This happened in America?

[Geoff_M]

Instead of rehashing the whole Schiavo episode... again... for the ump-teenth time, I'd like to point out (as I attempted to before) that, like it or not, the type of situation described in the opening post of this thread will be part of our "system" regardless of whether or not we stick with the current "system" or opt for a "universal" health system. At some point, when cost/benefit ratios cross-over and lean too far in one direction, people will be told that treatment is no longer a option (desired or not) and it's time to start thinking about dying. Whether the bad news comes from a hospital ethics committee, national health service guidelines, or an insurance company... the effect is the same. We can argue about the care offered and actions taken once the decision has been reached, but the need to rationalize health expenditures is not a "Texas", "Republican", or "American" thing.

 

[RitaZ.]

Surely someone from Hollywood could have stepped up to the plate and helped pay for some of it.

You know, the term Limousine Liberal comes to mind.

 

[CapeCodTenor]

You know, the term Limousine Liberal comes to mind.

 

[Charade]

Charade, this is also VERY common: 23% of DW's practice is "charity". She gets no payment for it of ANY kind. The average in her specialty is 20%. Whether somebody can pay does not affect they way they are treated and it would unethical for it to do so. MOST physicians do a great deal to "give back".

BTW, if our tax burden were only 1/3, I'd be throwing a party!

But she is doing it voluntarily and from a good heart. That's the difference.

 

[Galahad]

But she is doing it voluntarily and from a good heart. That's the difference.

Granted, but my point (which as usual was probably superfluous) is that MOST physicians do the very same thing from a good heart. I can understand being dubious of that. Being an OB's husband, I probably have a bit of an anti-attorney bias that is more than is warranted, for example. But most people that make a lot of money like doctors, in my experience, are not really greedy at all.

 

[Charade]

Instead of rehashing the whole Schiavo episode... again... for the ump-teenth time, I'd like to point out (as I attempted to before) that, like it or not, the type of situation described in the opening post of this thread will be part of our "system" regardless of whether or not we stick with the current "system" or opt for a "universal" health system. At some point, when cost/benefit ratios cross-over and lean too far in one direction, people will be told that treatment is no longer a option (desired or not) and it's time to start thinking about dying. Whether the bad news comes from a hospital ethics committee, national health service guidelines, or an insurance company... the effect is the same. We can argue about the care offered and actions taken once the decision has been reached, but the need to relationalize health expenditures is not a "Texas", "Republican", or "American" thing.

I agree.

But the final decision should to die should be up to the individual (or their family/guardian) regardless of cost/suffering and the "system" should just absorb it. That's my read from some of the people here who disagree with the Texas law allowing (not requiring) hospitals to end life support for terminally ill patients.

 

[Galahad]

At some point, when cost/benefit ratios cross-over and lean too far in one direction, people will be told that treatment is no longer a option (desired or not) and it's time to start thinking about dying.

I don't believe we are even close to making that cultural leap in the way we view healthcare. One thing that makes U.S. healthcare so expensive as well as cutting edge is our cultural attitude towards is not so sterile and clinical as to simply look at the dollars and cents. IMO, we will have to come to that societally in a way that will still take some time.

 

[dennis99ss]

The problem is that the law allows a difference of action dependiong on subjective factors, such as insurance. It is up to the hospital to decide. If there is insurance, the hospital can keep her alive. If there is not, they can pull the plug. It is subjective, and therefore open to corruption.

 

[mickeyfan2]

It is subjective, and therefore open to corruption.

Explain. How was the hospital corrupt in this decision?

 

[Planogirl]

I keep thinking of mercy killing and assisted suicide here. Isn't removing patients from ventilation for their own good and to avoid prolonging their suffering, almost a form of assisted suicide? Funny but there's a controversial doctor in prison now for doing almost the exact same thing as this hospital.

 

[Galahad]

I keep thinking of mercy killing and assisted suicide here. Isn't removing patients from ventilation for their own good and to avoid prolonging their suffering, almost a form of assisted suicide? Funny but there's a controversial doctor in prison now for doing almost the exact same thing as this hospital.

Not to mention "Logan's Run" (great jumpsuits though).

 

[Geoff_M]

I don't believe we are even close to making that cultural leap in the way we view healthcare.

Perhaps I was a bit terse in the way I phrased that. I agree that this is the general attitude now, but I think a move in that direction is inevitable. As the pressure to hold down health care expenditures will only continue to grow with time, expenditure rationalization will only continue to play a larger point in the healthcare picture as we go on. It's not going to matter whether it's the current system or a "single payer" system.

 

[sodaseller]

Instead of rehashing the whole Schiavo episode... again... for the ump-teenth time, I'd like to point out (as I attempted to before) that, like it or not, the type of situation described in the opening post of this thread will be part of our "system" regardless of whether or not we stick with the current "system" or opt for a "universal" health system. At some point, when cost/benefit ratios cross-over and lean too far in one direction, people will be told that treatment is no longer a option (desired or not) and it's time to start thinking about dying. Whether the bad news comes from a hospital ethics committee, national health service guidelines, or an insurance company... the effect is the same. We can argue about the care offered and actions taken once the decision has been reached, but the need to rationalize health expenditures is not a "Texas", "Republican", or "American" thing.

What you speak is true. But to suggest that any meaningful end of life issue debate can occur without the shadow of Schiavo looming thereover is akin to the proverbial "Other than that, how was the theatre, Mrs. Lincoln". That sordid episode will not be soon forgotten by it's victims, the largest of which was Truth itself.

You raise many of the complex issues that will have to be wrestled with in reaching the humanest policy available. All should understand in advance that it will be impossible to deliver the maximum available health care to all, and that there is no perfect justice. All good, valid points. And all of those "extenuating circumstances" may be present here - it may well be possible that the actual facts do not lend themselves to easy Manicheean dualism.

But the Schiavo episode saw one party's leaders uniformly appropriate the mantle of "life" and label their opponents as the party of "death" with the largest possible pulpit, so it should come as no surprise that those so labeled will take every opportunity to point out how demagogic and counterproductive that was.

And while I do not dispute the Schiavo family's professed beliefs regarding their daughter's condition and their son-in-law's perfidy, I do dispute that any of those beliefs were reasonable, even with what was known before the autopsy.

 

[cardaway]

While the whole issue was political before, it's certainly more so after Schiavo, and only one party is responsible for that mess.

 

[DawnCt1]

Average income for a medical doctor in Canada is $140,000. Certainly a living wage.

But it doesn't mean that they don't wish to avail themselves of an opportunity to make more. There is nothing wrong with that. When the province runs out of money at the end of the fiscal year, they find it more socially acceptable to "not be home" than to refuse to see patients for free.

 

[Geoff_M]

But the Schiavo episode saw one party's leaders uniformly appropriate the mantle of "life" and label their opponents as the party of "death" with the largest possible pulpit, so it chould come as no surprise that those so labeled will take every opportunity to point out how demagogic and counterproductive that was.

And overuse the analogy and it starts to ring as hollow as claiming every looming military conflict will be "another Vietnam".

 

[DawnCt1]

What color is the sky in your world?

American physicans generally travel extensively - yes, on cruises too. Being a nurse and having worked with many, many physicians I know this to be a fact. They have wonderful vacactions - foreign, exotic, leisurely. Who treats their patients? The other docs in the practice, docs who trade call with other practices, and in one case NO ONE AT ALL (his patients were told to go to the ER if they had a problem).

I am NOT talking about vacationing on a cruise ship, I am talking about taking a moonlighting job to work on a cruise ship as the ship's doctor. Those contracts are a minimum of 30 to 60 days. DH gets 4 weeks vacation per year, we usually only take a week at a time and not the entire four weeks. Every other year we go to Hawaii for 18 days. When he leaves for extended periods of time, the hospital has to hire a locum tenens (sp) physician to replace him.

 

[sha_lyn]

A decision that they could not have made without using the state law that permitted it, signed by Gov. Bush.

It wouldn't have made it to his desk if the state house had not passed it. I absolutely hate the left wing tactic of trying to ignore that bills must be voted on before a govenor or president signs them.

 

[Chuck S]

Ummm...that is why the governors and presidents have the "Golden Power of Veto".

 

[sha_lyn]

you do realize that a veto can be overturned by the US congress or a state house. A president or governors power is kept in check.