Our Death-Defying, Death-Denying Society - page 6

by TheCommuter 15,817 Views | 74 Comments Senior Moderator

The following is a psychic reading that will eventually prove accurate with every single person in existence today: we're all going to die. The fact is that life will end, and how Americans choose to cope with this reality gives... Read More


  1. 1
    Quote from TheCommuter
    Respectfully, I believe that certain aspects of healthcare should continue to be 'gatekept.' Organ transplantation is one of those aspects.

    There's a reason that current smokers typically do not qualify for lung transplantation. There's a reason that current alcoholics do not qualify for liver transplantation. If these members of the patient population have not successfully conquered their addictions, they'll simply destroy the new organs that they have received.

    There's a reason that people beyond a certain age will never qualify for major organ transplantation. Statistically, the advanced-age patient will die either during the transplantation or shortly after.

    Organs are precious commodities and simply cannot be 'gifted' to anyone who wants them. The number of hearts, lungs, kidneys, livers, etc., is limited and must be 'gatekept.'
    I agree with your statement that certain aspects of healthcare should continue to be gatekept. And that organ transplantation should be one of those aspects, but I disagree with what I read as your assumption about the degree to which organ transplantation is currently gatekept.

    People beyond a certain age DO qualify for transplant in this day and age if they are rich enough or powerful enough. To qualify for lungs or a liver, all you have to do is promise not to smoke or drink. And while I agree that even folks who are in our country illegally are entitled to emergency health care, perhaps triple bypasses and organ transplants ought to be subject to more gatekeeping than they are.
    microtutor likes this.
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    I agree, RubyVee. Commuter, I think you are splitting hairs on this one. When I spoke of gatekeeping in the context of my post, I was speaking of financial gatekeeping - putting an arbitrary limit on treatments on the basis of finances because we "can't afford" to keep people alive - yet we can somehow afford to spend billions on war and bailouts just fine.
  3. 0
    I think we do need to gatekeep "futile" care and that we cannot afford regardless of what is or isn't spent on war etc. Those dollars should be spent on providing health care to those that can then have quality of life.
  4. 0
    Quote from MunoRN
    I defer to this guy to explain the situation; he says it better than I.

    The Dying of the Light

    and

    Our unrealistic views of death, through a doctor’s eyes - The Washington Post
    Thank you for posting these articles. I found them very interesting.
  5. 3
    Quote from microtutor
    I don't care who "gatekeeps" healthcare. It should not be gatekept. When we endorse gatekeeping of healthcare - whether it is "because it is what we do", or based on financial concerns, or based on our conception of someone else's quality of life? We are denying individuals and families the right to make their own decisions on treatment.
    I do think that in the case of futile care, the family/individuals still have the right to decide their own treatments BUT the cost should be on them. It is outrageous to expect random strangers (a.k.a. taxpayers) to pay for it.
    duskyjewel, Aurora77, and TheCommuter like this.
  6. 2
    Quote from Szasz_is_Right
    I do think that in the case of futile care, the family/individuals still have the right to decide their own treatments BUT the cost should be on them. It is outrageous to expect random strangers (a.k.a. taxpayers) to pay for it.

    I do agree with this except: Most people have no idea what is futile. They have to listen to HCP who are not comfortable saying what needs to be said and doing what needs to be done. If a doctor is able to say to the family that further treatment will do no good and in fact will decrease the quality of life the family can make an informed decision. If the doctor says it is a crap shoot, the treatment might help, might harm and may do nothing that is a totally different set of information for the family. We are taught to never give up hope for remission, a late cure, etc. Doctors even more so. it takes a very special doctor to say we will do no more. We will allow a natural death. How can families be asked to make a decision to pay for useless care when it is a rare one who can actually say it is useless, or futile? I have worked with families who decided to do everything possible. In some cases it allows the family time to gather strength to accept what has been explained. In other cases the family hates it but does not feel comfortable being the bad guy who says to "pull the plug". No family member should ever have to make that decision. It is a medical decision. Somehow we put that responsibility on the family in many cases. None are in good shape to make an informed decision.

    I have been in the position of having to discuss this for my DH. I was fortunate. The doctors made the decision and told me they would "pull the plug, as it were, the following day. If I did not want that he would be moved to another place and he would still die but would not have the support of the ICU staff for him or me. I could easily see those doctors saying that if I chose to have him moved out to another area and maintained until all the organ failure overcame the machines that I would be responsible for the cost. I understood what was happening, most don't. I still do not think any decision I would have made at that time would be considered informed so the lawyers would get rich, the family get poor, and the person still die.

    I believe doctors need to get the education necessary to be able to say that a natural death is our goal. Until that time comes it is unfair to consider making the family pay for extended care.
    tewdles and Altra like this.
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    Quote from Asystole RN
    Who's ethics? Are your beliefs somehow more valid, more important, and the "correct" beliefs? Not everyone sees the human spirit in terms of electrical brain activity.
    But don't you see that you're placing death and dying *exclusively* within the realm of religion/cultural beliefs? Death is very much a natural physiological process that can be defined through science. As someone said, dead is dead. If a qualified physician states there's no medical reason to keep a brain dead person on expensive life support, that should carry the day over a family's religious beliefs. That's why we have separation of church and state. I'm sorry, but my tax dollars should not pay for medically pointless treatment based solely on someone else's spiritual beliefs. Let the family take him home and care for him in his last days as their culture demands. I'm sure that would be a much more cathartic experience for the family.
    TheCommuter likes this.
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    Quote from BrandonLPN
    But don't you see that you're placing death and dying *exclusively* within the realm of religion/cultural beliefs? Death is very much a natural physiological process that can be defined through science. As someone said, dead is dead. If a qualified physician states there's no medical reason to keep a brain dead person on expensive life support, that should carry the day over a family's religious beliefs. That's why we have separation of church and state. I'm sorry, but my tax dollars should not pay for medically pointless treatment based solely on someone else's spiritual beliefs. Let the family take him home and care for him in his last days as their culture demands. I'm sure that would be a much more cathartic experience for the family.
    I place it within the realm of beliefs, culture and religion being only some of the forces that influence such beliefs. A physician(s) did decide that the wishes of the patient and/or family were valid, hence why the physician(s) simply continue care and not fire the patient. If a physician does see that the efforts to sustain life are futile and wishes the termination of the life then he needs only to bring that issue to the already established system to deal with cases like these, the legal system.

    Not to get too political but you really need to research the the concept of "seperation of church and state."

    This is how the First Amendment reads;

    Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.
  9. 2
    Quote from Szasz_is_Right
    I do think that in the case of futile care, the family/individuals still have the right to decide their own treatments BUT the cost should be on them. It is outrageous to expect random strangers (a.k.a. taxpayers) to pay for it.
    Why are taxpayers funding anyone's healthcare?
    duskyjewel and Aurora77 like this.
  10. 0
    Quote from Asystole RN
    I place it within the realm of beliefs, culture and religion being only some of the forces that influence such beliefs. A physician(s) did decide that the wishes of the patient and/or family were valid, hence why the physician(s) simply continue care and not fire the patient. If a physician does see that the efforts to sustain life are futile and wishes the termination of the life then he needs only to bring that issue to the already established system to deal with cases like these, the legal system.Not to get too political but you really need to research the the concept of "seperation of church and state." This is how the First Amendment reads;
    I think a change in the legal definition of death is exactly what many of us are talking about. If a family brought in a dead body and demanded it be hooked up to life support, they would obviously have no legal leg to stand on. I think the same principal should be applied to patients who are brain dead with no chance of recovery. If we legally say that IS dead, just the same as the little old woman down the hall who died 3 hours ago, then the doctor wouldn't have to go through any legal process. As for the church and state thing, yes it is implied that our government will not make laws based on any particular religion. It may not be explicitly written down anywhere in the constitution or the bill of rights but it is an implied aspect of our government.


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