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

Nurses General Nursing Nursing Q/A

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. :D

Specializes in Telemetry, Case Management.

I think all this technology is a double edged sword. In some cases all this is wonderful, the young person dreadfully injured, brought back from death's door to be back with their families for fifty more years in a basically good condition.

On the other hand, as in a case in my own family:

70+ woman, chronic non complicant COPD'er. Smoked long after told to quit. On O2 at home for years. Chronic, chronic, chronic. Non compliant, non compliant, non compliant. Finally had an episode in April. Never fully recovered. Kept IN THE HOSPITAL, NOT EVER EVER EVER TRANSFERRED TO A NURSING HOME, BUT IN THE HOSPITAL, ON AND OFF THE UNIT FROM APRIL TIL DAY AFTER CHRISTMAS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Poor woman was coded at her husband's insistence NINE times. The day after Christmas was the ninth, maybe the tenth, I've forgotten, they finally give up, the husband stands at the door yelling at them to go back in and get her back. He could not, would not face the fact that not only had "God called", God was jumping up and down yelling for her!!!

The woman's siblings were against this coding. The children although all over 30 were with the dad in this. NONE of them could face reality. All they did was make this poor woman miserable for eight months to save themselves having to face her eventual departure.

This was over ten years ago. Her husband died September 2001. He told his family NOT to code him under any circumstances and they didn't. It made me MAD! How could he do that to her and then not want it for himself?

So in this case technology was IMHO, wasted to save the family some unavoidable heartache. I think if the patient, who was fairly well out of it from June on, had her opinion known, it would have been to let her go.

Sorry to rant. But technology is not always the best thing for every case.

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

JEMB: I agree with you. And this is why I want to do Hospice nursing. The patient is terminal and has accepted, more or less, that he/she is going to do so. At that point, all that needs to be done is to make the patient as comfortable as possible. Much more 'humanity' than 'technology', although certainly both are needed.

I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50).

And as for spending a million or two to keep any one person alive, no matter what the medical problem -- I don't get it. There are only so many healthcare dollars to go around, and I think that those dollars should be concentrated on men and women between the ages of 18 and 50 (and child geniuses), particularly those who have minor children still to raise, who can be reasonably helped.

I have a GF in her middle 60s who has been fighting breast cancer now for over a year. I know I will never do that because I've thought about it long and hard. She's had a good, long life (and so have I). Neither she (nor I) are making contributions to society that society can't live without. Perhaps it's time to 'move on' and make room for someone younger.

When we stop seeing death (well, first we'd have to take a look at death and so many average Americans are in complete denial that death even exists) in this country as a personal and medical 'failure', things will change. But this is the US, and all we have to do is read the morning newspapers to know that we don't admit to failure in ANY area in this country.

I am SO GRATEFUL I will never have to make a decision as to whether someone lives or dies. I keep hearing on this board that nurses don't have a lot of autonomy. At least when it comes to this, I AM GRATEFUL. I had a friend who was in Admin of a local hospital. The hospital took an anonymous poll of the doctors to find out who had committed a mercy killing. 38% of the doctors admitted to it. (That was 15 years ago. And, like she said, that 38% didn't include the doctors who didn't admit to it out of fear that, although the poll was anonymous, they'd still be found out somehow.) The doctors said that it had been a horrendous decision for them and that they still had some problems with the fact that they had done it. Although I'm grateful to them for doing what they thought was right (and probably was right all or most of the time), I am MORE grateful that all I will have to do is follow the doctors' orders.

Anyway, until we see and accept death as part of of life (even in illness and accident and not just old age), we're going to have a lot more 'technology' than humanity.

Some people don't want to be "responsible" in making decisions to "pull the plug", or for whatever reasons, I've seen very selfish decision making on the part of family members and/or significant others that makes me angry. All I can do it educate, educate, educate, and try to make patients as comfortable as I can. We've had to report cases to risk management/ethics committees to obtain humane care for patients that family members were not allowing. Also, on our unit, I would love to see family members pay a nominal "fee" for their family member on this ventilator unit - just something like $50.00 a month. I think we would see a little more family participation and evaluation. For example, we have a handful of people who are brain dead or barely above brain dead for a variety of reasons, who are full codes, and the family members never visit, or the rare times they do they are demanding and unreasonable. I think even such a little fee like that (which is barely above what some are paying for their cable TV) would make people think a little about what they are requesting. I tell you, we are really good at keeping people alive on our unit, if that's what you want, and it's not a very exciting picture at the end.

Technology can get kind of crazy, but I guess we all have different ideas of what living is.

(I work in a hospital on a assisted breathing center, where everyone is at some level of dependency on ventilators either partially or fully.)

Why make 50 the cutoff point? There are many people who don't really hit their stride until then.

There are 20 year olds who have less to offer than some 70 year olds.

Well, here we go, Matt--flame on. I find this both bizarre and completely arbitrary. So you're actually for witholding lifesaving treatment for children under 18? I believe that there are some childhood cancer survivors on this very board who might disagree with you.

And what qualifies as "extrordinary measures" and where do you draw the line? Not trying to be argumentative here-- I'd honestly like to know how you propose to quantify some of these things. If an otherwise healthy 51-year old has appendicitis, are you going to deny the appendectomy he needs and let him die of peritonitis? What about folks who only need dialysis temporarily, or even ONCE, because of a drug reaction or a kidney infection? Are they refused also? Are pacemakers and AICDs extraordinary measures? How about insulin pumps?

Believe me, as a former ICU nurse I am not someone who thinks everybody should be kept alive at all costs.--I completely agree with KaroSnowQueen's entire post. But I think your ideas swing a little too far in the opposite direction.

Specializes in Corrections, Psych, Med-Surg.

BT writes: "I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50). And as for spending a million or two to keep any one person alive, no matter what the medical problem -- I don't get it."

I agree completely (and I also am over the age of 50), and would impose other significant limits on our healthcare system (such as eliminating all subsidies for IVF, treating the predictable consequences of smoking, excessive ETOH consumption, IV drug use, obesity, among other things). Someone has to have the courage to say "enough." We need to recognize our limits instead of continuing to base our decisions on stale sentimentality and wishful thinking. When the country gets around to looking for a healthcare czar to do so, I volunteer myself (though I don't expect to be around THAT long).

The inability to recognize that our resources, healthcare and otherwise, are finite is to be living in a daydream. We in the US are already ripping off most of the rest of the world's resources just to maintain our present living standard and still we are leaving more and more of our own citizens behind for the benefit of those who already "have," not to mention those people who live in most other countries. IMHO.

And for those who believe that I am mistaken, cruel, and/or wrong-headed, then YOU pay for all this stuff if you want to, but count me out of paying for it (in taxes and insurance premiums). Put YOUR money, time, and effort--not mine--where your mouth is.

The Bible says if it is within your power to do good to someone then do it. That is enough for me. I still think God is in control no matter how much we do or don't do.

Come on, Stargazer. That's not at all what I meant, and you know it. We're not going to let anyone die from something that is considered routine or even almost routine health care. And not only do I still stand by what I said, I agree completely with Sjoe.

We simply cannot keep EVERYONE alive, no matter what the cost. (Of course, that's not even a consideration for those without insurance. Let them get a terminal illness and they're dead, most of them, and I know that for a fact, because I've seen it over and over.) Even with people with good insurance, we need to learn and accept when to let me them go. The doctors can't keep seeing a death as a failure, and relatives can't be allowed to keep comatose Grandma Sara in the end stages of cancer in ICU for three days while Grandpa comes to grips with the fact that she's going to die -- or already brain dead. And we certainly can't afford to keep everyone in the US who needs dialysis on it. That was one of the biggest healthcare dollar mistakes we ever made. And why should be keep Uncle Jake who is 60 and with terminal lung cancer (whether or not he smoked) alive for another five years, with chemo, meds and surgeries?? And as for the 10-year-old girl with any type of currently terminal cancer, perhaps all we should do is make life as comfortable as possible while she dies.

Many years ago our county had a Roman Catholic priest in his 40s who decided to stop dialysis and allow nature to take its course. My god, what an uproar. People accused him of committing suicide, for gripe's sake! But the Bishop tried to explain that it was perfectly within anyone's right not to be treated for a terminal condition, quasi or absolute. And the priest died.

We see death as 'The Enemy' rather than something that happens, irrespective of age. We don't have a God-given right to live to a ripe old age. And we don't have a right to rob another of minimal healthcare while we're using too many healthcare dollars to prolong our lives for a few more years simply because we're afraid to die.

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Originally posted by BellaTerra2002

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

I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50).

I have a GF in her middle 60s who has been fighting breast cancer now for over a year. I know I will never do that because I've thought about it long and hard. She's had a good, long life (and so have I). Neither she (nor I) are making contributions to society that society can't live without. Perhaps it's time to 'move on' and make room for someone younger.

I think your humanity on this is questionable, technology or no. Think about it: I was 10 years old when my parents were 50. So, someone decided 50 is too old to contribute to my upbringing, so let them die of cancer and not treat it. I think that is INHUMANE.

I think you need to look at this a bit differently and look at INDIVIDUALS. Maybe you had your kids when you were young so you think YOU have nothing more to contribute. So be it, go ahead and choose to die. My 50 year old parent had a LOT to contribute.

Ever see the movie Logan's Run?

Specializes in Corrections, Psych, Med-Surg.

BT writes: "Many years ago our county had a Roman Catholic priest in his 40s who decided to stop dialysis and allow nature to take its course. My god, what an uproar. People accused him of committing suicide, for gripe's sake!"

A good illustration of how far "Christianity" has gotten away from the person who is supposed to be their ideal example.

I suppose the same people would have berated JC for choosing "suicide" since he didn't even bother to defend himself against the authorities. If his death was an example of something useful, it was that hanging on to staying alive is NOT the primary consideration, but that it's value pales when contrasted to things like "meaning," for example.

Our present, costly, and often sadistic focus on "keep them alive no matter what" flies directly in the face of this lesson, but these people seem blind to such obvious logic.

Personally, I do not think age even has an issue in this discussion. My reasoning.....until last week we had a person in our facility that is 106, yes you read it right, 106 and was still living on our assisted living unit, caring for theirself, ambulating all over the building without the asisst of a walker and we're talking a multi floor complex here. This person took a fall and now is in healthcare, where is goes from here is up to God. Age is not the issue, it is quality of life. If you save my life, will I lay in a bed, urinate and deficate myself, drooling and having to be fed either per tube or another human....if so, let me go. But if there's a GOOD possibility that I can dance at my great grand daughters wedding, have at it and let's keep it ticking. Family members need to be more educated to think with their mind and not be selfish about letting go when the outcome serves no purpose but for them coming to see a body laying ina bed once every six months so they don't have to feel quilty. Death is NOT the worst thing that can ever happen to us, selfish relatives are. Yes, it hurts to loose thoses we love, I'm an expert on loss, but I would rather free my loved one up from this earthly pain and promise to meet them again someday and have a reunion when we are all happy and painfree.

Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Quote
Originally posted by sjoe

BT writes: "I absolutely disagree with taking any type of extraordinary measures, including dialysis, to keep anyone over the age of 50 alive (and that includes me, since I'm over the age of 50). And as for spending a million or two to keep any one person alive, no matter what the medical problem -- I don't get it."

I agree completely (and I also am over the age of 50), and would impose other significant limits on our healthcare system (such as eliminating all subsidies for IVF, treating the predictable consequences of smoking, excessive ETOH consumption, IV drug use, obesity, among other things). Someone has to have the courage to say "enough." We need to recognize our limits instead of continuing to base our decisions on stale sentimentality and wishful thinking.

And for those who believe that I am mistaken, cruel, and/or wrong-headed, then YOU pay for all this stuff if you want to, but count me out of paying for it (in taxes and insurance premiums). Put YOUR money, time, and effort--not mine--where your mouth is.

(Trying to bring the title of this thread "A philosphical question bound to regress to name-calling and flames" into fruition.)

Please don't take this as a flame, but on the other side of the coin, didn't Hitler carry this kind of philosophy? I realize that he didn't let nature take its course when he put all those people with malformations,genetic disorders,etc. in concenration camps along with the Jews, but where do we draw the line with this? It's too heavy for us as a civilized entity to decide this, and Dr.'s have to uphold the Hippocratic Oath, don't they? Darwin brought up this question already, and still, the question lingers as to who is qualified to decide whose life is more valuable than another's? I know I'm not, nor do I want that kind of responsibility. When I'm treating a patient, their insurance (or lack thereof) is none of my business or concern. A person's lack of money doesn't make them a less valuable person. And as far as taxes, the U.S. Income Tax rate is still fairly low compared to other countries.

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