I post this in Religion because there is only one mention of spiritual in the article. Data Analytics, devoid of religion dominates this article, and the discussion in Healthcare circles.
Of course, we taxpayers pay for most end-of-life activity in the elderly and those with severe disability.
End-of-Life is just one of many areas where we will increasingly hear Well the data and predictive analytics tells us to do X.
First, the Socialist planners came for the inconvenient unborn. Then they came for the expensive elderly. Then they came for me.
For later
I’ve had a doctor in a clinic for the last fifteen years where EPIC seems to guide, more and more, every encounter we have. It “guides” the provider on “best practices,” for example, statin recommendations, desirable blood pressure, and flu shots.
My last trip to the doctor, last month (he insists on seeing me every six months, or I get “scolded”) was somewhat tense. I’ve told him, for years, that I can’t tolerate statins but he keeps asking me to consider them. He tells me he doesn’t believe my BP readings are lower at home, that my new cuff must be inaccurate, and that the readings in the office (always much higher) are the only ones that matter. And that, because of controversial new BP guidelines, he would like to see me on even more medication. Then, off course, he’d like me to get the (near) useless flu shot.
He’s obviously under pressure from the big health system he works for to do what the “guidelines” tell him. And it only seems to have gotten worse over the years. I don’t feel I have the same kind of relationship with him that I’ve had with doctors in the past.
I dread this going forward as I transition into my medicare years. If this article is any indication, the time is rapidly approaching when my “provider” will be saying things like “the recommendations say you have only x years to live at such-and-such quality of life, so we don’t recommend x. Have you considered your end of life plans?”
I’m not looking forward to those “conversations.”
I seem to recall somebody not too long ago referring to this as “death panels”... seems they were also accused of being “tinfoil hat crazy delusional”.
Just about a year ago my mother went into the hospital after she was found lying on the kitchen floor seizing for how long - we didn't know. The first doctor was doing his best to prepare us for the worst. But every thing he told me by phone (I live in FL and she was in PA) didn't make sense that she was at death's door. It turned out the first doc was treating the DNR and not the patient. When we got another physician on the case and he started treating her and now she is living almost independently in an assisted living home and we talk periodically.
So even though my mother's case does not disprove their premise it does prove that population statistics cannot be applied to individuals AND that individuals should still be treated by competent caring staff and not people looking to cut expenses. It is bad enough that we are killing off millions of unborn, now we need to start killing off the elderly when they start to look inconvenient or too costly.
Yes the data seems cold when dealing with end of life. But when you think about it, how is that different from the opinion from an experienced physician? When I give an opinion on the chance of meaningful recovery, I am using the data (experience) from treating patients for years to make a prediction in the case at hand. Some families may see it as less biased and less emotional to look at raw statistics...
End of life discussions are difficult but necessary. We spend a lot of time and money literally torturing some people at the end of their lives. Just because we can put someone on a ventilator or artificial support does not mean we should in all instances. Patient and family input are what drives this care and as in any major decision, they should have the best data we have available to them in the form they most easily relate to - whether that is opinions of experienced medical professionals, computer data, or a mixture of both.
The best way to deal with end of life is based on a simple exercise plan:
Dig a hole in your yard that is deep enough to require you to use your arms to climb out.
Once a day, every day, jump into the hole and climb out.
Eventually, the day will come when you can’t climb out.
When that happens, simply lie down.
Good things to read in this context:
“Being Mortal” by Atul Gawande.
“The Median is Not the Message” by Stephen Jay Gould.
BTW, from the moment Obama said he wanted all of American medicine on computer, we have dreaded the day when they would start data dredging and numbers crunching in order to generate yet more government guidelines.