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It's baaaaaack!

Irrelevant to the topic.
Not at all, presuming that you would intervene if a perfectly healthy person wanted to starve to death, why does it suddenly become a viable option for people who are sick?
 
I See this whole 'end of life' issue in several different ways.

1) Planning on things for yourself is just common sense. You plan your education, your children's lives to an extent, your retirement - you should also plan the end.

2) Everyone dies, you cannot prevent this - you can just postpone this.

3) Postponing is often costly and not always beneficial.

4) Fear mongering, hate speech and emotional pleas don't change this - the entire subject is difficult enough without everyone clouding it over with political gusto.

Concerning the article - I disagree with this measure. MONEY should no longer be the focus - what SHOULD be the focus is what best for the patient, what's in their wishes or what's in the interest of the family and their views. . . NOT government or legal mandates and money
Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

But a lesson to learn is that if you DON'T make choices for yourself - then you're handing your life and private matters TO the government who will never have you in mind.

Always consider 'the end' when planning your will and everything else - I'm actually surprised to find that 'the will' considerations don't cover end-of-life planning already.
 
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What other choice would someone have?
What do you mean? I suppose they could off themselves in some more dramatic fashion but maybe it's this way that really appeals to them. Do we just sit back and watch it happen?
 
What do you mean? I suppose they could off themselves in some more dramatic fashion but maybe it's this way that really appeals to them. Do we just sit back and watch it happen?

I meant, "What other option would we have besides just letting them"?
 
Not at all, presuming that you would intervene if a perfectly healthy person wanted to starve to death, why does it suddenly become a viable option for people who are sick?

There is a large unsubtle difference between "sick" and "on life support only kept alive by machines".
 
I meant, "What other option would we have besides just letting them"?
Oh, thanks for clarifying. If it were someone I knew and they were serious about it, I would try to intervene, maybe even get them committed. In short, I would try to stop him/her from starving themselves. Many families of anorexics have to face this.
 
Oh, thanks for clarifying. If it were someone I knew and they were serious about it, I would try to intervene, maybe even get them committed. In short, I would try to stop him/her from starving themselves. Many families of anorexics have to face this.

Let's say they are absolutely committed to not eating. What then? Would you force feed them against their will?
 
There is a large unsubtle difference between "sick" and "on life support only kept alive by machines".
Ok, I don't dispute this, but machines keeping you breathing or your heart pumping are heroic measures. If someone wants to forgo these measures, I think they have the right. On the other hand, a feeding tube is different. I've actually had one after I broke my jaw and had to have surgery. It's just a tube that goes in your nose, down your throat and into the stomach. They pour the "food" into the tube to keep you fed (I for one was grateful to not have to actually taste any hospital food). It's very basic care, not a heroic measure. Do you see the distinction I'm making?
 
Is that not "heroic"?
No. If someone gives food to their baby everyday (as we hope everyone would) are they taking heroic measures to keep the baby alive?
 
What difference does it make?

In thi scase, choice is the ultimate distinction between whether or not the action is taken to save a life or simply sustain a life. It is assumed that an infant wishes to be fed, but has no way to convey that desire (actually, it will cry to get the attention it seeks). This is proven by th einfants active participation in the eating process when fed. By feeding the infant, you aren't actualy saving it from anything. You are merely executing its desires.

An adult perosn person who is willfuly refusing to eat, however, has made their decision.

By intervening against their wishes, you are actually acting to save them from themselves. Those who save others from some danger are heros, and their behaviors are heroic.

If something is heroic, it's heroic whether they want it or not.

True. Saving someone from some danger, even if that danger is themselves, is heroic.
 
After observing, up close and personal, my mother's "end-of-life" experience I have mixed thoughts on the subject. She was on her way out and they were keeping her alive all on Medicare's tab. In the last 6 weeks of her life, I bet the hospital and doctor's billed the government more than 150,000.00 on the ol' girl's demise. However, when the well started running dry, they kindly "put my mother down" much like a veterinarian might do with a terminally ill animal.

Don't get me wrong, I'm glad they could keep her around a bit longer. I know she would have appreciated it too if she had been conscience enough to realize she was still alive.

However, if it was me, I would have had them pull the plug as soon as they knew I was knocking on heaven's door, before I could no longer wipe my own ass.

Moral of the story: Make your own "end of life" decisions now when you are clear headed and logical, instead of leaving these decisions in the hands of those who just can't bring themselves to let you go. (Including doctor$ and hospital$.) Leaving the "pull the plug" decision to someone else is not fair to you or them when the grim reaper comes calling. Needlessly postponing the inevitable might be a cash cow to the medical profession but it's a drain on society. If they could have saved/extended my mom's life and given her some sort of quality of life, I would have approved of a million dollar treatment. But she was merely kept alive to drain the teat of the gov't cash cow for as long as they could suck it.

OMFG. What on earth is wrong with advising doctors to talk to their patients about end-of-life options??? And to encourage them to sign Health Care Powers of Attorney? And to execute Living Wills?

Do you not understand that medicine is as much about money as it is about any other aspect of a patient's health? It is time that we faced the fact that we are going to die!!! And time we faced that prolonging a patient's suffering in the name of some twisted sense of humanity is wrong.

At $10,000 a pop, doctors and hospitals are quite happy pumping chemotherapy into dying patients' veins until the very end. It is time we as a society grew up and faced reality. We are going to die. Terminal illnesses exist. And even if we can cure every terminal illness on the planet earth, we will simply dry up and blow away.

Death panels. Ridiculous.

The concern is that certain "end of life options" that are cheaper than treatment will be the ones promoted. I have no problem if the patient wants to give up, I just don't want them talked into it.

But that's not what's being proposed. What's being proposed is the discussion of ALL end-of-life options. I think that's appropriate. When my mom was dying, she was given the option of being put in a coma for a week... and then dying, or just dying. She chose the latter. The options are just that. Folks making a big deal out of this are wrong.

I quoted the above commentary because they all speak to both the personal and practical aspect of this dilemma.

On the one hand, I understand the concerns most people have. It's as X Factor points out. If doctors start seeing their terminally ill Medicare patients as "cash cows" and keep them alive just to sqeeeeeeeeeeze as much federal funds from them as they can even if it means placing them on life-support and lying to the heart struck caregiving, surviving family members, when does the fiduciary patient care end with such doctors who swore an oath to preserve life despite the cost to the patient and his/her family? In such unscruplous situations, the doctor could privately reason that "keeping that patient alive didn't cost the patient nor his/her family a dime; it was all on the federal government's tab". I say regardless of who paid for that "end-of-life care", the attending physician should still do the right thing and NOT take advantage of the vulnerable emotional state of the surviving family members nor the patient's caregiver.

The other side of the coin as I see it is the concerns for the patient. In this regard, there is a two-pronged personal issue at stake here. First, you have the patient probably being caught unawares as to the extend of his/her injury/illness prior to being hospitalized. In such cases, it is the duty of the attending physician to properly and fully inform the patient, his/her primary caregiver and/or surviving family members of the exact medical condition, treatment option and potential outcome of any and all proposed/prescribed medical treatments including surgical options. When a physician fails to properly inform in this regard, he has done the patient a grave disservice. There's just no two-ways about it here. Second, the patient does have a right to weight his/her treatment options carefully including how he may choose to die in his final days even if passing away means he does so at home in his own bed. The patient deserves to know what to expect, as well as his surviving family members/primary caregiver so that everyone involved understands exactly what the patient's needs are in his/her dying days. Why ANYONE would have a problem with this doctor-patient treatment and caregiving exchange is beyond me! It's informative care, not "well, since you're gonna die anyway, may as well not take these drugs or undergo this treatment; it would be such a waste of your time, your families and essential medicine or surgical procedures best reserves for those who stand a fighting chance at surviving." What a load of BS!!!

I experienced the same thing both Captian America and CaptainCourtesy did prior to my mother passing from cancer 2 years ago. To the best of my knowledge, she died peacefully in her sleep without the aid of life preserving drugs which would have merely prolonged the inevitable. (I was unable to be there with her at the end as I'm the only married child among my brother (who died soon after my mother's passing) and my three sisters, but thank God my siblings were there.) As far as I'm aware, the doctors did everything they could to care for her including recommending Hospice care, until she passed away.

So, for those who truly believe "end-of-life care" is just some fancy way of saying, "get rid of the sick, incurable slug," may God have mercy on your soul. Life, even in facing death, is still such a precious thing.
 
I quoted the above commentary because they all speak to both the personal and practical aspect of this dilemma.

On the one hand, I understand the concerns most people have. It's as X Factor points out. If doctors start seeing their terminally ill Medicare patients as "cash cows" and keep them alive just to sqeeeeeeeeeeze as much federal funds from them as they can even if it means placing them on life-support and lying to the heart struck caregiving, surviving family members, when does the fiduciary patient care end with such doctors who swore an oath to preserve life despite the cost to the patient and his/her family? In such unscruplous situations, the doctor could privately reason that "keeping that patient alive didn't cost the patient nor his/her family a dime; it was all on the federal government's tab". I say regardless of who paid for that "end-of-life care", the attending physician should still do the right thing and NOT take advantage of the vulnerable emotional state of the surviving family members nor the patient's caregiver.
I actually haven't argued this at all. Obama's the one who assumes the worst about doctors, not me. I assume the worst about the government bureaucrats and when they suddenly become so intensely interested in annual death counseling, it raises red flags for me.

The other side of the coin as I see it is the concerns for the patient. In this regard, there is a two-pronged personal issue at stake here. First, you have the patient probably being caught unawares as to the extend of his/her injury/illness prior to being hospitalized. In such cases, it is the duty of the attending physician to properly and fully inform the patient, his/her primary caregiver and/or surviving family members of the exact medical condition, treatment option and potential outcome of any and all proposed/prescribed medical treatments including surgical options. When a physician fails to properly inform in this regard, he has done the patient a grave disservice. There's just no two-ways about it here. Second, the patient does have a right to weight his/her treatment options carefully including how he may choose to die in his final days even if passing away means he does so at home in his own bed. The patient deserves to know what to expect, as well as his surviving family members/primary caregiver so that everyone involved understands exactly what the patient's needs are in his/her dying days. Why ANYONE would have a problem with this doctor-patient treatment and caregiving exchange is beyond me! It's informative care, not "well, since you're gonna die anyway, may as well not take these drugs or undergo this treatment; it would be such a waste of your time, your families and essential medicine or surgical procedures best reserves for those who stand a fighting chance at surviving." What a load of BS!!!
Why is it BS? Because you say so? You don't see the potential for abuse, that's great. I wish I could be so trusting, but there are certain realities that will have to happen with government subsidized health insurance. Decisions are going to have to be made about the best place to spend those limited funds. If certain folks who might would choose otherwise, can be nudged into deciding that they shouldn't want to "linger", well, that's just one less to worry about. And before you tell me insurance companies make that same sort of call already, did you know that Medicare denies more claims than any private insurer?

I experienced the same thing both Captian America and CaptainCourtesy did prior to my mother passing from cancer 2 years ago. To the best of my knowledge, she died peacefully in her sleep without the aid of life preserving drugs which would have merely prolonged the inevitable. (I was unable to be there with her at the end as I'm the only married child among my brother (who died soon after my mother's passing) and my three sisters, but thank God my siblings were there.) As far as I'm aware, the doctors did everything they could to care for her including recommending Hospice care, until she passed away.
Truly, I am sorry about your mom. I am not at all arguing against the right of people to make these decisions, I just want to ensure these remain the patients' decisions, not anybody else's.

So, for those who truly believe "end-of-life care" is just some fancy way of saying, "get rid of the sick, incurable slug," may God have mercy on your soul. Life, even in facing death, is still such a precious thing.
I agree with this.
 
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X Factor said:
And before you tell me insurance companies make that same sort of call already, did you know that Medicare denies more claims than any private insurer?
And did you know that the number one reason for Medicare claim denials (27.8%) is Claim adjustment reason code 16?

16 - Claim/service lacks information which is needed for adjudication. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).

An incomplete form. A little less innocuous than a preexisting condition or excessive costs...:lol:


And did you know that, according to Karen Pollitz, a professor at the Georgetown University Health Policy Institute, except in California, the insurance companies aren't required to provide insurance claims data to any state or federal agency, so they can manipulate the data anyway they wish.
 
Am I supposed to feel better that Medicare claims are denied most often due to a technicality with the paper work?
 
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