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2015-04-27 -Short Attention Span Theater-

Over 75? Sign Here If You're Ready For Death

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Posted by gorb 2015-04-27 11:33|| || Front Page|| [8 views ] Top

#1 As a lung physician, I've dealt extensively with DNR orders. It is very true that an out-of-hospital arrest is seldomly resuscitated and restored to former health status. Ditto for the very large majority of in-hospital arrests, even witnessed ones.

Further, death has 100% penetrance: we're all going to die of something. It's a fair question to discuss with an older patient, or any patient with a chronic, debilitating illness with a downward course, just how much they want done and how heroic they want the medical system to be. Most patients are clear-eyed, realistic and get it. Some need a little more time.

With that said, what NHS is doing is indeed trying to intimidate older patients simply to save money. If they'd like to prove otherwise, the high level managers could start by posting on-line their own DNR orders.

Cold-calling is inappropriate: DNR, living will, and heroic measures should be discussed at a time and setting conducive to answering questions, comforting people in a time of a potentially upsetting conversation, and ensuring that there is sufficient time to answer all questions. I do some work with ALS patients, and my initial consultation with them is 90 minutes precisely for this reason.

I'd look NHS in the eye and remind them that I wear a white coat, not a black robe.

Posted by Steve White 2015-04-27 12:34|| 2015-04-27 12:34|| Front Page Top

#2 Advance directives as a part of a living will are not new. Most people discuss such things with their attorney prior to the need. I was in a conversation with my physician about Obamacare and it's impact on healthcare the other day. He mentioned a patient he was treating for cancer. He said he could provide curative treatment for the patient but the insurance company would only cover palliative care, i.e. care which would make his quality of life better for awhile but not cure the disease. The point is that in the U.S., insurance companies, in fact, often make the end-of-life decisions for you.

Posted by JohnQC 2015-04-27 13:36|| 2015-04-27 13:36|| Front Page Top

#3 Further, death has 100% penetrance: we're all going to die of something

Yep, Death is a pie chart. Move one radii to make one area smaller only makes another area larger. Oh, and that's area special interest group scream louder for more research funding.

Posted by Procopius2k 2015-04-27 13:46|| 2015-04-27 13:46|| Front Page Top

#4 When members of Congress are elected to office, they each need to sign a "do not resuscitate" order. Only then will we negotiate.

Posted by Alaska Paul 2015-04-27 17:33|| 2015-04-27 17:33|| Front Page Top

#5 Useful thoughts. Thanks, Steve.

Posted by KBK 2015-04-27 19:02|| 2015-04-27 19:02|| Front Page Top

#6 OOOOOOOOOOO, you just know that GWCC intensifies towards Year 2050, + the US-World + mighty OWG-NWO = SPACE GOVT-ORDER = SPACE COMMAND starts building Spaceships + "Off-Earth Bases", "SOLYENT GREEN" WILL BE THERE!

Posted by JosephMendiola 2015-04-27 21:27|| 2015-04-27 21:27|| Front Page Top

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