Hope For The Dying

[Unknown Soldier]

I think we all agree that many people, especially those whose end is nigh, often end up living in pain in discomfort. Where we've disagreed is regarding what, if anything, can be done to help those who are always ill and possibly terminally ill. Many here have asserted, I think without much justification, that there's nothing that can be done to alleviate that pain and discomfort aside from a quick and "good" death. I've countered that no, there is much we can do to help alleviate that pain via better care. The medical establishment is just lax in serving people who are suffering.

What is the scientific evidence for better end-of-life care?

According to the February 2024 issue of Scientific American (see the attached file), I am right--better pain management is available. It just isn't getting to those who need it. It should come as no surprise that for-profit interests are fueling the decline in the quality of hospice care. Such entities get their money from Medicare based solely on the number of days hospice care is provided--the amount of care and the quality of that care is up to the discretion of the hospice. If the hospice's main goal is to make money, then it will cut costs by cutting care and in the process cutting people.

So I strongly recommend that we as a society support nonprofit hospices, and if such care is not available from them, then we demand better care from the for-profit hospices.

So read. Learn. Act on your knowledge.

 

[bilby]

I think we all agree that many people, especially those whose end is nigh, often end up living in pain in discomfort. Where we've disagreed is regarding what, if anything, can be done to help those who are always ill and possibly terminally ill. Many here have asserted, I think without much justification, that there's nothing that can be done to alleviate that pain and discomfort aside from a quick and "good" death.

Literally nobody here has ever asserted any such thing; It would be absurd to declare that there's nothing that can be done, (or that there's always something that can be done), other than on a case by case basis, and only then as a consequence of medical professionals trying various approaches.

Where we have disagreed is over whether, after that assessment has been made, a 'quick and "good"' death should or should not be an option for an individual who chooses one.

 

[EricH]

Many here have asserted, I think without much justification, that there's nothing that can be done to alleviate that pain and discomfort aside from a quick and "good" death.

To my recollection, nobody here has said that. I think you are making this up, or misrepresenting the opinion expressed by some forum members.

The medical establishment is just lax in serving people who are suffering.

Feel free to come up with a solution that works. Simply reading a magazine article does not make you knowledgeable on the subject.

According to the February 2024 issue of Scientific American (see the attached file), I am right--better pain management is available.

The article does not say anything like that. The article starts off by stating that everyone deserves a peaceful, pain-free exit, but does not claim that this objective can be achieved for those who are living with significant pain. Again something you made up, even deliberately misrepresented I would speculate.

So I strongly recommend that we as a society support nonprofit hospices, and if such care is not available from them, then we demand better care from the for-profit hospices.

Good idea. How do you propose we go about implementing this idea? Fact is that it is the doers who make a difference - those whining in some insignificant backwater forum on the internet, not so much.

So read. Learn. Act on your knowledge.

We are humbled by your willingness to spread knowledge. Especially given how condescending you sound when lecturing an audience that includes a physician who has spent 40 years treating that kind of patients that the article talks about. Or given how little you appear to actually know about the subject.

 

[pood]

So read. Learn. Act on your knowledge.

If you are ever inclined to vocalize this advice to another person, I suggest doing so to the person in your mirror.

 

[Lion IRC]

It should come as no surprise that for-profit interests are fueling the decline in the quality of hospice care. Such entities get their money from Medicare based solely on the number of days hospice care is provided--the amount of care and the quality of that care is up to the discretion of the hospice....

Yep.

Add to that the conflict of interest where family members with ulterior motives coincidentally agree that "it would be for the best if Aunty Jane or Uncle Joe were allowed to die with dignity."

....so we don't have to be burdened with their aged care needs and costs.

...so we can sell their house.

...so we can get on with reading the will.

 

[pood]

It should come as no surprise that for-profit interests are fueling the decline in the quality of hospice care. Such entities get their money from Medicare based solely on the number of days hospice care is provided--the amount of care and the quality of that care is up to the discretion of the hospice....

Yep.

Add to that the conflict of interest where family members with ulterior motives coincidentally agree that "it would be for the best if Aunty Jane or Uncle Joe were allowed to die with dignity."

....so we don't have to be burdened with their aged care needs and costs.

...so we can sell their house.

...so we can see get on with reading the will.

But you, as a self-described biblical theist, must realize that the sooner Aunty Jane and Uncle Joe kick the bucket, the sooner they will meet Santa in the Sky who will grant them eternal bliss — provided, of course, Aunty and Uncle were nice in this life and not naughty. If they were the latter, it’s coal for them and the coal is always burning and I mean ALWAYS.

 

[Lion IRC]

Another example of derail goading.

Did I mention God or religion?
Why are you trying to change the subject?

Why cant we just have an interesting secular discussion without the bait-and-switch?

 

[pood]

Let me put it this way. How many people do you think actually treat their dying loved ones this way, and what empirical evidence do you have to back up whatever number you name?

Then too, I find it passing odd that a self-described Christian theist would not see that under your own doctrine, a swifter passage from this vale of tears, especially for those who are terminal and often in great and untreatable pain — which is the main subject of this thread, and the earlier thread that spawned it — would be a good thing, meaning quick relief from pain and meeting their maker all the sooner.

 

[southernhybrid]

I was just thinking about this topic yesterday as a friend of mine said that not having the right to voluntary euthanasia is her greatest fear. She had posted an article on FB, about a man who entered an assisted living facility and killed his wife who was suffering with cancer and unrelenting pain. Then he killed himself.

A friend of hers said she had a friend from Australia who's aunt was fortunate to be able to choose euthanasia, as she was dying from cancer and no longer wanted to suffer. My friend said it was cruel to deny any of us that type of choice, or as it's often called, "death with dignity".

Suffering comes in many forms, but pain is probably the worst type of suffering. Still, I've watched people getting close to the end of life due to a terminal disease and they simply wanted to escape from this life. I can think of two. One was a middle aged woman with hep C. For some reason she didn't want to take what was a new drug at the time, so she opted for hospice. I visited her room and she told me she was dying and was ready for the end. I gave her a hug and told her how sorry I was. If she had wanted it, shouldn't she have had the right to an her misery? My other patient had multiple major health problems and he finally refused all aggressive care. His death came fairly quickly, which was good, but if it had been prolonged, shouldn't he have had the right to ask for a cocktail of drugs that would have eased him out a few days sooner?

Sure, it would be nice if everyone could have a pleasant end of life free of pain, but those types of deaths are rare, especially when one is well hydrated. Regardless, I don't understand why anyone, other than perhaps some religious conservative who things it's a sin, would deny someone else the right to choose their time of death, if their life expectancy is short and they want their suffering to end.

So, US, you have both a retired physician and a retired RN who have cared for people at the end of their lives, who have watched suffering that couldn't be relieved, and who support the right of others to choose to end their suffering in a humane way, yet you persist in telling us that we are wrong and you are right. How many people have you observed during the end of their lives and how many have you observed during the dying process? How many people have you seen on a ventilator? My husband's aunt asked to be removed after two days on one because it was so horrible for her. She died quickly after that.

Are you sure you wouldn't want to at least have the right to shorten your suffering if nothing was available to end it, other than death? I've read many times that few people actually choose euthanasia but many are comforted knowing they have that choice. I want to have that choice. Why would you deny someone like me that choice?

I've made it to my mid 70s and consider any additional time to be the gravy. But, I suffer from chronic arthritic pain in most of my joints. I've already built up a tolerance to low dose opioids and I'm scared of reaching the point where even higher doses won't help. NSAIDs give me severe side effects, so I can't take them any more. Plus there's something called hyperalgesia, a condition where higher doses of narcotics act by increasing pain, instead of relieving it. I share my friend's fear of being forced to suffer when I'm nearing the end of my life. It's cruel to deny me gentle help with dying if that's my choice.

 

[Lion IRC]

I'm more than happy to talk about Christian/biblical doctrines of heaven and the afterlife if you start a thread and send me the link.

As for elder abuse from adult children with “inheritance impatience” I think there is published data showing very high rates of self-reporting insofar as being a burden on family, friends/caregivers as the primary reason for the euthanasia request.

 

[southernhybrid]

Let me put it this way. How many people do you think actually treat their dying loved ones this way, and what empirical evidence do you have to back up whatever number you name?

Then too, I find it passing odd that a self-described Christian theist would not see that under your own doctrine, a swifter passage from this vale of tears, especially for those who are terminal and often in great and untreatable pain — which is the main subject of this thread, and the earlier thread that spawned it — would be a good thing, meaning quick relief from pain and meeting their maker all the sooner.

I've never met anyone who would do that. Instead, they try to keep grandma alive so they can use her SS check or exploit her savings, while not providing her with very good care. I've seen that more than a few times as home health nurse, but I've never seen anyone try to shorten someone's life in order to get their assets. Plus, you have to be in your right mind to choose euthanasia, so nobody can make that choice for you, at least not under any of the current laws I'm familiar with, although I know Canada has made it easier for people to make that decision recently. I just don't know enough about their law to have an opinion.

 

[southernhybrid]

I'm more than happy to talk about Christian/biblical doctrines of heaven and the afterlife if you start a thread and send me the link.

As for elder abuse from adult children with “inheritance impatience” I think there is published data showing very high rates of self-reporting insofar as being a burden on family, friends/caregivers as the primary reason for the euthanasia request.

Well, then, why don't you show us those statistics and the research that went into them. It's pretty hard to prove your claim.

 

[Lion IRC]

"Death With Dignity": A Recipe for Elder Abuse and Homicide (Albeit Not by Name)

Death with Dignity Acts in Oregon and Washington authorize physicians to write life-ending prescriptions for their patients. This article addresses various problems with the Acts, including the wording about who may administer the lethal drug and the fact that both Acts lack a consent...

scholarship.law.marquette.edu

 

[bilby]

Another example of derail goading.

Did I mention God or religion?
Why are you trying to change the subject?

Why cant we just have an interesting secular discussion without the bait-and-switch?

Because you can't make people forget your posting history.

You have baggage (as have we all), and nobody here is going to believe that you have discarded it, in order to make a purely secular argument. You have never made a purely secular argument here before, and it's basically too late to start now - even if you wanted to.

 

[Lion IRC]

Off topic and false.

 

[Unknown Soldier]

It should come as no surprise that for-profit interests are fueling the decline in the quality of hospice care. Such entities get their money from Medicare based solely on the number of days hospice care is provided--the amount of care and the quality of that care is up to the discretion of the hospice....

Yep.

Add to that the conflict of interest where family members with ulterior motives coincidentally agree that "it would be for the best if Aunty Jane or Uncle Joe were allowed to die with dignity."

....so we don't have to be burdened with their aged care needs and costs.

...so we can sell their house.

...so we can get on with reading the will.

Abuse of the disabled and elderly is rampant in our society, and as you imply here (and the attached article documents) money is very often a motive for it. Is anybody dumb enough to think that the benefits of "death with dignity" has nothing to do with the death of the dying and the dignity of their survivors?

Keep up the good work.

 

[Unknown Soldier]

I'm more than happy to talk about Christian/biblical doctrines of heaven and the afterlife if you start a thread and send me the link.

As for elder abuse from adult children with “inheritance impatience” I think there is published data showing very high rates of self-reporting insofar as being a burden on family, friends/caregivers as the primary reason for the euthanasia request.

Well, then, why don't you show us those statistics and the research that went into them. It's pretty hard to prove your claim.

You got it in post 13. It's time to concede that Lion's claim is proved true.

 

[Unknown Soldier]

Another example of derail goading.

Did I mention God or religion?
Why are you trying to change the subject?

Why cant we just have an interesting secular discussion without the bait-and-switch?

They've done that to me too. Whenever I score big, they start calling me a Christian.

 

[Lion IRC]

It's a gross logical fallacy to claim someone is wrong because they've "got baggage".

 

[Unknown Soldier]

So, US, you have both a retired physician and a retired RN who have cared for people at the end of their lives, who have watched suffering that couldn't be relieved, and who support the right of others to choose to end their suffering in a humane way, yet you persist in telling us that we are wrong and you are right.

Actually, the only retired physician I know is my brother. He has told me of a man in terrible pain who committed suicide to escape it. My brother explained that the man had been taking medication that effectively controlled the pain, but the medical bureaucracy no longer allowed his physician to prescribe it.

Better care is available like I've argued from the beginning. I am right. Concede it. And let's stop this shameful effort to profit from the deaths of the dying.