inspired by my personal experiences and this frontline episode, Facing Death, on PBS: http://www.pbs.org/wgbh/pages/frontline/facing-death/discuss. i suggest watching the program if you have time (available online) because it is super interesting (only an hour). also because it is easy to say in THEORY how you think/what you feel is "right", but then watching the program and seeing families and hearing from physicians makes you go "ehhhhh...maybe i'm not so sure..." and then the questions of whether our health care system (with rising costs) can even afford to sustain people on life support for years on end.this isn't just about "pulling the plug." its also about electing to stop treatment, for example. is that giving up? or being realistic? should there be a bigger emphasis on palliative care? or is that "medical waste?" is pursuing every possible treatment, even if the odds are slim, acceptable? unacceptable? here is the synopsis/intro from the website:
11/23/2010 9:50:54 PM
My mom spent the summer after I graduated from high school in a medically-induced coma. Over those two months, pretty much every organ in her body failed or was on the brink of failure. In July, for three weekends in a row, we were told that she wouldn't live to see the following Monday and were consistently urged to consider removing her from ICU and stopping treatment. Luckily we didn't, she woke up, rehabbed and eight years later is still kickin' it. But it's a personal decision and one that I don't think you can answer without being in that situation --- and every situation is incredibly unique. We didn't keep her going because we were just stubborn or because we had faith in some higher power, but I can't really say what it was that forced our decision. Maybe we just got lucky. Or maybe my mom is the Terminator.
11/23/2010 10:01:41 PM
^wow
11/23/2010 10:13:09 PM
11/23/2010 10:14:05 PM
one of my friend's wife was diagnosed with stage IV cancer. it was in her lungs and seven tumors in her brain. They did chemo and all that. He is very mad that they didn't tell him, that she probably wouldn't survive, go take a vacation and have a great time. He said the worst part was seeing the chemo kill her as much as the cancer. He said that they kept acting like it could all get better, not telling him it was terminal. They never even tried to write a will till the last minute.but then I think all cases are individual.such as Khadawal- it depends where the clots in her brain where, to know how much function she had lost. I think that long drawn out cancer deaths like that are terrible, becaue everyone is going through the greiving process, including the person dying.
11/23/2010 10:40:06 PM
To say her doctors urged us was using the wrong word. But it was an option that was brought up aplenty.]
11/23/2010 10:43:25 PM
^^ yea the individualism of it is the kicker i think. because even though, with AML, for example, there is this standard treatment or whatever, things affect people differently and each individual responds differently. like the doctors at duke my mom had (experts in their field) had never had a patient whose white blood cells just never came back after cancer. not even ONE. so they were kinda perplexed. so it was interesting to hear them talk about "medical waste" (which is mostly end-of-life care, i guess) because you can't really make any generalizations ever across the board (like all stage whatever cancer patients should just be sent home, because some make it). and it clearly isn't waste to the family. but should that even matter? i mean with the money saved could lots of other lives be saved? utilitarian argument. i dunno. tough questions. i think it'd be really hard to be an ICU physician. esp the med icu. but i guess super rewarding when patients do leave. but it is scary when science can't help or give a definite answer. because everyone is basically like...now what? tons of choices, with no clear right choice. and no definite outcome for any choice.^ oops yea. urged was probably wrong. but i've def heard it happening to other people. but then there are some families who i think need that. not urging really, but guidance.hopefully brainysmurf has some comments. i always like hearing her opinions![Edited on November 23, 2010 at 10:59 PM. Reason : .]
11/23/2010 10:51:22 PM
added to my topics. i'm much to tired to read/discuss this now.
11/23/2010 11:02:01 PM
Interesting topic. I personally am not a big fan of keeping people on life support. I have no idea who pays for it all, but I imagine it the government funds a big portion of it through Medicare/Medicaid, etc. I really feel like we should be spending our government funds to help people who do have a fairly realistic shot at getting better. I know it sounds very callous, but 12 doctors who are attending to a patient with almost 0 chance of living is really a waste of assets.On the flip side, I have never had to deal with this, and I imagine if I did my opinions might change a little or maybe even a lot.It's kind of similar (IMO) to the argument for or against the death penalty. I'd say it's a pretty safe guess that 99% of people put to death are guilty of the crime they committed, but is that fair to the 1% who are innocent? The same goes for people on life support... although an overwhelming percentage may never recover, is that fair to the extremely small number that will recover?
11/24/2010 2:03:42 AM
I'll take my 1%. Don't ever pull the plug on me.
11/26/2010 7:13:46 PM
http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawandefascinating article on hospice care
11/26/2010 7:18:30 PM
^^ really and truly? that is interesting, i like hearing differing viewpoints. but i'd always want a time limit. i wouldn't want to do that to my family...just drag out dying for years and years. but i mean, that is just my viewpoint.^ great find, thanks for sharing it. long...but worth a read, for anyone who is interested in the topic.
11/26/2010 7:43:16 PM
11/26/2010 8:58:21 PM
11/26/2010 9:21:37 PM
I don't know. Seems like if you spend an extended period in the hospital you're all but guaranteed to go broke, even with insurance. 20% on a bill for a month long hospital stay would still be an intimidating sum.1% chance to live and an almost 100% chance my family is paying for it until they're dead...
11/26/2010 9:24:22 PM
^ I personally would need MUCH better odds than 1%. I mean, at least double digits. Its awesome to hear stories and positive experiences like Ernie shared... But those are rare... If I'm on the verge of facing death, let me go. I've seen an entire family's quality of life brought down caring for another sick family member... I'm all for live together or die alone, however, I would hate to be the cause of my families burdens. Everyone's beliefs are different and there is nothing wrong with that. What really matters is understanding what that person wants before they are possibly put in a situation where a decision needs to be made, and carrying out their wish. [Edited on November 26, 2010 at 9:34 PM. Reason : .]
11/26/2010 9:33:02 PM
11/26/2010 9:44:21 PM
oh boy do i have opinions on thissome days i do leave work feeling like i prolonged misery rather than saved a life.the most recent disheartening case was a family that didnt remove life support after several horrible complications.....they trached and peg'ed their loved one because they couldnt afford a funeral....most of my opinions are very cynical at this point. for example we will flog the shit out of 70-90some year olds..........because the fam cant let them go yet. all so that if they do survive, they can spend the last year(if that long) in a nursing home.it boils down to decide what level of disability you are willing to live with. talk to your family. if you think they will argue about your life amongst themselves......find someone you trust to make that decision for you and get a health care power of attorney. do it now while you are healthy.ugh this topic is best discussed in person.........preferably with a beer or 3 in hand
11/26/2010 9:51:19 PM
brainysmurf+1[Edited on November 26, 2010 at 10:10 PM. Reason : .]
11/26/2010 10:10:35 PM
We treat animals better than people. There are very good euthanasia methods available now, but we force people to use messy alternatives.
11/26/2010 10:13:31 PM
^ even for a troll, you do have a valid point.^^^ thanks for sharing. i was hoping you'd find this thread!
11/26/2010 10:55:43 PM
folks need to think about do they want the Quantity of their livesor is quality more important...having both is rarely possible in the aftermath of a catastrophic injury or disease.[Edited on November 26, 2010 at 11:18 PM. Reason : ok the show is pissing me off as much as i thought it would]
11/26/2010 11:05:02 PM
11/26/2010 11:36:07 PM
when my dad found out he had pancreatic cancer, the dr wanted to continue probing even though they told him that he could go from the cancer at any time from three months to five yearsthen the dr found out that he had colon cancer as well and wanted to give him chemo for the colon cancer...at some point another dr got involved and told my dad that they didn't think the chemo would do anything to improve or lengthen his life, so he should consider seeking palliative care onlyit was good that the second dr gave that recommendation...it kind of helped some of us come into more realistic thinking about what was really going on. eventually, my dad decided to stop taking his medications (he was taking a metformin for diabetes from the pancreatic cancer and some other things) and take it as it came. i think my dad would've been miserable if he had continued medicating--his overall health went downhill so fast when he first started getting sick, he would've had to have quit working, he wouldn't want to be a burden on the family and he probably wouldn't have been able to do anything outside of the house for very long--so it was the best decision for my family that being said, i don't know that i would make the same decision...it would probably depend on my actual condition and what else was going on in my life at the time. my end of life care plan for if i ever become unresponsive will probably not include life support. if i was in the position to decide whether or not to take a loved one off of life support, i would probably choose how i think that person would choose. i would probably also try to support their decisions if they were in a position of considering whether or not to simply stop treatment instead]
11/26/2010 11:54:05 PM
I think for the pull the plug situation its always best to try to decide for yourself long before it becomes an immediate problem. And although my mother is in fine health atm, she has made it clear both to my brother and I what she would want to happen if the situation ever came to it.
11/27/2010 2:03:14 AM
^yes, there is voluntary euthanasia for humans in oregon.and washington, i think]
11/27/2010 2:09:39 AM
After age 75 or 80, just let me go.
11/27/2010 9:31:17 AM
11/27/2010 11:41:34 AM
^ no but what is the point of being unconscious on tubes/ventilators/etc for years on end? is that really living?
11/27/2010 5:57:33 PM
if you dont know whats going on, then no, it isnt living. i would never want to be a vegetable
11/27/2010 6:24:26 PM
11/27/2010 7:01:13 PM
I'll take hospice care and get stuff off my bucket list before I'm through. I refuse to be hooked up to a machine for months on end. Hopefully my loved ones will read my will and follow through. I'll get a DNR if I legally must, as well.
11/27/2010 7:20:54 PM
11/28/2010 10:03:37 PM
he started getting sick in november (tumor was collapsing his bile duct) but it wasn't until april when they put a permanent stent in that we got an official diagnosis. in retrospect, that seems like a really long time to give us a diagnosis..he passed in late june, so two months after the diagnosis and seven months after he started getting sick. he didn't stop taking his medications until late may, so it was only a month after he stopped taking the medications until he went. it's a really unpredictable thing.
11/28/2010 10:24:20 PM
11/28/2010 11:47:47 PM
11/29/2010 12:19:31 AM
I don't ever want to be the cause of financial/emotional stress n my loved ones. And I don't want them to have to make any tough decisions on my behalf. If I am not conscious, I urge them to pull the plug as soon as it is brought up as an option.
11/29/2010 10:09:05 AM
http://www.guardian.co.uk/science/2010/nov/28/scientists-reverse-ageing-mice-humans
11/29/2010 10:20:09 AM
That's what I'm talking about.Bunch of mother fuckers ready to die up in this thread.
11/29/2010 10:53:19 AM
^^ interesting article, for sure.but reversing aging does not equal reversing damage done by disease, injury, etc.^ or maybe just people willing to be realistic, given a set of circumstances. [Edited on November 29, 2010 at 6:04 PM. Reason : .]
11/29/2010 6:03:43 PM
You know what to do.
11/29/2010 7:31:32 PM
added to my topics. i'm much too tired to read/discuss this now.
11/29/2010 8:33:58 PM
11/30/2010 11:02:42 AM
Having watched someone I love slowly die, I wouldn't want to prolong the process once I reached a point where it's pretty obvious my quality of life wouldn't come back. Yes, medical advances happen, but when I'm at a point where I might have a year to live if machines do everything for me, science isn't likely to come up with a panacea in that time frame. I would rather just go home and heave palliative care than spend my last months in a hospital wreaking havoc on my family's emotions.
11/30/2010 11:15:11 AM
You could always freeze yourself.
11/30/2010 11:24:56 AM
I never want to be imprisoned in my own body. If there's no quality of life, pull the plug on me.
11/30/2010 4:40:22 PM
^^ even when your body is ravaged by disease and not simply old age? in hopes that some new treatment develops? i mean what if you had Alzheimers or Parkinsons or some type of cancer that had already been treated, but not sent into remission. you'd still want to stay on machines in hopes that one day they'd find some way to bring you back? seriously?i mean i get maybe being frozen in old age (well sort of but not really...but it seems more accessible to me than staying on a ventilator after having a debilitating brain injury or something) but i agree with ^^^, ^. and i think your use of the word "eager" is misplaced. no one is EAGER to pull the plug...its not like it is a fun/easy thing to do.[Edited on November 30, 2010 at 5:18 PM. Reason : .]
11/30/2010 5:16:22 PM
I'd more likely want to get frozen if I had some disease vs old age since I have more confidence in science curing a disease vs reversing old age. If the disease is not sent into remission why is it considered treated?
11/30/2010 6:25:22 PM
i guess i meant treated as in given treatment. remission in cancer, for example, doesn't necessarily mean "cured." it usually means just that it is responding to treatment (shrinking, or is being controlled, etc). so i guess i just meant treatment, failed or otherwise...but not totally cured (like i think if you have cancer after 5+ years w/o a relapse or something, some doctors call you "cured")so would you be frozen BEFORE the disease debilitated your body? like, if you read the post above about what my mom went through, would you just freeze yourself at a diagnosis? or first try the chemo type treatments (which also kill you, make you vulnerable to normally routine infections which can ultimately kill you, etc) and then freeze upon those not working?? or freeze upon becoming a "vegetable"? or at the end stages of fighting the disease...when patients can go into multi-system organ failure, etc. or what if you had a brain injury? would you still want to be kept alive or frozen? because someday they might be able to fix the damage or grow a new brain or something? i think i also made a thread awhile ago about cryogenic freezing...it is another topic which really fascinates me (lol..i am a weirdo).[Edited on November 30, 2010 at 6:44 PM. Reason : .]
11/30/2010 6:39:44 PM
Weirdo....If I was young I'd probably go ahead with the chemo. If I was older and it had a lower chance of itworking I'd probably freeze myself.If I had a brain injury I'd be fine with being kept alive assuming my condition wasn't worsening. If so, freezing seems like the best route.
11/30/2010 9:54:35 PM