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blatantninja t1_j4v49uq wrote

Reply to comment by [deleted] in Family Dynamics and Doctors' Emotions Drive Useless End-of-Life Care. Surveys repeatedly indicate that nearly all people would rather die peacefully at home, yet painful, long-shot treatments remain common, and efforts to reduce usage have failed by Wagamaga

If you want to waste your own money on that stuff fine, but it shouldn't be covered by insurance.

Part of that noise though DOES come from doctors. When my mother died from endometrial cancer, she had just begun a third chemo regiment that she reacted extremely badly to. She choose to just stop all treatment and wait for the end. Her hematologist/oncologist was practically begging her to try a slightly different treatment and not give up. My father had to basically escort him from the hospital room and instruct staff that he was no longer her caregiver and he was not to order treatment.

And we need physician assisted suicide. A family member recently died from COPD. She basically slowly suffocated to death over several months. Fortunately, I wasn't there to witness it but I got a lot of details about the oxygen deprivation panics,her wasting away from not eating, etc. It's one of the worst things I've ever heard. I don't know that she would have gone out on her own terms but she should have had the option to do it in a dignified and peaceful way.

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bivymack t1_j4v9f72 wrote

Totally agreed with the 3rd paragraph. Though I think “suicide” should be taken out of the terminology. I’m a hospice RN Case Manager in the southern US and a lot of people in these parts will call it “physician assisted suicide” with quite a negative connotation because suicide is sinful/blasphemy/whatever nonsense. Physician Assisted Death, or Death with Dignity might take away some of the stigma surrounding the practice.

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Brilliant_Draft7346 t1_j4vnkgi wrote

In Canada we call it MAID- medical assistance in dying. There still is some stigma, but this phrasing has seemed to make it a bit more palatable

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Propyl_People_Ether t1_j54h1w5 wrote

According to some news reports, too palatable - there are patient accounts of being pressured to sign MAID papers due to housing troubles or inability to work, for example, which is abominably unethical.

I like the way Oregon handles things: eligible patients are screened and offered a lethal prescription which they can choose to fill and use on their own terms or not. About half die naturally without using the prescription, & they and their families often say that the knowledge of chemical assistance being available/at hand creates peace of mind.

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PracticalShoulder916 t1_j4wolf8 wrote

The UK is so behind on this, the proposal gets shot down every time it's brought up. It's appalling that terminally ill people cannot decide themselves when they want to die.

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Yerwun t1_j4ymbp5 wrote

The 'dignity' term is controversial also for a few reasons. Medically assisted dying is the most neutral term.

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szpaceSZ t1_j4zicpg wrote

But physician assisted death sounds much more horrible than physician assisted suicide: it implies that the death was brought about by the physician as the primary actor, ie. it associates it with murder.

"Death with dignity" is a good teen, but it does not refer to the assistance

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0skullkrusha0 t1_j4vep7f wrote

I see where you’re coming from bc many doctors and hospitals benefit directly from continued treatments in prolonging illness as opposed to curing it (bringing it to an end.) But as a nurse, I mainly see patients’ families being the reason people are either not passing peacefully at home or ultimately drawing treatment out to the point that they choose hospice at the very last minute. I see so many people in their 90’s being “full codes” (wanting all life-saving measures taken in the event of their heart stopping or they quit breathing.) And these patients didn’t just turn 96, having been active in their community and at home, and then overnight they became sick. You find out they’ve been on a steep decline for some time and it’s worse when you discover they live in a facility of some kind. I’m baffled at how many family members just refuse to acknowledge the elephant in the room and you have to bear witness to their sad and pitiful withering away. They don’t eat, they don’t get out of bed, sometimes there are bed sores, and the amount of medications they are on is insane. It’s not “pointless” in keeping some of these patients alive longer than necessary. But the refusal to accept the inevitable is astounding. No one wants to lose a loved one. But all it takes is some therapy and some introspection to set one’s feelings aside and focus on the quality/quantity of life left for their loved one.

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Cream-de-la-Peach t1_j4wxtv8 wrote

That is the most asinine comment I have ever read. We should let insurance companies decide when someone’s life is no longer worth saving and when they will stop covering care? They already scam most patients out of money, anyone who ends up in ICU would get screwed by insurance trying to say “we aren’t covering futile services”.

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blatantninja t1_j4xza6d wrote

We already let them decide what care they cover within certain regulations.

And if they are futile it won't matter, the hospital won't be collecting anything

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Cream-de-la-Peach t1_j4ygu76 wrote

Well that’s half the issue with healthcare is that insurance dictates what care patients get and that’s not how it should work. What really needs to change is that patient’s advance directives should be followed according to their wishes and we shouldn’t let family member’s wishes supersede those of the patient when they no longer have capacity to make decisions. A lot of families that will continue life sustaining measures when the patient clearly wrote they did not want it in their advance directive or they never had one.

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blatantninja t1_j505epb wrote

I agree on the second part but not the first. There has to be a gatekeeper if you want healthcare that's affordable. Doctors don't want to be it (understandably) and patients will abuse the hell out of it. If a patient has met their deductible/out of pocket they don't even blink an eye if a treat is $100 or $1000000. That's a big part of our cost over overruns.

In a perfect world, sure cost shouldn't determine care, but unfortunately it's something that has to be considered in the real world. If it's not the doctors and if the patients won't do it themselves, that leaves either insurance or the government.

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standupstrawberry t1_j4x449p wrote

One of my neighbours suffered like your family member but with lung cancer. He was not able to sleep a full night because of his breathing, he was refusing to eat, and the pain was terrible. He chose to take all his medicines one evening. Assisted suicide and euthanasia are illegal where we live so he made his daughter go out with her friends (she's an adult and was visiting for a week) whilst his wife was away for an evening so he could do it and they wouldn't be implicated. His wife was so sad she couldn't be with him, that he had to do it alone.

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suspendersarecool t1_j4wrefu wrote

If you don't want something covered by insurance then that just means that you want poor people to not have as many options.

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blatantninja t1_j4xzmam wrote

No, I just want reasonability in the process so I'm not paying ridiculous premiums so people can throw hundreds of thousands of dollars at a losing cause just because of some misguided belief that everyone moment of life is worth fighting for.

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2017hayden t1_j4wbrvt wrote

I’d like to take a moment to address your first sentence. Whose going to determine what treatments are worth performing and being covered by insurance and what ones aren’t? At what point should the cutoff occur? Is a 20% chance of success too low? 30% 40%? Where is the line where it’s no longer acceptable to try and prolong someone’s life? Should it be on a sliding scale based on their age? Take of 10% for every decade over 60? Whose to say those procedures won’t extend that persons life by a decent margin? They’re long shots not impossibilities, otherwise insurance wouldn’t cover them. Most insurance companies don’t cover experimental surgeries for instance because they aren’t proven to be effective yet. Do we really think it’s a good idea to start making it even harder for the average person to achieve the same level of care as wealthy individuals would?

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LGchan t1_j4ytdpz wrote

"prolonging your life shouldn't be covered by insurance but euthanasia should be because staying alive is a waste of money."

Yeah, as someone who has had family members use physician assisted suicide and fully supports it, shut up please. You've got no business making calls like that. :-/

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sarcastic_meowbs t1_j4yslbh wrote

People should get all the facts, and then THEY should make their own minds up, and insurance should have to cough up the money. Damn thieving insurance companies should be terminated and replaced with universal health care like every other developed country.

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QuantumInteger t1_j4ytwna wrote

Just call it humane euthanasia. We do it to dogs and cats at their end. Because we love them and don’t want to them to suffer. Why not also for human? Being able to choose your end is hell of a lot better than letting it come for you.

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