Medicine: Have we gone too far? And, is our system ethical as a whole?

Nurses General Nursing

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Sometimes I disagree with some of the things that I do in my job. I'm sure we've all felt this, such as a 95 year old full code on a vent, or other such scenarios.

Personally, I feel like medicine often goes too far, especially in prolonging end of life. People view it as their salvation from death, in almost a religious way. Meanwhile, some people don't even have access to clinic care because of their lack of insurence.

Medicine will spend 1 million + for organ transplants to save one life, then some clerk at 7/11 can't even be followed by a primary doc because they don't have insurence.

I had a pt last night, a man on his last leg, who should have been a no code, but we're spending a small fortune on him. As a side note, he brought his health problems on himself entirely due to his terrible health habits. How about drug and ETOH addicts that then cry out for liver transplants! Where's the justice in that while some kid in South America just needs clean water?

The world is basically an imperfect and unfair place all around. I was adopted myself, it's a complicated situation even when you were adopted as a newborn. Nowadays, it's even more so, with open adoption, foreign adoption, paternal rights, liberal policies on birthmothers changing their minds.

Huscarl what is your problem with baby boomers, like we have profitted so much. If there are so many of us it is because of our parents and all the luxuries they had..everyone owened their own home, drove cars to industrial jobs that they never got the opportunity to expereince student loans, they are the ones to come up with the concept of social security and medicare and the ones that get to retire early enough to enjoy it. Don't blame the baby boomers also known as the sandwich generation that currently supporting both the retired class and lower class, lucky enough to have acquired student loans and to get to take care of aging parent while having children at home.

We don't need to look at other country's models of universal health care, nor do we have to compare it to socialism or communism. Just take a look at how our military hospitals and VA hospitals are ran and use that as our model for universal health care in the United States. From what I have seen from the VA it runs like a well oiled machine compared to civilian hospitals in this country.

The point seems to be just because we can do something to save someone doesn't mean we always should.

Could we put a little thought into it?

The highest medical costs are now in the last 3 weeks of life in many cases. We do a lousy job explaining outcomes of illness to people. Plus people have come to believe there is a 'fix' for everything!

Didn't read all the posts, so this point may have already been made.......

Just because someone has an advance directive (No machines, no feeding tubes, etc) doesn't mean the doctor won't order them and the family won't consent to them. In fact, most cases I have seen is just that. Patient with massive stroke or multi organ failure who is just laying there, family consents to tube feed, dialysis, etc. Ethics committees are a FARCE!!!!! Have never seen one do anything, vbesides it takes about a week to get one arranged and then nothing is ever done. Docotr won't have a frank discussion with family.

You know the old saying, a dead patient doesn't sue, the family does! That's why the family is ALWAYS catered to instead of the dying person's wishes.

Then you could also bring up the topic that some couple go through million dollars worth of treatment to produce a baby when there are thousands of kids in the foster care system that need a good home. They may not be perfect blond haired blue eyed infants ( but who of us is perfect).

I see absolutely NOTHING wrong with someone spending money out of their own pocket in order to conceive a child.

Now, if the taxpayers were forced to pay for it, that's another story...........that's why the discussion here. People demand all these expensive treatments and test done for free, on the taxpayer's dollar. Those of us with private insurance and copays know better, or are willing to pay up for it.

Specializes in CRNA, Finally retired.
The point seems to be just because we can do something to save someone doesn't mean we always should.

Could we put a little thought into it?

The highest medical costs are now in the last 3 weeks of life in many cases. We do a lousy job explaining outcomes of illness to people. Plus people have come to believe there is a 'fix' for everything!

Hey don't tell me. Write a letter to the editor of your local newspaper. Nursing could use the PR and the public could use the education. This is a huge issue with lots of political ramifications. Get your letter in the AARP magazine - they have a huge PAC in Washington.

As a psych nurse-I have to remind myself that ETOH abuse is still a disease and that we, as humans, have been given the gift of opposable thumbs and creative brains to reason on how to cure diseases of poor choices (and arguably genetics). I agree that we need to educate the puiblic on making death dignified-even for substance abusers. What I think the medical profession should rally on is not the amount of drugs that we CAN use, but when insurance tells us there are drugs we CANNOT use. Why should some desk jocky somewhere in a high-rise building tell any of our patients what a doctor can or cannot prescribe or how a client can take medication while hospitalized but be denied after discharge. The medical system is beyond flawed when Medicaid will pay for a 680.00 a day acute stay but won't pay 100.00 a month for medications. maybe some of the hard-on-there-luck citizens would be able to get off the juice to begin with if healthcare systems supported life. Then we could truly evaluate if we have gone too far.:idea:

Specializes in acute medical.

Where I work, our hospital is commencing an initiative called "Respecting Patients Wishes" (I think that is what the title is). As I understand it, there is education provided for all staff and I think patients are asked at the beginning what sort of care they receive, and thats not just relating to death. But do you think I have seen it in action? Apparently they are using it in alot of southern Australian hospitals with good results.

It would be good to use something like this because:

1. patients would have some education and obviously some choice.

2. nurses wouldn't have to "jump" on everyone who doesn't have a do not resuscitate order.

Ah well, one can only dream of practical policies

The medical system is beyond flawed when Medicaid will pay for a 680.00 a day acute stay but won't pay 100.00 a month for medications. maybe some of the hard-on-there-luck citizens would be able to get off the juice to begin with if healthcare systems supported life. Then we could truly evaluate if we have gone too far.:idea:

AMEN!

or to delay the inevitable.......................

perhaps it could be one of those "mandatory" things on the docs check off list as we get older- seems every yr another simple preventative test goes on ( or every few yrs - you know - paps - then mammograms then this test and that as we get older) -

i dont think the suggestion ( dont recall who made it ) though it was a nice thought - i dont think it shoudl be mandatory to graduate high school - its not like cpr that doesnt need much comprehension of life- like my dad half jokingly said as he made me executor - " now dont just go pull the plug because LOL" - twas all in fun for my teens benefits as they are uncomfortable talking of death and happened to be there and were no9t happy about the conversation - but what really do teens and younger adults know or can even fathom of things lke this other than they are untouchable lol.

however as we mature and get older if it were added - i dont even know what age - 30 maybe ( lol for my dear hubby itd be 80 lol) once a person has had time to appreciate life and consider things beyond today and tomorrow. ( or sooner if one gets ill of course) i dont knnow the solution - just a thought from my end.,

Specializes in OB, M/S, HH, Medical Imaging RN.
The reason, though, that people don't address it is fear. People are afraid of death, pure and simple. Even devout religious people are.

I agree and that is so very sad. I think devoutly religious people who are afraid to die and not truely "religious", they walk the walk and talk the talk but when it comes right down to it if you truely love and trust God you won't be afraid to die. I'm not saying you wouldn't be upset if you found out you had terminal cancer. I'm saying when the time comes you wouldn't fight it because you know you're going to God. JMO.

There are, actually, some people who are permanantly dependent on public assistance, and do know the system inside and out. You can't project your own middle class standards on everyone and assume that everyone shares your desire to contribute and be productive. Yes, sadly, a certain segment of the population is not able to function within the framework of modern society and will seek to exploit the generosity of the social welfare system.

i am sure every state is different - but here in wisconsin there is no such thing as a generous welfare system - used to be 20 yrs ago - thank god or id never had made it through school raising my 2 wee ones plus my alcohlic brothers 2 wee ones ( same ages as mine so like 2 sets of twins eeks lol) -

its work for welfare- you work they pay you - they tell you where to work - you cant just get money anymore - and the rest of the programs also are very stringint - i know its cause wisconsin had a very ( at least in my area) high rate of abusing the system long ago - its unfortunate- i know many a single mom with several kids lefyt behind by deadbeats who are stuck in dead end jobs cause they cant go to school and work at the same time ( and before im blasted by " yes they can i did it yada yada " please dont bother- not everyone is capable of doing so - i know i would never have made it thorugh nursing school had i had to work and go to school both full time - nope wqouldnt have happened - ) the gals i now would bust butt to get a degree and be able to get off as soon as tey coul and support thier fmailies better - however now they beg for whatever they can get cause the best they can get is a mcdonalds job...... that to me is sad - that there really was ( and i am sure still is - ) rampant abuse of the system making it bad for thise who would use it for good.

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