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

[GardenDove]

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?

[twotrees2]

Interesting. I had someone ask me last week. "If we believe we will go to heaven, why do we fear death?"

It is of course within every living organism the inate "need" and there fore struggle to survive. Reproduction is linked to this survival response.

my own view- faith wise i do not fear death - its leaving the ones i love behoind - afraid of what will happen to them if i do die ( like my kids- what would hppen if they were stuck with my alcoholic, emotionally disturbed husband ) before situations are stable for them that if im not here they owuld be ok.

[twotrees2]

ACCESS to health care is unethical.

i believe the USA is the only industrialized nation without universal access to health care.

many of us have children who are 23 y.o. and kicked off the insuramce role. they/we must forage for affordable health insurance coverage and self-pay.

if they are without insurance and need an expensive diagnostic test such as an mri, it's cash up front -- or no mri. and the average ER visit is about a thousand dollars.

at the other end of the spectrum -- look how many 70 and 80 year olds (and older)are on cholesterol-lowering drugs. WHY???

given the cost (which is being transferred to taxpayers now) and the age, haven't these drugs ALREADY done what was intended?

they lower cholesterol in order to prevent a cardiovascular event. their effectiveness is measured in DECADES. so, one who starts on these drugs will see the actual intended effect about 10 years down the road.

i don't get it.

even when they do have ins its rediculous - my son had 2 doc office visits - his total out of pocket wsa over 200 for thise 2 visits and a xray- they wanted to d0o an MRI- his total out of pocket would bbe over 1000 - i finally got through to him to go through the VA where it will be totally covered as its due to 3 tours in iraq - it just surprised me as my hubby used to work at this place and they had great ins- i was bowled over by the change.

[twotrees2]

Mandatory euthanasia at 40 y.o.--there's the solution!

Just recently googled the National Debt. It's just under 9 trillion dollars, or about 28000 for every man, woman, and child in the US. That's a lot, but...we aren't wasting trillions at a time in Iraq, on healthcare, or anywhere else. The billions do add up, but a trillion is still a lot of money.

A big part of where baby-boomers squandered our national treasure was on educating our children. Also highways, healthcare, and defense. A lot has been wasted, but a lot has benefitted everyone alive today, including the children and grandchildren of the boomers. The reality is, we all expect a certain level of service, and we have to pay for it either through taxes or deficits. There are still too many people who think the government should pay for its various programs, rather than the taxpayers.

As far as healthcare goes, I still think we probably spend more on 4x4s than on heart transplants. I think we'd see fewer full codes if we did a better job of educating people about advanced directives. I think we'd see fewer dubious ER visits if people had better access to primary care. I don't think we'll see much progress on the latter until we have a national health insurance program, but I'm sure I'll groan as much as anybody when I start seeing the premiums coming out of my paycheck. Still, universal health coverage ought to greatly reduce the need to draw money out of the general budget for Medicaid, and that money could then be used to help reduce the deficit.

It's a proven fact that we can run the country without deficits. It does require some sacrifice to do so, and, unfortunately, a significant part of that sacrifice will have to be in the form of higher taxes (interpreting premiums on universal health care as, essentially, a tax).

having had numerous eoropean students at our house as exchange students - theyall thought our health care sucked- they have healthcare for everyone- however they also pay MORE THAN 50% of thier income in taxes- can you see americans willing to give that much in taxes to add healhcare of everyone- most of us complain about the taxes we do have to pay al.ready. i just dont see the consesus saying yes we will pay that much to have universal health care.

[subee, MSN, CRNA]

my own view- faith wise i do not fear death - its leaving the ones i love behoind - afraid of what will happen to them if i do die ( like my kids- what would hppen if they were stuck with my alcoholic, emotionally disturbed husband ) before situations are stable for them that if im not here they owuld be ok.

That's the business of life that you have to take care of NOW because you could not be here tomorrow. I once had a young female patient on chemo who knew she wasn't going to make it but she had to stay alive long enough to make arrangements so keep her kids out of her husband's house. You see so many patients on chemo that are just lining someone's pocket, but I'll never forget her because she really needed to live long enough to get this finished and suffering the toxicities was well worth it. Good luck to you and your children.

[twotrees2]

That's the business of life that you have to take care of NOW because you could not be here tomorrow. I once had a young female patient on chemo who knew she wasn't going to make it but she had to stay alive long enough to make arrangements so keep her kids out of her husband's house. You see so many patients on chemo that are just lining someone's pocket, but I'll never forget her because she really needed to live long enough to get this finished and suffering the toxicities was well worth it. Good luck to you and your children.

thanks :) not that hubby is " bad" hes sick - i do lov him dearly and he isnt to bad a dad ( though he doesnt work he does fair being stay at home dad ) adn he hsant been able to drink with no job as i wont give him money - - so maybe if i cant win the lottery to set them well off maybe i could find them a new wife / mom LOLOL> god bless

[kate1969]

The long term acute care facility I work at weans people off vents that are more difficult than most to wean, if/when we deem a patient unweanable we inform families of other options ie: compassionate weans/terminal weans. In my state however, medicaid will not allow us to terminally wean their recipients, instead, we must pay for an ambulance service to send the patient to a long term care facility so that they may carry out their compassionate weans....the government would rather spend more money in transporting these patients to other facilities so they can "save" money...hehe, generally these patients are over 90 years old...cracks me up!

[NurseguyFL]

Yes, and I'm sure we've all seen our fair share of questionable stuff. What it all boils down to at the end of the day is that health care is a business just like any other, and, for the most part, money is the name of the game. We often hear talk about ethics, but those of us with any experience at all in the game know that a lot of it is nothing more than lip service. In some cases its dangerous to rock the boat even by talking about this stuff, and I've seen nurses get fired for it. We learn in nursing school that we are supposed to give support and encouragement to patients and their families, but I am always very careful about whatever I say to them because I've seen nurses get in trouble for that, too.