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  • btdt100 btdt100 Aug 11, 2009 12:21 AM Flag

    Health care bill end of life counseling

    doc, I have started to respond to a number of your posts and haven't. Can't let it go any further and I am ready to dump more words than the board would allow.

    Yes healthcare in this country is in a mess, and yes it is not all the fault of the practioners out there, but no, MDs do have their share of responsibilities in that mess.

    First to your comment: "As far as end of life care, that is just another stupid attack on physicians. It's the Republicans attempt to be in favor of all life extending treatment like with Teri Schaivo as long as someone else is paying for it."

    You are very wrong on a number of issues but first, as far as end of life care, I read some of Ezekiel Emanuel's pubs this weekend. He is hardly a republican. I suggest you read him too as he obviously is the person that educated Obama as to how physicians prescrib way too many drugs not needed and the more expensive, and how physicians perform way too many tests and procedures that are not necessary, like the pediatrician that removes tonsils when not necessary. Obama said that, not a republican. If a physician merits attack, Emanuel does though I don't think he rightly merits the title (he has an MD, PhD in Political Philosophy, was bioethicist at NIH before becoming Czar to Obama, and yes he is Raul's brother).

    You grossly minimize and distort the ideas he expouses which are expressed in that health plan. There is a BIG difference in a person facing end of life decisions, and in a doctor dealing with a person with serious death potential illness and making an assessment as to that person's worth to society in productivity versus the cost of saving their life and deeming their life not worth the dollars. He actually presents the case in comparison of such a person to a younger person in need of health care who has more productivity remaining, and recommends that the younger be treated while the older not have the money wasted on them. Ah yes, they would have death counselors besieged upon them and he has a pathetic article on that. let me just say JFC. Now either you really don't have a clue as to what is going on in that plan and the direction they are going with it, or you are being very dishonest.

    Now as far as Terri Shavo. Life support equipment that makes a heart continue to pump for example, is NOT equivalent to the basic essentials of life - food and water. No one unplugged a life support machine to Terri Shavo and let her die. They instead denied her food and water so that she dehydrated and starved to death. It would have been less cruel to take a gun and blow her brains out. Her parents begged to be allowed to take her home where there would have been no cost to any one but them. Not the same actions at all and you of all people as an MD, should know that. Shame on you and all the MDs who did not step up to the plate in that situation and clarify exactly what was really being done to that human being.

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    • http://news.yahoo.com/s/ap/20090811/ap_on_go_pr_wh/us_health_care_end_of_life_q_a

      <The National Right to Life Committee opposes the provision as written.>

      And that should tell you what this fight is really about. It is not about terminal illness and living wills but a reach around to the abortion issue.

      As far as Schiavo goes, the wiki page here, http://en.wikipedia.org/wiki/Terri_Schiavo_case, is pretty good.

      As to what it was really about, "At the same time, the so-called Schiavo memo surfaced, causing a political firestorm. The memo was written by Brian Darling, the legal counsel to Florida Republican senator Mel Martinez. It suggested the Schiavo case offered "a great political issue" that would appeal to the party's base (core supporters) and could be used against Senator Bill Nelson, a Democrat from Florida, because he had refused to co-sponsor the bill.[66] Nelson won re-election in 2006."

      <They instead denied her food and water so that she dehydrated and starved to death. It would have been less cruel to take a gun and blow her brains out.>

      The courts have decided there is a difference in letting someone die and in actually killing them. However, they have given providers an out. These people can be given enough pain medicine that it can shut off their drive to breathe.

      Between the drugs she was given and her brain, which had shrunk to half its usual size, she didn't know she was hungry or thirsty.

      The law on Terri Schiavo is crystal clear. The pecking order for who makes end of life decisions in the absence of a living will is spouse, then children, then parents.

      Furthermore, judges ruled that Terri Schaivo did not want to be continued on life support after hearing testimony from friends and family.

      The argument that a ventilator is life support and feeding tube is not is silly. A Life support device means if you do not have said device you would die.

      <Her parents begged to be allowed to take her home where there would have been no cost to any one but them.>

      And that is exactly what Terri Schiavo didn't want. The law is about what the patient wants not the parent's wishes.

      But in this case comes the total hypocrisy of the Republican position. The Republicans supposedly say they want the government out of health care, but Congress and the president butted into this affair even though they had no legal right to do so.

      Furthermore, most Republicans certainly want the government to butt into women having abortions, and Terri Schaivo was just putting the right to life premise in the news.

      The NLRC members are huge Republican supporters, and you would think that such a "pro-life" group would oppose the war in Iraq, but they didn't.

      • 1 Reply to docjoe999
      • <The National Right to Life Committee opposes the provision as written. And that should tell you what this fight is really about. It is not about terminal illness and living wills but a reach around to the abortion issue. >>

        BS. Right to life issues involve what constitutes murder which includes euthanasia and doctor assisted suicide every bit as much as abortion. I am not trying to argue the issues, only what the issues truly are.

        <The courts have decided there is a difference in letting someone die and in actually killing them. However, they have given providers an out. These people can be given enough pain medicine that it can shut off their drive to breathe.>>

        By your own admission, doctors can now legally and knowingly end the person’s life without the person or his family comprehending what is being done. Thanks for admitting it publicly.

        <<Between the drugs she was given and her brain, which had shrunk to half its usual size, she didn't know she was hungry or thirsty.>>

        Really? I do not buy that – we are not at that level of knowledge in neurology and it is dishonest to state that is a known truth rather than just an opinion. Besides, if we are going to kill a person, than do it quickly with injection. We give criminals that much. To my knowledge, Schivo was not given any medications at all and certainly not enough to speed her intended death.

        <<The law on Terri Schiavo is crystal clear. The pecking order for who makes end of life decisions in the absence of a living will is spouse, then children, then parents.

        And that is a problem with the law, especially in this day and time, as Schiavo clearly reflected. I had (thank God past tense) a son in law who did not give a flip about my daughter but rather was an opportunist and moron to boot. He and I never endured to each other – he would have the plug pulled for no reason other than to spite me, and then was in the subjective position of gaining wealth. I was extremely concerned about him having such rights but luckily, she realized pretty quickly what he was about. For the grace of God, go you.


        <<The argument that a ventilator is life support and feeding tube is not is silly. A Life support device means if you do not have said device you would die.>>

        The argument was not “silly” to Pope John Paul who took a position on it at the time. It would be hard to find anyone of greater education, credentials, and experience to address issues of ethics and morality. Food and water are basic essentials to ALL human life. Anyone and everyone will die without them, even you. Terri was not on a feeding tube. She needed assistance in eating, just as children do, and a host of many others with health issues. A ventilator is a whole different machine, used only in circumstances where the lungs are functioning insufficiently. It is not essential to everyone but rather aiding certain inflicted to stay alive when they would otherwise likely die. There is no controversy over turning the switch off and allowing those people to either live or die on their own accord because it is not intentionally causing death, but rather allowing death to occur naturally. To deny basic essentials of life to those who simply need assistance in eating is to knowingly and intentionally cause death. And that is not a silly issue but a very very important one.

    • More for doc and food for thought for all the rest of you.

      At the turn of this century, a revolution occurred in technologies for treating cancer - we are into a new age of what are called smart drugs, the first being Gleevec. Are you with me doc?

      The scientist who did that drug is now dead and will never design more for us. There remains however, many more scientists to develop and perfect the technologies involved. (And anyone who has experienced chemo and radiation can greatly appreciate the benefits of such drugs as they don't tend to kill you in the process of killing your cancer.) Catch is that the new smart drugs are expensive, too expensive for our health plan.

      Question doc. How is research and development suppose to develop those drugs to the point that they are more effective and not so expensive if they are going to be stopped from use?

      Who is going to invest the dollars to get such new drugs on the market if they would never be "sold" (i.e. no market) due to the great Obama Health plan? Is this what "progressive" means?

 
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