Not like the rest of us. They insist on less treatment.
Have you given thought to this — or better yet put instructions in writing (and gotten those instructions into the right hands)?
Okay, it won’t do much good if you’re living out your days in a FEMA detention camp, I know. (Overtreatment won’t be a problem there, I’m sure.) Or if we end up with the much-dreaded Obamacare “death panels.” But for those still on their own, I suspect that medical choices are a neglected variety of freedom. People don’t like to think about the subject.
As an aside: there are many alternative/holistic treatments to traditional chemo/radiation that I wish more people would check out. Cancer isn’t always the certain death sentence big medicine makes it out to be.
I just returned from yet another long road trip, as I attended the funeral of another family member who suffered from cancer and went the conventional treatment route, which prolonged his life (and his suffering) for only a few months, not to mention the hell his family went through with hospitals and doctors.
I don’t have a living will yet, (thanks for the reminder) but we plan to do that soon. Everyone who knows me well understands that I would never do chemo/radiation, and that I don’t want to be kept alive just to prolong my dying.
Incredible read this morning, … thank you for this link. I’m forwarding to my mother who has been a social worker at a hospital for 20 years. Very anxious to get her thoughts.
I know a number of doctors who feel this way, who would not allow their family members or themselves to be put through the physical discomfort or mental anguish of some traditional treatments. (Neither would I.)
What the author doesn’t mention is that both hospitals and doctors are acutely aware of mortality rates. Hospitals don’t want deaths coming out of their building, and many doctors are egotistically taught to believe they can treat anything and beat every disease.
So hospitals send patients out to nursing homes to die (who rush them back to hospitals for final care because the N.H. doesn’t want death on its reputation either), and many doctors do not encourage living wills, but will “try anything” rather than face the reality of death.
And neither hospital nor doctor wants to accept that the patient/family has more right to make that decision than they have. (More often than not, the judicial system is beginning to interfere as well — which leaves the patient and family no recourse to determine their own fate.)
I guess most folks forget that Medicine is a BUSINESS and like any business they will recommend what you need along with the options that line their pockets with profits.
I know lots of waitresses/cooks who never eat where they work. Perhaps it is the same sort of thing here?
“I know lots of waitresses/cooks who never eat where they work. Perhaps it is the same sort of thing here?”
Well, not exactly. Medicine deals with lives, *other people’s* lives for which the medical profession is responsible, that goes beyond simply getting sick from the food we eat. One can sue a restaurant or not eat there again, but one cannot get adequate restitution from mismanaged diagnosis or treatment resulting in permanent injury or death.
The business of medicine is to treat and heal (if possible) the sick, and prevent negative results from medical action such as added injury or infection. Hospitals are there to care for the sick (and they too were established for the convenience of doctors and caretakers/nurses), and the doctors’ responsibility is to diagnose and treat the patient within the scope of his knowledge and with the patient’s blessing.
But patients are frequently not given the full compliment of options that are available — with drugs, types of tests, pros and cons from results of treatment, conservative or dynamic choices of treatment (e.g. internal medicine vs surgery), etc. So it’s impossible for patients to know what should be done, or what’s in their best interest, when they’re not given that knowledge beforehand. Doctors (and hospitals and institutions in general) assume a “I know best” attitude that patients cannot always break through.)
Medicine became a “business” in the sense that you mean when Business Managers (often educated as CFOs) became Hospital Administrators. Then drug companies, insurance companies, and of course government stuck their noses into it — all with the blessing of medical schools who kowtowed to them, and began teaching for the benefit of their own research money, not for the benefit of “do no harm” to the patient.
Excellent article! Do complete a “living will” or advanced directives soon – even young people. Death is no respecter of youth.
And encourage those who face any end of life decision to include hospice at the earliest opportunity. One of the saddest parts of my work with hospice was that so many families learned of hospice so late… or never.
These statistics are from http://dying.about.com/od/hospicecare/ss/hospice_stats.htm
The National Hospice and Palliative Care Organization and the National Association for Home Care and Hospice provided updated facts and figures representing data collected in 2005 as part of November’s National Hospice and Palliative Care Month.
Interesting findings from these statistics include:
In 2005 1.2 million people with life-limiting illness received care from one of the nation’s hospices. This number was an increase of more than 150,000 people from 2004. (This number includes 800,000 who died, 200,000 that were admitted in 2005 and still alive in 2006 and 200,000 patients who were discharged alive.)
Approximately one-third of all deaths in the United States were under the care of a hospice program.
The average length of hospice service increased from 57 to 59 days.
The median length of stay also increased from 22 to 25 days.
Number of hospice programs in the United States grew from 3,650 to 4,160.
Cancer diagnoses continue to account for less than half of all hospice admissions at only 46 percent. The top non-cancer diagnoses for being admitted to hospice include heart disease, dementia, debility, lung and kidney disease. (See Diagram)
Pediatric Palliative care programs are increasing with twenty percent of hospice programs actively provide or are developing pediatric palliative care programs.
One in five patients admitted to hospice are of a minority race.
*****
And the newest statistics are even better. http://www.nhpco.org/i4a/pages/index.cfm?pageid=5994 (all pdf files)
When I first entered hospice nursing in 1992, hospice programs of all kinds were rare and served only about 7% of the eligible population. Now that figure is 41.6 %. In 1992, most patients were only “on service” for a few days, with many dying before the paperwork was done. This has improved dramatically with the growing acceptance and availability of hospice care throughout the country.
A friend passed away in the mid-90s under hospice care – can’t say enough good things about the service and compassion involved.
I can also recall a man who lived at home during his last months with brain cancer. On the day that he died a family member called for an ambulance and he was rushed to IC. It was a real shame to see the atmosphere during those several hours that he and family were subjected to – and of course – he only survived a few hours once he’d been ‘stabilised’. Having spoken with him I knew that he wanted to die peacefully at home – not being prodded and poked in such a noisy and frantic environment.
Speaking for myself only – I intend to pay attention to the experience when it happens and probably will not want any distractions. (should I be so fortunate as to have any choice in the matter…)
I don’t know if this is still an issue with hospice now – but during the time my friend died under their care – they did manage to afford her some relief from pain – but did express some concern about oversight and the use of pain medication. Apparently – even when one is past any point of recovery some within the .gov and medical establishment would prefer they not have access to proven pain relief. Such a shame…
“Apparently – even when one is past any point of recovery some within the .gov and medical establishment would prefer they not have access to proven pain relief. Such a shame…”
That is a shame.
I can’t speak for hospices everywhere, but the ones I’ve dealt with as a nurse in hospital settings have never held back when pain is the issue. The doctors would not put a cap on pain medicine for their hospice patients, and even non-hospice nurses in hospital would not question the need. Depends on the local (hospital) policies, I think.
Maybe MamaLiberty can respond — she knows more about hospice policy in general than I do.
I don’t like doctors, and have managed to avoid them for decades, so I had to chuckle when reading that – I discovered I agree 100% with them…..
My father didn’t have the proper forms in order when he had congestive heart failure, and actually died a dozen times and revived 11 of those….each time he “came back” his heart worked a lot less and he lost more quality of life….
I have all the forms and instructions, not just because of what he went thru but because I have lived my life by doing all I had wanted to and accomplished all I had plans to do…..I see no reason to prolong the inevitable, especially if it’s just a painful time……
The newest thoughts are how to avoid possible FEMA camps, and whatever else forms of torture along those lines pop up, and I think I’d have no problem seeking a way to end my life rather than live that way until it ends in some other method….
But then I don’t fear dying, nor do I have problems with being alone (at any time) either…….It’ll be interesting to see if dying can be done with the same freedom I’ve tried to have while living…..
Claire,
Thanks for sharing this great article. What a blessing!
Both my folks went out quietly and with dignity–they had prepared ahead. My Mom was an amateur herbalist. She treated all of their issues with diet until the very end (late 80s).
I think doctors are great folks–they have helped me a lot. You know, reattaching a finger, removing shrapnel, etc.
Now that I think about it, the only doctors I’ve ever been to (except for rare physical checkups) are dentists, optometrists (I wear glasses) and surgeons (I had an active youth).
I know of no doctors who believe they can treat anything and beat every disease. All through training and beyond, any doctor who does hospital work sees futile cases repeatedly. What they fear is a lawsuit from some family member if things were not enough was done to satisfy that family member. If is like an employer needing to fire somebody – everything has to be documented to fight a potential lawsuit. That is one major factor in this problem. Another major factor is our third party payment system – somebody else getting the bill. The attitude of most people, if asked what it is worth to spend on grandma, will say “it is worth every penny” – of somebody else’s money. If the family had to pay their own money, then their attitudes would change in a hurry. In a free market, without lawsuit abuse, this problem would not exist. Regarding effective pain treatment, that is also a governmental problem. Read Dr. Feelscared by Maria Szalavitz at http://reason.com/archives/2004/08/01/dr-feelscared/singlepage to get an accurate picture of why doctors are scared of DEA agents and shy away from pain management. They are sent up the river sometimes. Getting government out of medicine would solve all these problems.
edit – 3rd sentence should read “What they fear is a lawsuit from some family member if not enough was done to satisfy that family member.”