seeler's picture

seeler

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How long should we keep people alive?

Over in politics there is a thread about the Green party that is discussing this matter. I think that it deserves its own thread. Is there a time when it is wrong (futile, economically wasteful, cruel?) to keep someone alive? Who decides? What guidelines do they follow?

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seeler's picture

seeler

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For instance: less than a century ago, life expectancy was less than 65 years - few people lived to draw OAS when it was first introduced. They were considered OLD.
But antibiotics, hip replacments, transplants, advances in modern surgery, better diets, etc. are keeping people alive and active into their 80s and 90s. Many of the diseases people died from are now preventable or curable. Others that don't necessarily kill but interfer with quality of life are still around. So people with deteriorating mental ablilities, disabled from strokes, with failing lungs, hearts, and/or kidneys are kept alive (sometimes for years). When do we say enough is enough? When do we say that this elderly bed-ridden, blind, deaf, person who has lost the ability to communicate and has to be fed with a tube, should not be rushed to the hospital and treated for a lung infection? When do we let them die?
When, when someone is severely injured in an accident - is broken in body and almost brain dead, should be allowed to die?
How premature does a baby have to be before it is considered a miscarriage?
And when do we say that the pain, suffering, and outcome do not justify the expense? Or perhaps that it is sinful to keep this person alive just in hopes that medical science might learn something from its condition or treatment?

ninjafaery's picture

ninjafaery

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Hi Seeler. Personally, I'm angered and terrified at the prospect of losing my right to choose what to do with my own body if I'm profoundly disabled, incurably ill or in terrible pain. It seems nothing short of criminal to me that I won't have the power to say when "enough is enough". My own mother went through this. She was ready to die two years before she did, and they were extremely painful, degrading and hard years.
To me this seems the ultimate in cruelty. We treat animals better.

Now it's really important IMO that this isn't a choice taken lightly or in isolation (unless there's truly no one else to give input). Depression should be ruled out and everything done that can be, but the prospect of getting old would be a lot easier for me if I knew I could exit when I'm ready.
One's last time on earth shouldn't be so awful. It also creates sad, difficult memories for the families and friends. I wouldn't want that and neither did my mother.
When it comes to other people making the decision, it gets dicey. Not sure how I feel about that.
I guess that's where "living wills" come in.
I think this is an increasingly important topic as we boomers age.
Hope the laws change.

lastpointe's picture

lastpointe

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I can't find the link now but there is a statistic that the Health Care system spends 80% or so of it's money in the last 30 days of someones life.

and yet I know when my dad was in hospital and eventually died I didn't think of whether it was worth the money to try.

seeler's picture

seeler

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I don't want to put words in anybody's mouth, but it seemed to me that someone stated in the Politics thread that socialized medicine wastes hugh tax dollars keeping people sik.
Again, as I read it, they later clarified that the money is used in hopeless cases extending life rather than letting people die a natural death. (That is not a quote but my understanding.)
For the purpose of this thread: does socializd medicine tend to keep people alive past their natural lifespan, wasteing untold tax dollars and who and how do they decide. Should it be a choice between the medical profession and the family (and the patient if she is able to understand and communicate); or should there be some arbitrary cut-off line? Does government have the say or does the person (people) involved have a choice.
If it is a question of money, then wouldn't the privatized system be worse?
Wouldn't only the rich have the right to choice - spend any amount but keep my 105 year old father, who hasn't recognized anybody for two years alive even if it means more expensive treatments - I have the money? But the person 25 year old unemployed labourer who needs a kidney transplant might be refused that choice on the basis of money.
And wouldn't insurance companies bulk at paying hugh amounts for treatments that they consider experimental? Wouldn't this add to the high cost of health care?

MikePaterson's picture

MikePaterson

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f it was me on life support, I'd rather see the money spent on a decent clean well somewhere it's need.

If it was my child, I'd really be torn. If the prognosis was bad enough, I'd go with the well. How bad,? I'd have to be in that place, g*d forbid.

If this is about privatised health care Vs socialiised, I'd have to say that I've never seen privatised health care serve well those who most need health care. If anything, it denies them access, always.

waterfall's picture

waterfall

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I think that whole key is that you have to think about it, acknowledge that it may happen and somehow convey that information when you are well enough to do so.
I don't believe in having one set of rules for everyone. It is an individual choice, whether or not you or I agree with it, but someone else needs to know what you want if you can't convey it.

InannaWhimsey's picture

InannaWhimsey

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Seeler,

long enough to say your goodbyes
To tidy up
One last time to be overwhelmed by
The Mystery
When they turn the page to see the ending
That the rest of us don't get to see
Until it is our turn

carolla's picture

carolla

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That's lovely Inanna.

This is a highly complex ethical issue, being dealt with daily in our hospitals. Opinion varies widely, sometimes based on religious values, at other times on family & personal dynamics.

In the health care system, we often do not take enough time to fully and sensitively educate people, families, etc. about anticipated processes & potential outcomes. It can take a long time to absorb this information, to consider and grieve potential decisions, and skilled staff to help people through that process. I've learned over the decades that outcomes can never truly be predicted - they are just a best guess, based on information and experience.

As others have said, it's truly valuable to talk with those who may end up enacting your wishes if you are rendered unable. It eases the way so much for loved ones to understand that this is not THEIR decision to make, but rather that they are helping you to receive what you wished for, when you cannot speak for yourself.

Pinga's picture

Pinga

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When I was at the hospital, in the early stages of losing the twins, there was a decision to be made.

The doctors were determining if some new surgery at the time, would help. This was 16 years ago, when twin-to-twin transufsion syndrome was new in diagnosis/treatment. As they discussed the probability of survival, risk, etc, my body forced a different decision. These babies were going to be born. Had I been there an hour earlier....I might have had to make a decision on surgery or not, possible save, possible loss, probable damage from the syndrome, though different for each twin. Had I had a reasonably intelligent ER doctor, I would have. (I was held in Cambridge for approx 2hrs, until an OB arrived, who immediately threw be in lights/sirens to mac -- no change in symptoms, just she accepted my story, and new what was up)

As it was, the decision still had to be made.
a) delivery via c-section, unlikely to be able to every carry another child
b) deliver vaginally, higher probability of damage during delivery

In either case, there was a high probability of significant damage to both our children.

As it was, we went with delivery. The girls both died shortly after birth. In all probability, the same would have happened with c-section.

SpecialMom and I have discussed how I feel when speaking with parents such as specialmom. How would I have handled twins with severe damage -- one definitley with CP, one definitely with heart damage, probably both damaged. I look at them, and recognize, though miracles occur, there are far more parents left to care for little ones, requiring a huge amount of care and finances. Just? I think not? I grieved the loss of our daughters, but I do not grieve not having to carry that burden.

How is this relevant? In many cases of a little one who is medically fragile, there are many, many little decisions that lead to a situation which others may wonder why the little one was not allowed to let go. Individuals who ask that, don't realize the carrot of "hope" to be the miracle the doctors speak of.

If anything, I feel the question is, how do we support those, who with the assistance of our medical system, threw the dice hoping for life, and it ended up being a medically fragile one. We desert these families.

Any one of those little decisions has a high probability of being a challenge at the time, and heart-wrenching as one looks back.

killer_rabbit79's picture

killer_rabbit79

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I've been thinking about this topic myself too Seeler. I don't think we need to keep people alive if they are suffering to the point where they can find no comfort and when there is no hope of recovery. I also don't see why a hospital would want to spend money on keeping coma patients alive when they have no chance of ever waking up again (this doesn't apply to all coma patients of course but it does apply to enough). It seems wasteful to me (as cruel as it sounds, it's true).

I've also thought about how life expectancy has changed over time. Prehistoric humans had a life expectancy of 40 years. Most probably didn't even make it close to that. We have almost doubled that life expectancy and it's not uncommon for people to live into their 80s, 90s and even 100s. So it seems to make sense to my why we begin to age once we make it into our 40s, because we aren't made to live beyond 40 years. We are pushing the limits of nature and even though we live longer, it's not going to be as great as it is up to around the late 30s. This doesn't mean I think we should euthanize everyone over 40, I just think we should be thinking about whether or not it's worth it to keep some old people alive when their quality of life is at the point where there's not really anything left to enjoy.

LBmuskoka's picture

LBmuskoka

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For me the issue is not how long or how much money, but whether there is respect and dignity offered to the patient and family.

This was hit home this week at work; we had several residents sent to the hospital for one reason or another. All were treated horribly. One woman was asked "when do we pull the plug" - she was not on death's door having suffered an angina attack. She was left to lie on a hospital stretcher for two days, frightened and humiliated.

I might have been more sympathetic if the Emergency department had been overwhelmed but it hadn't. It was a quiet weekend. I might have been empathetic if I did not know the particular doctor involved and know that this is how he behaves to anyone, including the dying.

Treating someone with respect and dignity costs nothing.

LB
It is not wealth one asks for, but just enough to preserve one's dignity, to work unhampered, to be generous, frank and independent.
W. Somerset Maugham

seeler's picture

seeler

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Hi Killer:
I just checked to confirm and you are in the young adult age group.
It's funny how the concept of old age changes as we age. (My mother died at 40 and I (at 14) couldn't understand why everyone was murmuring about 'so young'.)
I'm in my late sixties now, my husband in his early seventies. We have friends in their 80s and a couple pushing ninety. One 89 year old woman volunteers at the nursing home - among other things she teaches yoga to the residents - she used to teach them belly dancing. Another at 87 broke his ankle this spring and for awile we thought that this might slow him down - but it healed well. He drives his own car, bowls 4 times a week, helps with the score keeping and other details, but recently missed two games in a row because he was tearing the old deck off the back of the house. He is still sharper than I am in a car game. When my husband and I get old (ha, ha) we hope to be like these people.

But we have seen quality of life compromised for some of our friends.
John and Sadie live in their own home but depend a lot on their children for help. Sadie has aultimizers, John recently got a pacemaker. John hopes to retain his driver's license so that they can continue getting out.
Although Paula is my age and Jack only a bit older he requires full time care at home (hospital bed in living room, help with a wheelchair, spoon fed, unable to communicate). She has to hire a sitter, or depend on their son, whenever she wants to get out.
George has been in and out of the hospital every few months with diabetes, heart and lung problems - he walks with a walker and sometimes falls. He is a big man and his little wife is over 80 herself. She won't leave him home alone so she helps him in and out of the van. He plays cards, watches bowling and tells me that he feels useless.
I love them all.

But I can see that their lives are drawning near the line. Sometime within the next year or so, maybe sooner, maybe later, we will have to let go. Sometime their quality of life will reach a point when the pain, suffering, and yes expense of keeping them alive is not the best choice. And because no one knows when sickness or accident may strike, it may happen to anyone at any age.

When adding up all the factors, who makes the choice on whether to continue treatment, try something more expermental, invasive, expensive, or when to simple provide paliative care? And - since this topic started in the Politics thread, does private or public medicare better in this situation?

Panentheism's picture

Panentheism

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It is not socialized medicine that keeps people alive as a policy - it is true of all medical action - in fact it is foundational to medical training.

In one sense this is good because to withhold medical services on the whim of the doctor can lead to real problems. Having said that one of the issues in medical ethics ( which transcend the way service is provided) is when is life over?.

It is true that the last days of a life is most often in a hospital - it is a truism most people die in a hospital but that tells us nothing but that we get sent to the hospital.

There are movements to create places where people die supported - but that death is not hurried up. Yet even there there are issues of medicating. For increasing morphine will speed up death but it also lessens pain. This has to be asked for - permission given so morphine is increased.

First everyone should have a living will because one of the important ethic grounding is choice. We can determine the extent of how much technological activity should be done - every hospital depends on this to make a choice when to shut off the machines.

Secondly one has to get ones family on board because the hospital by law has to respond to families if there are no living wills. Even with one there can be problems.

These things show the problem - being on an ethics committee at a hospital we deal with families who do not want to do what the patient wants and sometimes threaten the hospital when if follows through. This suggest the problem society has with death - we don't want it and it has to be very clear nothing can be done for people to let go.

Now there is the issue of when medically nothing can be done yet nothing is in place and the family resists - what power do doctors have to continue to allow that which is useless to continue ?- at the moment they cannot to stop treatment and this is now a new ethical discussion.

The cost issue should not enter the ethical discuss other than the commitment of a society to provide medical care to all as a basic right - how far should this go? is the question. To stop treatment on only economic grounds is dangerous for who determines what is the cost benefit equation? We do make ethical discussion when there are scarce resources - we create lists to determine who is next based on some value system - at the moment is is first in line.

We should have a say in end of life determinations and this still leaves open active ending. When is active euthanasia illegal and should it be? How active should a doctor be in responding to ending a life - here the assumption is death is not immediate nor is one comatose but is in pain or knows death is in the future. At the moment active euthanasia is not legal but passive is.

Pinga's picture

Pinga

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Heh killer_rabbit, when i was about 12?, I remember saying to some other Girl Guides, "I hope I don't live past 40...". I was reflecting on my perception of those over 40, as slower, less in-tune with life, ...or so i thought.

I am now 10 years past 40, and look at amazing people in their 80's, and sure hope no one was listening to my young teen self too much!

killer_rabbit79's picture

killer_rabbit79

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Pinga,

I realize that not everyone ages the same way and that many old people can be very competent both physically and mentally. What about the ones that don't though? Should they still be kept alive just because other old people are about to remain active and stave off senility? I'm not trying to be ageist but we should still be aware of the potential consequences of keeping people alive past life expectancy.

ShamanWolf's picture

ShamanWolf

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I say once people get to really old age it should be about choice, and/or when one is ready to die. We shouldn't spend tons of money keeping people sick, as Arminius said. That wouldn't be ageist at all. Everyone will probably realize at some point that they are ready to die, and when they reach that point they should be allowed to go.
My grandmother said she wished she could have died sometime while she still had some of her youth and abilities, so she wouldn't have to watch them all slip away... my grandmother was very old and very wise.
Also, I read in Maclean's that increasing lifespan might be part of the reason for rising divorce rates - death doesn't part you as soon any more...

Pinga's picture

Pinga

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what about those who are not competent due to alcohol or drugs in their 30's? should we also not keep them alive? who makes the call? who says they can't "get better"

my grandmother, in her late 70's, was unable to stay in a home, was in the hospital quite ill, got released to a nursing home. She was able to get better enough to look at what was the matter, study it, realized it was med's, started to get herself off them, started walking, etc. She became well enough to move out on her own again. She lived 10 years longer than would have thought. I am thankful for those years, as I, a young woman by then, got to know her. She started a patient's rights group, and a newsletter while she was in that nursing home.

there is always hope, there is often a miracle, a spark or life, which if it can catch, can turn things around, maybe not as dramatically as that, or maybe more...but, who wants to be the one to make the call?

DaisyJane's picture

DaisyJane

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This is such a highly complex situation. The possible scenarios are incredibly vast.

In our experience massive resuscitation was done on specialson before I was conscious and before specialdad was invited to be involved. We went from having a baby that should have been healthy to a baby born dead and revived. In these situations what adds to the complexity of the situation is that medical technology exceeds the pace of social and community services. We have massive medical technology which allows medicine to keep VERY complex people alive but the resources to manage their lives are scarce.

And then there is the very heated debate of live vs. quality of life and how is "quality of life" determined.

I must agree with pinga's comments. We were given the opportunity twice to discontinue specialson's life support. However, at the time they could not predict how disabled he would be...perhaps it wouldn't be that bad. What parent would discontinue life support in that situation. The hope of a miracle abounds.

How long should we keep people alive? I honestly don't think I could answer that question. But it is very fair to say that I think that we spend a lot of time, money and energy focusing on LIFE vs. quality of LIFE,

seeler's picture

seeler

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Thank you Pinga and Specialmom who have been in the situation and see it from the other side.

bygraceiam's picture

bygraceiam

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Hello seeler........God bless you...

Dear Lord...I pray your Precious Blood over all of the suffereing in the world..
Lord it is a hard place to be sometimes...gives us the answers we need....
Give us your gift of Salvation....and show us the path we must go...
I pray all Love the Lord with all their heart, all their soul, all their strength..all their soul and love your neighbours as you want to be loved....we know all else will be added to it.......Praise the Lord..In Jesus name I pray...amen and amen......

Band's picture

Band

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I do know that if I am considered brain dead I would not want to live in a hospital until my body fails.

LoveJoy's picture

LoveJoy

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In my experience working in hospitals as an associate chaplain, nobody keeps brain-dead people alive. Unless it's their family insisting on it - and then only for a time until someone talks sense into them.

You have the right to refuse medical treatment as well. If you're not able to do so, your family can - to a point. Unless there's some hope you'll recover, of course.

The exception to this "rule" seems to be very old people. They do all manner of treatment on folks whose quality of life is very poor. But nonetheless, they aren't imminently dying per se. I am aghast at the amount of money we spend on older people in this country. 99% of hospital patients in medical wards are well past life expectancy. It's interesting to muse about, but what can you do, really? Nobody's going to advocate refusing ANY medical treatment to someone just because they're old.

Revolutionary's picture

Revolutionary

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A person should have the right to refuse life extending treatment if the outcome will be eventual death. When my mother died at age 86, she requested they not try to resusitate or prolong life. She went to sleep, ready to die. When she woke up a few hours later, she asked, "Am I still here?" When we told her yes, she replied, "Well, this is just bullshit." (We had to get out of the room to laugh because she NEVER used that language in her life.)

Abeliever's picture

Abeliever

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When will we stop trying to play God here?

Man was never meant to live forever. Once the body gives out, and the brain is dead, what's the sense?

People just need to realize that we cannot live forever.

seeler's picture

seeler

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I think that the problem is deciding when the body gives out and the brain is dead. People have come back from being in a coma for days or even weeks and lived happy productive lives (I'm thinking of a friend in her 40s who was in a terrible accident. Three times in the next few days the family were called in to say goodby. In a coma she didn't give up. The family was told that she would never wake up. She opened her eyes and said "Hi Dad." She was told that she would never walk again. Although paralized in one leg, she manages quite well with a leg brace and a cane. She sings beautifully and has recently cut a second DVD of gospel music. She lives in her own home with a full time attendant who has become a friend. Is her life not worthwhile? Would it be less worthwhile if she was eighty and struggling to come back after a stroke?

If we didn't "play God" we wouldn't do any medical intervention and life expectance would go back to less than 40 years. I don't think anyone is proposing that. Medical intervention is not "playing God". Medical intervention is using our God given compassion, intelligence and talents to help others.

Mely's picture

Mely

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I think we need laws and medical ethical standards to decide these things. If you start leaving it up to individuals, or start letting people choose an assited suicide, this opens up a real Pandora's box.

If an ill person has a choice about these things, they might feel pressured into choosing a quick death to spare their relatives from watching their long drawn out death. More sinister yet, the relatives might try to pressure the sick person to choose to die quickly because they want to inherit money sooner, or the government might start putting subtle pressure on people to choose a quick death, to save money.

Mely's picture

Mely

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killer rabbit wrote:
we should be thinking about whether or not it's worth it to keep some old people alive when their quality of life is at the point where there's not really anything left to enjoy.

-------------------------------

Well when you get really old your self, and you decide there is no point living anymore, let us know. Until that time you might want to withhold judgement.

SLJudds's picture

SLJudds

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We should keep people alive as long as they want to be alive.
The difficult part is that "alive" and "dead" are becoming more and more difficult to define and differentiate.
In my mind, an inert mound of flesh kept as living tissue by artificial means with no reasonable hope of recovery is already dead, even though the heart is still beating. If I lose my self awareness, I am dead even though my body still lives for I am more than flesh and bone.

jlin's picture

jlin

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I remember when I was a kid thinking that if I couldn't run, bike, swim and pick buttercups that my life wouldn't be worth living. I was really so depressed when I broke my scapula at age 5 - because I had thought previously that I was invincible and the breakage proved to me that I was inferior to others who were unscathed and uninjured. Yes, I really thought those things and I was truely depressed . . . so much that though I can remember every moment leading up to the break and walking home in excruciating pain and there not being anyone there and my friend running around town _ literally - to find my mother and being take to the hospital by my dad and the Doctor "setting" my arm ( you can't set a scapula really) in a sling - the entire healing is completely blocked from my memor. The next memories are like waking up from amnesia. Dad was driving me to the hospital and I asked him what we were doing and he said that we were going to get the sling off and check my shoulder. I looked at the sling and my arm and didn't recognize them and I remember feeling nervous because I had no knowledge of the time that had lapsed. all I could remember was the accident and the pain and waiting for my mom and dad.

The above story is about peoples' opinions about when life is over. Clearly, I really did feel that I had no reason to live and I did not come back to life until the arm was healed.

jlin's picture

jlin

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With regard to the above post by me; it is likely that a clavical should never be referred to as a "scapula" . . . ahem.

fairway's picture

fairway

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Good point Lastpoint. Just look at pet owners and how much THEY spend on the last few days of THEIR dying pets.
Fairway

lastpointe's picture

lastpointe

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There are different types of critically ill patients though they both take up lots of health care dollars.

there is the catastrophic type Special son, massive heart attacks/strokes, massive car accidents..... These patients are born or transported to hospital in very critical condition and there is no time to step back and say " well lets weigh the pros and cons and decide if we will treat them". They are treated, revived and then in a calm moment the medical history is figured out.

Special mom, i have been a many delilveries where we have worked our asses off to save a very compromised baby. the issue is always how compromised?, when? how long? and someitmes once the baby is revived there is no turning back. those are difficult ethical situations as you well know and no easy answers. My heart always breaks when you talk about special son and hsi situation.

the same things happen with children and adults who are rushed to hospital. No easy answers. Firstly they are "saved" then the history is figured out. WOudl you prefer that first they figure it out? no time for that.

the other type of patient is the chronic health condition patient who gets worse and needs more care. how do the medical staff evaluate quality of life. Its that "Tracy Latimer" situation. Who are we to say that 80 is old, or Trisomy 21 is not worth it, or that stroke is non recoverable .

Sometimes though the decisions can be made ahead of time and that needs to be thought out carefully. It's easy to say " no life support" but suppose you were in a bad car accident. Surgery worked but now you have bad pneumonia. you need ICU, ventialtions, really expensive antibiotics due to the particular strain. And you are 45, well? life support for a week? Probably but if you are 80? why not, they might be very active, bowl weekly, attend church , read to the elderly at their residence, travel, maybe that elderly person is writing his memior.

It's not simple.

I have a current example. My mom has Altzeimers. She lives in a seniors home and is pretty independant though she needs support from us and her companion. Her mental status has been stable more or less but it is well documented that anesthetics and morphine type drugs will markedly increase the rate of altzeimers. decline
she has a breast lump. Most likely cancerous. She is 86. Our decision has been to not treat or do surgery. She wouldn't understand it, she would be frightened, it isn't too lilkely to extend her life by much, she is too frail to undergo radiation and chemo and wouldn't understand it anyway.

So we are electing to not treat for something that won't really increase her quality of life.

Is it the right decision? welll for my siblings and i it is. Others would do it differently. Certainly her OB/gyn guy agrees and the nursing home doctor doesn't.

Arminius's picture

Arminius

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Hi seeler: I was the one who made the wildly exaggerated statement that modern medicine keeps people sick longer, and thereby severely offened graeme, and perhaps a few others. I promise to tread more carefully this time.

I've lived in splendid rural isolation for the past thirty years, seeing more deer than people, and it occured to me that I've never see any sick deer. But they don't have modern healthcare, and we people do, yet so many of us are sick! Could it be that modern healthcare makes us sick?

This, of course, is a facetious statement. But one can't help but realize that, although modern healthcare has raised our individaul life expectancy, it has rendered our species sicker and weaker.

Bacteria, viruses, and all manner of illness keep the organism healthy in a sort of predator/prey relationship. Viruses keep us resistant and fit, illness keeps us well--as a species--at the expense of sacrificing some individuals. If we suppress illness with medication rather than allowing it to do its natural cleansing, then we render our species sicker with the passage of time.

It seems that a healthy lifestyle, prevention, and natural cures are a better way to go.

But I myself will go to hospital next month for back surgery; it is hard to refuse those blessings of modern medicine :-)

When are heroic measuers, to keep everyone alive at all costs, for as long as technologically possible, too much?

I don't know. I'll decide when I get there--if I can.

seeler's picture

seeler

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arminius - thanks for coming on board. I think I know where you are coming from. It's survival of the fittist. The strong survive, and the weak perish. You never see a sick deer for two reasons. Animals, especially prey animals try to hide their weaknesses. When they can't keep up, they try to hide until they regain their strength or die. The old, the young, the slow, the inattentive, the stupid become easy prey to a multitude of carnivores. They die.
So you seldom see an orphaned fawn - they die. You seldom see an animal much past its prime - it dies. You seldom see one injured or sick - it either manages to hide or it is killed. Only the strong and well survive.

Is that what you want for people? Or do we use our superior intelligence and our compassion to find ways of keeping sick people alive until they can be cured?

Arminius's picture

Arminius

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seeler: No. that's not what I want for people.

I just wanted to bring everyone's attention to the fact that misguided self pity, and self pity turned outward (which is not necessarily compassion), in combination with high tech medicare, may be doing us a disservice as a species.

We have to find ways to be compassionate without ruining the ecosystem of our planet, or ourselves as a species. I'm sure there is a way.

High tech medical care is very expensive, and one aspect of cosumerism. Many people think money is just money, but it isn't. Currency is won and kept hard by a combination of human labour and environmental exploitation. In nature, planetary beings give more to the planetary whole than they take, thereby enriching the whole. We humans take more than we give, thereby impoverishing the whole and endangering ourselves. Instead of comsuming the milk of our Mother Earth, we consume her lifeblood. Currency is won and kept hard at the expense of our Mother Earth. All money is blood money, dripping with Her lifeblood. Unfortunately, we don't see the blood. The hands that handle money seem clean, and to make ever more money with ever more money seems honourable.

Granted, there are other forms of consumerism that could and should be stopped rather than high tech medicare, and high tech medicare possibly is the most justifiable aspect of consumerism, but it nevertheless is an aspect of potentially destructive and self-destructive consumerism. North America spends more on pet health care than some third world countries spend on human health care. Our level of expensive high tech health care, as well as our level of general consumption, could not possibly be sustained for all people of our planet.

If we want global equality, then we have to learn to do with less. If we want to preserve our ecosystem, and survive as a species, then we have to learn to do with less. We are well on our way to speciescide (suicide of the species).

The_Omnissiah's picture

The_Omnissiah

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This remins me of an article I read in Today I think it was. In the US they are in the final reading of passing a law stating that doctors can refuse to provide certain services based on their religion. i.e. abortion, birth control, life support, et cetera.

Interesting no?

Salaam Alaikum
-Omni

Arminius's picture

Arminius

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Omni: Yes, interesting.

Alaikum Salaam,

Arminius

jlin's picture

jlin

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I guess that the U.S. has built a bigger mythology than the Greeks at last! the xian fundies can tell Hippocrates where to shove it! That must make them feel very special, indeed.

killer_rabbit79's picture

killer_rabbit79

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Mely,

"Well when you get really old your self, and you decide there is no point living anymore, let us know. Until that time you might want to withhold judgement."

I never said all old people are miserable and useless. But some don't seem to be worth the effort. And as for me withholding my judgement for when I become old, maybe it's best that my opinion is objective. Typically that keeps emotions from getting in the way of logic.

Panentheism's picture

Panentheism

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This issue of Doctor's refusing to offer care is alive and well here in canada. It comes in many forms- for example in man. there was a man in a comatose state and the doctors all agreed that it was hopeless and the machines are to be shut off - the family went to court - the question is, when does medical knowledge enter and determine care?

Then there are two rights conflicting - care and personal ethics - one solution is that a doctor MUST send the person to another doctor if his/her ethics suggest they cannot serve the patient... the issue is personal values and collective values in tension - how to decide this ?- in Ont the human rights suggest the doctor must serve and this raises the question of force - which right is absolute?

Then there is the issue of decision - personal, family - this is where living wills come in.

The important point is we must play God for we have created a medical system and a human value system that interferes with nature. Given the complexity we come up with universal rules. "I don't believe in having one set of rules for everyone. It is an individual choice, whether or not you or I agree with it, but someone else needs to know what you want if you can't convey it." The fact we live in a complex situation means we must have a set of rules for everyone - individual choice is important but it must be within the agreed set of rules - thus one of the medical ethical understandings is choice of medical treatment - it cannot be forced.

Yet the case of hopeless treatment comes up against choice - do we have the 'right' to demand treatment when it is known to be useless ( now known is always complex but there are situations where we have arrived at a universal understanding of hopeless and that applies)

As has been pointed out we have great skill and medical technology that makes the ethical decision difficult and we have individual attitudes of what we want- and the desire of living enters. Now sometimes the desire is selfish, sometimes the desire is consumer created, and sometimes the desire is realistic. Thus we are always balancing these issues with medical knowledge of has life ended or is near ending.

Whatever we decide needs to be: would we want this to apply to all? This is a helpful way of answering the issue - or one of the ethical standards that is crucial to make an ethical decision - it cannot be individualistic. Yet one, in the name of ethics, can make an decision to end ones own life but realize we may not to institutional it.... thus a limit to active euthanasia and only letting passive be the standard - yet within that one can break the law and keep in place the rule.

Arminius's picture

Arminius

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Yes, pan, the good of the whole needs to be paramount; whatever we decide needs to be for the good of all. And not just for all of humanity, but for all planetary beings. Nature has done that splendidly for millenia. Perhaps we can learn from her?

We will, of course, always be more caring of humans, those of our immediate family and community in particular. But in doing so we must not lose sight of the fact that we can only be well when all is well, and all are well. We have to subordinate the wellbeing of the part to the wellbeing of the whole; we have balance the wellbeing of the part with the wellbeing of the whole.

Actually, when the whole is well, then the part is always well. But when the wellbeing of the part is considered separately and one-sidedly, then the whole is not necessarily well.

Wholistic or Unitive Consciousness is just a buzzword, but we have to make this buzzword into a living reality.

Panentheism's picture

Panentheism

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Yes the natural world must also enter the ethical calculus.

Revolutionary's picture

Revolutionary

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I told my sons I don't care how crippled I get, I hope to live to be 100 and get shot by a jealous husband. :-) The day I die is none of my business, and no one else's either. Let nature take its course. It is appointed unto men (and women) once to die... it's an appointment that isn't within our control.

Band's picture

Band

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As long as they want to be kept alive.

eliu87's picture

eliu87

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But...what if they're in a state where it is impossible to determine what their wishes are? ie: They are in a coma and they left no previous wishes/instructions.

marylinda's picture

marylinda

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I called the ambulance for my 66 yr old father back in June. After 2 days in hospital I was asked about putting DNR on his chart. His blood pressure was so low they thought his heart could stop at any moment. The skin on one side of his ribcage was necrotic because of poor nutrition and had been was found lying on the floor after an undetermined amount of time. There was a head injury, but they didnt thnk it was a stroke. Nerve damage rendered his left arm and leg paralized. He had worms. The alcohol was coming out or his systems and he was seeing things. I thought he was going to die and I was RELIEVED.
After 5 weeks in hospital and re-hab they sent him home. He remained dry for maybe a month. Now I live in fear that he will drive his car into a group of children walking to school or oncoming traffic. For me the question is "why do we keep some people alive?"

jrw2020's picture

jrw2020

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......in the meantime had you agreed a "DNR" and it had been executred, you wouldn't know the difference now would you? Who knew? Quite frankly I think you will know when the time comes - if you don't, you waited too long.

jrw2020's picture

jrw2020

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..and on top of that, my father fell down a long flight of stairs two years ago and has not been the same since....including severe damage....and I as the only child live thousands of kilometres away across the ocean.......it would be so much easier if he just said good-bye now....and hey I know this wil engender outrage and comment) but we need to face the realities of life (and death)

jlin's picture

jlin

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Well, for the efficient in life you can always follow the efficient plan, convince your parents or grandparents that it is their duty to die at a certain time and help them do this by putting them in a home rather than helping them get proper care in their own homes.

speeds up death by 2 - 10 years. quick inheritance value.

marylinda's picture

marylinda

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I detect a note of sarcasm.
As for proper care his mother lived in her own home and drove until almost her 90th birthday. She helped move her own belongings. She took excellent care of her health and was loved by many.
My maternal grandmother remained in her own home and died there as she planned. Health care came to her and her family ALL helped. She was 89.
My father is quite capable of killing himself in his own home. I think he has developed a new strain of bacteria in the pots left out on top of the stove.
I have spoken with AA. I have organized meals on wheels. I have spoken with CCAC and contacted the minister at his church (where he was asked to leave)
I regularly change the battery in his smoke detector.
I've seen his hospital bill and I find it unbelievable that the canadian taxpayers had to foot the bill for something he brought on himself, and continues to do so.
I have to disagree with the comment about people dying faster once they go into a home, in this case healthy food and a routine would keep him alive longer than his own care.

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