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How doctors choose to die (2012)

theguardian.com

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Re: How doctors choose to die (2012)

#21

Post by shiven »

sho_hn wrote: post #6
cup wrote: post #2

This has been posted a number of times in different iterations on HN. I'm curious why the user group here has such a fascination with medical doctors.

Engineers have a peculiar relationship with doctors. When they have need of one, and the doctor decides on a treatment plan for them, they think about the complexity of the problem space the doctor had to navigate to reach that decision. They wish the doctor would chart the parameter space for them, so they can agree or disagree with the choice in an informed manner, and have more of a clue about the competence of th…

Or, as a (former) doctor, I love telling my engineer friends:

Intuition can't be formalized.

Part of the reason simply being the "system level" thinking that has to be developed, practiced and honed by any doctor worth his/her salt. And when you think of it, even with our current understanding of the human organism and the phenomenon called life, we are primarily working using 'heuristics', barely glimpsing the ultra-complex jigsaw that makes everything tick. Someday, when the ken of this knowledge is complete, we may be able to formalize the logic, albeit, the 'computer' it runs on, may well be as complex as our own brains!

Re: How doctors choose to die (2012)

#22

Post by sago »

Afforess wrote: post #4
cup wrote: post #2

This has been posted a number of times in different iterations on HN. I'm curious why the user group here has such a fascination with medical doctors.

It has nothing to do with a fascination with doctors and everything to do with a fascination with death. Death today in first world countries is so far removed from what death ought to be, that it's almost unrecognizable. Dying in a sterile white room, in a building that houses thousands of sick people, with bad food, busy nurses, and often alone, is what I'd imagine a dystopian future from a Hollywood movie like Soy…

To be fair, in Soylent Green you died by opting for assisted suicide in an environment with good food, beautiful views and classical music. I'll go with that over a lot of other options. I'll swap the environment for home, and be surrounded by family, but yeah. Soylent Green was hardly the worst dystopia, I think.

Re: How doctors choose to die (2012)

#23

Post by berberous »

mct wrote: post #3

A few years ago, I heard an NPR interview with a doctor who's friend was terminally ill. Rather than opt for treatment, the friend spent his remaining time living with his doctor friend. He died a few months later. The doctor said that this is how she wanted to die, too. I've tried a number of times to find the story, but I haven't been able to. Does it ring a bell for anyone? I'd love to listen to it again. Thanks!

That does not specifically ring a bell, but Radio Lab did a piece on this topic once. Perhaps it's in there:

http://www.radiolab.org/story/262588-bitter-end/

Re: How doctors choose to die (2012)

#24

Post by themartorana »

sago wrote: post #20
themartorana wrote: post #18

Earlier quoted context omitted.

It's really hard to change perceptions about death when it requires considering one's own mortality. It is in this only that I understand the desperate quest for religion. The idea of going dark forever is terrifying to me, and considering I'm pretty much an atheist, I don't have much hope of anything else. When people ask me if I'm religious, I usually tell them I'm hopeful that I'm proven wrong. I know we all die.…

It doesn't frighten me. It won't go dark forever. Just as there was no 13.5bn years of darkness before I was born. There will be no qualia of time. I think attitudes are changing. The campaign to be able to determine how and when we die is shaping up to be a significant battle for a fundamental civil right. I think we'll win it. Whether it is soon enough for my wife to avoid threat of prosecution if she is with me wh…

Right - it's that ceasing to be, as before I was, that scares me. Now that I have existed, I like it much better than before.

That said, that's my hangup, and has nothing to do with your right to choose to die with dignity. It's silly to me that you could choose to jump off a bridge, but can't choose something much less gruesome without fear that your or a loved one might find themselves tangled up legally.

Re: How doctors choose to die (2012)

#25

Post by sago »

themartorana wrote: post #24
sago wrote: post #20

Earlier quoted context omitted.

It doesn't frighten me. It won't go dark forever. Just as there was no 13.5bn years of darkness before I was born. There will be no qualia of time. I think attitudes are changing. The campaign to be able to determine how and when we die is shaping up to be a significant battle for a fundamental civil right. I think we'll win it. Whether it is soon enough for my wife to avoid threat of prosecution if she is with me wh…

Right - it's that ceasing to be, as before I was, that scares me. Now that I have existed, I like it much better than before. That said, that's my hangup, and has nothing to do with your right to choose to die with dignity. It's silly to me that you could choose to jump off a bridge, but can't choose something much less gruesome without fear that your or a loved one might find themselves tangled up legally.

I know this is getting OT, so apologies. And thank you for the second paragraph. But I'm interested in the first.

To me it doesn't seem like I will cease to be, in any meaningful way. To cease to have something is to have it at some point but not another. I will never experience not being. So I find it hard to worry about that. Of course I enjoy being, but it's not like I would rather be than not be, because the latter would suck. So I find your first paragraph strange. And therefore interesting. [edit, add:] I scan sympathise with the point made about others: I'd very very much rather my wife was than ceased to be. But me? Only for other people's sake. I can't imagine how it could possibly make any difference to me. I can't even imagine the idea that I'd miss out on all those good experiences I'd have if I lived. Because again that just presupposes that I'd be missing something.

Re: How doctors choose to die (2012)

#26

Post by [deleted] »

FireBeyond wrote: post #8
jimt67 wrote: post #7

I thought this was thoughtful and well written but all I see is anecdote...there is no data presented that MDs choose different options than non-MD patients.

Adding to the anecdote, I'm a paramedic who has also opted for 'no heroic measures'. Even with CPR survival rates in this county being amongst the highest in the country.

[deleted]

Re: How doctors choose to die (2012)

#27

Post by sandworm »

It isn't just how they die. Similar articles could be written on "How doctors loose weight", "How doctors pick their doctors" or "What do doctors do when their kids are sick". Insider knowledge and the education to effectively employ that knowledge always has advantages.

I do take issue with the concept that these docs are dieing "without treatment". They get treatment. They are diagnosed (a big deal) and have ready access to a host of pain management drugs. Having a full understanding of your condition, along with the knowledge that any pain can and will be managed very quickly, is a massive stress reduction. That's a form of treatment imho.

Re: How doctors choose to die (2012)

#28

Post by wjkm »

sago wrote: post #25
themartorana wrote: post #24

Earlier quoted context omitted.

Right - it's that ceasing to be, as before I was, that scares me. Now that I have existed, I like it much better than before. That said, that's my hangup, and has nothing to do with your right to choose to die with dignity. It's silly to me that you could choose to jump off a bridge, but can't choose something much less gruesome without fear that your or a loved one might find themselves tangled up legally.

I know this is getting OT, so apologies. And thank you for the second paragraph. But I'm interested in the first. To me it doesn't seem like I will cease to be, in any meaningful way. To cease to have something is to have it at some point but not another. I will never experience not being. So I find it hard to worry about that. Of course I enjoy being, but it's not like I would rather be than not be, because the latt…

Yes, you're exactly right. I think one of the reasons a lot of people get anxious and scared about death is because they think that when they die they're going to be locked up in a dark room forever... but you won't, because non-existence is not an experience. As Alan Watts put it, death will be just like going to sleep and never waking up, just as being born was waking up never having gone to sleep.

Re: How doctors choose to die (2012)

#29

Post by themartorana »

sago wrote: post #25
themartorana wrote: post #24

Earlier quoted context omitted.

Right - it's that ceasing to be, as before I was, that scares me. Now that I have existed, I like it much better than before. That said, that's my hangup, and has nothing to do with your right to choose to die with dignity. It's silly to me that you could choose to jump off a bridge, but can't choose something much less gruesome without fear that your or a loved one might find themselves tangled up legally.

I know this is getting OT, so apologies. And thank you for the second paragraph. But I'm interested in the first. To me it doesn't seem like I will cease to be, in any meaningful way. To cease to have something is to have it at some point but not another. I will never experience not being. So I find it hard to worry about that. Of course I enjoy being, but it's not like I would rather be than not be, because the latt…

I never said it was a rational feeling :)

I don't know the right way to explain the feeling. I think it's mostly the same sadness that one experiences when anything particularly wonderful comes to an end. I have known loss in a variety of ways, and I imagine dying taps in to that same idea of mourning. Something that I enjoy terribly must end, I have to say goodbye to not only a terrific experience - but to experience itself.

It's mostly the anticipation of the thing, not so much the thing. I'm sure once I'm dead I won't care so much that I'm dead. I just care now that one day I will be.

And thus concludes my inability to lend written word to irrational emotion.

Edit: as I sit here reflecting now, I wonder if part of it isn't the fear of regret - of not having taken full advantage, of not having loved enough or having wasted time on things actually inconsequential. It's also making me wonder if I already know that I'll have those regrets and maybe should make a few changes. Tonight got deeper that I expected it to...

Re: How doctors choose to die (2012)

#30

Post by seanmcdirmid »

sago wrote: post #15

This is anecdotal evidence from a small (2) sample. But not all doctors die without treatment at home. Some (many?) are aware of the drugs they need to hasten their demise in a way that minimises their suffering. One doctor I discussed this with said that assisted suicide, in a very limited and measured way, isn't uncommon, if you know what to look for. As someone with a degenerative incurable condition, I'd like the…

My mom suffered from MS here entire life, and a few years ago left us on her own terms (with the help of some pills) before the age of 60. I don't blame her of course. I also have no idea if she had any help from a doctor or not.
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