tag:blogger.com,1999:blog-19305198.post360376920029946146..comments2024-03-27T03:19:11.216-04:00Comments on Assistant Village Idiot: Five On Health Care: V - Hidden MessageAssistant Village Idiothttp://www.blogger.com/profile/01978011985085795099noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-19305198.post-54255320867358648902012-07-19T20:51:47.559-04:002012-07-19T20:51:47.559-04:00karrde - we're off the front page, so no one m...karrde - we're off the front page, so no one may see this. Maybe I will flag it somehow.<br /><br />Yes, you touch on the exact problem. We see a pile of money we want to save, and we think we can somehow adjudicate that wisely. But the predictions are poor, and we screw people over. The temptation may cloud our judgement.<br /><br />It's a terrible thing when that happens, and I fear government being the arbiter - even more than the other groups with similar temptations: insurance companies, school districts, inheritors.Assistant Village Idiothttps://www.blogger.com/profile/01978011985085795099noreply@blogger.comtag:blogger.com,1999:blog-19305198.post-3546183408159167272012-07-18T21:07:08.340-04:002012-07-18T21:07:08.340-04:00I've been fortunate in that I haven't had ...I've been fortunate in that I haven't had to assist in these decisions. My in-laws have not had this need. But over the years I have had to put down well loved dogs. I found that the difficult part was not that I had to do it, but the worry that I would do this for my convenience and not their welfare.<br /><br />I've found this cuts to the core of medical care at end of life. We don't know when that end will come so it is astonishingly easy to justify it as for the patient when it is really for our ease. Plus the whole idea of insurance is for such high cost events.<br /><br />In addition, through most of history medical care was largely ineffective (if not dangerous). But if no one tried, no one would have made improvements and advances. These advances are often made by solo practitioners not consensus (see childbed fever and sanitation for example). A committee that decides treatment A is heroic and not cost effective will forever preclude finding out that a small modification could be a wonderful treatment.dmoellinghttps://www.blogger.com/profile/13128088863830769762noreply@blogger.comtag:blogger.com,1999:blog-19305198.post-13582631924559534922012-07-18T13:17:17.616-04:002012-07-18T13:17:17.616-04:00We have a friend whose father explicitly rejected ...We have a friend whose father explicitly rejected cancer treatment, reasoning that it was very unlikely to do him much good, would certainly be hideous to experience, and would wipe out the savings he had hoped to pass on to his family at his death.<br /><br />He reached a decision that made sense for himself. I wouldn't have wanted to see anyone reach that decision for him.<br /><br />When I have been involved in the medical decisions of very old, ill relatives, what has most concerned me was to prevent insanely heroic, intrusive, and expensive procedures that made no sense in terms of quality of life. My late aunt's DNR made complete sense for a 96-year-old woman who had no desire at all to be dragged off to an ER to die with strangers poking and jabbing her.<br /><br />It's much more difficult, of course, to decide what to do about a young person who may well pull through. But if I had pancreatic cancer, I'd be focusing on how to make the most of the little time I had left, with a minimum of medical intervention, without leaving my husband impoverished, and without expecting total strangers to kick in to support a forlorn hope. But all of this presupposes that I will be making decisions about my own life with my own resources.Texan99https://www.blogger.com/profile/10479561573903660086noreply@blogger.comtag:blogger.com,1999:blog-19305198.post-40756244821758043872012-07-17T23:35:30.283-04:002012-07-17T23:35:30.283-04:00I had a closed-head-trauma wound in an auto accide...I had a closed-head-trauma wound in an auto accident.<br /><br />Late in my teenage years.<br /><br />The prognosis during that first week ranged from "wouldn't ever be able to take care of himself" to "will need lots of help".<br /><br />Thankfully, all those prognoses were wrong. My social skills needed re-training, as did planning and short-term memory. My scholastic skills remained very high; I graduated when I had expected to and did well in college studies.<br /><br />I agree fully on distrusting the frank discussions with clouded terms. If we are going to have frank discussions, let's say that we're spending the same amount of money to provide some 70-year-olds with another decade of life, and to keep other 70-year-olds alive for six months.<br /><br />And that telling the difference between such cases is sometimes easy, sometimes hard, and sometimes a coin-toss.karrdehttps://www.blogger.com/profile/00205160745963596856noreply@blogger.com