How to Die
How to Die
Here is a link that describes the quiet and conservative end of life way that most physicians choose when they know their cards are up.
http://zocalopublicsquare.org/thepublic ... ead/nexus/
Article is self explanatory. I still have nightmares from residency and doing CPR. I don't want to ever do it again, and I don't want to see it. I am still young and father and husband, so OK, at this point even a 99% hopeless case I'd be willing to fight on because my kids still really need me. But not later on.
http://zocalopublicsquare.org/thepublic ... ead/nexus/
Article is self explanatory. I still have nightmares from residency and doing CPR. I don't want to ever do it again, and I don't want to see it. I am still young and father and husband, so OK, at this point even a 99% hopeless case I'd be willing to fight on because my kids still really need me. But not later on.
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Re: How to Die
Thanks for the link,,powerful article
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Re: How to Die
Good read, and food for thought.
A multi-course meal, in fact.
A multi-course meal, in fact.
Re: How to Die
I'm sitting here, digesting this article, in a knot, going back and forth about making a very personal comment.
Last Tuesday my mother was admitted to the emergency room in great distress. She had perforated her bowel, and she was septic... badly so. Our options were complicated surgery with low odds and all sorts of machines (respirator, feeding tube, colostomy bag) in the aftermath of the procedure or giving pain relief and palliative care. We opted for the latter. For the next 30 hours she was free of pain and all of her children, sisters, brothers, nieces, and nephews visited her, expressed their love and care, and-- in whatever way they were able-- said their goodbyes. She went into a deep sleep that same night and never woke up. Her passing was gentle, pain free, dignified, and encircled by love.
I know we made the right decision. Reading this article, so soon after the events of last week, was both heart-rending and comforting.
biasion, thanks for posting the essay. You know that la dottoressa was touched by this as well.
Last Tuesday my mother was admitted to the emergency room in great distress. She had perforated her bowel, and she was septic... badly so. Our options were complicated surgery with low odds and all sorts of machines (respirator, feeding tube, colostomy bag) in the aftermath of the procedure or giving pain relief and palliative care. We opted for the latter. For the next 30 hours she was free of pain and all of her children, sisters, brothers, nieces, and nephews visited her, expressed their love and care, and-- in whatever way they were able-- said their goodbyes. She went into a deep sleep that same night and never woke up. Her passing was gentle, pain free, dignified, and encircled by love.
I know we made the right decision. Reading this article, so soon after the events of last week, was both heart-rending and comforting.
biasion, thanks for posting the essay. You know that la dottoressa was touched by this as well.
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Re: How to Die
A timeless article, thanks Biason for educating the public. I am reminded of a private, rather macabre pathologist insider joke when reading:
She had severe diabetes and terrible circulation, and, at one point, she developed a painful sore on her foot. Knowing the hazards of hospitals, I did everything I could to keep her from resorting to surgery. Still, she sought out outside experts with whom I had no relationship. Not knowing as much about her as I did, they decided to perform bypass surgery on her chronically clogged blood vessels in both legs..
(which I won't repeat here.)
She had severe diabetes and terrible circulation, and, at one point, she developed a painful sore on her foot. Knowing the hazards of hospitals, I did everything I could to keep her from resorting to surgery. Still, she sought out outside experts with whom I had no relationship. Not knowing as much about her as I did, they decided to perform bypass surgery on her chronically clogged blood vessels in both legs..
(which I won't repeat here.)
The cure shouldn't be worse than the disease.
Re: How to Die
Don't know the age and health status of your mother. But you almost certainly made the right call. When the time came for both by parents, they got comfort care only. A simple course of antibiotics in one case and a feeding tube in the other would have significantly prolonged my parents lives. It was not the way they or I would want to live. In my mother's case I actually had to fight hospital administration against further care. They wanted no part of it, even offering to discharge her home. Even as a doctor who knew the game. We as a country are not even close to being ready to have this conversation.cinghiale wrote:I'm sitting here, digesting this article, in a knot, going back and forth about making a very personal comment.
Last Tuesday my mother was admitted to the emergency room in great distress. She had perforated her bowel, and she was septic... badly so. Our options were complicated surgery with low odds and all sorts of machines (respirator, feeding tube, colostomy bag) in the aftermath of the procedure or giving pain relief and palliative care. We opted for the latter. For the next 30 hours she was free of pain and all of her children, sisters, brothers, nieces, and nephews visited her, expressed their love and care, and-- in whatever way they were able-- said their goodbyes. She went into a deep sleep that same night and never woke up. Her passing was gentle, pain free, dignified, and encircled by love.
I know we made the right decision. Reading this article, so soon after the events of last week, was both heart-rending and comforting.
biasion, thanks for posting the essay. You know that la dottoressa was touched by this as well.
Re: How to Die
Thank you for starting this topic and for thoughtful responses so far. I would definitely like to avoid broken ribs, artificial life extension, and other torture like medical treatments.
Victoria
Victoria
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Re: How to Die
thanks for postingbiasion wrote:Here is a link that describes the quiet and conservative end of life way that most physicians choose when they know their cards are up.
http://zocalopublicsquare.org/thepublic ... ead/nexus/
Article is self explanatory. I still have nightmares from residency and doing CPR. I don't want to ever do it again, and I don't want to see it. I am still young and father and husband, so OK, at this point even a 99% hopeless case I'd be willing to fight on because my kids still really need me. But not later on.
RIP Mr. Bogle.
Re: How to Die
sorry for your loss cinghialecinghiale wrote:I'm sitting here, digesting this article, in a knot, going back and forth about making a very personal comment.
Last Tuesday my mother was admitted to the emergency room in great distress. She had perforated her bowel, and she was septic... badly so. Our options were complicated surgery with low odds and all sorts of machines (respirator, feeding tube, colostomy bag) in the aftermath of the procedure or giving pain relief and palliative care. We opted for the latter. For the next 30 hours she was free of pain and all of her children, sisters, brothers, nieces, and nephews visited her, expressed their love and care, and-- in whatever way they were able-- said their goodbyes. She went into a deep sleep that same night and never woke up. Her passing was gentle, pain free, dignified, and encircled by love.
I know we made the right decision. Reading this article, so soon after the events of last week, was both heart-rending and comforting.
biasion, thanks for posting the essay. You know that la dottoressa was touched by this as well.
RIP Mr. Bogle.
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Re: How to Die
Yes, thank you biasion for that insightful piece. So much to think about in the article and the thread itself, I'm sorry for your loss cinghiale.
Re: How to Die
Now that was a very interesting article. Thanks.biasion wrote:Here is a link that describes the quiet and conservative end of life way that most physicians choose when they know their cards are up.
Link to Asking Portfolio Questions
Re: How to Die
Good article - that's what my Dad, an MD has told me when the time comes, and it is in his living will which is supposedly an important document.
I should get mine done I suppose.
I should get mine done I suppose.
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Re: How to Die
biasion -- I really appreciate your sharing of this article. I've given a lot of thought to end-of-life care having witnessed my own mother and 2 grandparents die peacefully in hospice care after prolonged illnesses and currently making healthcare choices for another grandmother also in hospice care with severe dementia.
cinghaile -- You also have my condolences for your recent loss. It's wonderful that your mother is at peace and spent her last days with family at her side. Thank you for sharing what must have been a very difficult time.
cinghaile -- You also have my condolences for your recent loss. It's wonderful that your mother is at peace and spent her last days with family at her side. Thank you for sharing what must have been a very difficult time.
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Re: How to Die
My father-in-law, a good and wise man, chose a similar course.
He declined treatment and gathered his children and grand-children around him for his few final days.
That's what I plan and hope for myself.
He declined treatment and gathered his children and grand-children around him for his few final days.
That's what I plan and hope for myself.
Re: How to Die
Good read, both for physicians and patients.
I also would want to avoid unnecessary suffering for myself or my family in the face of similar conditions.
But, it is a very personal decision, and one that no one should assume they can make for someone else:
A good friend of mine, an Ob-Gyn, retired a few years back and bought his dream home on the water in Florida. Later, he was diagnosed with advanced and unresectable pancreatic cancer. I was more than a little surprised that he did not make the same decision as Charlie in the article. Instead, he went for max treatment with standard and some experimental methods - to make a long story short, he lived over 2 1/2 years after diagnosis, and was reasonable comfortable and quite active until the last 2-3 months.
I know from conversations we had that he had no regrets on his decision, and certainly his family didn't.
I also would want to avoid unnecessary suffering for myself or my family in the face of similar conditions.
But, it is a very personal decision, and one that no one should assume they can make for someone else:
A good friend of mine, an Ob-Gyn, retired a few years back and bought his dream home on the water in Florida. Later, he was diagnosed with advanced and unresectable pancreatic cancer. I was more than a little surprised that he did not make the same decision as Charlie in the article. Instead, he went for max treatment with standard and some experimental methods - to make a long story short, he lived over 2 1/2 years after diagnosis, and was reasonable comfortable and quite active until the last 2-3 months.
I know from conversations we had that he had no regrets on his decision, and certainly his family didn't.
" Successful investing involves doing just a few things right, and avoiding serious mistakes." - J. Bogle
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Re: How to Die
Thanks for posting biasion. Also, thanks to all the other posters that responded in personal ways.
It just so happens that my wife and I are meeting with our attorney next week to revise our estate plan. I had previously written a living will with instructions that no heroic actions should be taken. I will be reinforcing that language next week.
My wife's parents, both in their 90s, passed away peacefully under hospice care without any heroic measures taken. A peaceful death is a blessing to not just the individual but to the family as well.
It just so happens that my wife and I are meeting with our attorney next week to revise our estate plan. I had previously written a living will with instructions that no heroic actions should be taken. I will be reinforcing that language next week.
My wife's parents, both in their 90s, passed away peacefully under hospice care without any heroic measures taken. A peaceful death is a blessing to not just the individual but to the family as well.
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Re: How to Die
Thanks for posting the essay. We are not immortal..biasion wrote:Here is a link that describes the quiet and conservative end of life way that most physicians choose when they know their cards are up.
http://zocalopublicsquare.org/thepublic ... ead/nexus/
Article is self explanatory. I still have nightmares from residency and doing CPR. I don't want to ever do it again, and I don't want to see it. I am still young and father and husband, so OK, at this point even a 99% hopeless case I'd be willing to fight on because my kids still really need me. But not later on.
Chaz |
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Re: How to Die
Good article, thanks for posting. I swore off chemo after watching what it did to my dad.
How would a healthy person go about determining their wishes? Is there a questionnaire covering likely scenarios and the choices they present?
How would a healthy person go about determining their wishes? Is there a questionnaire covering likely scenarios and the choices they present?
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Re: How to Die
Given the projected Medicare deficit, the younger cohort may not have to make this difficult decision.
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Re: How to Die
My father stated many times that he wanted to die at home. He left articles around the house regarding elder care, the right to die, etc.
Fortunately, he died during his afternoon nap a year ago, quietly slipping away, and getting his way, as he so often did.
This is a nice article. I think there is a dividing line between, as the OP stated, a younger person with family to raise, and an older person who has faced his/her on mortality and is prepared to meet it on its own terms.
The tattoo is a good idea-- I'll consider getting one when my kid graduates from college. Until then, dang it, I am going to do my best to see him all the way through.
Fortunately, he died during his afternoon nap a year ago, quietly slipping away, and getting his way, as he so often did.
This is a nice article. I think there is a dividing line between, as the OP stated, a younger person with family to raise, and an older person who has faced his/her on mortality and is prepared to meet it on its own terms.
The tattoo is a good idea-- I'll consider getting one when my kid graduates from college. Until then, dang it, I am going to do my best to see him all the way through.
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Re: How to Die
Sorry for your loss Cinghiale. It takes great courage to make these decisions for loved ones.cinghiale wrote:I'm sitting here, digesting this article, in a knot, going back and forth about making a very personal comment.
Last Tuesday my mother was admitted to the emergency room in great distress. She had perforated her bowel, and she was septic... badly so. Our options were complicated surgery with low odds and all sorts of machines (respirator, feeding tube, colostomy bag) in the aftermath of the procedure or giving pain relief and palliative care. We opted for the latter. For the next 30 hours she was free of pain and all of her children, sisters, brothers, nieces, and nephews visited her, expressed their love and care, and-- in whatever way they were able-- said their goodbyes. She went into a deep sleep that same night and never woke up. Her passing was gentle, pain free, dignified, and encircled by love.
I know we made the right decision. Reading this article, so soon after the events of last week, was both heart-rending and comforting.
biasion, thanks for posting the essay. You know that la dottoressa was touched by this as well.
The strong do what they can and the weak suffer what they must -Thucydides
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Re: How to Die
I work in an environment where CPR is almost a daily occurrence. I can't blame a person for wanting the medical team to "do everything" if/when death appears to be imminent, but I think if most people could see what being a "full code" really entails they would change their minds. I know it has changed my thoughts and opinions. The truth is that resuscitation is ugly, violent, painful, and (obviously) isn't always effective.biasion wrote:Article is self explanatory. I still have nightmares from residency and doing CPR. I don't want to ever do it again, and I don't want to see it. I am still young and father and husband, so OK, at this point even a 99% hopeless case I'd be willing to fight on because my kids still really need me. But not later on.
Thanks for the article.
.Anon1234 wrote:How would a healthy person go about determining their wishes? Is there a questionnaire covering likely scenarios and the choices they present?
While simple, I've found a document entitled 5 wishes to be a good starting point. It isn't filled with medical lingo, yet gets to the stuff no one wants to talk about. At the very least it gets the conversation started. My wife and I have each gone through it (we're both in our 20's) and I've given it to my parents as well. A sample of it can be found here: http://www.agingwithdignity.org/five-wishes.php
Re: How to Die
Probably almost everyone would rather die peacefully than in the midst of heroic but painful and strenuous efforts at resuscitation. But it might not be as simple as that. After all, people can recover from cracked ribs. I think a lot of people would risk cracked ribs if that gave them, say, a 1 in 3 chance of getting through some acute medical problem. If there were a document you could sign right now that would guarantee no heroic measures that might result in cracked ribs or intubation, say, could be used to revive you, would you sign it? Really? If you were told that your cancer could be treated with a chemotherapy agent that had extended the median survival rate in the past for other patients with your type of cancer from 3 months to 6 months, would you take it regardless of cost or side effects? No? Is your answer the same when you understand that the extension in median survival is consistent with a complete cure in a minority of cases?
Greg, retired 8/10.
Re: How to Die
amber waters, thanks for the link.
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Palliative Care Doctor Fought for Life: NYTimes.com
Here is an irreconcilable article about a doctor, a doctor that specializes in end of life care, a Palliative Care doctor, who believed in a peaceful death.
She has a change of heart when faced with her own mortality and fights to the end - enduring brutal procedure after procedure against her doctors' advice.
http://www.nytimes.com/2010/04/04/health/04doctor.html
Additionally, here is very interesting talk on Doctors and the "God complex".
http://www.ted.com/talks/tim_harford.html
Thank you for posting the link to the original article.
She has a change of heart when faced with her own mortality and fights to the end - enduring brutal procedure after procedure against her doctors' advice.
http://www.nytimes.com/2010/04/04/health/04doctor.html
Additionally, here is very interesting talk on Doctors and the "God complex".
http://www.ted.com/talks/tim_harford.html
Thank you for posting the link to the original article.
Re: How to Die
Thanks for posting this important article. It reminded me of a new book I recently I read, "Your Medical Mind," by Jerome Groopman and his wife, Pamela Hartzband, both M.D.s. I would highly recommend it for anyone who thinks their end-of-life preparations are adequate for every situation.
"Yes, investing is simple. But it is not easy, for it requires discipline, patience, steadfastness, and that most uncommon of all gifts, common sense." ~Jack Bogle
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Re: How to Die
While I agree with the others and won't be a full code at any point after say, 60 years old, the idea that people being coded are feeling pain is nonsense.
But don't discount the usefulness of heroic measures in certain instances. I once had a guy come in with a heart attack who we shocked 15 or 20 separate times. His heart rhythm would return each time and he would wake back up. We got so good at it a few times that he hadn't even lost consciousness before we shocked his heart back to its normal rhythm. Can you imagine 200 joules running through your chest while fully conscious.....a dozen times? He thanked us profusely both between shocks and after his stent was placed in the cath.
Just because most codes don't work doesn't mean some do. I wear a watch given to me by someone I successfully coded at a baggage claim.
But don't discount the usefulness of heroic measures in certain instances. I once had a guy come in with a heart attack who we shocked 15 or 20 separate times. His heart rhythm would return each time and he would wake back up. We got so good at it a few times that he hadn't even lost consciousness before we shocked his heart back to its normal rhythm. Can you imagine 200 joules running through your chest while fully conscious.....a dozen times? He thanked us profusely both between shocks and after his stent was placed in the cath.
Just because most codes don't work doesn't mean some do. I wear a watch given to me by someone I successfully coded at a baggage claim.
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Re: How to Die
I have discussed this many times with others in the medical field and see a huge paradigm shift on how different generatons view death.
It is interesting to see how much the views on "end of life" care is changing between generations. The older folks it seems had a great fear of death AND had some fascination with outliving everybody else. Younger generations seem to accept dying as a part of life on a more philosophical level.
I am young (mid 30's) and have already decided my perfect time to pass on would be the second after my wife passes. I could not imagine wanting to continue to live without my significant other. It just would not be worth living (at least not for me).
Good luck.
It is interesting to see how much the views on "end of life" care is changing between generations. The older folks it seems had a great fear of death AND had some fascination with outliving everybody else. Younger generations seem to accept dying as a part of life on a more philosophical level.
I am young (mid 30's) and have already decided my perfect time to pass on would be the second after my wife passes. I could not imagine wanting to continue to live without my significant other. It just would not be worth living (at least not for me).
Good luck.
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Re: How to Die
staythecourse wrote:I am young (mid 30's) and have already decided my perfect time to pass on would be the second after my wife passes.
I misread your comment as indicated above... perhaps I'm more of an optimistic when it comes to finding relationships .xerty read wrote:I am young (mid 30's) and have already decided my perfect time to pass on would be after my second wife passes.
No excuses, no regrets.
Re: How to Die
Agree with fishndoc that this is a very pesonal decision, and can vary from one individual to another no matter what their reasons are. However, as a 74 year old retired physician, I totally agree with the article and its main thrust. Of course there are indivdual cases and anecdotes that don't subscribe to the course followed by the majority of cases, and one has to be sensitive to them and act accordingly. But this does not diminish from what the article says, and the great need for a tremendous amount of education that still needs to be done in our society regarding end of life issues from moral, spiritual, unnecessary suffering, and cost perspectives.fishndoc wrote:Good read, both for physicians and patients.
I also would want to avoid unnecessary suffering for myself or my family in the face of similar conditions.
But, it is a very personal decision, and one that no one should assume they can make for someone else:
A good friend of mine, an Ob-Gyn, retired a few years back and bought his dream home on the water in Florida. Later, he was diagnosed with advanced and unresectable pancreatic cancer. I was more than a little surprised that he did not make the same decision as Charlie in the article. Instead, he went for max treatment with standard and some experimental methods - to make a long story short, he lived over 2 1/2 years after diagnosis, and was reasonable comfortable and quite active until the last 2-3 months.
I know from conversations we had that he had no regrets on his decision, and certainly his family didn't.
Re: How to Die
This is similar to investing. Some people, some times are lucky to be in the positive tail of a statistical distribution, but the middle of the distribution is more useful for making decisions.EmergDoc wrote:Just because most codes don't work doesn't mean some do. I wear a watch given to me by someone I successfully coded at a baggage claim.
Victoria
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Re: Palliative Care Doctor Fought for Life: NYTimes.com
I think I can explain an apparent contradiction. Dr. Desiree Pardi profiled in the article was comfortable with her husband acting as a proxy between her and the doctors who were treating her. There was a merit in this approach, because she knew too much about medicine and could overreact to the information about her own health. In some cases, not knowing the bad news is useful, because one preserves an optimistic outlook -- and the optimism itself could be healing.dodonnell wrote:Here is an irreconcilable article about a doctor, a doctor that specializes in end of life care, a Palliative Care doctor, who believed in a peaceful death.
She has a change of heart when faced with her own mortality and fights to the end - enduring brutal procedure after procedure against her doctors' advice.
http://www.nytimes.com/2010/04/04/health/04doctor.html
Thus Dr. Desiree Pardi's decisions to prolong treatments were not based on her professional knowledge, but on the representation she received from her husband who is in very different profession. The husband wanted to keep her alive, and thus his interpretation of the medical information most likely was as optimistic as he could make it. It seems that trying to avoid the pessimism of overreacting to bad news, Dr. Desiree Pardi has created for herself the opposite problem of prolonging her life and suffering without knowing her realistic prognosis.
Victoria
Inventor of the Bogleheads Secret Handshake |
Winner of the 2015 Boglehead Contest. |
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Re: How to Die
On death and dying: Personally I agree with the article. If and when I get something really terminal, I don't want all the poking and probing etc. That being said, the premise of the article is that "most doctors" want this. Where is his data? I am not convinced that doctors do or do not choose the path of least resistance to death any more than the general population.
Re: How to Die
If a doctor does not provide the most aggressive treatment available, she may later be sued for negligence. Overtreatment is commonly a defensive strategy on the part of medical professionals.Leesbro63 wrote:That being said, the premise of the article is that "most doctors" want this. Where is his data? I am not convinced that doctors do or do not choose the path of least resistance to death any more than the general population.
Victoria
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Winner of the 2015 Boglehead Contest. |
Every joke has a bit of a joke. ... The rest is the truth. (Marat F)
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Re: How to Die
That's how I read it as well....had to re-read a couple of times to get it!xerty24 wrote:staythecourse wrote:I am young (mid 30's) and have already decided my perfect time to pass on would be the second after my wife passes.I misread your comment as indicated above... perhaps I'm more of an optimistic when it comes to finding relationships .xerty read wrote:I am young (mid 30's) and have already decided my perfect time to pass on would be after my second wife passes.
Re: How to Die
True. But this has nothing to do with backing up the unsupported premise of the article that docs opt out of medical heroics significantly more frequently than the general population.VictoriaF wrote:If a doctor does not provide the most aggressive treatment available, she may later be sued for negligence. Overtreatment is commonly a defensive strategy on the part of medical professionals.Leesbro63 wrote:That being said, the premise of the article is that "most doctors" want this. Where is his data? I am not convinced that doctors do or do not choose the path of least resistance to death any more than the general population.
Victoria
Re: How to Die
I have DNR engraved on my forehead, and the legal ramnifications of doing so, stamped on my neck.
Re: How to Die
From physicians talking among themselves about these issues vs. what non-medical families decide, I would say that the premise of the article is correct. I wish there are statistical studies to corobrate that.Leesbro63 wrote:True. But this has nothing to do with backing up the unsupported premise of the article that docs opt out of medical heroics significantly more frequently than the general population.VictoriaF wrote:If a doctor does not provide the most aggressive treatment available, she may later be sued for negligence. Overtreatment is commonly a defensive strategy on the part of medical professionals.Leesbro63 wrote:That being said, the premise of the article is that "most doctors" want this. Where is his data? I am not convinced that doctors do or do not choose the path of least resistance to death any more than the general population.
Victoria
Re: How to Die
I hope you are correcting for possible bias due to surveyed representatives of the younger generation being young. I get the impression that people who seem enthusiastic about letting old people die sooner and cheaper are thinking mostly about other people dying, not them dying.staythecourse wrote:I have discussed this many times with others in the medical field and see a huge paradigm shift on how different generatons view death.
It is interesting to see how much the views on "end of life" care is changing between generations. The older folks it seems had a great fear of death AND had some fascination with outliving everybody else. Younger generations seem to accept dying as a part of life on a more philosophical level.
Greg, retired 8/10.
Re: How to Die
Thank you for sharing. This was a great article.
Re: How to Die
Today is the 31st anniversary of the killing of John Lennon. A quote attributed to him was " life is what happens while you're busy making other plans."
For those of you who have been moved to action by this thread I would recommend that you make your plans today and not eventually.
Nobody can plan for everything including death, especially death. There's no time like the present to state your wishes for your end of life 'plan'.
For those of you who have been moved to action by this thread I would recommend that you make your plans today and not eventually.
Nobody can plan for everything including death, especially death. There's no time like the present to state your wishes for your end of life 'plan'.
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Re: How to Die
Great article.
I'm not sure what, if any, changes I will make because of this, but it makes me stop and think.
1210
I'm not sure what, if any, changes I will make because of this, but it makes me stop and think.
1210
Re: How to Die
As a 4th year medical student doing my emergency medicine rotation this article is powerful.
Makes me think about life insurance, disability insurance, writing a will, etc
Makes me think about life insurance, disability insurance, writing a will, etc
Re: How to Die
Just went through this with my father-in-law. He had dementia and could make no decisions. If he had not done a written advanced medical directive of his wishes, I hesitate to think what his children might have done to "save" him, at 93 years old. His written directive made it easier for the family and with great palliative care physicians he was pain free and gone in a couple of days. Not to be crass, but the outline of care one physician laid out would have easily cost the system close to half a million dollars when all said and done, for nothing. May he rest in peace.cinghiale wrote:I'm sitting here, digesting this article, in a knot, going back and forth about making a very personal comment.
Last Tuesday my mother was admitted to the emergency room in great distress. She had perforated her bowel, and she was septic... badly so. Our options were complicated surgery with low odds and all sorts of machines (respirator, feeding tube, colostomy bag) in the aftermath of the procedure or giving pain relief and palliative care. We opted for the latter. For the next 30 hours she was free of pain and all of her children, sisters, brothers, nieces, and nephews visited her, expressed their love and care, and-- in whatever way they were able-- said their goodbyes. She went into a deep sleep that same night and never woke up. Her passing was gentle, pain free, dignified, and encircled by love.
I know we made the right decision. Reading this article, so soon after the events of last week, was both heart-rending and comforting.
biasion, thanks for posting the essay. You know that la dottoressa was touched by this as well.
Don’t wear yourself out trying to get rich; be wise enough to control yourself. |
Wealth can vanish in the wink of an eye. It can seem to grow wings and fly away |
like an eagle. - King Solomon
Re: How to Die
Here is another relevant article, albeit a bit longer, from one of my favorite author/MD's regarding end of life care, etc. There is a bit more emphasis on the economics surrounding the issue but still a powerful piece of writing.
http://www.newyorker.com/reporting/2010 ... ntPage=all
http://www.newyorker.com/reporting/2010 ... ntPage=all
Re: How to Die
The San Jose Mercury News has been running some good articles on End of Life issues recently.
http://www.mercurynews.com/cost-of-dyin ... -directive
They discussed a relatively new document that is emerging as a alternative to DNR orders called "Physician Orders for Life-Sustaining Treatment" or POLST.
http://www.emsa.ca.gov/pubs/pdf/ApprovedPOLSTForm.pdf
Happy Easter
http://www.mercurynews.com/cost-of-dyin ... -directive
They discussed a relatively new document that is emerging as a alternative to DNR orders called "Physician Orders for Life-Sustaining Treatment" or POLST.
http://www.emsa.ca.gov/pubs/pdf/ApprovedPOLSTForm.pdf
Happy Easter