Posted on 06/22/2005 1:25:39 AM PDT by FairOpinion
The politicization of Terri Schiavo prompted the American Medical Association on Tuesday to adopt policy opposing any legislation that presumes patients would want life-sustaining treatment unless it is clear that they would not.
Tuesday's action at the annual meeting of the nation's largest doctors group also reaffirms existing AMA policy that says it is ethical in some cases to discontinue life-sustaining treatment if it is in the patient's best interests.
(Excerpt) Read more at suntimes.com ...
Well, I guess that is only when there is a whole lot of money involved. Usually, that is taken care of with a will. Now, if I had any worries about my wishes being followed, I would put something in my will as to the effect that: If my wishes are not followed as to my life's ending, then my money will be divided equally among those members of my family who wanted to follow my wishes, and the money that would have gone to the one or ones who did not follow my wishes will go to my favorite charity in their names. ;)
Or, a whole lot of bother. Or, an elephantine ego armed with tons of money and who really couldn't care less whether she gets written out of the will.
The fact that you are proposing all these schemes to stop what would have been unthinkable a bare few decades ago, should be a huge red flag to you. Slippery slopes slide on, the drain on Medicare becomes more and more tempting to meet by encouraging people to make the earliest flimsy-excuse-for-reasonable exit they can from this mortal coil, and it is a prescription for nothing but trouble.
What has been perhaps the most destructive element in health care today is the selective panel of insurers. That means an insurance company or group of insurance companies come into an area, hire a select panel of physicians, exclude others, and then once the group is "hooked" then beging to amend "rules" as to how the doctors practice medicine. Some physicians will leave the company, some will comply. There will always be plenty who will comply. Let me give you and example. If the drug of choice for a certain affliction cost $1800.00 and the second and third drug of choice cost $180.00 and the insurance company or PPO or HMO excludes the drug of choice; from its panel, then the patient will not get the best drug, he will get the second best drug. If, for example, that is an antibiotic, and the 2nd choice is a cheaper antibiotic which does not do the job, then at deposition the physician will be forced to say he chose the 2nd best choice and the resultant complication of inadequat therapy and subsequent drainage of abcess is because of falling below the standaard of care. The HMO does not take the fall, the physician does. To make the scenario much more odious, the physician who "spends"less of the HMOs money will often be rewarded with a bonus for "rationing" care or medication. The same is true for surgery recommendation. Often surgeons will have to call a high school trained secretary in Munsing, Michigan to get "approval" to perform a proceedure. Prior approval is the insurance companies way of keeping premiums in the pipeline for a longer period of time. If I recommend a Laparoscopic Cholecystectomy in a patient who is myserable and a secretary tells me and the patient we have to wait for prior approval, it might be 12 hours or a few weeks to obtain prior approval. It creats a hardship for all of the principals.
What has become very dangerous is when a group of physicians put on the "insurance companies hat" and tries to exclude insurance money managers so the doctors "cut" will be greater. It happens all of the time. I will give you an example. A group of physicians got together and decided to form a PPO. They laid out the guidelines, requirements. I was on the board and told them it could not possibly work because of conflict of interest. Well the board started parring down certain expensive drugs, proceedures, etc. which were considered the gold standard of care. When some of us refused to comply, it became very contentious. Finally, when they were 1 million dollarsdebt due to fiscal mismanagement the organsization went bellyup.
I believe in the final analysis, and it pains me to say it, but health care delivery will come down to 2 disparate systems. The first will be a Hillary-like system...much like that of Great BRitian. It will dissappoint all of its members and all of its providers. The second system will be for the extremely wealthy who subsidize through grants and being able to pay these exorbidant costs. The days of cost-shifting are numbered. Just as we have been conditioned to expect perfection in outcome (or you sue the physician) we will be conditioned to expect less. These will be generational changes, but the changes are already being implemented. Think about it. YOur freedom to choose which physician, which facility you want is already curtailed. We have come to accept that as the norm.
Take heart in this...that most physicians are decent and want to do the right thing. But just like teachers and the NEA, the AMA has been coopted by social engineers who are governed by moral relativism and expediency, and in the final analysis, the marketplace. Lives will soon have an actual price placed on them...For example, it will be said to be "immoral" to spend tax dollars on a person with certain chronic illnesses beyond age 68. Euphemism will be used to indoctrinate people to begin to think like this. We have already seen it happen. (Right to Choose=Abortion=Killing).(The Shiavo case-The judge "did her a favor" by dehydrating her unto death") Many, even on FR, are fervent advocates of this world view.
It seem evident to me after being in medicine some 30 years, that we, as a nation, have lost our moral moorings and are adrift. The anchor,that it is wrong to kill,has been detatched from 3 generations of young people. And now, the organization used to codify these notions in the minds of patients and doctors alike, has served up a dose of the "physicians right to choose or advocate death". Don't misunderstand me, I am a big believer in Physician Directive. I and my wife have such document regarding our lives. But as a treating physician, I know I cannot devine the mind of others or what their wishes would be, and therefore must err on the side of life. I have never stopped fluids or a ventilator. I have allowed myself to participate in the care of patients whose family assigned a DNR.
These are difficult concepts to wrangle with. Every responsible adult should procure a Directive to Physician.
Finally, all of my bitching will not supercede the defined will of HCFA or insurance companies. Their claws are sunk deep into the medical profession and those medical professional have families to feed just like you. Like all men, they want to keep their jobs. These changes seem glacial at pace, but we have moved a staggering distance from the salad days of 1980. That included much pro bonum, insurance, medicare, medicade, and being paid with a half gallon of blackberries. Those days are gone, and not for the betterment of any of us.
Thank you for your post. I wish we could get many physicians on here for an anonymous discussion of the problems in our medical care.
I worked in a corporation medical dept. and remember well the warnings when the HMO's and PPO's were implemented and the TRUTH of what a "gatekeeper" does - allows some to enter for care, some turned away.
I also saw our Medical Director see an employee who had very little blood in his system due to the care from an HMO for his medical condition. Don't remember the details but this employee had been fighting with the HMO's to get his condition treated and just got weaker and weaker. This medical director got on the phone and demanded that this employee get the medical treatment that the medical director demanded. So, he saved the life of that employee.
He immediately came out and told each of us "this is exactly why you should never use an HMO". So, although the medical doctors in the corporation were totally against the HMO's in the Medical Plan, it was done anyway.
I will not use an HMO but instead use the PPO portion of our medical plan. You pay a little more but you always have the choice of either using physicians in the plan or paying a little more to go to unlisted doctors.
HMO's do not allow that option. They also draw physicians that cannot make it in private practice, that do not mind skimping on the care of patients or who just want a easier practice.
I too wonder if they sometimes tell us things to make us choose the path they wish.
Of course in your father's case, his death was oncoming due to the Altzheimer's.
When my mother went to the hospital for a possible stroke - they could not tell if she had had one. However, the doctor seeing her condition, that she was totally unable to do anything for herself and the dementia/altzheimer's was progressing told me she might need a pacemaker but due to her condition, he did not recommend putting in the pacemaker.
He told me sometimes you have to look at what you are giving them by providing the surgery. In her case, he said, a death by heartfailure would be a lot easier on her than the coming death by altzheimer's destruction on the brain. He also said if it was his mother, he would not do it.
After Terri, I looked back on this and wondered if he was one that would usher people "out the door" by his recommendations. Then I realized he was correct and that her downward progression was going to continue no matter what we did. And, would it be better for her to live to see her brain make her forget how to chew, make her body forget to breathe? Or, a more peaceful death if her heart just failed should that occur.
We all have to make decisions when the aged are leaving this life. We just have to honor them and give the very best we can for them due to love. If not love, then total respect for the one that gave us life. If other more distant relatives, we just have to be the ones making sure they are treated with respect for them and their wishes, honor and kindness as they go to meet their Maker.
But, it is a different matter when it comes to non-dying people.
We must remember "as you do unto the least of these, so you do unto Me". If you remember that, we will not have to worry about euthanasia, greed, murder.
They appear to be saying that the movement to eradicate the presumption for life was a done deal for a while now and just the tip of the iceberg.
COMMENTARY: CASE POINTS UP URGENCY OF WILL TO LIVE
By Burke J. Balch, J.D., director of NRLC Dep't of Medical Ethics
"It should come as no surprise that, with important exceptions, the prevailing view in the judiciary, as in the medical profession, is receptive to the quality of life ethic. Judges are often dismissive of our position that all human beings possess dignity and the right to live, regardless of their age or degree of disability. When the relative or other individual designated by state law to make health care decisions for an incompetent person who has left no clear advance directive chooses to cut off food and fluids, courts are rarely willing to agree with other relatives who seek to overturn that decision."
"Indeed, the current battleground is over efforts by health care personnel to cut off food, fluid and life-saving treatments from patients they think have a poor quality of life AGAINST THE WISHES of the patient and family. A large body of medical and ethical opinion holds that even when there is no doubt that a patient wants to live, or when family members are united in saying the patient should get life-saving treatment, doctors and hospitals should be able to say no.
I think they're right.
This decision by the Supreme Court was outrageous. And cities are already jumping to confiscate property.
Even abortion doctors do that. What is your point?
Thanks for the ping!
My point is that it's not a conspiracy by the AMA, it's not a conspiracy by Scientologists in Florida, it's not a conspiracy by good ol' boys in Florida, and it's not a conspiracy by _______________(fill in the blank). The AMA made a decision that as doctors they have a relative understanding of what constitutes a hopeless case and what doesn't. God can work in any situation and does but there's a point that one has the God-given sense to just let the person go. Unfortunately some don't, or won't, see that
I agree. There are no "little green men" conspiring to influence public opinion and politicians concerning health care morality in the US.
We have our own masses of well paid lobbyists with weird science agendas together with precedence setting lawyers paid by insurance companies trying to save a few billion bucks to do that.
Yes of course. They're all out to get you. Weird science agendas? Keeping a body 'alive' past the point of all hope because someone wants to make a point is a 'weird science agenda'?
That's great. God still does perform miracles. However our medical system as is will not support continued support of every situation in which there is not a living will or directions otherwise. Doctors know more than we do and we have to put some authority in their hands in situations where a living will does not exist
Exactly...and this was the main reason for the Terri Circus.
Unless you are placed in a position where the presumption of death vs the presumption of life issue smacks you right in the face ....it's just another point of discussion. For the majority the US population the later is true.
This ignorance of the reality of what is being proposed by proponents of the presumption of death is the hoped for lubricant for the inoculation of the society.
The reality is that it cost our insurance company over $200,000 to bring my spouse "back to life"
As for your "infallible" medical professionals involved in the case.... First there was the incorrect pronouncement of death, then the incorrect pronouncement of survival chance, then the incorrect prognosis for cognitive recovery, then the incorrect prognosis for physical recovery.
I know there are thousands of "miracles" walking around right now with similar stories. Why our current society would want to kill people who are put in the position that my spouse was in is not hard to figure.
+$200,0000 minus one human = +$200,0000
+$200,0000 multiplied by thousands of prevented "miracles" = one huge stinking pile of amoral dung.
Question here. Exactly how long was your spouse in this situation? 15 years with no change? At what point do you just up and let go? What you are advocating will have every bed in the hospital system taken up by those at death's door because the family members refused to let go.
I know there are thousands of "miracles" walking around right now with similar stories. Why our current society would want to kill people who are put in the position that my spouse was in is not hard to figure.
That's great. However our society does not 'want to kill people'. That's what living wills are for. If you have one, the doctor can't touch you. If not, the spouse makes the decision. You made one decision, Schiavo made the other decision. If he made the wrong decision he'll be the one paying for it. I've already told my family if I'm in the same situation give me an amount of time they deem reasonable, then shut off the machines, unhook the tubes, and turn off the lights on the way out to live the rest of their lives
+$200,0000 minus one human = +$200,0000
+$200,0000 multiplied by thousands of prevented "miracles" = one huge stinking pile of amoral dung.
Another fallacy. Who's going to pay for it? You'll bankrupt every insurance company out there eventually. Which will lead to more nationalized healthcare. Not exactly the conservative stance to advocate an expansion of government costs that would make even the current liberal administration blush
Long enough for the Physicians to declare that the "quality of life" would be permanently compromised and the "patient" should be allowed to die.
What you are advocating will have every bed in the hospital system taken up by those at death's door because the family members refused to let go.
Better get some more beds. The general public is still against presumption of death according to the AMA's own studies.
"However our society does not 'want to kill people'."
Let me correct that statement..it's not the society or the people that want Carte blanc to kill others, it's the majority of Physicians, the insurance companies and a few wackos cheering on the sidelines for full blown euthanasia.
"That's what living wills are for. If you have one, the doctor can't touch you."
Studies show that the medical profession would like that little problem called a living will to be taken care of as well.
Who's going to pay for it? You'll bankrupt every insurance company out there eventually.
Go ahead and raise my rates..they never had a problem with it before ...why now?
"Which will lead to more nationalized healthcare. Not exactly the conservative stance.."
Have you ever heard of a little proposal to let people pay into a medical saving account to supplement for premium health care if they choose it? It follows along the same line of thinking for private social security accounts.
Sounds like a conservative stance to me to let those who have worked their arses off all their lives decide if they want to pay extra themselves to live on this planet for as long as they choose, in whatever condition they choose.
Just let the doctors at the AMA get their way and try to quietly ring in the new age of euthanasia. We will see how many people disagree with their version of "conservative" then.
It seem evident to me after being in medicine some 30 years, that we, as a nation, have lost our moral moorings and are adrift. The anchor, that it is wrong to kill, has been detatched from 3 generations of young people.
Satan is always busy.
He isn't blind, he just thinks he is blind.
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