Reminds me of the slow code article a while back
I Lied When I Said We Did Everything We Could
71–80 of 337 posts
Re: I Lied When I Said We Did Everything We Could
#72Earlier quoted context omitted.
> There should be laws preventing family members from prolonging the suffering of their loved ones. I can't think of a way to implement a law like that which wouldn't be fraught with horrible problems. Just imagine the misery associated with doctors deciding to "kill people's children," which in fact in some cases would be unjustified. (Nobody can always get it right, not even doctors.)
That doesn’t mean we can’t explore the idea. In Australia, and I believe most places with well developed legal systems, you can get in quite a bit of trouble for mistreating an animal. No so much if you mistreat someone under the auspice of medical or aged care. Our culture has institutionalised the mistreatment of the terminally ill and frail-aged. There are good arguments to be made that this should be seen as a pr…
Brutal but I remember reading an excerpt from an army doctor during the Napoleonic wars. He had two soldiers in his care who had been burned in a gunpowder explosion. A one point a solder came in saw them and then bluntly asked if they would live and was told that it was hopeless. The guy then went and cut both of their necks. The doctor in shock screamed at the man you monster to which them man screamed back I'm not the monster you are.
Re: I Lied When I Said We Did Everything We Could
#73Earlier quoted context omitted.
> seems to me like it's a cultural thing as well. This is true. I think that it's also a religious thing as well, and almost Christians. Other religions are more accepting of death, but Christianity has taught many to sincerely believe that Jesus himself would step into the room and heal their loved one, therefore every attempt must be made to save them. This is something I've seen first hand in my years as a Paramed…
I believe this might be more prominent among uneducated folks of (at least in my neck of the woods) non-mainline American Protestant denominations. At least the doctors of the Catholic Church will specifically talk about preparation for death, dying well (also mentioned by Fred Rogers in the documentary I saw about him), etc.
More simply, it's not easy to let go of someone you love and say goodbye to them.
It's not fair to the person ready to die, but there's a lot of pressure put on people (through TV, movies, friends) to fight for those you love, even when they don't want you to.
Re: I Lied When I Said We Did Everything We Could
#74Earlier quoted context omitted.
You seem to be thinking of a case where an otherwise healthy person is dying of an incurable disease, and risky treatments might bring their health completely back. I don't think that's an accurate portrayal of most sicknesses and death in a hospital for the elderly. It's more like a progression of failures and problems (or a constellation), some mitigated, leading to more or less prolonged suffering with no end in s…
No, it makes zero sense. My grandfather had advanced Parkinson's, but had zero intention of dying to it or its cornucopia of related symptoms/effects. So what if he has a major disease that made life many orders of magnitude worse for him? Life is still life, and death is still infinitely worse. Giving up and accepting death may seem reasonable to some, but not for me or my grandfather. There's always a root cause, a…
My grandma had cancer. A doctor had ignored her complaining of throat pain for too long, and it didn't look good. The doctor who told us chemo was an option was pushing my grandma really hard to just go ahead and die instead of trying chemo. It was horrible, and I hate the attitude that people shouldn't try so hard to stay alive.
My grandma tried the chemo. She did die anyway, which I'm sure some folks will see as a reason that she never should have tried.
Re: I Lied When I Said We Did Everything We Could
#75Earlier quoted context omitted.
> There should be laws preventing family members from prolonging the suffering of their loved ones. I can't think of a way to implement a law like that which wouldn't be fraught with horrible problems. Just imagine the misery associated with doctors deciding to "kill people's children," which in fact in some cases would be unjustified. (Nobody can always get it right, not even doctors.)
>I can't think of a way to implement a law like that which wouldn't be fraught with horrible problems. Existing child protection laws are for the most part perfectly satisfactory, if they're actually used. The courts routinely decide on whether a parent is fit to make decisions about their child, or whether a particular decision is in the best interests of that child. Many of these cases will individually present ver…
Yeah, the Terri Schiavo case is a great example of how pro-life activism unnecessarily prolonged someone's suffering: https://en.wikipedia.org/wiki/Terri_Schiavo_case
Re: I Lied When I Said We Did Everything We Could
#76"Everything we could" [and more than we should]
I can't help but wonder if there was anyone with medical training acting as a patient advocate in this and similar situations.
Re: I Lied When I Said We Did Everything We Could
#77Wonderful article. This is a not-uncommon situation in end of life care. It's difficult for a family to accept a tragedy like this, a loved young woman dying in the prime of her life from something untreatable. The families often are in almost some sort of denial (understandably, I'm saying that without judgment) and demand that everything be tried, even when it's futile and ends up making the situation worse like in…
> seems to me like it's a cultural thing as well. This is true. I think that it's also a religious thing as well, and almost Christians. Other religions are more accepting of death, but Christianity has taught many to sincerely believe that Jesus himself would step into the room and heal their loved one, therefore every attempt must be made to save them. This is something I've seen first hand in my years as a Paramed…
It’s really strange to me. Christianity also teaches that death is temporary and you’ll be reunited with your loved ones (assuming everyone is righteous). Why such a fear of death?
Re: I Lied When I Said We Did Everything We Could
#78> “You all did everything you could, didn’t you?” he asked hopefully. > I wanted to tell him no. I wanted to tell him that if we had done everything we could she would have ... I struggle with things like this. Its like I want to answer accurately, but then have to consciously remember the culture and consequences. Other people are so natural at this
> I want to answer accurately, but then have to consciously remember the culture and consequences. Other people are so natural at this (elsewhere) > I had seen this person once a month obviously deteriorating in line with what every prognosis and statistic would say... it was a spot on analysis IMHO these two are inextricably linked. Most people want to live in their own emotion-mediated reality. By not innately edit…
It's necessary because people have very different reactions. I remember when my doctor accidentally referred to my test results as a brain tumour (rather that the less immediately concerning to the layperson benign growth or glioma). I was thinking it's a growth that hasn't changed for five years and is barely visible on a contrast MRI (small enough that one of the MRIs reported that it wasn't even there) - it's nothing to worry about, but I can could tell that my mother was panicked. You have to convey the meaning and consequences, even if it's technically slightly inaccurate or imprecise - sometimes the technically correct answer leads to the wrong interpretation (as to treatment/prognosis), in part due to the emotional baggage it carries.
Re: I Lied When I Said We Did Everything We Could
#79Earlier quoted context omitted.
I know some parents who had a child with an extremely rare degenerative disorder that attacks the nervous system. They were wealthy enough to afford extremely good care and as such, kept their poor suffering child "alive" for 12 years longer than anyone else who had ever had the same disease. Life expectancy of newborns with this disorder is about 1-3 years. At every turn, the doctors and nurses charged with the chil…
> There should be laws preventing family members from prolonging the suffering of their loved ones. I can't think of a way to implement a law like that which wouldn't be fraught with horrible problems. Just imagine the misery associated with doctors deciding to "kill people's children," which in fact in some cases would be unjustified. (Nobody can always get it right, not even doctors.)
The current situation is already fraught with horrible problems! We torture innocent children to death! Would the problems you’re imagining really be worse?
Re: I Lied When I Said We Did Everything We Could
#80Wonderful article. This is a not-uncommon situation in end of life care. It's difficult for a family to accept a tragedy like this, a loved young woman dying in the prime of her life from something untreatable. The families often are in almost some sort of denial (understandably, I'm saying that without judgment) and demand that everything be tried, even when it's futile and ends up making the situation worse like in…
> The families often are in almost some sort of denial It was like pulling teeth to try to get doctors to tell me anything realistic. I don't get the impression that anyone in the medical community is trying to change this. Unlike my other family members, I had seen this person once a month obviously deteriorating in line with what every prognosis and statistic would say. My other family members were there every day…
When my father was dying a few years ago, the doctors and nurses were very pragmatic and rather blunt in their prognosis and the options. They carefully did not make recommendations, but laid out the results of the various options.
I appreciated that.