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Medical professionals and DNR - Input Junkie
December 9th, 2011
08:58 pm

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Medical professionals and DNR
Here's an article which makes strong claims that end of life care is so painful and ineffective that the vast majority of medical professionals refuse it in favor of dying quietly at home or at a hospice.

I've seen the article cited in a couple of places and seen questions about whether the claim is true-- there's just anecdotes in the article.

So, any medical professionals care to say what your decisions are on the subject? What do you know about other medical professionals and their choices? What country are you living in?

I'm interested in comments from people who aren't medical professionals, too, just let me know whether you are or not.

I think I only have a modest number of medical professionals who are likely to comment, so if you pick up this question on your blog, please let me know.

This entry was posted at http://nancylebov.dreamwidth.org/517912.html. Comments are welcome here or there. comment count unavailable comments so far on that entry.

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From:malkingrey
Date:December 10th, 2011 02:33 am (UTC)
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I'm not a medical professional, but Himself is an EMT and knows a lot of them, and most of them are strongly against heroic measures when it comes to end-of-life care. (As one of them said, "I'm thinking of having DNR tattooed on my chest.")
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From:lysystratae
Date:December 10th, 2011 03:41 am (UTC)
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I've threatened to get that same tattoo
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From:agrumer
Date:December 10th, 2011 07:58 pm (UTC)
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Now I'm thinking about a popular music band called DNR, inspiring its fans to tattoo its logo on their chests.
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From:inquisitiveravn
Date:December 10th, 2011 08:56 am (UTC)
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My mom, who is an MD, has talked about getting "No Code" tattooed on her chest.
(Deleted comment)
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From:ritaxis
Date:December 10th, 2011 03:38 am (UTC)
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I am not a medical professional: however I've been pretty closely involved with these decisions a couple of times (and, of course I do not hesitate to remind the world that my kid worked as an EMT and is a year and a half away from being Doktor!).

My feeling is that it is not as simple as "DNR" or not.

My mother always wanted me to promise I would never allow any resuscitation efforts for her. Then when she was actually dying she made it clear she wasn't sure any more: I think that was because there was a small chance that she could have a reasonable remission and get to finish reconciling with my brother. When it became clear that she wasn't going to get that we "weaned" her from the ventilator, and she died in front of me. They did resuscitate her once during that week of uncertainty.

My father was basically dead, but my stepmother kept him on life support for three days so that his close friends from around the world could get there to say goodbye to him. My part of the family didn't object because it was pretty clear that my father wasn't actually experiencing anything by that point, and my stepmother was going through a lot of heavy, heavy things at the time, including her own near-fatal stroke and the recent death of almost all her female relatives from breast cancer.

My husband died too fast to even think about it.

I've talked to my kids and I trust them to do the best thing they can think of doing at the time, which is all that you can ask.
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From:sodyera
Date:December 10th, 2011 04:52 pm (UTC)
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Why does Amerika want you to die for their country, but not for your own reasons? Maybe it's becuase the medical lobby isn't through picking you to actual death with added medical fees. Just another test, we'll need just another test...

One should be able to determine certain things in your own life: the length of your own hair, the way you want to live, the implicit right to wear your favourite colour wherever and whenever you want, and how, or maybe even when you want to die.

Christians got it into their heads somewhere that they could push everybody around, and this led to the Republican Party becoming the American Fascist Party in disguise. All a Fascist wants to do is control things from behind, like dark puppeteers and Hindmosts. The Republicans just want women to get back in their place and vacuum the house instead of trying to run the House, or the Senate. The right to die has been accepted in many civilised countries, so it's about time this country became civlised, too.
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From:nancylebov
Date:December 10th, 2011 05:20 pm (UTC)
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I don't think this is just about Christians, though it's possible that the fear of hell gets transferred into the fear of making mistakes.

I think part of the problem is an American trait, not related to religion or political orientation. It's the desire to do something heroic and get a low-probability victory.

This isn't entirely a bad thing-- sometimes an extraordinary effort does work-- but it can lead to ignoring sensible maintenance and kindness.

And, as you say, in this case, it leads to wanting to be in charge, not to mention that there's more money in taking drastic measures whether or not they make sense.
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From:sodyera
Date:December 10th, 2011 05:41 pm (UTC)
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This is why I referred to the Republicans and the Christians. With them It's always money over people. People ought to have rights, esp. over their own bodies and choices.

Don't make me do Hellen Reddy.
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From:nancylebov
Date:December 10th, 2011 05:55 pm (UTC)
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I'd like to see a timeline for the problem-- I'm pretty sure it was in place long before the current Republican dominance. And note that at least some of the R's would rather not spend tax money on it, even though they'd also rather not spend money on more reasonable things, too.

The desire to take charge of people for their own "good" isn't limited to one party.
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From:sodyera
Date:December 11th, 2011 02:22 pm (UTC)
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Orwell.
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From:sashajwolf
Date:December 10th, 2011 11:20 pm (UTC)
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I am not a medical professional, but I have thought about this a lot after sitting with three relatives and one friend while they were close to dying and, more recently, visiting my father after his stroke and Parkinson's diagnosis. I have decided that death and dying are not the enemy. I would definitely prefer to die at home or in a hospice if it is practicable at the time, and I would not want to be resuscitated, fed artificially etc, if I had the degree of disability my father now has (he cannot walk, tend to his own basic needs, read anything more complex than the sports pages, or follow anything he sees on TV).
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From:olifhar
Date:December 11th, 2011 03:20 pm (UTC)
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Good question. I'll ask around with my connections and see what anecdotes turn up.
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