I'm not proposing rationing or coercion. I don't want to make decisions for pts or families. What I DO want is someone objective, to honestly and compassionately provide hard truths about what death and dying looks like.
Doctors, for the most part, are not objective. Some I work with want to keep the pt alive as long as possible because it means a paying customer. End of life is when most of the health care dollars are spent, and that's where MDs and hospitals make the most money.
Death panel? Call it what you want, but our society is sorely lacking in honest accepting discourse about death.
Some people want to live forever and will submit themselves to any test, drug or procedure for that end. I respect that decision.
Some people want to live as long as possible, with quality of life determining how much intervention they want.
Shouldn't these people be given hard, basic information to guide them in these decisions?
Ummm.....even in THIS country an alcoholic that has destroyed thier own liver HAS to be sober for an extent of time before they can even be placed on a waiting list for a liver. A woman I used to work with had an alcoholic mother who distroyed her liver and was told she had to be sober 6 months to be put on the list. And even that doesnt mean she will get one in 6 months it just means that after 6 months she would be eligable once she came to the top of that list as long as she continued to remain sober. However she was a true alcoholic, and thought that meant she would get a new liver in 6 months......and then would be able to drink again.
Media Matters doesn't skew things and they link to all their sources so it's easy to verify accuracy. Facts are stubborn things...
Okay- you're definitely preaching to the choir with me. But after viewing the site, it does seem a bit skewed (in the right direction ) but definitely skewed. :)
Here is a man who damaged his liver to the point of cirrhosis at the ripe old age of 22. He admitted to be an alcoholic from age 13. He was sober less than a year.
For the sake of argument- lets say there is another patient on the list in the same hospital and one liver becomes available. The other patient's profile is like this:
A 43 year old health care worker with a liver destroyed by Hep C which she contracted several years before after being stuck by a patients IV needle. No other health issues and no history of alcohol or drug abuse.
Who gets the liver? The young man who deserves a second chance at life or the middle aged health care worker who had no say in the matter, became ill as a consequence of the job.
These decisions are made every day in the US.
Yes, it is horribly sad that a 22 year old man had to die. But what exactly entitled him to a liver over someone else on the list?
Organs are not a first come first served kind of treatment.
Wait....it is still a DEATH PANEL decision. That was the point. He would not even be given the chance....looking at your example...what if there were 2 livers. He wouldn't get one. He wasn't sober long enough.
Besides...we are taught the alcoholism is a disease, so you can't say he did it to himself...or did he....????? That would be a heartless conservatives position!
Organs in this country are a worst come worst served (who is in the worst condition). If the 43 yo was in worse shape, she would get it first and he would have still died if no other liver became available.
Wait....it is still a DEATH PANEL decision. That was the point. He would not even be given the chance....looking at your example...what if there were 2 livers. He wouldn't get one. He wasn't sober long enough.
Besides...we are taught the alcoholism is a disease, so you can't say he did it to himself...or did he....????? That would be a heartless conservatives position!
Organs in this country are a worst come worst served (who is in the worst condition). If the 43 yo was in worse shape, she would get it first and he would have still died if no other liver became available.
It's not that cut and dry. A LOT of people don't make the donor list even though without a new organ they will die! "Panels" make those choices everyday! I really don't know how to explain that in any simpler terms. If you don't think they take into consideration someone's lifestyle, other health conditions, age, etc. when placing them on the list you have your head in the clouds.
I stand by my opinion that 'death panels' (as some of you like to coin it) have been going on here in the form of insurance companies and organ transplant committees all along. This is nothing new. This isn't 'obama care'. This is reality. There aren't enough donor organs to go around. Teams have to decide who will best benefit from a transplant, who has the best chance of surviving and who is the most likely to conform to a lifetime of maintenance medication and medical care.
Specializes in Spinal Cord injuries, Emergency+EMS.
In this country he would have lived.
I presume you have full access to his medical notes and are able to screen high risk patients for their suitability for high risk surgery ?
I presume you can also prove that had he been placed on the potential recipient list that a compatible donor organ would have become available before he became too ill to have a transplant
i notice you have conveniently ignored the existance of the NHSBTA guidelines
the new medicare benefit simply provides physician reimbursement for "voluntary" end-of-life counseling (advance care planning). it gives the medicare beneficiary the opportunity to decide their own end of life care. it isn't a death panel or rationing of care.
half of the people posting, show up to work day after day and are paid with the same money they are declaring the doctors and hospitals are out to get. it is the descision of the family or pt to make on what their care should be.
If you are in the medical profession, then you surely know what informed consent is. If that is provided, then the family can make a decision based on the likelihood of an outcome they would feel is acceptable. For example, many patients I have cared for believe that if you get CPR you recover and function normally. The evidence does not support this as an outcome and if patients even manage to survive a code, they will likely be left with many impairments and will not return to normal functioning.
A 45-year old man with out any medical co-morbidities will likely have a better outcome if he codes versus an 85-year old female with respiratory failure and multi-system mets. Would the 85-year old want to be put through the trauma of bone-breaking chest compressions and the violence of a tube down her throat if she could die in her sleep peacefully? She has a right to make either decision, but it has to be voiced to her in real terms.
I remember when I was an oncology nurse, there were patients who were quite comfortable with their mortality. I remember a 82 year lady who had chosen here sister as her medical health power of attorney. The sister was in her 80's also. On the day that her sister passed away family members were in the room just kicking and screaming do something. The sister sat in the chair by her sister and said I do not know why they are so upset because my sister had already made all of her arrangements. She was prepared. I believe living wills and medical health power of attorney are important. And family members should give it to someone who really know and can carry out their wishes.
Specializes in ICU,ED, Corrections, dodging med-surg.
I am always surprised when I ask family and pt if the doc has talked to them about "if your heart were to stop or...." referring to very sick and terminal, they say "we want everything done" I always ask them if they understand....and put it very direct "I don't want to sound insensitive, but...and I have to ask if you would want to live out your last days ...(explain to them probablities, pain, outcomes, suffering.etc) And on occasions I have had family say, "I never thought about it that way" they almost always change their mind, and I have had prepped docs before going into talk to the pt about what I said and have they have told me thank you. I spend time also asking if their loved oned is spiritual/religious........I wish docs were more direct with families. These instances happened in a busy ED, where it is exceptable to have these talks when the doc is with other pts. Just wish the PMD would too, before they get to that point.:heartbeat
:igtsyt: probably gonna be telling my age here but, remember the days when people just died when it was their time? no heroic methods, surgeries... etc. today, the medical field jumps right in, from one thing to another, doing their best to 'save his/her life'... ah, yes... quadruple bypass on a 70 yr old who now is plagued with dm ii, emphysema, copd and only one kidney, knocking on the 'dialysis door'. but her heart is strong!!! why do we do this to people?... and why are they so eager to jump at the chance? i guess we all might at some point think we want to live forever but even then, we must be realistic. and so, why not discuss 'end of life care'? just three years a nurse and already i know what it is i want when i reach my end ... and my kids do too. just let it be...peacefully.
) but definitely skewed. :)
Spidey's mom, ADN, BSN, RN
11,305 Posts
I disagree that they don't skew things.
Just in that link you provided there are skewed things.
But, we'll just have to agree to disagree, as usual. :redbeathe
steph