An interpretation of healthcare reform bill

Katnip, RN · Aug 19, 2009

I am a huge proponent of doctors discussing advanced directive options with patients. Too many just prefer to avoid the issue, and will continue to do so if not told to. How many patients have you seen who had no idea what their options are to filling out a legal document to make their wishes known? i've seen way too many who don't understand what we do to them when they say "do everything."

The time to start discussing this is when a person is young and healthy. Even young adults can have accidents that can render them unable to make those decisions for themselves.

As far as the slippery slope and having "death panels" and all that nonesense, do you really believe the American people will go with that depite laws? Look at other countries that have universal healthcare. Does the UK have them? Canada? Australia? I think not. Who in their right mind would think that we would go and require something like that? People who stand to lose a lot of money.

oramar · Aug 19, 2009

I can't understand why people have to involve doctors in their living will. Both my mother and I did ours and there was not a medical doctor in sight. You can write a living will, see a notary and sign it with out ever talking to a doctor.

PeachPie · Aug 19, 2009

I live in Texas, and it's amazing how many people truly believe that "That (insert derogatory racial slur, socialist, etc) president" is going to kill people off at age 65. I've asked some of them what their end of life plans are, and many draw blanks. I suppose ignorance is bliss.

I also think that everyone making such a decision needs to watch a video of what goes on during codes in different scenarios. For example, show a successful resuscitation and outcome as well as what happens to fragile 90 years olds who will still die in the ICU after having all their ribs broken. Too many people think that codes are like they are in the soap operas.

elkpark · Aug 19, 2009

I can't understand why people have to involve doctors in their living will. Both my mother and I did ours and there was not a medical doctor in sight. You can write a living will, see a notary and sign it with out ever talking to a doctor.

Of course that's possible and the way a lot of people do it, but lots of people have questions about different levels of interventions in resuscitation, potential outcomes, etc. Those of us working in healthcare are reasonably well-informed, but much of the general public isn't. I ask people about advanced directives all the time when I'm admitting them at work, and most of them have no clue, even when I've explained on a v. simple level what I'm talking about ...

Jiminocala · Aug 19, 2009

We ARE standing at the edge of that slippery slope. There has been a Death Cult operating in the background of the healthcare debate for many years. Their purpose is to promote death as a way of reducing the population of undesirable individuals-life unworthy of life. According to the Progressives, these people are getting a slice of the economic/resource pie but producing nothing worthy of keeping them alive. This is the whole purpose behind end-of-life counselling; to get people to take the "hemlock" route when they are old, or simply not be born for the young, the poor, and the defectve. Ever seen the movie, "Soylent Green?"

Tait, MSN, RN · Aug 19, 2009

Ah yes, lets use movies as a basis for our unfounded fears.

Anyway, I will be picking up a copy of this mans book in January when it comes out.

http://www.npr.org/templates/story/story.php?storyId=111997932

http://www.amazon.com/Last-Acts-Discovering-Possibility-Opportunity/dp/1416580379/ref=sr_1_1?ie=UTF8&s=books&qid=1250716077&sr=1-1

Doctors being requested to discuss the future of their patients lives with them. Yeah bad idea...I will think of that next time I have a 97 y/o s/p ischemic stroke patient with a family that thinks "momma will get better".

Tait

elkpark · Aug 19, 2009

We ARE standing at the edge of that slippery slope. There has been a Death Cult operating in the background of the healthcare debate for many years. Their purpose is to promote death as a way of reducing the population of undesirable individuals-life unworthy of life. According to the Progressives, these people are getting a slice of the economic/resource pie but producing nothing worthy of keeping them alive. This is the whole purpose behind end-of-life counselling; to get people to take the "hemlock" route when they are old, or simply not be born for the young, the poor, and the defectve. Ever seen the movie, "Soylent Green?"

Oh, please -- death cult??? Promoting death for "undesirables"?? Give me a break.

lucky1RN · Aug 20, 2009

We ARE standing at the edge of that slippery slope. There has been a Death Cult operating in the background of the healthcare debate for many years. Their purpose is to promote death as a way of reducing the population of undesirable individuals-life unworthy of life. According to the Progressives, these people are getting a slice of the economic/resource pie but producing nothing worthy of keeping them alive. This is the whole purpose behind end-of-life counselling; to get people to take the "hemlock" route when they are old, or simply not be born for the young, the poor, and the defectve. Ever seen the movie, "Soylent Green?"

Please provide some evidence/proof/citations for the above!?

talaxandra · Aug 20, 2009

Despite the prevalence of violent death on TV and in films and video/computer games, we live in a death-adverse culture. Between the reduction in infant and childhood mortality rates, improvements in chronic disease management, advent of CPR & ICU, oncological advances, and transfer of aged care and dying into institutions, many people have little first-hand exposure to death.

For example, none of my three siblings (aged 31 - 38) have: seen dead body, visited an ICU, visited a nursing home, known someone with a chronic progressive disease that has advanced to even mild incapacity, or even has an idea about how very sick you can be without being dead.

They are not alone. When the majority of our information about life-saving treatment comes from medical dramas it is not surprising that their perspective is skewed away from the data. These programs consistently misrepresent CPR success rates, rarely show complications of resuscitation,

and mischaracterise the population resuscitated.

I really enjoy much of what Sandy Schwartz writes, and I appreciate her concern about slippery slopes. The problem is that slippery slope arguments are fallacious rhetorical devices that ignore the multitude of steps required to get from A (apparently reasonable starting point that appears unobjectionable) to Z (terrible outcome no right-thinking person could ever accept).

In this case - does anyone really think that, if this Bill were both passed and enforced in the way Schwartz described, doctors and consumers (including families of these poor aged people counseled to death) would accept it, resulting in the withdrawal of health services and funding for 20% of the US population (I have no idea, incidentally, on what grounds she included HIV positive people), resulting in their unwilling deaths?

I want to write about Respecting Patient Choices but have an out-patient appointment and have to go, but will return, fascinated to see more responses to this thread.