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comment by inferno31
inferno31  ·  3874 days ago  ·  link  ·    ·  parent  ·  post: How Doctors Die (2011)

    I think that physicians are equipped to have these discussions but are discouraged from doing so, especially in the wake of the post healthcare battle "Death Panels" scare that was so pervasive.

That's actually a great point, it's mostly the older physicians I've seen who are uncomfortable having these discussions. The medical-legal landscape scares off many doctors from wanting to have this discussion though, you can see the hazards of it even in the article. It's all about documentation.

    If you are big pharma or a med device company you lobby hard to keep life extending policies in place. More of their products are consumed in the last days, weeks and months of life than the whole rest of life combined. (Okay, I made up that stat, but I would bet it's true). It's all about money, including the money the hospitals and physicians can make. It's not about what is best for the patient.

While this is a pretty cynical view I can see where it's coming from, and the last few years of life account for well over 60-70% of total healthcare expenses. A lot of physicians do want what's best for the person, especially if they've been treating them for years. You can argue the surgeon doing the tracheostomy or placing the G-tube doesn't really care, but more often the primary physician either publicly or privately will voice concerns or hesitation. I really don't think people are adequately informed. You always hear that one story of the doctors wanted to pull the plug but little betsy against all odds survived and now shes an astronaut! People don't like dealing with the harsh realities of end of life care because it's uncomfortable to do so.





thenewgreen  ·  3874 days ago  ·  link  ·  

    You always hear that one story of the doctors wanted to pull the plug but little betsy against all odds survived and now shes an astronaut! People don't like dealing with the harsh realities of end of life care because it's uncomfortable to do so.
-Very true. Most people will fight tooth and nail to keep a loved one alive, not realizing the being alive isn't necessarily living.

    A lot of physicians do want what's best for the person, especially if they've been treating them for years. You can argue the surgeon doing the tracheostomy or placing the G-tube doesn't really care
That wouldn't be my argument at all. What I would argue is that doctors are people and as such they are subject to influence. When you have a billion dollar industry hell bent on convincing you that the best thing for patient "X" is their product or procedure, eventually it can sink in. You think to yourself, I'm following protocol and doing the right thing. Hell... even physicians can buy in to the little girl astronaut story.

I do think we will see major changes in the next couple of generations in regards to how this is handled. But people like theadvancedapes would likely say that advances in technology and the eventual singularity may make this discussion moot.

inferno31  ·  3874 days ago  ·  link  ·  

    I do think we will see major changes in the next couple of generations in regards to how this is handled.
I hope your right - right now the patient definitely isn't coming out on top. Thanks for the replies! Just started out on this hubski thing, trying to figure it out still.
thenewgreen  ·  3874 days ago  ·  link  ·  

Thank you too, I've enjoyed the conversation. If you have any questions about Hubski let me know, I am happy to help. Welcome to our community, glad you found us. One suggestion, when you get a moment check out the "badges" link at the top of the page. Some of the best content is therein. Also, to get the most out of the site, in my opinion, follow around 10 or more people and a few tags. You can always unfollow these users or tags if you don't enjoy them. Good luck!