The problems with our socio-economic/healthcare battle cannot be fixed until we fix the "new" medical ethics implemented by a lawsuit happy America. The fundamental nature of medical ethics should be and has been until modern times, "Can I? And if so, should I?" For example, a doctor must ask himself for the motorcycle accident victim on life support "Can I keep him alive on life support?" Often, the answer is yes, the technology to keep a brain dead or nearly brain dead victim alive has been around for quite sometime. Nextly, he must ask himself, "Should I keep him alive?" Often the answer is no, if one is in a coma with little to no chance of recovery, they and often their family would rather die than live in a personal prison. I certainly would rather die than live in my body as a jail cell. I have an Advanced Directive and DNR to cover these bases. Not all people do. Often, the second ethical question has turned into "Might I get sued if I don't do this"? This is the defensive medicine referred to in the article. Ethical decisions are no longer being based on ethics, but CYA. In fact, in the earliest days of my first medical training, we learned that one of the centerpieces of the medical profession is CYA. Cover Your Assets. In order to stop costly, unwanted end of life care, we must fix the "new medical ethics" and allow Hippocrates' Oath and similar doctrine to once again govern medical decisions. The only answer to our current crisis is Tort reform. We must protect medical professionals against being forced into useless Defensive medicine.
- MIke S, NM-EMT-B
‘The Case For Killing Granny’
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There's no point in going bankrupt to save unsavable lives. But that's a lot different from "killing grandma."
C. Wight Reade,M.D., Seattle, Wash.
As a cardiology nurse of 15 years, this esoteric debate is a daily reality. Patients are often ready to have honest discussions with their health-care providers, but I've found that family members (who are the ones who sue doctors and institutions) are terrified to have conversations about death and dying. If nothing else happens in health-care reform except discussions about realistic expectations of survival, recovery, and quality of life for the elderly, I will count it a success.
Amy Knight, R.Nn.,Grayson, Ga.
Your story was informative and needed. However, the headline was outrageous, misleading, and inflammatory.
Carleton Mckita, Chaplain,Hospice of Nash General Hospital, Rocky Mount, N.C.
For too many seniors, the mere sight of your cover may be enough to convince them that what they've read and seen from a few vocal, right-wing extremists about what health-care reform will do is true. I'm afraid most will fail to get another perspective from the article inside.
John Cosgrove,Keyport, N.J.
As a long-time hospital social worker, I can attest to the importance of older patients discussing their health-care wishes. However, often the most heartrending situations involve non-elderly adults who are terminally ill or suffered a sudden trauma and cannot speak for themselves. Perhaps if the discussion of advanced directives and end-of-life care were multigenerational, "granny" would find it easier to express her wishes since close kin were also expressing theirs. Too often discussions happen in the hospital under stressful, hurried conditions. Better to plan ahead than wait for crisis.
Mary Yank,Franklin, Wis.
Quality of life is what it is all about. If I have a terminal illness and good quality of life, then, by all means, I want continued care. But if I am miserable, then please let me die in peace.
Elliott Brender, M.D.,Villa Park, Calif.
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