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How Doctors Die

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Re: How Doctors Die

#61

Post by MrMatters »

vacri wrote: post #52
mfringel wrote: post #48

Earlier quoted context omitted.

What if "NO CODE" is the name of a band? You're asking someone to make a quick life-or-death decision on ambiguous data when there is a clearly known and socially agreed upon way to express the sentiment. Having it on an annoying bracelet that is explicitly used to signal medical intent sounds pretty good to me.

So what if "NO CODE" is the name of a band? I'm talking about "Do not resuscitate" - and if you tattoo that on your chest because it's a cool band name, you're an utter fuckwit. 'No Code' is stupid anyway because not everywhere uses that jargon, while 'do not rescuscitate' is clear, plain English. As for the bracelet, I hate jewellery and anything from my elbows down catches on anything that I'm working on with my ha…

Of course, "do not resuscitate" across the chest is pretty clear of your intentions when you get it. But I don't think you realize how hard it can be to have that power over someone's life and make that call. I think the point about old tattoos is much more relevant than a band named that; if there are former neo-nazis with ultra racist/symbolic tattoos that regret them, there could be people that just got a "Do Not Resuscitate" tattoo because they thought it was hardcore when they were younger but now regret it. I know this isn't always the case but when you're deciding whether or not to give someone another shot at life, or to let them die, a RECENT bracelet would be more definitive with all the thoughts racing through your head.

Also, if getting a tattoo is less annoying than wearing a bracelet you probably have some of them already and it can become even less clear.

Re: How Doctors Die

#62

Post by pefavre »

biesnecker wrote: post #4

Never been a big tattoo fan, but after reading that, I might consider a big "NO CODE" tat on my chest.

Experience show that it's sometimes not enough, and if no explicit paperwork can be found medics will perform CPR anyway...

Re: How Doctors Die

#63

Post by vacri »

MrMatters wrote: post #61
vacri wrote: post #52

Earlier quoted context omitted.

So what if "NO CODE" is the name of a band? I'm talking about "Do not resuscitate" - and if you tattoo that on your chest because it's a cool band name, you're an utter fuckwit. 'No Code' is stupid anyway because not everywhere uses that jargon, while 'do not rescuscitate' is clear, plain English. As for the bracelet, I hate jewellery and anything from my elbows down catches on anything that I'm working on with my ha…

Of course, "do not resuscitate" across the chest is pretty clear of your intentions when you get it. But I don't think you realize how hard it can be to have that power over someone's life and make that call. I think the point about old tattoos is much more relevant than a band named that; if there are former neo-nazis with ultra racist/symbolic tattoos that regret them, there could be people that just got a "Do Not…

getting a tattoo isn't less annoying than a bracelet, but having a tattoo is much less annoying.

In any case - where is the rash of young people with 'do not rescusitate' tattoos? Everyone I've seen that is supposed to have had one is a greyhair, well out of the young-and-dumb age. And even if you do 'later regret' the tatt and don't want to stump for tatt removal, just tatt a couple of lines through it or tatt something over it.

And then there's the young people who genuinely do not want to be rescusitated - what about them? Stigma enough carrying a medical bracelet amongst the young to begin with. I just don't see this supposed grey area of young people tattooing themselves with a mythical band name.

EDIT: To put it another way, this mythical youth tattooing himself errantly is such a vanishingly tiny fringe minority. Plenty of laws exist allowing for people to freely express themselves to death. The more stringent US states have a maximum blood alcohol content of .08 for drivers, which is higher than the level at which measurable cognitive effects occur on your co-ordination and attention. If we're really concerned about 'free expression' deaths, bring that number right down. There are tons of laws like it. There is no reason not to make it another social norm to say "tattoo 'do not resus' on your chest, and you won't be resuscitated". There's no need to pander to base idiots.

Re: How Doctors Die

#64

Post by vacri »

andrewmu wrote: post #54
vacri wrote: post #40

Earlier quoted context omitted.

Telling people to give up because of money or some sort of gentleness to yourself or your family is alien to me. Maybe it's our harsh climate uphere. Swedes seems very in tune with our suffering. It's not about being tough and macho. A lingering decline can be psychologically painful for everyone involved. Pretty much everyone I know that has been involved in caring for someone who suffered a slow decline - particula…

A lingering death can sometimes be easier for those round about you, to some extent. They know what's happening, get a chance be resigned to the future, but still talk to you before the end. And if it's painful, they can feel relief that your suffering is over. When you die quickly, you personally don't suffer, but those around you are stunned by the sudden, often unexpected loss and life. It seems cruel and arbitrar…

There's a difference between a quick "he was fine this morning" death and a quick "gone in two months" death. The idea of letting the disease take it's course with only comforting care gives people time to say goodbye - it's mentioned in the main article as even being able to give more quality time with loved ones.

Re: How Doctors Die

#65

Post by rdouble »

vacri wrote: post #41
janzer wrote: post #29

Earlier quoted context omitted.

Not to mention that at least where I'm from a tattoo will not and cannot be accepted by EMS personnel as a valid order. Here is the relevant part from our Medical Control treatment protocols on what can be accepted as a valid do not resuscitate order: "Patient is wearing a do-not-resuscitate identification bracelet which is clearly imprinted wit the words “Do-Not-Resuscitate Order”, name and address of declarant, and…

How bizarre that they'll accept 'do not resuscitate' on jewellry, but not tattooed across the chest. "Do we think he really meant it? Nah, he just got the tattoo - if he really meant it, he'd be wearing one of those constantly annoying bracelets"

The bracelet is an official state issued thing for people with terminal diseases. Obtaining one requires a doctor's order.

A tattoo (or any other non-official marking) could be anyone, like a depressed person who is going to attempt suicide.

Something related to this actually happened where I live last week. A 30 year old afghanistan vet wrote "do not resuscitate" on his arm with a sharpie and then shot himself in the chest in a hospital parking lot.

Re: How Doctors Die

#66

Post by VMG »

Jach wrote: post #51
VMG wrote: post #19

One alternative that hasn't been mentioned here is cryopreservation. Once I have the resources and the technology has progressed, I'd certainly choose that option above being treated and "NO CODE".

Totally on board with cryonics, it's really depressing that it gets swept under the rug considering it probably has at least 5% chance of working for a patient suspended today. Though your excuses for presently avoiding it seem pretty flimsy unless you're really dirt poor (I'd wager unlikely), especially when life insurance payable to the cryonics company is cheap (you only need $28-$35k for CI) and so are membership…

It's not exactly about the money - I'm in Europe and the only providers I know of are situated in the US. The last time I looked into it they needed a DNA sample from me in person, so at least I'd have to book a trip to go there.

But from a cost-benefit perspective, it still is pretty flimsy. Definitively one of my worst cases of akrasia.

Re: How Doctors Die

#68

Post by spodek »

kalid wrote: post #59
dcurtis wrote: post #6

I was in Best Buy earlier today and the sales guy who was trying to sell me a TV reminded me a lot of the doctors/residents I was dealing with during a few weeks I spent caring for a family member at Mass General Hospital a couple years ago. I don't think they do it consciously, but doctors try to sell you on their philosophies for healthcare. But it doesn't matter. You're sitting in a small room with dim lights and…

Humans are notoriously bad at predicting what will make them happy.

Humans who haven't thought about it aren't, but when you've thought about it you can predict very well.

Re: How Doctors Die

#69

Post by mikeash »

RobbieStats wrote: post #39

I'm conflicted about this. On the one hand I don't want to be hooked up to a ventilator or go through extreme suffering to prolong life. On the other hand, my grandmother (who recently passed away) went through late stage breast cancer in her mid-50s, lung cancer in her 60s, had a severe heart attack in her 70s and died in her 80s. It was so bad one time the doctors told us she would die in a matter of days. After sh…

How was your grandmother's quality of life in those last 8 years after the doctors said she had just a few days left?

As for "The doctors gave him 6 months to live and that was 5 years ago," keep in mind that you get a horribly biased sample. People don't generally go around saying "The doctors gave him 6 months to live and he died 6 months later," even if that may happen far more often.

Re: How Doctors Die

#70

Post by jlangenauer »

ssharp wrote: post #47
defdac wrote: post #21

Tonight I will tell the mother of our child that if I reason in any way that resembles this article she should slap me in face and tell me to fight for my life. For my daughter and my own sake. In Sweden medical care is free. I can fight as long as I want without them getting in trouble. I also suspect I should fight so hard as if the illnes is truly terminal I will end sooner in flames, not later. I want all the tub…

"In Sweden medical care is free. I can fight as long as I want without them getting in trouble." It's not free. It's free to you, but it is placing additional costs on the Swedish medical system, which somebody is ultimately paying for. You don't have to internalize the costs of your decision. I'm not arguing whether or not you're a making a good or bad decision, or whether or not "free" medical care is a good thing.…

As would a pay-for-treatment medical system, like in the United State, which simply skews decision-making in a different direction.

(Or, if your uninsured/indigent, reduces the choices you have available to make a decision between anyway)

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