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

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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 problem with this line of thinking is that who would be the one to choose who gets extencive measures to save their life? Doctors take Hippocratic Oaths after they graduate. (Its an oath that says they will do everything in their power to save a life regardless of income or circumstance.)

I think if the quality of life is bad and we are otherwise unable to help then it is time to discuss DNR orders. Until then I would fight like hell to save a life, (especially mine if it were the case)

Futhermore why would it stop at the old and feeble, I dont like the Idea that I have to pay taxes so that some petifile in prison for raping youg girls can have medical insurence. Now Im sure that he just might have had a change of heart and when he gets out he'll give back to the community, but I doubt it.

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Specializes in Global Health Informatics, MNCH.

- When working Labor & Delivery and Mother/Baby, I realized there were more patients there on Medicare than private insurance. The ones with Medicare got the same treatment, including all the freebies as anyone else. Who pays for all this? Taxpayers. These were people who fully able to work but refused so they could get free housing, free medical care, free groceries, etc and not have to leave home to work for it.

Do you mean medicaid? I can't see someone who qualifies for medicare being able to have a baby and it not being investigated. I know many young women who qualify for medicaid who also work, therefore they are taxpayers and entitled for benefits, I couldn't pay my rent on what they make a month, that's why they qualify.

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Do you mean medicaid? I can't see someone who qualifies for medicare being able to have a baby and it not being investigated. I know many young women who qualify for medicaid who also work, therefore they are taxpayers and entitled for benefits, I couldn't pay my rent on what they make a month, that's why they qualify.

You're right. I always get the two confused. Sorry 'bout that.

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Specializes in Critical Care, Pediatrics, Geriatrics.
There are lots of things I don't agree with but happen anyway.

- We had a patient who was homeless and admitted. They did surgery and later found the name he gave didn't match his SS#. For some reason, they couldn't release him because of that and because of him not having any place to go. He remained in the hospital for a year getting dialysis.

- Another hospital, another homeless person. He got a private room while there were some who work and have insurance having to share semi-private rooms. Private rooms cost more. But he got the private one because he has a tendency to hit someone if they touch him while asleep.

- When working Labor & Delivery and Mother/Baby, I realized there were more patients there on Medicare than private insurance. The ones with Medicare got the same treatment, including all the freebies as anyone else. Who pays for all this? Taxpayers. These were people who fully able to work but refused so they could get free housing, free medical care, free groceries, etc and not have to leave home to work for it.

- It doesn't stop with the young "women" either with people living off the system. There are so many people who can work but don't who wind up in the hospital at one point or another and get all the same treatment as those who work and have insurance. What really burns me up is there are so many who know how to play the system and get what they want while there are those who really can't work and can't get help or either it takes them years to get it.

Are you implying that someone should not receive healthcare or should receive inferior healthcare if they don't have private insurance.

I agree that there are problems within our system and that there are patients who will manipulate the system if they have the opportunity, but insinuating that a 'medicare' pt or a homeless pt that has a medical need should get inferior or bias care based on their insurance or lack there of is simply unethical. There are laws that are designed to protect patients from that very point of view. Now I see why they are so necessary.:rolleyes:

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Yes, we supposedly have laws to allow all people access to our hospitals regardless of ability to pay. But, what about access to non-acute aspects of healthcare, such as clinics, preventative care, etc? Wouldn't it be cheaper and more ethically sound if the uninsured were able to establish a relationship with a doctor through a clinic, rather than waiting until they are in a full blown crisis and end up in an ER?

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Specializes in Lie detection.
are you implying that someone should not receive healthcare or should receive inferior healthcare if they don't have private insurance.

i agree that there are problems within our system and that there are patients who will manipulate the system if they have the opportunity, but insinuating that a 'medicare' pt or a homeless pt that has a medical need should get inferior or bias care based on their insurance or lack there of is simply unethical. there are laws that are designed to protect patients from that very point of view. now i see why they are so necessary.:rolleyes:

i don't think the op was implying those women get inferior or no medical care. i think she was just venting as we all do sometimes. and maybe that the ones that could work get jobs!!!:rolleyes:

after years of dealing with some "entitlement" minded patients, it can be frustrating. that is not to say they don't deserve treatment. it just tests your patience at times. for example, it may bug me a bit when i see one of my medicaid pt's coming home from the salon with a new hairdo and freshly done nails. not only is the taxpayer's money funding her rent, medical care, food, pet care,cigarettes, but apparently all beauty stuff too! this while someone else is being denied care. not so fair right? and that's just a tiny example.

there's no simple answer to this problem. i don't agree to prolonged agonizing treatment for pt's that are obviously not going to make it. i think it's selfish on the family's part. in icu, we as nurses make these pt's look all clean and neat for visiting hours. these families rarely see what's under the sheets. the mottled, skin, stage 3 decub, fecal bag, etc. they still think uncle harry's going to magically wake up. i really wonder if families were given the prognosis( a poor one) and told that they had to pay out of pocket, would they still be as aggressive? just a thought...

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NOOOOOOOOOOO! I was not implying that someone on Medicaid or someone who's homeless shouldn't be allowed healthcare by any means. I thought I'd said so, but I see I left it out. I was just pointing out there are other ways that healthcare costs the taxpayers a bundle, in addition to what the OP was saying about people with no hope receiving treatment or for alcoholics to get new livers. My main point in that is that a lot of these people I was talking about are capable of getting jobs but refuse because they can get it all for free while someone pays for it for them.

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Specializes in Critical Care, Pediatrics, Geriatrics.
NOOOOOOOOOOO! I was not implying that someone on Medicaid or someone who's homeless shouldn't be allowed healthcare by any means. I thought I'd said so, but I see I left it out. I was just pointing out there are other ways that healthcare costs the taxpayers a bundle, in addition to what the OP was saying about people with no hope receiving treatment or for alcoholics to get new livers. My main point in that is that a lot of these people I was talking about are capable of getting jobs but refuse because they can get it all for free while someone pays for it for them.

Thanks for clarifying. I agree that people manipulate the system and it is indeed frustrating, as well as compounding the problems/issues referenced by the OP. But we must be careful not to lump everyone into a stereotyped category. Your 'medicaid' mom may be milking the system, but (for her baby's sake at the least) she should be given equal care. And there are lots of medicare moms that don't abuse the system...my sister is one of them. I would hate to think any nurse would be bias in their care towards her and my nephew because of the other pitiful souls that perpetuate this stereotype.

I agree with another poster who said that more needs to be done to get these underserved populations into the ambulatory care setting, instead of our hospitals taking in patients in critical conditions because they haven't received basic healthcare. Our first line of defense is preventative medicine and health promotion. That's the only way to keep costs down and keep healthcare affordable.

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Specializes in Maternal - Child Health.
Are you implying that someone should not receive healthcare or should receive inferior healthcare if they don't have private insurance?

I am not trying to speak for the OP, but I would like to voice my opinion on this issue: I don't believe that those without private insurance should receive inferior quality healthcare, but nor do I believe that those who receive healthcare courtesy of the taxpayers should get benefits SUPERIOR to those of us who work to pay for ours and theirs.

I lived in PA a number of years ago, at a time when recipients of taxpayer funded healthcare received comprehensive medical, dental, prescription, and vision benefits. Both my husband and I were gainfully employed, paid substantial premiums thru payroll deduction, and neither of us had dental or vision insurance. We also had to meet deductibles before our coverage "kicked in", and were limited in our choice of providers, while those covered (at no personal expense) by publicly funded plans had benefits far superior to ours with no financial obligations.

That is not right, either.

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Specializes in L&D, PACU.
nor do I believe that those who receive healthcare courtesy of the taxpayers should get benefits SUPERIOR to those of us who work to pay for ours and theirs.

That is not right, either.

I agree.

I also agree with a previous poster...we need to concentrate MUCH more of our attention on prevention and early care, to prevent the huge run-up costs of catastrophic care later.

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Specializes in Critical Care, Pediatrics, Geriatrics.
I am not trying to speak for the OP, but I would like to voice my opinion on this issue: I don't believe that those without private insurance should receive inferior quality healthcare, but nor do I believe that those who receive healthcare courtesy of the taxpayers should get benefits SUPERIOR to those of us who work to pay for ours and theirs.

I lived in PA a number of years ago, at a time when recipients of taxpayer funded healthcare received comprehensive medical, dental, prescription, and vision benefits. Both my husband and I were gainfully employed, paid substantial premiums thru payroll deduction, and neither of us had dental or vision insurance. We also had to meet deductibles before our coverage "kicked in", and were limited in our choice of providers, while those covered (at no personal expense) by publicly funded plans had benefits far superior to ours with no financial obligations.

That is not right, either.

I agree with you. In fact, I agree with most people's voiced frustrations throughout this thread.

I guess my point is that we need to be very careful to focus our frustrations and complaints on the system and not the individual...not stereotyping those who receive government assisted healthcare into one category.

Sometimes its easy to place our frustrations with the healthcare system on a specific group of people, or label those people according to the bad apples that we come across in our practice...but there are many people out there that NEED that assistance.

I also think that the population that suffers the most under our system (besides the elderly who are living off what's left of our pitiful social securtiy system...but that's a whole diff thread lol), are the middle class.

Like myself and my parents, we make too much money to qualify for government programs, in fact we are their main source of revenue, yet we don't make enough to pay out the high insurance premiums that result from them.

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And part of the reason for high premiums is to pay for the last ditch, and often futile efforts, to save the life of a person who hasn't come to terms with his/her situation. Since I've worked in the ICU the past year, it's really driven this fact home to me how much we, as a healthcare community, spends on these heroic attempts to reverse the irreversable.

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