Reply to Bias towards elderly who will not go quietly

Forum Index » Eldercare

Reply to "Bias towards elderly who will not go quietly "

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]Absolutely terrible thread title, BTW. [/quote]

Agreed, it is a disgusting title.

I am an attorney who changed careers and have been working in mostly hospice care for the last near decade. The majority of my patients have been elderly, but some were DNR based on chronic degenerative conditions at younger ages.

I’ve noticed that the majority of doctors are just as uncomfortable as the average person with having conversations about death. They may be more matter of fact about it in their own thinking, but they don’t really want to talk about it with patients. There is a lot of avoidance of spelling things out plainly to people who are avoiding accepting it themselves. Even some doctors and nurses who work in HOSPICE, whose jobs are all about helping dying patients die, sometimes push too far to keep people on the alive side of things even if it means prolonging discomfort.

I can’t agree with your OP at all, not the ugly thread title. The truth is that the situation in American medicine is overwhelmingly the flip side of the coin - we spend astronomically to keep people alive in the final years or months, and often causing much anguish in the process for patients and families alike. All because we can’t talk about death in this country and most folks are terrified of it.

As to your parents OP - this is a well tread area of medical ethics and not some ageism bias of the doctors. When patients are in their 80s and beyond, they are statistically much less likely to fully recover from many procedures and treatments - exponentially less likely than a patient in their 50s, 60s, or even 70s. Same with their statistical likelihood of experiencing complications which hasten greater disability and/or death.

This factors into the physician’s determination of what is in the best interests of the patient, and no doctor is required to perform a surgery or treatment on a patient if they feel it is going against their best interests. Some doctors are skilled at explaining this and others just hem and haw and avoid flat out saying how things are. It has nothing to do with a lack of caring about your loved one. I would argue that there is more caring on offer from someone who nudges you in the direction of recognizing your impending mortality than in steering you toward further denial.
[/quote]

[b]The patient alone determines what is best for them. [/b]Physicians may be learned intermediaries but they have no right to decide whether a patient gets treatment or not. They have a duty to explain all options and the likely results of each. If they can’t do that, they should switch to pathology.

Not everyone who resists being “nudged” toward the beyond is in denial. Some just have more hope than the people doing the nudging. [/quote]

No, patients don’t dictate their care. You can’t just order a doctor to do this or that, if it’s not medically indicated. No wonder so many people are leaving the medical field. You think you can boss them around like they’re your nanny.[/quote]

While medical arrogance may know no boundaries, it is the physician’s duty to explain options and associated prognoses. Failure to do so is prima facie negligence. What is “medically indicated” is a matter of opinion, and patients have a right to have that opinion and the grounds for it made clear. Hiring a physician to provide services does not create a custodial relationship where the physician holds the power of life and death to be exercised at his or her caprice. Oh, and I don’t “think” I can boss the Great Exalted around, I know I can, and I do. [/quote]

Your post is laughable, because nobody is asserting that the physician controls the patient’s choice. The patient can always get a second opinion and if they look long enough, they will doubtless eventually find a physician more motivated by medical fees to be collected than by the Hippocratic oath.

If your parent has reached the twilight years and still hasn’t learned this fundamental truth of medicine, please do explain it to them. It is not the doctor’s obligation to urge them to seek a second opinion. [/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics