Obama discusses deathbed measures

[WriteDown]

Source: LA Times

Reporting from Washington -- President Obama suggested at a town hall event Wednesday night that one way to shave medical costs is to stop expensive and ultimately futile procedures performed on people who are about to die and don't stand to gain from the extra care.

In a nationally televised event at the White House, Obama said families need better information so they don't unthinkingly approve "additional tests or additional drugs that the evidence shows is not necessarily going to improve care."

He added: "Maybe you're better off not having the surgery, but taking the painkiller."

Obama said he has personal familiarity with such a dilemma. His grandmother, Madelyn Dunham, was diagnosed with terminal cancer and given less than nine months to live, he said.

She fell and broke her hip, "and the question was, does she get hip replacement surgery, even though she was fragile enough they were not sure how long she would last?".....

Read more: http://www.latimes.com/news/nationworld/nation/la-na-health25-2009jun25,0,1978875.story

---

I predicted this would be necessary, but I am curious who would be making these decisions.

[vadawg]

1. hopefully not the same people who work at the DMV, should be the patient though.

[newinnm]

2. Fuck that noise

If its one of my family. The only people in the right position to make that decision is my family. No god dam insurance company, hospital executive or government bureaucrat should do that.


-nnnm

[WriteDown]

4. Not sure if I'd even trust some in my family...

Haha. :)

[AngryAmish]

43. I certainly wouldn't trust those decisions in my loved ones being made by your family

[Warpy]

10. I would hope that someone would give you the facts

about chance of success for any treatment, what the recovery period would be like, the possibility of ruining an elderly person's remaining time on earth with heroics that really won't do much good, and the fact that keeping a person comfortable is not part of the package when heroics are decided upon.

Doctors are notoriously lax in this department, often with tunnel vision that states for disease process x, y is the treatment. There comes a time when enough is enough. If we're lucky, our parents are still alert enough to tell us when that is. If we're not, we have to make the decision, often when chirpy and optimistic docs are not giving us all the facts.

Obama's choice of a hip operation was a poor one, though. Broken hips are extremely painful and fixing them reduces the pain and offers even a terminally ill patient a few more days, weeks or months of mobility. Extra courses of futile chemo or drastic surgeries like coronary bypass are quite a different matter.

[newinnm]

13. You think coronary bypass is a drastic surgery?

That procedure is performed daily for hundreds of patients. These patients can be as young 20 yo.

-nnnm

[Warpy]

27. Excuse me, there's a difference between major and routine

Yes, it's become routine at large hospitals.

However, it's an extreme stress on anyone's body. It is just not going to work well in an elderly person debilitated by other severe disease processes.

In that case, it makes much more sense to try to manage them medically.

[thecrow]

19. My dad had a quadruple coronary bypass when he was 73

He had just had 2 heart attacks in one day and they gave him very slim odds of surviving the operation. He is now 88 and going strong.

[Warpy]

26. He probably had a good chance

because the odds really don't start to roll off considerably until the mid 80s, as long as there aren't other disease processes like terminal cancer.

My own dad had a carotid endarterectomy at 78 after a stroke and recovered about 95% of his function for the next 11 years.

My advice was to take into account the person's overall condition and listen to what s/he has to say. It's not a hard and fast decision that can be made without ever looking at a person. It's something the patient and/or family need to decide.

I just wish physician input were a little more realistic.

[rustydad]

55. My facts

My father had heart surgery, by pass and new valves, at 80. Then a pacemaker a year later. Then my mom died of cancer leaving him alone. He had sever arthritis and took copious amounts of tilenal. One day two years ago we found him passed out on the floor. The hospital gave him 50/50. Myself and siblings took shifts caring for him at home. Eventually he recovered and could get around with a walker. That is until a few weeks ago. His heart doctor had him on several blood pressure medications. For some reason his blood pressure dropped to 50/30 and so we are off to the hospital. They changed his medications and he went home 3 days later. The next weekend he had a coughing episode in the middle of the night and the next morning he could barely breath. Off to the hospital where they found he had pneumonia do to aspirating some fluids into the lungs. Three days later he came home and was on serious antibiotics which promptly gave him severe diarrhea which dehydrated him. A few days later he was back in the hospital because the pneumonia had gotten much worse. In the hospital they finally tested his swallowing and found that liquids were going into his lungs when swallowing. There is no effective treatment. So yesterday we decided to take him off of all medications and oxygen. He was on morphine so there seemed to be no pain. He died last night. All this cost Medicare hundreds of thousands of dollars. He got 10 years, the last few years being of very poor quality. There has to be a better way. Bob

[laylah]

61. Oh Bob!

I am so sorry for your loss and for what your dad had to go through. Condolences to you and your family :hug:

[DemBones DemBones]

72. I'm very sorry for your loss.

I know about back and forth trips to the hospital with a dying family member and it's rough.

[rustydad]

82. Thanks

It is not the death that is sooooo troubling. It is the prolongation at such expense. That expense comes at a cost to our young and should be healthy folks. The live-at-any-cost is driven by our malpractice industry in the main. Doctors and hospitals do every procedure that exists to prolong life because to not do so would be to invite a lawsuit. I have no idea how we can reform this huge issue. Bob

[Hekate]

80. I'm so sorry for your loss. My mom was a similarly tough bird whose last 2 years were hell...

I will not go into the details, but yes, there has to be a better way.

Hekate

[frogcycle]

90. my story is pretty much the same

I won't recite the litany, but I counted nine ambulance rides and forget how many ER visits, ICU stays, etc in Dad's last 18 months.

He asked to be a DNR, and we made sure the hospital knew that each time he was admitted. I sat up by his bed one night in the ICU after he asked to have the C-PAP removed, with full knowledge of the probable outcome. The next morning he woke up and said "Am I still here?"

He beat me three games out of three at checkers the day he finally died.

Each decision to proceed with a treatment was tough. Medicare spent a bundle. If he had died from the fall that started this downward spiral, I would not have the few good memories from those 18 months, and would also not have all the tough ones. His "quality of life" was lousy. He was ready to go (hence the DNR), but his body kept responding to generally non-draconian but expensive treatment.

In at least one case when he was in the hospital for an infection and I complained about a lack of basic care, the duty nurse said "well, he's a DNR." I responded "that means "do not resuscitate," not "do not clean!" He'd probably have been better off in a hospice*.

This is a tough, tough subject for all of us. All we can do is try to do what feels right. Looking back I can't pick an event where I say "you should have let go" but the fact is the 18 months weren't much good to him.

You have my sympathy/empathy. Work to remember the good times.

*An afterthought on re-reading this before posting: perhaps a significant effort to expand/improve hospice care nationwide would be a good thing. Much of what passes as "rehab" funded by medicare in nursing homes is really just warehousing pending death. Care is neglected in favor of the healthier, just as with dad in the hospital. A facility where people KNOW why they are there, accept it, and everyone involved is committed to making the best of it might be far preferable.

[Happy Vic]

45. "Let Grandma Die for the greater good of.... AFLAC?"

They are suckering him in.. Get the Insurance companies out of the equation..

Establish a national medical saving account where people and businesses put in less than they pay for Insurance coverage now. Hold the money directly in the treasury for that sole purpose. (no Stock market investment crap)

Set up a Board consisting of equal numbers of Medical personnel and citizens. Let them with Congressional Oversight set the rates of compensation for services and be generous.. force concessions from the Pharmacies in return for protections from non-negligent suit. (unintended consequences related to medications)

Half of all the money we spend today is on Lawyers, Insurance Companies and Administrative Costs.. Get that stuff (except for minor admin costs) out of the equation and there will be plenty of money for medical care for everyone. Even money to care for those Without Papers and those who suffer medical malpractice.


Get Good care.. not where we Let Grandma Die for the greater good of AFLAC?

[Abq_Sarah]

56. AFLAC

Doesn't pay for grannie. The taxpayers do so what this is really about is should we spend money to extend Grandma's life by months or a couple of years or should we drug her and warehouse her until she kicks off.

[Happy Vic]

58. Throw Grandma under the Bus...

Actually, it is all about AFLAC and other so called insurance providers..

Lawyers and Insurance companies.. are sucking the arterial blood from the medical system.. They engage in all manner of mechanisim to increase profits, avoid and reduce costs (their costs).

Slow pay, limited pay schemes (where they tell the physician what they will pay for a particular treatment....no pay.

For example if a Doctor sees you on Monday and says come back to the office Thurs with that fasting urine sample. While your here lets do another resting ekg..

In many cases he only gets paid for the first visit that week. The second one he does "Gratis" because the insurance company says "we only pay for one visit a week regardless of what is medically indicated..

(By streaching out our diagnosis and treatment they might be killing us but they slow the costs they must pay while continuing to recieve monthly premiums from you and perhaps your employer. Slick, No?

What they are about is keeping those premiums coming in and keeping their revenue up.

What they are not about is caregiving, in no way are they people who dedicate their carrers to improving the health and care of others.

Those Insurance companies their suits and lawyers are leeches who ride on the backs of your physician,your nurse, your hospital staff, you, your spouse, your kids ...
and Grandma..

Stop and think about it.

What do they contribute materially to your medical care?

Absolutely nothing.

Could it be that a bunch of suits sit down with their lawyers and say to each other "The people we are working for (ourselves and our shareholders) are really being put out by all these icky sick people.

You know... their sick anyway so if we set up some protocols which initially deny a percentage of the people their medication in various categories or deny them treatment. First off we get to delay payment (more monthly ongoing revenues there) We also know with certainty some will be too sick, frustrated or discouraged to fight for their medications or care. (More money for our Hookers and Cocane)

Let's add a component that requires them to coordinate their "appeal process" through their physician taking up time and energy from the physician and his or her staff as well... That's "reasonable" (wink smirk)

Of course the real message we're sending to the Dr. is.

"We would never interefere with your prescribed treatments or medications .. but gee going down this road is a hassle isn't it?.. a real uncompensated time burner (smirk)
why don't you try this cheaper medication or treatment..

They can't do that!!!

That would be a conspiracy possibly a RICO violation if the public were ever to find out....

Silly citizen....

You see the reason for having lawyer weasals present in the discussions in the 1st place is so they can write up a little synopsis of the meeting where this takes place and then it all becomes better... now it is privileged communication, lawyers "work product". As such protected from disclosure. Supoena? Deposition? Hey were scum of the earth lawyers we eat supoenas and depositions all day.. It may be crap to you but it's money to us...(Smirk).

Now let's have a show of hands// how many here think neither the weasel lawyers nor the thugs in Suits are above such conduct..?

Is that a hand in the back?.. no? Oh your just scratching..

Just like what I described only scratches the surface of the Corporate take over and debasement of our medical system..

Capitalism, the ability to work hard and make a good living have nothing to do with this Kleptocracy and Corpocratic Coup America and Americans are being subjected to..

Grandma an Ill Child a Disabled Soldier just your ordinary Soccer Mom. They are the reason for quality medicine.. Not the enemy.

We do not have to let them die to afford the costs of medical care for all. They are not the problem.

You have to decide for yourself who you really think is distroying American Medicine arguably the most technically capable in the world. Where are the billions of dollars really going that we as a people spend on medicine?

The Cardiac Surgeon's Escalade? The Head of Nursing's Volvo?.. The $250,000 MRI Machine?

Maybe.... then again maybe not.

[Abq_Sarah]

59. Grannie

Is on Medicare.

[Lagomorph]

70. My father left instructions that he....

...didn't want to continue living on artificial support.

Last Monday, a day before his 85th birthday, he had a car accident that left him with broken ribs, a broken sternum, ruptured lungs and a damaged heart. He was breathing on a ventilator. When he finally woke up in the ICU on Wednesday, we explained to him that he had heart and lung damage and would have to remain on the ventilator for months or years. He was lucid enough to nod his head when we asked him if he wanted it removed. He nodded his head "yes" and we let the hospital staff remove it. They pulled the tube out and he asked how Mom was. We told him she was OK and we would take care of her. He was given a mild sedative for pain, but without the ventilator, he quickly lapsed into unconsciousness and passed away in 20 minutes.

[DemBones DemBones]

73. I think your dad made the right choice

for his situation, it's the one I'd make, but I'm sorry for your loss. :hug:

[Happy Vic]

78. He made the call

Sympathy for the loss of your Father first.

That he made the call is most important.

Let's just keep it that way for all the other folks that come down the line.

[Hekate]

81. I'm sorry for your loss. My folks also died as they wished to: without prolonging the final episode

Back when my mother's dad was dying of cancer (1950's) my mom made up her own mind about not prolonging the inevitable. The thing she feared more than death, more than even intractable pain, was helplessness and the inability to make her own decisions.

I have to say their attitudes have influenced me a great deal.

Again, I'm sorry for your loss.

Hekate

[Hekate]

79. Would you or your family accept compassionate counseling from medical/psych professionals?

If what you heard Barack Obama say is that "insurance companies" should have any part of such a decision, then I think you heard wrong.

What he is referring to is a very well-known phenomenon whereby families' finances are absolutely drained in the last few weeks of hospitalization for a dying person. Dying -- you know, with no hope of recovery, but let's try this thing and that thing and hook 'em up to a raft of machinery and by the way yes it hurts but we wouldn't want a dying person to become addicted to anything.

Personally I would like to be able to talk to grief counsellors and hospice workers and other compassionate professionals with experience in helping families and their loved ones make this difficult transition.

Hekate

[Mari333]

3. fine. suggest it obama. now, I suggest

you end the conflicts in irag and afghanistan and cut the defense dept budget by 2/3..that would pay for everyone's medical care in the whole nation .

[Democracyinkind]

7. I always feel like reserving a room for you somewhere here for when the ship is going to sink.

You make way more sense than America can take. I always wonder how someone whose opinions I usually like so much gets along over there.


Peace dividend, anyone? Gotta love empire.

[Mari333]

21. ..

:hug:
I have a feeling a lot of people feel as I do, or maybe I am in denial.
I have a garden, it keeps me sane.

[SammyWinstonJack]

28. +1

:applause:

[Zhade]

49. INDEED.

NT!

[DemBones DemBones]

74. Hear, hear!

:thumbsup:

[bluestateguy]

5. What a poorly written article

I watched that whole show, and the headline and the lede are totally off-base.

[Joanne98]

6. I agree because people are getting tortured before they die.

Just to make a last buck off them. It's cruel and inhuman and it should stop.

[WriteDown]

8. Depends on what you want....

Some, maybe most, want their lives extended as long as possible.

[mopinko]

23. i think you are wrong about that.

it is my recollection that there were some polls done around the oregon death with dignity law, and the majority did not want heroic, useless procedures. i know i sure the hell don't. every member of my family knows that i sure the hell don't. that goes double for languishing in a nursing home.
no, no link. just my recollections and opinions.

[WriteDown]

24. Most people's survival instinct is pretty high...

Also, what is old? 70, 80, 90?

[mopinko]

32. old is when your quality of life already sucks.

simple as that, i think.

[TimesSquareCowboy]

20. My sister is an MSW for a hospice.

Some of the patients who come to her say, I realized I'm just being used as a cash register for the health care community. The patients wise up and decide they'd rather go without the treatment and have quality of life for their last months.

[high density]

9. I watched the discussion and got a totally different feel from it

There was a clip set up of a Mayo Clinic doctor saying that lots of money was being wasted on futile, death bed procedures and months of intensive care. It was followed by two people offering sob stories, one of them about a 99 year old woman who survived a surgery and is now 105 and another case that seemed almost like a flashback to Terri Schaivo. (I.e. keep the woman alive because we the family demand a body to visit in the hospital.)

I don't remember his exact wording, but Obama's overall response was (obviously) much more thoughtful than the way the LA Times is reporting it here.

[newinnm]

33. Sob Stories?

These were real people with real issues. Maybe they dont matter to you but they do matter.


-nnnm

[Baclava]

11. There is no sanctuary

Last day... Capricorn 15's... Year of the city... 2274... Carousel begins

[WriteDown]

15. Haha....

that brings back memories.

[Baclava]

66. The book had them expire at 21 instead of 30 in the movie.

Let's make a compromise and kill anyone over 60.

Lives are pretty much over by then anyway, right?

[DemBones DemBones]

75. I've got friends living active lives in their 80s and 90s.

Not to mention those in their 60s and 70s. People vary.

[get the red out]

12. It was also stated

by the President that sometimes having the procedure would actually save money in hospital stays and such.

I agree that a lot of outrageous procedures are done for no purpose on people. I think the medical profession needs to be forced to take a look at that. What works and what doesn't, that's the bottom line on what medical advice to give. And what does the family want for the dying person, and yes, we all die.

My Mother had the experience of a nursing home violating the express wishes of our family by giving my dying grandmother a feeding tube. My Mother, an only child, had told the nursing home in no uncertain terms that there would be no feeding tube. My grandmother was in a vegetative state from having Alzheimer's for years. The nursing home inserted the tube when my Mother wasn't around and told her that once it had been placed, it could not be removed. So tax payers, through Medicare, paid to make sure my grandmother lingered needlessly against the wishes of her only child, causing terrible pain and betrayal to my Mother and our whole family. Maybe these are the kinds of things the President is talking about.

[Bluenorthwest]

14. He should just say what the truth is

He's rich and he'll do anything he wants. But the rest of us need to die fast so they can buy more war!

[SammyWinstonJack]

30. +1

:thumbsup:

[newinnm]

34. Thank you

The reality is that there will always be two health care systems. Thos who have money will always be able to afford the care they want and those who dont have money will always have to get the care that whatever system they are in (public or private) will afford for them. One cased in point.. I had a former manager that wanted an elective surgery that the medical ins wouldnt pay for so he just took a "medical vacation" and had it done in India.


-nnnm

[JonQ]

16. I am in favor of voluntary euthanasia

namely people of sound mind choosing to forgo treatment any longer because they'd rather die than suffer painful, humiliating, and/or ultimately futile treatments. But I'm weary of having it foisted on individuals by the government, hospital administrators, etc to tidy up this months budget report.

[stray cat]

17. Of course we can't treat people exhaustively when treatment does no good

right now the doctors have incentive to treat regardless because they get paid for each procedure whether a good idea or not or risk getting sued if they don't continuously treat.

[SemiCharmedQuark]

52. It's a harsh truth, but it;s a truth. Other countries deal with this. Why can't we?

And the reality is, without insurance, you aren't going to treat forever anyway because you won't be able to afford it.

[cornermouse]

18. 9 months would be a long time to lay in a bed with a broken hip.

In fact, 2 months would be a long time to lay in a bed with an untreated broken hip. Throw in possible skin ulcers to add to the pain and it makes a rather ugly picture.

[sisters6]

42. We fix broken bones--. I think he comes across crass on

this issue.

[SemiCharmedQuark]

51. Did you even watch it? Or are you just going by this story?

[madokie]

22. My wifes grandmother

passed away a few years back at the age of 102. The last two weeks of her life was a living hell. The doctors were doing exploratory surgery on this woman and all she wanted to do was to die, go on to what she felt was her reward for living a good long life. Finally after days of this I spoke up and asked the doctors what the hell they were trying to prove, putting this 102 year old person through all this hell when it was obvious that she was dying. I'm still mad about it all these years later. The doc's looked like I had shot them when I asked them what the fuck are you guys thinking. We all knew what they were thinking and they knew that I knew what they were doing. The exploratory surgeries stopped and a few days later she passed on. To this day I feel guilt for not having spoke up earlier to save her the agony of being autopsied while still alive. My regret is that I didn't talk to an attorney about this, not to sue for money but to get it out in the open as to what they were doing and are more than likely still doing.

[Zhade]

50. I'm sorry for your experience. That's awful.

: (

[Ron Green]

25. I believe this is the crucial "third part" of the health care reform question:

The other two being single-payer coverage and universal education toward good "lifestyle" choices. Realistic expectations about end-of-life issues ought to become as much a part of our cultural awareness as have racial, sexual orientation and disability issues over the past 50 years.

[These Eyes]

29. I believe that's why it's so important to have it in writing…

how far you want to go with medical procedures. We as a society have such a fear of death. No one is gong to get out of this life alive. Don't get me wrong -- I would love to live to a ripe old age. However, if I had a terminal illness, I would rather die well than to prolong the pain. Some measures that are taken to prolong a dying person's life only add to the suffering when they are going to die anyway. I think this really has to be a personal choice which is why it's important to put your wishes in writing. It takes the stress and possible guilt off of your loved ones and would eliminate interference from outside of the family.

[Dappleganger]

31. Definitely have a Living Will

as well as TALK about it with your family and those closest to you so that there aren't any surprises when that time comes. When my mother had her last stroke, we all KNEW what she wanted because she talked about it with each of us so there was no questions about whether or not to remove her from life support (which she was put on to allow me time to get there). We had it removed and stayed with her for the eight hours or so it took for her to pass, and while it was the hardest thing I've ever been through it was done with dignity and respect for her wishes. No more pain, no more restrictions, no more wheelchair, no more being stuck inside a body which had become a prison to her.

[ohheckyeah]

35. Oh gheesh.

I wish he hadn't said that. It's already been commented on at my blog as the very reason people don't want a public option.

[Karenina]

36. The medical industry book$ $ERIOU$ g'een$

Denying us death with dignity in any way they can.

[JonQ]

37. I don't think most people are forced to get treatments they don't want

[Odin2005]

38. This concerns me.

I can see this attitude spread to the severely disabled, being denied treatment because they are a seen as money pits that would be better off dead.

[newinnm]

39. Ever heard of eugenics?

[Odin2005]

40. Of course I do, that's exactly why I'm, concerned.

[sisters6]

44. Obama was out of line--very much so-speaking the way he did. It

is medically and morally wrong NOT to fix a broken hip. Will he let her lie in bed not able to get up and go to the bathroom? That is NOT dying with dignity. Even palliative care takes care of issues to decrease pain. She would lie in bed and not move because of the pain. The hip needed fixing. I care for the elderly and know what I am talking about.

[newinnm]

47. No he wasnt.

He was just playing that 5 dimensional 423 piece chess game that he is 4302 moves ahead on.




-nnnm

[sisters6]

54. ............

AARP should be all over him for this.
What does he think?==we should let a person with a broken hip lie in bed and suffer (of course pump him up with morphine).

Obama has on several occasions spoke of "Best Practices". He knows nothing of them as the best practice for broken hips to immediately take them to surgery for repair and then once back in the room get them up walking. Physical therapy usually assists with this for the first few times. To leave a person with a broken hip is a death wish as if bedridden, they will develop ulcers, pneumonia, blood clots, and god knows what else.

[NYC Liberal]

64. Umm, that's why he said he wants people to have good INFORMATION from doctors

so they can make an informed decision. He never said *anything* about what he thought should happen in every given situation.

[SemiCharmedQuark]

48. He didn't say ANYTHING like what you are suggesting.

He was not saying that she shouldn't have the surgery or that the surgery shouldn't be offered to her, he was saying that the question is difficult. You don't know her situation so who are you to judge?

[Blandocyte]

41. 2-B-R-0-2-B

Vonnegut: free ebook

[Zhade]

46. It's a good point he makes. Remember the idiots who thought Terri Shiavo could "wake up"...

...despite the fact that her cerebral cortex (and thus, personality and all she was) had disintegrated?

I don't envy the decision. But I do think people should accept when nothing will change. Prayer has been proven to do nothing for patients, and sometimes all you can do is turn off the machines and remember the beloved.

[Frank Cannon]

77. That was my first thought. I could not believe the stupidity on this very forum...

from people who obviously didn't have the first fucking clue what a brain is or how it works.

I believe that some sort of basic Anatomy & Physiology class should be mandatory for high school graduation in this country. I think we would see less teen pregnancy, less drug and alcohol abuse, less smoking, better medical decisions, and less idiocy of the type displayed in the Terri Schiavo matter.

[excess_3]

53. the Office of Medical Rationing will know when to pull your plug .nt

[hedgehog]

57. the first thing we need is a massive across the board study

of patient condition, procedures and outcome. I doubt even doctors can judge who is going to go through 2 weeks of ICU and come out with another 20 years of good life and who is going to end up dead. Until we all have some good data to work with, we're all working in the dark. All to often, decisions are made out of guilt more than anything else.

My dad had a massive hemorrhagic stroke 22 years ago. He was in and out of the ICU for three months. He's 80 years old now, and still working part time. In his case, all the investment paid off in a good life. My grandmother was dying of Alzheimer's and stopped eating. There was an option to surgically implant a feeding tube. Instead, my aunt cared for her at home, keeping her clean and warm and letting her slip away in peace.

Ultimately, the patient and those who love the patient must have all the information and make the decision. We treasure life, but we also need to understand that everyone dies.

[Zynx]

60. It's very touching that everyone brings up the exceptions here, but the fact

is that Obama is entirely correct in principle here. We waste hundreds of billions on treatments that maybe extend life an extra couple months. A great many do nothing.

[Arugula Latte]

63. I agree.

The life is extended a couple days, weeks, months -- for what? The person gets to lie in a hospital bed with massive brain damage.

My own advanced directive says "Pull the plus and donate the organs" in so many words.

[Taverner]

62. Oh shit, he just stepped in a pile of potential dogshit

Not that I don't agree - I do, I do

But - this is the kind of stuff the Wingnuts will take apart, take out of context, misquote, and raise the phony fear alarms that "THE GOVERNMENT WILL HAVE THE ABILITY TO DICTATE LIFE OR DEATH" (of course, isn't the Death Penalty the ultimate expression of this?)

[Xenotime]

65. This is just common sense advice. There should be a mortality age for each person.

There probably should be rules on how late in life you can have children too. Too many people have children late in life then die leaving the burden on those left behind. It's just not fair.

[DatManFromNawlins]

68. While you're at it, there should be rules on who you can marry

And what car you can drive.

And where you can live.

And what water fountain you can drink from.

And which restrooms you can use.

And what businesses you can frequent.

I mean, we wouldn't want this wacky thing called freedom to get in the way of all your rules, would we?

[Xenotime]

69. Now you are just being ridiculous.

[DemBones DemBones]

76. And what would happen when a person

reached their mortality age? Euthanasia?

[IndianaGreen]

87. A Brave New World, isn't it Xenotime?

There are troubling aspects to what Obama said.

[The Straight Story]

92. How about a time machine to the late 1930's and a plane ticket home for you

:)

[JeanGrey]

67. Oh god here we go.....................

[Karmadillo]

71. Soylent Green you can believe in!

nt

[boppers]

83. It says right in the quote:

"Families need better information"...

Why are you "curious who would be making these decisions"?

For that matter, why are people screaming about doctors making these decisions, or insurance companies, when the whole freaking point is FAMILIES making the decisions?

[IndianaGreen]

84. Family should make those decisions, not the State

State should not keep someone alive, as in Shiavo case, or euthanize them (which disturbingly sounds what Obama is saying).

[dflprincess]

86. I don't think Obama was even close to talking about euthanasia

he may have been treading the line of letting nature take its course - but that is often the decision families have to make. There does come a point when only comfort care makes sense.

[harry_pothead]

85. When I reach 94 years old or whatever

and I know that that's it for an active and good quality life, I'm taking my chips and checking out. I see no reason to put myself and my family through hell by dragging out my death over a year or two, especially if I've lived 7, 8, or 9 decades healthy and happy. I'm going to arrange a family get together where I'll say my goodbyes, and then do some kind of quick life-ending procedure.

[No Elephants]

88. Doctors were not honest enough with my husband when his father had cancer. They "sell" the

surgeries. We assumed that the surgeries were prolonging his life. Maybe they shortened it, or just made his last months more miserable than they would have been without the surgeries. We'll never know.

The doctors should have told us very honestly what would happen if he had the surgery versus what would happen with it, within the scope of the entire oourse of the illness. Instead, they told us only why they were recommending surgery. I am not even sure the slanting was conscious on their part.

I think their impetus is to do whatever they can while they can, even if it results only in one extra day of life, and a fairly miserable day at that. That's not always what the patient might choose though, if they really knew all the pros and cons. True informed consent is what's necessary, not those "you may die during surgery, get a rash, have a hiccup" etc. forms.

[mbperrin]

89. This country is in love with credentialism. As if doctors know all outcomes.

In 1988, my dad received three courses of chemo, and the doctor said that there was no reason to do more, that he would be dead in 90 days. But my sister had just had twin girls, and he wanted to see them get a little older, so he asked for another course, to much grumbling from the doctors, as well as his insurance company.

He just attended the girls' college graduation in May, and he volunteers Habitat for Humanity nearly full time. He's an active and contributing member of the community, as well as his family.

But if they had convinced him not to do the extra course, the doctor would have been right. He'd have been long dead.

My dad attended the doctor's funeral in 1998. Doctor died from an undiagnosed cardiac condition at age 56.

So, as with all other mortals, we must always keep an eye out for our own interests. No one is infallible, and doctoritis is not an unknown cause of death. These decisions must be made by the patient. They are the only ones who know what they're feeling, and what they wish to do.

And please everyone shut up about we can't afford all these procedures.

We can afford $12 trillion dollars in bailouts and guarantees for incompetent bankers.
We can afford trillions more to kill foreign people in their own countries for years on end for no particular reason.
We can afford billions in great health coverage for politicians.

And lots more.

So cut some of that shit out if we need more resources for healthcare, instead of just putting people down like unclaimed animals at the shelter.

[primavera]

91. Everyone should have a living will

So that they can make these decisions for themselves while they're still able, and not place the burden of such decisions upon their loved ones.

[lunatica]

93. My mother has stipulated that if she dies, they are not to try recuscitate her

When she was in the hospital and in rehab after that I was asked in both places if I wanted them to resuscitate her if her heart stopped by itself. It's standard in California I think. It's certainly a standard question in Kaiser. I have Power of Attorney and can make that decision.