Yeah, I get the point about this guy and his wishes.

The larger question (to me) is the many people who have been unplugged because of a supposition of an irreversible coma, due to apparent brain inactivity and unresponsiveness.

Why were they terminated? Because technology was not sufficient to communicate with them.

Should they have had a choice? How long do we maintain them if they choose to live? Who pays? Why?

I am pushing this one totally off the deep end, before any more silly answers pop up.


Soylent Green...........................................





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You have the choice before the fact. The standard in most health care settings is that if you have a legal document saying that you want to be kept alive no matter what, medical providers will do everything they can to keep you alive.

If you don't have a document, then your next of kin get to be the lucky folks who make that decision for you. Hopefully they know you well enough to know what you would want.

If you don't have a document or a next of kin or a close friend who is willing to make that decision, then the medical team (usually with an ethics advisor) makes these kind of decisions for you. For better or for worse.


FWIW life in a vegetative state is not easy. People can get bedsores and ulcers if they are not turned every couple of hours. They lay in their urine and poop until someone cleans them. Sometimes saliva pools in their mouth, causing them to drool and gag on their own secretions. Feeding tubes can get infected, and tube feeds can get aspirated into the lungs. Infections can be common. People usually get "terminated" (but really withdrawal of life-prolonging care) not so much because of the communication issue, but instead when it becomes clear that there is more suffering than living going on.

Re: fMRI studies (and not to discount the usefulness of fMRI), I ran across this recently and thought it was amusing:

IgNobel Prize in Neuroscience: The dead salmon study | The Scicurious Brain, Scientific American Blog Network

Really interesting Frontline tonight called The Suicide Plan. It was about assisted suicide with a strong focus on the Final Exit Network. I didn't know such a network existed although I knew about the Hemlock Society and the book Final Exit.

__________________
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They're good questions. What are your answers to them? Lots of medical decisions are made while balancing quality of life with longevity and, yes, the financial cost. Geriatric people, for instance, often have do-not-resuscitate orders, even though medical science has the ability to revive them.

Is it worth the financial and social cost to keep an all but unresponsive person alive for a decade so he can speak a sentence or two?

BTW, poking around a bit I found definitions that distinguish "coma" from "vegetative state." A vegetative state is apparently stable enough that some patients can even live at home, and they may respond to external stimuli. So my assumption that Routley was bedridden and hooked up to a respirator may not have been accurate. The story describes him as vegetative, not comatose. I'm assuming he would require a feeding tube like Terri Schiavo.

Will Scott Routley recover fully? Boy, that would be something, wouldn't it. Right now his case sounds all but unprecedented. I don't expect to see footage of him tap-dancing anytime soon, but who knows?

The toll of his injury and its aftermath extends to his family, of course, I wonder whether his care, the hopeful waiting, the disappointments have affected his parents' health, or ultimately, their lifespan. I'm sure they love their son, but it's possible they might have suffered less if he had died in the accident rather than lingered in semiconsciousness for a decade.

The previous msg linking to "Holy Grail" was especially apt. "I feel a bit better".

I know I am not the first guy to say this, but science and technology is far outstripping or ethical and moral and communal understanding or judgement. Life and death issues come to us all. Nobody gets out alive. Most of us will die in fear, pain, and alone. In some hospital with our family a thousand miles away. In another thread I mentioned Alduos Huxley's book on a different subject. He addresses death rather well, too.

let me throw a little gasoline on the fire:
Liverpool Care Pathway: minister orders report into cash rewards - Telegraph

No, just another political half-truth that's good when it's your (collective your, not you personally) side and bad when it's your opposition's. If you can read it on a bumpersticker, you can count on it being 1/2 the story. Unfortunately that's about as much as many in the populace are able to process.

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I've got this mental image of Paul Ryan pushing the non-ambulatory granny off the cliff.

Maybe you could give us your opinion, then we could be the tiger and you could be the christian...

If our society is going to stand a chance of decent health care, people in this condition, unless they have private means, should be unplugged.
Way too much money spent on this kind of garbage, while people who can still contribute to society are lacking in basic health needs.
To some degree, the healthcare provided by a government or society needs to be looked at with a business eye (where's Rmoney when you need him?)
The person receives the healthcare so they can continue to be an asset to society.
This guy will never be anything but a drain on resources. Pull the plug.

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1983 300SD - 305000
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https://media.giphy.com/media/X3nnss8PAj5aU/giphy.gif

That which we call a rose, by any other name, would smell as sweet.

Or something along those lines.

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1980 300TD-China Blue/Blue MBTex-2nd Owner, 107K (Alt Blau) OBK #15
'06 Chevy Tahoe Z71 (for the wife & 4 kids, current mule) '03 Honda Odyssey (son #1's ride, reluctantly) '99 GMC Suburban (255K+ miles, semi-retired mule) 21' SeaRay Seville (summer escape pod)

Hey, hey, hey! My goal is to suck every possible penny back out of the system!

But for the other guy, by all means.

__________________

1980 300TD-China Blue/Blue MBTex-2nd Owner, 107K (Alt Blau) OBK #15
'06 Chevy Tahoe Z71 (for the wife & 4 kids, current mule) '03 Honda Odyssey (son #1's ride, reluctantly) '99 GMC Suburban (255K+ miles, semi-retired mule) 21' SeaRay Seville (summer escape pod)

MY solution is totally utilitarian -- you want it, you pay for it. Else, die.
Hope that's clear.

Quote:

I wonder how Obamacare will handle it.

I’d imagine it will start with a review of existent elder law and go from there. Plus as has been stated there is a lot of precident for this.

Iirc back in the early 1960s, President Kennedy made a sweeping change in how indigent and disabled elders were cared for. Before this time, the old and disabled were essentially warehoused in filthy and disgusting establishments. The change Kennedy advanced (again iirc) was the establishment of a long list of standards used in the treatment of State and Federal paid health care institutions. These changes were the cause to establish so-called skilled nursing facility. Since that time the standards have continually evolved. Care today is mostly very good compared to what took place before 1960.

My partner is a RN and I asked her about how they cared for people who could not do so themselves. She worked in a number of different State managed facilities over the years. I can’t begin to encapsulate the minutia (nor do I know more than a tiny bit) but accordingly, the goal is to make these people as comfortable as reasonable. I predict this will be unchanged, except to accommodate advances in care giving – the role that gerontologists play treatments for this group of people continues to evolve.

With medical insurance the insurer provides at least 2 payment caps - 1 is a lifetime limit of what the insurer will pay and 2 is what they will pay per malady.

Of course with current law, once the insured runs out of insurance or if they don't have any, the care giving entity is entitled to go after payment from the beneficiary. Once that is exhausted, it falls to the State to provide care. I can’t see broad change in this kind of law as families will rightfully pursue the care giver to the Supreme Court if there is the slightest whiff of malfeasance or malpractice.

In recent years there has been a growth of tolerance for assisted suicide for some states, and this trend will only continue, and there is nothing wrong with it, as long as the person to die agrees.

It is more than possible that at some time someone will come along and present money saving as a platform to at least try and provide incentives to snuffing people who can’t care for themselves, against their will and current law, but I am positive that will not originate from our current president or anyone who wants to be seen as respecting human life.

Quote:

MY solution is totally utilitarian -- you want it, you pay for it. Else, die.

Quote:

Hope that's clear.

(As a note, the forum software will not let me encapsulate the comments above in one set of quotes.)

I'm curious - do you and your wife have a statement defining this on an advanced directive and living will? Or did you leave this decision for your children to decide? Do your children have this statement on their advance directive and living will? Because it could possibly fall to you to make that decision for them.

FWIW, the kind of comment you wrote is easy to type, but it is not so easy to let go of a loved one, let alone participate in their murder, er, assisted suicide. Of course that not to say a lot of people don’t do that.

To me, that would be like a NASCAR driver being allowed to drive faster than speed limit. After all, nobody can argue that he is better than the average driver so the law should not apply to him. We did take the abilities of the average driver into account when making the speed limit but that driver has shown the ability to surpass that.

People were allowed to die in the past because technology was not sufficient to fix their ailment. We can't base today's decision on next year's technology.

Yes they should have a choice as long as they can pay for it. So if a certain condition, based on the average prognosis is poor, why are we throwing good money after bad? On the hope of a "Hail Mary" pass? Now if they want to and can play the odds on their dime, I'm good with that.

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