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

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

#101

Post by inglor_cz »

bruce511 wrote: post #73
____tom____ wrote: post #25

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…

Yeah, it is a big difference to undergo aggressive treatment at 50 vs. 80. Not just because of the potential years or months gained, but also because older bodies don't heal that well, or at all.

This is something that may be revolutionized through regenerative medicine, but hasn't so far.

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

#102

Post by teiferer »

djoldman wrote: post #4

> Even when the right preparations have been made, the system can still swallow people up. One of my patients was a man named Jack... He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. > Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to…

> It's interesting that our laws punish homicide with maximum criminal penalties, but the opposite (keeping someone alive against their wishes) seems to be assault and battery at worst, with much much lighter punishment.

It's not just the punishment but also how it's investigated / reported / charged. If somebody dies and there is just the slightest hint that another person was involved, by neglect or active help, police gets going right away. If somebody died "of natural causes" while suffering, or isn't even dead, just suffering, who is going to bring the charges? The suffering person won't. They are often unable to do so, that's why they are suffering in the first place. It's just an accepted part of being old and dying. Not even to speak of religious grounds (some of which consider suffering just being part of god's will).

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

#103

Post by sleepychu »

teiferer wrote: post #92
bruce511 wrote: post #73

Earlier quoted context omitted.

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…

I think you've got it exactly right:

- what is the expected gain? Years+Quality

- what is the maximum gain? Years+Quality

The older you are the smaller your maximum gain of Years can be.

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

#105

Post by alex-moon »

Here in the UK there is an ongoing debate happening more or less behind the scenes around the language that should be used for families of patients nearing end of life. The standard question is: Should we "do everything possible" to keep someone alive? The proposed better question is: Should we "allow natural death"? Any doctor understands intimately that these two questions are equivalent. Understandably, the average person doesn't. Why wouldn't you "do everything possible"? In most of these conversations the argument against just doesn't come up.

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

#106

Post by mchinen »

teiferer wrote: post #95
throwawayk7h wrote: post #72

Earlier quoted context omitted.

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.

Are you knowledgeable about this, and are you talking about the established institutions? If so please explain.

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

#107

Post by xandrius »

zemvpferreira wrote: post #87
bruce511 wrote: post #73

Earlier quoted context omitted.

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…

The father of a good friend passed away recently from a brain cancer. He was a doctor, but atypically accepted every treatment available. His last 3 years were spent in surgery or sick from chemo, did not have one good day after his initial diagnosis. If he could have gone back I'm sure he would have decided not to be treated.

Unless going back gets you to re-roll your dice then I'm sure they would still have done it.

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

#108

Post by khalic »

I really don’t agree here. The focus should be on combating the observational bias that is the cause of these decisions. The doctors remember the “futile” cares for the patients where it had the worst results. We’re wired to concentrate on the negative outcomes, and doctors are bathing in it.

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

#109

Post by buran77 »

teiferer wrote: post #92
bruce511 wrote: post #73

Earlier quoted context omitted.

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…

> Why is that?

By 80 most people have reconciled with the idea that they don't have too many years left even in the best of conditions. There's no hope of extending life, and there's little to look forward to, they already lived through all the important milestones they could realistically see. Quality is all that's left to hope for.

At 50 they still can still hope for recovery and a life beyond that. They have a lot of moments and milestones ahead of them, at least with family and loved ones - see their kids graduate, get married, or have their own children. So if the hope is stronger than the pain, they'll sacrifice the quality of life.

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

#110

Post by garyrob »

____tom____ wrote: post #25

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…

I had cancer, it came back twice in 5 years, but now I'm 10 years out from the last time and my odds are good. Just mentioning it, in case it's helpful to hear a positive anecdote.

Sending my hopes for your recovery. You're right that new research is yielding fruit, but I don't have to tell you that.

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