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

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91–100 of 170 posts

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

#91
> They want to be sure, when the time comes, that no heroic measures will happen – that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with cardiopulmonary resuscitation (that’s what happens if CPR is done right).

I have been seeing so much anti-LUCAS-machine content on the internet lately; it is far too prevalent to be anything but an astroturfing campaign. From whence this meme?

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

#92

On the spectrum or go gentle vs fight, I'd have to say, now is the time is history where "fight" makes the most sense. This is not abstract for me. I have not one, but two forms of cancer. Both were considered incurable when I was diagnosed. Both have treatments now that, IN SOME PEOPLE, lead to remission. I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat. New t…

Lots of people will take any treatment offered. Indeed I would. That's a perfectly acceptable approach. Yes, medical treatments are improving and hanging on is a good approach cause something may be around the corner. I don't think the article is advocating for no treatment ever. I think it is advocating for a balanced understanding of what treatment looks like, and balances that with quality of life. And indeed bala…

Agreeing with your overall sentiment, but this caught my eye:

> If I'm 80, I'm (somewhat) less concerned with length of life, and more concerned with quality. If I'm 50 that's a different equation

Why is that? Is quality less important at 50? Would you be more willing to endure suffering if you are younger? Why? I'm thinking that no matter age, people would generally like to avoid a painful death. Maybe it's because it feels more likely to "beat this thing" when you are younger, and then still potentially have decades ahead of you?

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

#93

On the spectrum or go gentle vs fight, I'd have to say, now is the time is history where "fight" makes the most sense. This is not abstract for me. I have not one, but two forms of cancer. Both were considered incurable when I was diagnosed. Both have treatments now that, IN SOME PEOPLE, lead to remission. I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat. New t…

Hero - keep fighting!

I think it's exactly this attitude which the article is about.

Of course I wish the best to whoever decides to fight. But fighting at any cost isn't the best advice.

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

#94
post #84

As a doctor, I think we are prepared for our own death (not so much for illness though). Especially during the last days or months we know exactly what's happening. I agree that the less-care-but-less-side-effects way is chosen much more often by doctors for themselves and their close relatives (I personally administered to my mother opioid to accelerate death due to terminal cancer a couple of days before the expect…

> administered to my mother opioid to accelerate death Isn't that illegal is most countries? Does it not count as doctor assisted suicide?

Causing death in the course of administering treatment is not illegal.

For someone in severe pain, it’s completely legal to offering increasing doses of morphine to treat pain even if it results in death.

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

#95

On the spectrum or go gentle vs fight, I'd have to say, now is the time is history where "fight" makes the most sense. This is not abstract for me. I have not one, but two forms of cancer. Both were considered incurable when I was diagnosed. Both have treatments now that, IN SOME PEOPLE, lead to remission. I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat. New t…

if nothing works, try cryonics. Maybe AI-2040 is right and we'll be able to revive you in a few years.

The cryonics industry is an unbelievable scam. You habe watched too much scifi my friend.

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

#96

Last week one of my patients with preterminal NYHA Stage IV cardiac failure looked into euthanasia. He found predictably that it is now legal in my country but takes months and formidable legal resources to obtain it. Legalisation of euthanasia has, as everyone in the field warned multiple times, made it much harder to obtain and now requires a lot of time, effort and money. The well meaning, naive proponents of lega…

> The well meaning, naive proponents of legalisation of euthanasia have actually made things a lot harder for those who want it.

In your mind, what should have been done instead of legalizing it?

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

#97

Earlier quoted context omitted.

I've never heard the term "load-bearing" used outside of the civil engineering world until the more recent versions of Claude suddenly decided everything was "load-bearing". Did you internalize Claude terminology, use Claude to write/translate your post, or lead Claude into temptation by being the OG? Asking out of genuine curiosity and not at all trying to throw shade.

I have heard it in the way that Claude uses it going way back. Since I have to use Anthropic models for work, and they use that term prodigiously, it's been added to the list of "perfectly fine phrases that have been ruined" to me. It's really frustrating too because I don't know what other phrase I would use.

Yeah the stupid machine could have picked "let us circle back" or something but nope.

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

#98
post #84

Earlier quoted context omitted.

> administered to my mother opioid to accelerate death Isn't that illegal is most countries? Does it not count as doctor assisted suicide?

The patient must be hospitalised and the administration is justified as an analgesic, sedative and for heart failure when pressure, pulse and breath start to reduce. I believe any doctor whould agree after discussion with the relatives. The problem is the doctors rarely bring it to surface and the people don't know to demand it.

Thank you for the through answer! I hope I remember what to ask if/when the time ever comes.

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

#99
post #19

I'm a physician, an old one. We're lucky to live as long as we do, but life will end. The article emphasizes the value of dying peacefully. Sure, that's how we want it to be, but we have to make it known to assure it goes that way. Don't know what happens elsewhere, but every time I see a doctor someone asks if I have a signed, notarized directive. Yes, I've done that, but so should everybody else concerned about the…

> Why haven't you?

It is (mentally) painful to think about that this life is going to end. And even more (mentally) painful to think about the consequences of a (physically) painful end. The mind goes to great lengths to avoid pain.

Plus, society doesn't exactly create a culture in which this kind of talk and preparations are encouraged.

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

#100

Earlier quoted context omitted.

This reminds me of an interview with neurosurgeon and author Henry Marsh who had prostate cancer. He described how he's arranged to end his own life should he get alzheimer's or dementia as he didn't want to waste away. But he explained that he has access to knowledge and things ordinary people don't.

I looked into this recently and it seems like it is basically impossible to pre-arrange assisted suicide for alzheimer's or dementia. Even in countries which allow death with dignity. I find it very strange because it’s so common and I’m sure many people would prefer DWD in those circumstances.

You can do it in Canada. Canada is on a euthanasia tear, and something like 3-4% of all deaths are by euthanasia or assisted suicide, and on track to reach double digits in the coming years. But euthanasia for dementia is a fine ethical line to navigate (Canada notwithstanding) because consent is either absent or suspect when the time comes.
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