Die as I prescribe, not as I die

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Typhoon
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Die as I prescribe, not as I die

Post by Typhoon »

Smithsonian | How do doctors want to die?
Joseph Gallo, a doctor and professor at Johns Hopkins University…discovered something striking about what doctors were not willing to do to save their own lives. As part of the decades-long Johns Hopkins Precursors Study, Gallo found himself asking the study’s aging doctor-subjects questions about death. Their answers, it turns out, don’t sync up with the answers most of us give.

Ken Murray, a doctor who’s written several articles about how doctors think about death, explains that there’s a huge gap between what patients expect from life-saving interventions (such as CPR, ventilation, and feeding tubes), and what doctors think of these very same procedures.
Essentially, what doctors would want for themselves and what they provide to patient is quite different. They don’t want CPR or dialysis or chemotherapy or feeding tubes—treatments they themselves prescribe regularly.
Not surprising.
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Re: Die as I prescribe, not as I die

Post by noddy »

yes - i read an interesting article from a long term nurse with similar viewpoints.

politcally impossible conversation to have, queue death camps et all.
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NapLajoieonSteroids
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Re: Die as I prescribe, not as I die

Post by NapLajoieonSteroids »

Something is queued alright; but it ain't the death camps.

What doctors want reveals more about the psychology of doctors then the merits of their procedures.

And doctors (particularly those not in pediatrics or primary care) tend towards being control freaks.

No control freak wants to be in a position where he or she has tubes stuck down their throat; radiated and full of chemicals; and at the whim of other professionals.

It must be a huge psychological pain to go from giving the orders for feeding tubes only to be then subject to them.
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Re: Die as I prescribe, not as I die

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Typhoon wrote:Smithsonian | How do doctors want to die?
Joseph Gallo, a doctor and professor at Johns Hopkins University…discovered something striking about what doctors were not willing to do to save their own lives. As part of the decades-long Johns Hopkins Precursors Study, Gallo found himself asking the study’s aging doctor-subjects questions about death. Their answers, it turns out, don’t sync up with the answers most of us give.

Ken Murray, a doctor who’s written several articles about how doctors think about death, explains that there’s a huge gap between what patients expect from life-saving interventions (such as CPR, ventilation, and feeding tubes), and what doctors think of these very same procedures.
Essentially, what doctors would want for themselves and what they provide to patient is quite different. They don’t want CPR or dialysis or chemotherapy or feeding tubes—treatments they themselves prescribe regularly.
Not surprising.
AS in Snake oil salesmen don't believe the snake oil does anything good ? Or that they just see it done day after day and have seen enough?
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Re: Die as I prescribe, not as I die

Post by Enki »

Probably more like it costs a million dollars to extend your life by three years, your quality of life during those three years is in the shitter. So better to live 18 months rather than 5 years, leave your inheritance to your children and have a better quality of life for that short period of time.
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Disinfecting the Injection Site for Euthanasia.......

Post by monster_gardener »

NapLajoieonSteroids wrote:Something is queued alright; but it ain't the death camps.

What doctors want reveals more about the psychology of doctors then the merits of their procedures.

And doctors (particularly those not in pediatrics or primary care) tend towards being control freaks.

No control freak wants to be in a position where he or she has tubes stuck down their throat; radiated and full of chemicals; and at the whim of other professionals.

It must be a huge psychological pain to go from giving the orders for feeding tubes only to be then subject to them.
Thank You VERY Much for your post, Nap......

Not sure if this is related but am remembering a story.... not sure if it is true..... about a doctor with a terminal disease who before giving himself a lethal injection disinfected the injection site :shock: :roll:

The raconteur presented the story as showing the force of habit..........
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Re: Die as I prescribe, not as I die

Post by Mr. Perfect »

This is a 100% Medicare issue, there is a gov't gravy train to milk, feeding tube patients means more golf course time.
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Re: Die as I prescribe, not as I die

Post by Enki »

Mr. Perfect wrote:This is a 100% Medicare issue, there is a gov't gravy train to milk, feeding tube patients means more golf course time.
If you didn't have the patients you could spend more time on the golf course. I mean if all you care about is golf you can work at McDonald's and spend the rest of your time at the golf course.
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Re: Die as I prescribe, not as I die

Post by Typhoon »

Mr. Perfect wrote:This is a 100% Medicare issue, there is a gov't gravy train to milk, feeding tube patients means more golf course time.
This is not clear to me.

Such milking probably does occur for both govt and private healthcare. However, I doubt that the situation is as simple as that.

Withholding treatment for a patient, especially if the family demands it, has legal liabilities, both civil and possibly criminal, for the attending medical doctor[s] does it not?

Even if the treatment does not extend the patient's life beyond a short time and during which time the patient has to endure a miserable quality of life.

So I think that the following factors come into play:

1/ Patients and their families hope for so-called medical miracles based on misunderstanding of what is and is not possible;

2/ The false hope for such medical miracles results in the family being unable to let go and come to terms that the life of their loved one is at an end; and

2/ Medical doctors have to be seen and be on record as having done everything possible to extend the patient's life.
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Re: Die as I prescribe, not as I die

Post by Mr. Perfect »

And it's all very convenient. Dr's can rake in the Medicare fees and have a great cover for doing so.
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Re: Die as I prescribe, not as I die

Post by Zack Morris »

Gotta love Mr. P's logic. If a national health care program decides to give patients the option of refusing end-of-life care, it's big bad government trying to kill you. When the government tries to keep you alive as long as possible, it's big bad government trying to kill you.

When private insurers deny claims? That's freedom!
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Re: Die as I prescribe, not as I die

Post by Mr. Perfect »

Oh Zack Morris, fighting the old wars. Stuck in the past.

The Government runs healthcare now, and the Government dictates that we overspend now so we can be bankrupt later. You got your way, the pine box industry has an unlimited upside. Thank you for your governance, you guys are geniuses, truly.
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Re: Die as I prescribe, not as I die

Post by Enki »

Mr. Perfect wrote:Oh Zack Morris, fighting the old wars. Stuck in the past.

The Government runs healthcare now, and the Government dictates that we overspend now so we can be bankrupt later. You got your way, the pine box industry has an unlimited upside. Thank you for your governance, you guys are geniuses, truly.
It's funny that Starve the Beast and Cloward-Piven are the same strategy, just both sides expects the outcome to be in the favor of their faction.

I am pretty sure Obamacare is built to fail so that they can push Single-payer through. Of course all this gun fervor is probably going to halt those plans.
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Re: Die as I prescribe, not as I die

Post by Mr. Perfect »

I don't think anyone ever tried to "starve the beast".

I don't think anyone really has a plan, but that doesn't mean there won't be an outcome.

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Re: Die as I prescribe, not as I die

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Enki wrote:Probably more like it costs a million dollars to extend your life by three years, your quality of life during those three years is in the shitter. So better to live 18 months rather than 5 years, leave your inheritance to your children and have a better quality of life for that short period of time.
I believe the time is "last two years of life" TInker.

While the doctors get paid for performing the procedures. Answer: Ban doctors not guns? Medical death panels? Or pay doctors for outcomes rather than procedures?

Except it isn't so simple. I suspect that doctors often get placed in the position of God. With the patience praying to them. Even though the doctors know that ultimately they will fail. Its the "why not make a few bucks while trying?" part that is troublesome.

Insurance companies pre-obamacare dealt with this by life time limits on cost of medical care. So how about doctors get paid huge amounts for saving lives for say 5 years and very little for performing procedures? Something along those lines anyway.
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Re: Die as I prescribe, not as I die

Post by Zack Morris »

That doesn't sound like a free market solution. The market approach is simplest: those who have money, live, those who do not, die.
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Re: Die as I prescribe, not as I die

Post by Marcus »

Zack Morris wrote:Gotta love Mr. P's logic. If a national health care program decides to give patients the option of refusing end-of-life care, it's big bad government trying to kill you. When the government tries to keep you alive as long as possible, it's big bad government trying to kill you.

When private insurers deny claims? That's freedom!
Zack, Mr. P may be alternatively overstating and over-simplifying the issue, but, that said, I hope you never have to find out just how right he is.

We live in a system designed to make us sick and keep us sick.
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Re: Die as I prescribe, not as I die

Post by Zack Morris »

Marcus wrote:
Zack Morris wrote:Gotta love Mr. P's logic. If a national health care program decides to give patients the option of refusing end-of-life care, it's big bad government trying to kill you. When the government tries to keep you alive as long as possible, it's big bad government trying to kill you.

When private insurers deny claims? That's freedom!
Zack, Mr. P may be alternatively overstating and over-simplifying the issue, but, that said, I hope you never have to find out just how right he is.

We live in a system designed to make us sick and keep us sick.
That's a different subject altogether and that's not what Mr. P is saying. Mr. P has long lauded the quality of American health care and mocked the notion that any industrialized nation has comparable care.
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Re: Die as I prescribe, not as I die

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Zack Morris wrote:That's a different subject altogether and that's not what Mr. P is saying. Mr. P has long lauded the quality of American health care and mocked the notion that any industrialized nation has comparable care.

If that's what Mr.P is arguing, he needs to look at current life-expectancy and neonatal death rates by nation.
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Re: Die as I prescribe, not as I die

Post by noddy »

Zack Morris wrote:That doesn't sound like a free market solution. The market approach is simplest: those who have money, live, those who do not, die.
nice emotional appeal that misses the reality of most westerners not being in the extremes of poverty nor being hyper rich and dropping top dollar on cutting edge cures.

what we really have here is the mess of conflicting ideology around choices and responsibilities and the fact america is probably doing the worst case blend of all that.

the vast magority of westerners can throw the 10-30 dollars a week or whatever it is for private healthcare and they can afford to eat healthy and exercise, if they actually did prioritise lifespan and elderly health.

the simple fact is most dont choose that and then we have all sorts of systems paid for buy taxes to try and fix that.. from health department budgets for advertising to sin taxes on fatty,salty foods or alcohol and the FDA controlling who is allowed to sell what foods to who, all the way to the end game of hospital treatment.

the right wing argument is that if you stopped taking all that money for things that apparently arent working anyway then atleast the people who do prioritise health issues would have more money for doing so.

we have an expectation for puritan health nut outcomes and a frustration with the fact most people would rather get wasted and eat junkfood going on here..

im in the latter category for most of my life, im under no illusions about how much the guvmint can save me from myself.

maybe your arguing for a more authoritarian regime to force us to prioritise health choices.
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Re: Die as I prescribe, not as I die

Post by Mr. Perfect »

Zack Morris wrote:That doesn't sound like a free market solution. The market approach is simplest: those who have money, live, those who do not, die.
Sounds quite a bit like the government approach. When society has money some people live, but when it runs out of money everyone dies.
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Re: Die as I prescribe, not as I die

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Zack Morris wrote: That's a different subject altogether and that's not what Mr. P is saying. Mr. P has long lauded the quality of American health care and mocked the notion that any industrialized nation has comparable care.
The quality of American health care overall is without peer. We have the best hospitals, doctors and medical schools in the world. I haven't seen anyone even contest that.

But it's a moot point. If an opera singer isn't allowed to sing, is he a great opera singer? Only government can come up with these silly conundrums.
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Re: Die as I prescribe, not as I die

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noddy wrote: maybe your arguing for a more authoritarian regime to force us to prioritise health choices.
Government spends 2 minutes on such things then moves on. As result when the bill comes do such meta changes are past their implementation schedules, and they fill up pine boxes.
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Re: Die as I prescribe, not as I die

Post by Marcus »

Mr. Perfect wrote:The quality of American health care overall is without peer. We have the best hospitals, doctors and medical schools in the world. I haven't seen anyone even contest that. . .
Mr. P, you are dead wrong. America may have (?) the most technologically-advanced medicine, but that does not equate to health care. Seriously, check the life-expectancy and neonatal death rates by nation.
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Re: Die as I prescribe, not as I die

Post by Mr. Perfect »

I have. We have the best health care. We also have the most difficult population to care for, ie fat people. Fat people get more diseases and die sooner.

I hope no one suggests that people are fat because of the health care system, or that the health care system should be making people less fat, or that other countries are less fat because of their health care systems, because none on that is true.

It is true, no one disputes, that health care is expensive and harder to get for the poor. Of course this is mostly because of government but as mentioned earlier this is the old war now, the industry is under the control of the government and all those debates have ended;

So all that's left is pine boxes as governments go bankrupt.
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