Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

How Doctors die. It’s not like the rest of us (2016)

archive.cancerworld.net

Post reply on HN
Print view View original

211–220 of 300 posts

Re: How Doctors die. It’s not like the rest of us (2016)

#211

Post by tcard »

marton78 wrote: post #192
slim wrote: post #179

Earlier quoted context omitted.

Tunisia, North Africa

I have always found the humility of Muslims saying "In sha'Allah" admirable. It's a beautiful way to remind ourselves that our fate -- and our life -- is not entirely in our hands.

This was also commonplace in Spain, traditionally. Some people, especially old ones, will say "si Dios quiere" literally every time they refer to any event in the future, even if it's just "see you tomorrow". Not doing so would be considered a "challenge" to God, or Fate, more generally.

Curiously, from "inshallah" Spanish got the word "ojalá", a very common term for expressing hope of something happening (and with no religious or any other "deep" connotation anymore; just like you'd use "I hope").

Re: How Doctors die. It’s not like the rest of us (2016)

#212

Post by zimpenfish »

wombatmobile wrote: post #127

The important difference between physicians and non-physicians in relation to death is not that doctors understand disease mechanisms. It is that doctor's are familiar with death. Ordinary people aren't as familiar with death, and don't have a wide range of responses to it because society hides it and pretends it doesn't exist. The main place regular people encounter death is on the news as a statistic of war and cri…

> Sitcoms don't include death

UK sitcoms beg to differ - just look at Coronation Street or Eastenders - they cover pretty much every category of death you can think of (except, I suppose, by wildlife.)

Re: How Doctors die. It’s not like the rest of us (2016)

#213

Post by denton-scratch »

gerdesj wrote: post #40
spaceflunky wrote: post #8

Several of my grandparents spent way too long in ICU and hospice care and ultimately it wasn't worth it. I feel terrible about how their final days went, but other family members were adamant about 'throwing everything they could at it.' But the family members making that choice weren't footing the bill and they didn't have to lay in bed all day, so why wouldn't they try? I also feel they had a gross misunderstanding…

"But the family members making that choice weren't footing the bill" That appears to be the crux of the problem: "footing the bill". It may sound counter intuitive but I have found that when cost is removed from the equation, then better decisions may arise or at least a few extra distortions are removed. When money is directly involved then there are several potential, and in my view damaging, extra approaches that…

> Health care systems that are funded by taxation ie pre-paid, in my view, escape those problems and encourage end of life scenarios that are more likely to be better (for a given value of better)

It remains a serious criminal offence in the UK to assist in suicide (suicide itself hasn't been a crime for decades).

> I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax".

That is utterly incorrect. National Insurance is not ring-fenced; the money goes into the government's revenue pool, same as Income Tax. It can then be spent on weapons, wars, or subsidies for fossil-fuel industries.

NI is just a wheeze to allow governments to increase taxes on income without appearing to raise the rate of Income Tax. There's a reason the rate of NI has never gone down.

[Edit] I appear to be wrong: NI income doesn't go into the "general pool", at least not directly (it seems to be complicated).

NI is an obnoxious tax. It is capped; earnings over about £900 pw are untaxed. Pensioners are untaxed. So the burden falls most-heavily on less-well-off working people (the less you earn, the greater proportion of your earnings goes in NI).

Re: How Doctors die. It’s not like the rest of us (2016)

#214

Post by TheOtherHobbes »

maccard wrote: post #194
supperburg wrote: post #104

Earlier quoted context omitted.

You are a person who has never been in the very unfortunate position of needing to die. That’s why suicide will never be accepted. Because so few people ever get stuck in that situation.

I'm very on the fence on this topic; I've watched family members/friends pass in varying degrees of pain, and at least in those cases I'm not sure having assisted suicide would have helped that much. What _definitely would_ have helped would have been better end of life care. > who has never been in the very unfortunate position of needing to die. Defining that line is very, very, tricky. People only reach this point…

It is very tricky to define the line for terminally ill people. But the reality is that if you ended up on the wrong side of the line you would welcome the choice.

It's not the same line as "Life is wretched and miserable (because of depression, bankruptcy, relationship breakdown...) and therefore I'd like to check out." Those are all at least potentially fixable with reasonable odds of success.

Something like locked-in syndrome after a bad stroke, or late-stage Alzheimer's - potentially a vegetative state that can last a decade - isn't.

The real problem is making sure the choice is free and informed - not being "encouraged" by other family members for personal gain, revenge, or some other unacceptable motivation. Possibly after a person is no longer considered legally competent, but may still be signalling a current desire to avoid death even though they left a living will stating they would welcome it.

It does indeed get messy very, very quickly.

Open legalisation complicates all of that and turns it into a much harder problem than it is already. The courts would spend a lot of time dealing with those cases.

Re: How Doctors die. It’s not like the rest of us (2016)

#215

Post by birksherty »

TeMPOraL wrote: post #190
birksherty wrote: post #149

Earlier quoted context omitted.

Family also pressure to give birth even in cases where the potential child leads a terrible life and it's abused too.

This is the reverse case, though. Plus, child abuse can in principle be found out and mitigated. Death is irreversible. Incentives are different too. Outside of highly fundamentalist cultures, there isn't really a strong benefit to a family from pressuring someone to keep a child. In developed countries, children are a huge liability for the first ~20 years of their life. Meanwhile, with assisted suicide, there are s…

Child abuse is just one thing. There are people who don't have the capability to give proper physical and mental care, they don't even know anything, just wanted a cute thing because they don't have anything else to do. Then there genetical disease. Many just wanted a boy, so they play gamble and give birth to 3 girls. These kids are here for someone's selfish wish, may live miserable life in 3rd world countries. Bring someone to life, but don't let anyone escape unless going through huge suffering whole life.

Car kills many, doesn't stopped that from banning cars completely. Yes do it carefully, but no. Even people who live alone, doesn't have anything valuable, are not able to die with dignity. Must suffer.

Re: How Doctors die. It’s not like the rest of us (2016)

#216

Post by scotty79 »

tcard wrote: post #211
marton78 wrote: post #192

Earlier quoted context omitted.

I have always found the humility of Muslims saying "In sha'Allah" admirable. It's a beautiful way to remind ourselves that our fate -- and our life -- is not entirely in our hands.

This was also commonplace in Spain, traditionally. Some people, especially old ones, will say "si Dios quiere" literally every time they refer to any event in the future, even if it's just "see you tomorrow". Not doing so would be considered a "challenge" to God, or Fate, more generally. Curiously, from "inshallah" Spanish got the word "ojalá", a very common term for expressing hope of something happening (and with n…

In Poland we have a saying "jeżeli Bóg pozwoli". "If god allows" which funyly shows that deep down people "understand" (as their pre-monotheistic ancestors "understood") that the God is the malevolent being that messes up your plans and ultimately kills you.

Re: How Doctors die. It’s not like the rest of us (2016)

#217

Post by scotty79 »

OneEyedRobot wrote: post #46

What ticks me off no end is the folks who (often successfully) fight against physician assisted suicide. Dementia is the interesting test case, but I think should still be allowed. With all the talk about 'controlling our bodies' in terms of abortion, and I can see both sides of that one, your own life is the one thing you really own. To have that control taken away is the worst kind of insult by the state.

Especially since current practice when it comes to dementia is waiting till the patient forgets how to swollow food and then let him/her starve to death.

Re: How Doctors die. It’s not like the rest of us (2016)

#218

Post by denton-scratch »

spywaregorilla wrote: post #70
pochekailov wrote: post #61

Earlier quoted context omitted.

I never understood people who defend death If there is a tiger chasing you, wouldn't you try to escape or fight? Or just give up and let the tiger eat you? It is natural, tiger also want to eat, right?

If your mental image of people who support the notion of death is people who are just apathetically suicidal, then you're missing the point.

> people who support the notion of death

Isn't that a bit like supporting the notion that there is a sky above us?

Perhaps you are referring to people who reject the notion that death is to be avoided in all circumstances, whatever the consequences.

Re: How Doctors die. It’s not like the rest of us (2016)

#219

Post by scotty79 »

TheOtherHobbes wrote: post #214
maccard wrote: post #194

Earlier quoted context omitted.

I'm very on the fence on this topic; I've watched family members/friends pass in varying degrees of pain, and at least in those cases I'm not sure having assisted suicide would have helped that much. What _definitely would_ have helped would have been better end of life care. > who has never been in the very unfortunate position of needing to die. Defining that line is very, very, tricky. People only reach this point…

It is very tricky to define the line for terminally ill people. But the reality is that if you ended up on the wrong side of the line you would welcome the choice. It's not the same line as "Life is wretched and miserable (because of depression, bankruptcy, relationship breakdown...) and therefore I'd like to check out." Those are all at least potentially fixable with reasonable odds of success. Something like locked…

I think once we figure out depression, assisted suicide will become uncontroversial. If you understand what dying means (end of everything you have and will ever have) and don't have depression, but you want to die then we should let you make that decission. You must have good reasons.

Re: How Doctors die. It’s not like the rest of us (2016)

#220

Post by Chris2048 »

TheOtherHobbes wrote: post #214
maccard wrote: post #194

Earlier quoted context omitted.

I'm very on the fence on this topic; I've watched family members/friends pass in varying degrees of pain, and at least in those cases I'm not sure having assisted suicide would have helped that much. What _definitely would_ have helped would have been better end of life care. > who has never been in the very unfortunate position of needing to die. Defining that line is very, very, tricky. People only reach this point…

It is very tricky to define the line for terminally ill people. But the reality is that if you ended up on the wrong side of the line you would welcome the choice. It's not the same line as "Life is wretched and miserable (because of depression, bankruptcy, relationship breakdown...) and therefore I'd like to check out." Those are all at least potentially fixable with reasonable odds of success. Something like locked…

> making sure the choice is free and informed - not being "encouraged" by other family members

How would you do this?

One way or the other, I think you would end up attempting to create a metric for QoL. Some people, for example, might want death after losing their limbs, or their sight - a difficult life, but not a painful one, some people are born without these facilities and manage to live fruitful lives. If you allow death for those cases, why not evaluate regular suicides the same way?

Post reply on HN