Even as Doctors Say Enough, Families Fight to Prolong Life

[Guest guest]

The " Ethics Question " involved in the US health care system is mainly

smoke, mirrors, and distraction. Ethics has never played a major role

in the US health care system. To take a look at the spurious research, the

evilness of the drug companies, the underhanded actions of the AMA, the

suppression of real non toxic better cures, etc, etc, etc, to see how " ethical " ,

or really unethical, the whole sytem is.

 

 

Economics has usually been the only overiding consideration. If you view a

changing " ethics " situation, it usually just reflects and is an " excuse " to

change to a better more profitable economical model.

 

Most all medical decisions are purely economic, I have never seen any medical

system in USA ever stop treatment, no matter the ethics involved, if there was

ample monetary resources involved. In fact ample monetary resources usually

provides the motivation and very real risk that the patient may then be doctored

to death. - Frank

 

 

 

 

 

" Zepp " <zepp

 

 

Sun, 27 Mar 2005 15:43:33 -0800

[Zepps_News] #Even as Doctors Say Enough, Families Fight to

Prolong Life

 

 

 

 

<http://www.nytimes.com/2005/03/27/national/27death.html?hp & ex=1111986000 & en=51b\

849279cffe573 & ei=5094 & partner=homepage>

Even as Doctors Say Enough, Families Fight to Prolong Life

By PAM BELLUCK

 

Published: March 27, 2005

 

OSTON, March 26 - For years, when families and hospitals fought over how

to treat critically ill patients, families often pressed to let their

loved ones die, while hospitals tried to keep them alive.

 

But in the last decade or so, things have changed.

 

Now, doctors and ethicists say that when hospitals and families clash,

conflicts often pit families who want to continue life support and

aggressive medical care against doctors who believe it is time to stop.

 

" The most common case that comes before the ethics committees, " said Dr.

John J. Paris, a bioethicist at Boston College, " are families now

insisting on treatment that the doctors believe is unwarranted. "

 

Extraordinary medical advances have stoked the hopes of families. Also,

more patients and families feel empowered to make medical decisions, and

some are skeptical of doctors' interpretations or intentions.

 

When asked in polls about Terri Schiavo, the brain-damaged Florida

woman, 60 percent to 70 percent of respondents said they would remove

Ms. Schiavo's feeding tube and, in similar circumstances, would choose

not to keep themselves or a spouse alive.

 

Many right-to-die requests would not cause conflict with a hospital

these days because they are more likely to be in sync with doctors'

assessments. When there is a conflict, it typically involves families

who feel their loved one would not want to endure surgery or treatment

that might not succeed.

 

But even families who say they believe in removing life support may find

that position untenable when their own relatives are involved.

 

" About 15 years ago, at least 80 percent of the cases were right-to-die

kinds of cases, " said Dr. Lachlan Forrow, the director of ethics

programs at Beth Israel Deaconess Medical Center in Boston, who handles

50 to 100 end-of-life conflicts a year. " Today, it's more like at least

80 percent of the cases are the other direction: family members who are

pushing for continued or more aggressive life support and doctors and

nurses who think that that's wrong. "

 

Dr. Lisa Anderson-Shaw, co-chairwoman of the ethics committee at

University of Illinois at Chicago hospital, said that in 1998 she

consulted on 2 such cases, while last year, she fielded 11.

 

Chuck Ceronsky, a co-chairman of the ethics committee of Fairview

University Medical Center in Minneapolis, said, " The right-to-die

families find a more receptive audience in the hospital, as opposed to

years ago when a doctor might say, My job is not to end life. "

 

" We have a disproportionate number of cases where people come in with

something they think ought to be tried, or that they've read on the

Internet ought to be tried, " Mr. Ceronsky added.

 

Ethics committees resolve most cases, often through repeated family

discussions over weeks or months.

 

But at least three states, Texas, Virginia and California, have laws

that let doctors refuse treatment against the wishes of a family, or

even a patient's advanced directive in certain circumstances. In other

states, like Wisconsin, doctors are seeking such laws.

 

" When they're asking for things that become absolutely nonsensical, then

you don't have to do it any more, " said Dr. Kay Heggestad, who is the

chairwoman of the ethics committee of the Wisconsin Medical Society and

is helping draft a " futile care " bill in her state. " If someone marches

into my office with normal kidney function and demands dialysis, I am

not required to offer that. "

 

Recently, several life-support requests have landed in court.

 

In October, when doctors at a hospital in Salt Lake City declared

6-year-old Jesse Koochin brain dead and planned to remove life support,

Jesse's parents, Steve and Gayle Koochin, went to court. A judge ruled

against the hospital and granted the Koochins the right to take Jesse

home, where they kept him on a ventilator and said they were convinced

that he could get better with alternative medical treatments. A month

later, Jesse died.

 

In Boston, doctors considered it so inhumane to keep alive Barbara Howe,

a 79-year-old woman with Lou Gehrig's disease, that the chairman of the

ethics committee wrote in June 2003, " this is Massachusetts General

Hospital, not Auschwitz. "