TDB&TB Question #1 ~ Medical Technology

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Parlez
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Unread postby Parlez » Mon May 05, 2008 10:11 pm

Eye. And here we get into the issue of what human life is worth - both from the perspective of the medical establishment and society. When does a person's life no longer have worth, or value, to themselves or to the so-called 'common good'?

There was an interesting program on PBS the other night about this very thing. One expert posed the question: 'When does a person stop being a person?', meaning if a person's mind or body has become so compromised that he or she simply isn't the same person he or she was up to that point, does that mean his or her life is no longer worth living/saving/prolonging? Society conditions each of us to feel that under certain circumstances we as human beings no longer have merit. At what point we internalize the issue and decide we should, in fact, be written off.

Unfortunately, in my work with the elderly, I witness a lot of people who have essentially written themselves off. They don't need anyone to tell them their lives no longer have worth; they've already made up their minds about it. They look in the mirror and conclude they're no longer the person they used to be, and this stranger looking back at them is not someone they care to know. When that happens, it's extremely difficult to convince them otherwise. For them, there's no quality of life; there's just waiting...
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Unread postby Liz » Mon May 05, 2008 10:52 pm

Inthezone wrote:
"youse guys" - sounds like an east coaster! :eyebrow: LOL

Nope. That's just my gangster speak. I still haven't let go of the last book/current movie....Public Enemies.
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Unread postby Liz » Mon May 05, 2008 11:04 pm

Parlez wrote:Eye. And here we get into the issue of what human life is worth - both from the perspective of the medical establishment and society. When does a person's life no longer have worth, or value, to themselves or to the so-called 'common good'?

There was an interesting program on PBS the other night about this very thing. One expert posed the question: 'When does a person stop being a person?', meaning if a person's mind or body has become so compromised that he or she simply isn't the same person he or she was up to that point, does that mean his or her life is no longer worth living/saving/prolonging? Society conditions each of us to feel that under certain circumstances we as human beings no longer have merit. At what point we internalize the issue and decide we should, in fact, be written off.

Unfortunately, in my work with the elderly, I witness a lot of people who have essentially written themselves off. They don't need anyone to tell them their lives no longer have worth; they've already made up their minds about it. They look in the mirror and conclude they're no longer the person they used to be, and this stranger looking back at them is not someone they care to know. When that happens, it's extremely difficult to convince them otherwise. For them, there's no quality of life; there's just waiting...


But I think Shadowydog's point is that trying to do as much as one can for a patient is a good thing, generally speaking. The point is to prolong life, even if once in a while it turns out not to be a quality one. The intentions are good, and progress is made. To try to save someone's life is not an experiment. And improved techniques have saved lives overall, methinks.

In regards to your work, Parlez...it must be heart wrenching to see that day in and day out. I'm having to deal with my dad and my mother-in-law in that respect right now, and I feel for them. And it won't be too long before I'm there.
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Unread postby gemini » Mon May 05, 2008 11:48 pm

Parlez wrote:Eye. And here we get into the issue of what human life is worth - both from the perspective of the medical establishment and society. When does a person's life no longer have worth, or value, to themselves or to the so-called 'common good'?

There was an interesting program on PBS the other night about this very thing. One expert posed the question: 'When does a person stop being a person?', meaning if a person's mind or body has become so compromised that he or she simply isn't the same person he or she was up to that point, does that mean his or her life is no longer worth living/saving/prolonging? Society conditions each of us to feel that under certain circumstances we as human beings no longer have merit. At what point we internalize the issue and decide we should, in fact, be written off.

Unfortunately, in my work with the elderly, I witness a lot of people who have essentially written themselves off. They don't need anyone to tell them their lives no longer have worth; they've already made up their minds about it. They look in the mirror and conclude they're no longer the person they used to be, and this stranger looking back at them is not someone they care to know. When that happens, it's extremely difficult to convince them otherwise. For them, there's no quality of life; there's just waiting...


What is human life worth.? This question covers a much larger span then just how much of what we have is still working. Is the childs life worth more than the old? Is the able person worth more then the invalid? Even to themselves, as Parlez says, to some life is more important than to those who give up. These questions should not have to be answered so I agree that the medical profession is correct when they attempt to save everyone regardless of the chances they have.

Nebraska brings up another good point about ethics. The trials where only half the subjects get the meds and the others the placebo. The fact that wars have advanced the medical knowledge so much, and then some of the horrors of trials that were held on people without their knowledge. Then just the inequality of who can afford treatment. This is the real slippery slope. Look how much trouble we are having on trying to decide what is best for ourselves and our loved ones and then try to wonder about those who thought they were making the best choice for the so called common good.
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Unread postby trinni » Tue May 06, 2008 2:28 am

Inthezone wrote:
trinni wrote:I think that I will have to answer Yes medical technology can have a negative effect but one can only really answer this in retrospect to the event.


Trinni - do you mean the equivalent of "hindsight is 20/20?" Or are you referring to medical mishap? I'm just 'wonderin.



Inthezone I meant hindsight, the negative effect is only seen if the treatment does not result in a return to health or "acceptable" level of disability. And I think that that level of disability that is acceptable is hugely different from individual to individual.

Medical mishap is another can of worms altogether :-/
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Unread postby Parlez » Tue May 06, 2008 8:05 am

Liz wrote:
But I think Shadowydog's point is that trying to do as much as one can for a patient is a good thing, generally speaking. The point is to prolong life, even if once in a while it turns out not to be a quality one. The intentions are good, and progress is made. To try to save someone's life is not an experiment. And improved techniques have saved lives overall, methinks.


To elaborate on the question of where we would be without the advances that medicine and technology have made over time...I would suggest we might be back in a more natural rhythm and flow of life and living. Prolonging life, whether it's through vaccines that innoculate against childhood diseases or through the invention of things like respirators and life-support systems, may not automatically mean that the quality of everyone's life is better over the life span. The effects of these things, as we see everyday in the headlines, are taking a toll in terms of over population, stress on environmental resources, and economic brinksmanship.

It seems to me we are getting mixed messages regarding the sanctity of human life ~ on the one hand we are told it merits every medical and technical aid available at any cost, and on the other hand we are told that if we live too long and/or become something less than a viable, productive player in society, we are a liability. Who can win at this game?

Gemini, your point about the cost of these medical and technical marvels is well-taken. I would suggest that the majority of people who sign DNR (Do Not Resuscitate) directives do so not only because they prefer not to gamble with fate but also because of what they imagine to be the long-term cost of resuscitation.
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Unread postby nebraska » Tue May 06, 2008 8:36 pm

Parlez wrote:
Liz wrote:

To elaborate on the question of where we would be without the advances that medicine and technology have made over time...I would suggest we might be back in a more natural rhythm and flow of life and living. Prolonging life, whether it's through vaccines that innoculate against childhood diseases or through the invention of things like respirators and life-support systems, may not automatically mean that the quality of everyone's life is better over the life span. The effects of these things, as we see everyday in the headlines, are taking a toll in .


I think you have hit the nail on the head, as it were, Parlez.

I cannot help but compare some of this discussion to what I see in my job in a veterinary clinic where owners have the choice to euthanize a pet when life has become worse than death. I see the gamut of those who choose to end a pet's life when the pet is suffering..........to those who prolong life to the point that they bring in an almost-alive-object that has no relation to the pet they actually loved, having allowed untold suffering for that pet. Euthanasia is a different subject, I know; but the emotional connotations are similar. There is a point where we prolong life because it is in the best interest of the patient; and there is a point where we refuse to accept death because of our own emotional involvement and our refusal to accept reality. I think that is where we have a problem about honoring the wishes of our loved ones.......

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Unread postby shadowydog » Tue May 06, 2008 8:54 pm

Parlez wrote:
Liz wrote:
But I think Shadowydog's point is that trying to do as much as one can for a patient is a good thing, generally speaking. The point is to prolong life, even if once in a while it turns out not to be a quality one. The intentions are good, and progress is made. To try to save someone's life is not an experiment. And improved techniques have saved lives overall, methinks.


To elaborate on the question of where we would be without the advances that medicine and technology have made over time...I would suggest we might be back in a more natural rhythm and flow of life and living. Prolonging life, whether it's through vaccines that innoculate against childhood diseases or through the invention of things like respirators and life-support systems, may not automatically mean that the quality of everyone's life is better over the life span. The effects of these things, as we see everyday in the headlines, are taking a toll in terms of over population, stress on environmental resources, and economic brinksmanship.

It seems to me we are getting mixed messages regarding the sanctity of human life ~ on the one hand we are told it merits every medical and technical aid available at any cost, and on the other hand we are told that if we live too long and/or become something less than a viable, productive player in society, we are a liability. Who can win at this game?

Gemini, your point about the cost of these medical and technical marvels is well-taken. I would suggest that the majority of people who sign DNR (Do Not Resuscitate) directives do so not only because they prefer not to gamble with fate but also because of what they imagine to be the long-term cost of resuscitation.


Wow that is a loaded one there Parlez. What if the more natural rhythm meant going back to the world of black plaque; polio; tb; etc as killers?

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Unread postby Parlez » Tue May 06, 2008 10:24 pm

True true, Shadowydog. What if? The Black Plague is a good example. Today, inspite of all our modern medical/technical advances, we have the threat of pandemic drug-resistant viruses that would no doubt decimate the population just like the plague did. Attempts on the part of national and international health organizations to prepare for coping with such a scenario have basically failed; a potential nightmare that has resulted in filmmakers jumping into the fray with a rash of sci-fi blockbusters. Go figure. :-/

We also face, IMO, a more immediate humanitarian/health threat - hunger. For people who do not have access to food, things like medical attention and innoculations against childhood diseases are literally dead issues. Starvation is becoming the #1 killer on the global scene. Interestingly enough, it is also the #1 killer (by choice) of residents in nursing homes.

Which gets back to my main point about quality of life vs quantity of years. Prolonging life just for the sake of prolonging life can have less than rosy outcomes.
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Unread postby Liz » Tue May 06, 2008 10:58 pm

There is definitely no easy answer to this question. But maybe it is just like life itself…..not perfect; and you have to take the good with the bad, trade a positive for a negative, yin and yang. :mort3:
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Unread postby gemini » Thu May 08, 2008 2:09 pm

Parlez wrote:Which gets back to my main point about quality of life vs quantity of years. Prolonging life just for the sake of prolonging life can have less than rosy outcomes.

Or we could do somethng a bit more simple or radical to some peoples views. Let the patient decide (when he or she can) instead of the government or an instutuion.
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Unread postby shadowydog » Thu May 08, 2008 2:29 pm

gemini wrote:
Parlez wrote:Which gets back to my main point about quality of life vs quantity of years. Prolonging life just for the sake of prolonging life can have less than rosy outcomes.

Or we could do somethng a bit more simple or radical to some peoples views. Let the patient decide (when he or she can) instead of the government or an instutuion.


Oregon already allows that option. And a lot of doctors also do so under the radar. When my father was sent home from the hospital with only a short time to live, I was shocked that they sent him home with enough morphine to overdose him... :-O

But I agree that it does not seem right that we can put a pet to sleep when their quality of life deteriorates but can't make the same decision with a person. People have been prosecuted for refusing medical treatment for a terminal relative. Given the limited resources for medical care, this seems criminal to me.

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Unread postby Parlez » Fri May 09, 2008 12:14 am

nebraska wrote:

I cannot help but compare some of this discussion to what I see in my job in a veterinary clinic where owners have the choice to euthanize a pet when life has become worse than death. I see the gamut of those who choose to end a pet's life when the pet is suffering..........to those who prolong life to the point that they bring in an almost-alive-object that has no relation to the pet they actually loved, having allowed untold suffering for that pet. Euthanasia is a different subject, I know; but the emotional connotations are similar. There is a point where we prolong life because it is in the best interest of the patient; and there is a point where we refuse to accept death because of our own emotional involvement and our refusal to accept reality. I think that is where we have a problem about honoring the wishes of our loved ones.......


I agree - it's often the generalized fear of death, or of seeing death as some kind of failure, that goes along with the medical/technological establisment's rather barbaric attempts to extend human life no matter what. I don't know what the answer is to make things different/better, but I tend to think the government needs to either get whole-heartedly in the picture or get whole-heartedly out of it.

Nebraska, your thoughts about humane pet care hit home for me. When my first cat became debilitated with feline diabetes, I ended up having her put down. It was such a traumatic experience I vowed I'd let my second cat die a 'natural death'. Boy, was I in for a shock! Her dying and death, just from 'old age' without any complicating illness or disease, turned out to be a much more tortorous process for both the cat and myself than I ever imagined it would be. I'll never go down the 'natural' road again with another pet. :-/

Obviously, I have conflicting views on the subject of when to call in the troops (medical/technical intervention) and when to just let things be. I've contradicted myself several times - right here, right on this deck! It's a hard call.
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