' overriding the wishes of the patient and demanding that heroic efforts be made to sustain the life of someone who has little quality of life, and might be in great pain.

    Quote from Asystole RN
    That statement I have bolded is not for you, me, or society to decide. The quality of one's life is a personal judgement and the cost/benefit of extending one's life or the life of a loved one is again a personal decision that is based upon one's culture, religion, and personal preference.
    You're practically saying that we dare not broach this topic. Is it worth sustaining the life of a 98-year-old person in a coma, whose prognosis is grave, at the expense of providing health care to an infant, if it comes to that? As has been stated, it's rarely the 98-year-old who's paying.

    Quote from Asystole RN
    At what point does a life become worthless?
    The issue is not that life becomes worthless. But then, how much is it worth to sustain the life for two months of a very sick person, with no hope of recovery? A million dollars? A billion dollars? Ten billion dollars? Does life have a value?

    Quote from Asystole RN
    Are you going to be the one that decides who holds value in society and who does not? At what point do we shut off healthcare? Is a life worth a fiscal cap of 2 million, 3 million, or some other arbitrary number? Should services be cut for those over 65 since they no longer contribute to the GDP and are simply a drain upon society?
    As the original poster stated, there is no call for "death panels." The question is, Why do Americans have such a perverse attitude (by world standards) toward death? Why the extreme fear and denial?

    Quote from Asystole RN
    AtMedicare is in shambles and unsustainable, the problem firmly lays in Medicare itself and not with the patients.
    Really? Look at how much money goes to end-of-life care. Then tell me what the problem with Medicare is. It's neither in shambles nor is it unsustainable, but if it does go away, so will many elderly. They will die from lack of care, whether or not they're near the end of their natural lives.
    Last edit by Cold Stethoscope on Aug 20, '12
    lindarn, pomegranate, tewdles, and 6 others like this.
  3. Aug 20, '12 by
    Life may not be worthless, but it can be ... over.

    (I was assigned the classic Kubler's Death and Dying as a sophomore student and it changed my professional life.)
    catlvr, not.done.yet, NurseDirtyBird, and 1 other like this.
  4. Aug 20, '12 by
    Quote from Cold Stethoscope
    The...
    For clarity I am going to respond outside of the quote tree.

    As to your first point, the extraordinary measures in the face of insurmountable odds are what many would call keeping hope alive. I personally do not feel that keeping someone on a vent for years who is brain dead is exactly what I would do for my family but those decisions are for the patient/family to decide. As for family overriding the patient’s wishes, that is an issue for the court.

    As to the second point, I think this is a valid topic but I believe that the decision of providing life supporting care is something that is personal and the decision is driven by one’s culture, religion, and personal beliefs.

    I have personally found that western culture is not the predominant culture that pushes to extended life preservation but rather those of Native American or foreign origin.

    I personally do not believe that the 3rd party reimbursement system is the most effective system. I do not think that the system fosters the competition and quality of care. Medicare is unsustainable due to the fact that a larger population is/will be utilizing the system compared to the population that supports it. There are many serious problems with Medicare but I will leave that for another thread…
    Aurora77, lindarn, and Susie2310 like this.
  5. Aug 20, '12 by
    To clarify my position;

    I do not think that providing social workers, councilors, or case managers to educate patients on the end of life process is such a bad thing. Some families may indeed push for extended end of life care due to a lack of education but I am willing to bet that many know exactly what they are doing, in my experience. Where I draw the line is in forcing someone against their wishes.

    I see this issue like I do abortion and the right to die issues. I do not agree with the decisions many make concerning their bodies but I firmly believe that when it comes to issues regarding someone's body that the decision should firmly lay with the individual and not the government.
    TJ'sMOM and lindarn like this.
  6. Aug 20, '12 by
    Quote from Asystole RN
    As to the second point, I think this is a valid topic but I believe that the decision of providing life supporting care is something that is personal and the decision is driven by one’s culture, religion, and personal beliefs.
    To this I would like to add a lack of education. People think that when we do these surgeries/codes/treatments that people will just get better. I dont think people fully understand the implications or potential outcomes or lack thereof for what we do sometimes. You can point the finger wherever you want to on this. You can point to faith, hope, culture, heck even media plays a part in it. People think that extreme measures always yield positive results. It doesnt.

    I live my life by the mantra of "Today is a good day to die, but a better day to live". Once I cant say the second part I want to go. I dont want to live here if I cant actually live.
    TJ'sMOM, Aurora77, joanna73, and 7 others like this.
  7. Aug 20, '12 by
    I could not agree with you more OP. While I do think every patient/family has the right to decide on their treatment and when to say enough is enough I also believe there needs to be more discussion about what exactly these treatments entail. I've seen many people well into their 70s or 80s offered chemo, radiation, etc for their cancer when they have a very poor prognosis and just feel miserable with the treatment. Just as with the discussion of DNR/DNI, I think most patients and families dont understand that it has a low success rate and people dont just wake up back to their old selves like on tv.
    TJ'sMOM, lindarn, pomegranate, and 2 others like this.
  8. Aug 20, '12 by
    Quote from That Guy
    To this I would like to add a lack of education. People think that when we do these surgeries/codes/treatments that people will just get better. I dont think people fully understand the implications or potential outcomes or lack thereof for what we do sometimes. You can point the finger wherever you want to on this. You can point to faith, hope, culture, heck even media plays a part in it. People think that extreme measures always yield positive results. It doesnt.

    I live my life by the mantra of "Today is a good day to die, but a better day to live". Once I cant say the second part I want to go. I dont want to live here if I cant actually live.
    I would agree that education plays a significant part in the decision but I would be careful in assuming that a decision by a patient or the family that is counter to your own beliefs is founded upon a lack of education.

    While I worked at a SNF I had a patient who was on a vent for the last three years, brain dead, who was coded and revived several times (hence the brain death) who's POA was a cardiologist. They kept him going for strictly the patient's wishes and religious reasons.
    lindarn, microtutor, and Susie2310 like this.
  9. Aug 20, '12 by
    Quote from Asystole RN
    I would agree that education plays a significant part in the decision but I would be careful in assuming that a decision by a patient or the family that is counter to your own beliefs is founded upon a lack of education.

    While I worked at a SNF I had a patient who was on a vent for the last three years, brain dead, who was coded and revived several times (hence the brain death) who's POA was a cardiologist. They kept him going for strictly the patient's wishes and religious reasons.
    Oh I was not implying this at all. Im sorry if it came across that way. I know many people do not share my beliefs/thoughts and it is how it is. This is one of the reasons I get along well with my patients, that even when we disagree on things, I can still provide the care that they need and deserve.
    TJ'sMOM likes this.
  10. Aug 20, '12 by
    "Countless procedures, medications, treatments, and consults that are ordered during the immediate time frame prior to the end of life end up being futile. Also, many patients and family members want everything humanly possible done to fight off death despite having received a terminal prognosis."

    Billions of dollars are spent at the end of life , in a fruitless effort to prevent the inevitable. Many more than the dollars spent at the beginning of life.
    The only answer is teaching at the doctorate level. Future physicians need to be TAUGHT that their role is not to prolong life.. but to enhance the quality of life of every patient they care for.
    TJ'sMOM, LaughingRN, and SoldierNurse22 like this.