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Passions in Poetry

The Sick And Elderly's Obligation to Die

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Huan Yi
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0 posted 03-02-2012 06:54 PM       View Profile for Huan Yi   Email Huan Yi   Edit/Delete Message      Find Poems  View IP for Huan Yi

.


Can one argue there is a moral social obligation
for the sick and old to die sooner than later?
There were cultures that forced the issue through
abandonment as a matter of culture and custom;
it was then an understood thing.  The yet to be born
are still in the hands of others; why not those about
to anyway die?

http://www.smh.com.au/world/mobile-euthanasia-units-go-on-the-road-t o-make-house-calls-20120302-1u7y3.html


http://www.usatoday.com/money/industries/health/2006-10-18-end-of-life-costs_x.htm


.

[Fixed title - Ron]

[This message has been edited by Ron (03-16-2012 03:31 PM).]

Bob K
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1 posted 03-03-2012 01:33 AM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K



     I thought the article was about health care directives, John.  Am I misreading the text here?

     I've been reviewing my mother's with her and making sure that they're up to date, so that we can be sure to carry out what her wishes are as closely as possible if she is incapable of communicating them to us at some point in the future.  There were points where she had wanted most everything possible done, but she's changed her mind now.  She wants to be kept comfortable if there are no signs of ability to think.  She wants fluids but no antibiotics and so forth.  The exact details are pretty much private.  

     The family's willing to do the best we can with her wishes.  We're not trying to rush her out of this world.

     If you force an intervention on a patient, it may prolong his or her life.  If that's what he or she wants, that's terrific; but it can be something that's a much of a burden as it is a help.

     My thinking is that it's probably a good idea for the patient to make that set of decisions as best he or she can while they are still able to do so.  As a Republican, that ought to be familiar ground — a guy makes as many of his own decisions as he can for as long as he can do so,m and the only time somebody else takes over is when they have to.

     I can't sat that I agree with that all the time, but if we can arrange to do that as much as possible, it seems like a pretty good idea.
Huan Yi
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2 posted 03-14-2012 07:16 PM       View Profile for Huan Yi   Email Huan Yi   Edit/Delete Message      Find Poems  View IP for Huan Yi

.


Approximately one third of the federal government medical expenditures
are for what proves to be the last year of a patient’s life; half of that in what
can be with confidence determined beforehand as a patient’s
last month of life.   Given there are limited resources, doesn’t the
government have an obligation to triage patients under its care?


.
Bob K
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3 posted 03-14-2012 11:06 PM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K


     I would argue that they do not.

     It would be a conflict of interest to do so, in the first place.

     Why would the Government or agents of the government feel the need to substitute judgement of the Government or of other parties, when the judgement of the person involved seems perfectly useful given the Democratic  traditions of the country.  

     I would imagine that if the person was not competent to formulate a judgement, the story might be different; but even then, our democratic traditions would suggest that the government's only role in the matter would be to protect the interests of the individual from exploitation.  Probably, it would best be able to do this by serving as the judiciary.

     I'd be interested in seeing what other points of view there are, though.
Essorant
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4 posted 03-15-2012 03:38 AM       View Profile for Essorant   Email Essorant   Edit/Delete Message      Find Poems   Click to visit Essorant's Home Page   View IP for Essorant

No, it is the other way around.  Just as when we come into this life we are treated a bit more as being precious and innocent in the vulnerable condition of our age, when we are going out of life through a door of weakness, we deserve to be treated as precious as well.  It should be a law that every elderly person is taken care of with the utmost dignity and care.
  
Bob K
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5 posted 03-15-2012 01:47 PM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K



     That's an interesting point of view, Ess.

     I find it oddly seductive, but that's the problem as far as I'm concerned.  One can justify doing all sorts of ugly things to people in their best interests, just as all sorts of terrible things are done to children in their best interests — as graciously defined by other people who are only too happy to do things that way.

     "This hurts me more than it hurts you," may be a familiar turn of phrase to you, Ess.  I would say, "Hopefully, it isn't," but you should be aware of the number of folks who would disagree with my right to say that.  We have discussions about this sort of thing relating to the prevalence of circumcision among male children as a non-religious practice, for example, and about the usefulness of physical punishment of children for child rearing.  

     Each of these practices are justified as necessary for the good of the other.

     Suggesting that "It should be a law that every elderly person is taken care of with the utmost dignity and care," seems to me to be a way of taking the power of defining exactly what that means out of the hands of "every elderly person" individually, and this troubles me no end.  Why can't elderly people have rights to take care of themselves?  

     Current laws about living wills are meant to do exactly that and to my mind are quite effective.  The problem is that people do not always take advantage of them.
Huan Yi
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6 posted 03-15-2012 05:21 PM       View Profile for Huan Yi   Email Huan Yi   Edit/Delete Message      Find Poems  View IP for Huan Yi

.


Write all the laws you want.

The US doesn't have the money now.

The top 1% of the US pay 40% of the income
taxes, the top 10% pay 70%.  You going
to get more from whom then?

China has its own old to take care of,
(they're going want the money they've already
loaned us for that purpose).  

And our doctors don't work for free.


.
Essorant
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7 posted 03-16-2012 01:10 AM       View Profile for Essorant   Email Essorant   Edit/Delete Message      Find Poems   Click to visit Essorant's Home Page   View IP for Essorant

quote:
Suggesting that "It should be a law that every elderly person is taken care of with the utmost dignity and care," seems to me to be a way of taking the power of defining exactly what that means out of the hands of "every elderly person" individually, and this troubles me no end.  Why can't elderly people have rights to take care of themselves?



No, I certainly didn't mean it that way Bob.  I meant when they are being taken care of by others because they can't take care of themselves or can't very much.  In such situations it is not very different from children being in our care.   Whatever we wouldn't condone for a young child on behalf of his/her dependance and vulnerability, we shouldn't condone for an elderly adult in his/her dependance and vulnerability either.   The point of a law would be to try harder to standardize much better care for all elderly people and monitor it better to prevent neglect that takes place far too often.
Bob K
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8 posted 03-16-2012 02:12 AM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K



     Beg pardon?

     We do have some problems that way, I agree, but for me, the issue seems to be extending the definition of life fairly dramatically into the inorganic realm, before birth, and not in extending the definition of life into old age, when nobody would deny it exists.

     It certainly is expensive to prolong, and it probably should depend on the wishes of the person whose life is being prolonged as to whether it should go on, and how long, and under what conditions.

     As far as I am aware, there is a movement that allows that folks should have the right to end their own lives when they wish.  My personal feelings about this are very mixed, having been on several occasions been pressured to help people kill themselves by having reference made to a person's right to die.


(quote)


Write all the laws you want.

The US doesn't have the money now.

The top 1% of the US pay 40% of the income
taxes, the top 10% pay 70%.  You going
to get more from whom then?

China has its own old to take care of,
(they're going want the money they've already
loaned us for that purpose).  

And our doctors don't work for free.

(/quote)

     No new law needs to be made, far as I'm aware.  Simple obedience to the old ones requiring following the patient's wishes about heroic measures would probably be enough.  Each patient should have such documents on file and available.  I haven't seen any legislation requiring people to die before they're ready to do so.

     A conversation between patient and physician should be part of the medical relationship, and it should cover this material frankly and explicitly.  Of course, I'm not a doctor, nor do I play one on tv.  

     Nobody has an obligation to die to anybody except to God, should your beliefs run that way; and the only people that I've actually heard talking about God telling them they need to die have been frankly psychotic, whose symptoms were not limited to the auditory  ones they were using to justify their attempts to die.  Other factors apply as well.

     I'm sure the pay scale of physicians has something to do with this.  I simply don't know what it is.  I'd think that obeying the law about patient wishes would probably save money, since I don't know any patient wishes that include the wish to be resuscitated time after time without regard to expense or quality of life or degree of pain consequent to the procedures,  There may be such directives, though.

     I'm curious what suggestions others might have for such directives.  It seems to me, for example, that if somebody wishes their body frozen, they ought to be able to have that done, though probably at their own expense.  The effectiveness of the treatment has not been demonstrated.



Stephanos
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9 posted 03-16-2012 02:33 PM       View Profile for Stephanos   Email Stephanos   Edit/Delete Message      Find Poems   Click to visit Stephanos's Home Page   View IP for Stephanos

Bob:  
quote:
I find it oddly seductive, but that's the problem as far as I'm concerned.  One can justify doing all sorts of ugly things to people in their best interests,


I could be wrong, but I imagine Essorant was referring to an educated and informed "best interest" including a knowledge of the trauma involved in end-of-life interventions, such as mechanical ventilators, electric shock, chest-compressions, feeding tubes, tracheostomies, etc ... etc ... This would also include education on typical prognoses after such interventions, and how very few gain any meaningful quality of life afterwards.  That's not to say there isn't a time for such things.  But it is to say that "best interest" really isn't that frightfully complicated when it comes to end-of-life-issues.  Ignorance has clouded the issue.  I think "end of life issues" should be a required course in highschool.    


On the other hand, I'm not ready to euthanize the elderly either.  Reminds me of the policies of the third reich, all in the name of optimizing humanity and efficiency.  It's too easy to dehumanize the human at either end of the spectrum of age (and all years in between!).  


Stephen
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10 posted 03-16-2012 09:43 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

http://en.wikipedia.org/wiki/Oregon_Death_with_Dignity_Act
serenity blaze
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11 posted 03-16-2012 09:53 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

My apologies if my link was mentioned previously--lost my glasses--again. I only knew about this due to a very touching documentary I watched a couple of months ago.

But the whole "death with dignity" thing, I also wrote about watching a dear friend die, after a long (for this generation) of life, and how I felt honored to witness a man complete the cycle...and I found dignity in that.

I guess it's a matter of perspective...until you calculate financial perspective, and then what? At what age would we start calculating contribution to the general good of society? What constitutes accomplishment? I fear mass graves and a slant-eyed viewpoint of a despot...
Bob K
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12 posted 03-17-2012 03:59 AM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K



     I tend to agree with you, Stephen, about the uncomplicated nature of a lot of end-of-life issues, but the complexities do have a way of cropping up, even when you think they aren't there.  That's what living wills are all about, and why people get a chance to issue directives in advance of these situations.

     What was the name of that poor woman in Florida a few years ago who was in a persistent vegetative state and whose family was fighting the husband to keep her going by machines, even though she had flat-lined years before?  This seems to me to be an example of end-of-life issues gone mad.  Folks really need to have directives in place — me included, by the way — that are specific about the amount of pain and indignity the person wishes to subject himself or herself to.  In my case, if there's minimal chance of recovery and my quality of life is shot and I'm in pain, I don't want to be kept around to suffer to no real purpose.

     Don't rush those conditions, but once they're met, I really don't want to survive with my sole purpose in life to be some corporation's profit center.
Ron
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Yes, everyone should have Living Wills. Everyone should also put a few percentage points of their net income aside during the fifty or sixty or seventy years they will be earning a living. That would almost guarantee they have enough money of their own so they never become a burden on anyone else.

Most people, however, will never do either.
serenity blaze
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14 posted 03-17-2012 04:38 AM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

That poor woman in Florida was Terry Schiavo.

I've had the honor of meeting her beautiful daughter, after her daughter's mother became a pawn in one of the most painful debates regarding just who is in charge of ultimate life contest of wills which underscored the argument of science vs. divinity, comparable only to to the books of the Old Testament.

Terry Schiavo's medical records provide proof of brain activity--periodic spikes of signs of intelligence--which ultimately tore that family apart with the extremes of hope to a shudder of a shrug of non-committal which they must endure as it tears them even further apart as other miracles occur, as others are reported to just "wake up" after years of a medically diagnosed coma...and those definitions change.

And I still don't know which side of the feeding tube is more horrific.

I hope I never do.
Huan Yi
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15 posted 03-17-2012 10:14 PM       View Profile for Huan Yi   Email Huan Yi   Edit/Delete Message      Find Poems  View IP for Huan Yi

.


My father died at 73 but it was a body built working in the steel mills
of Gary, and eight years of medical miracles, ( today, according  to George
Will, 40% of those on Medicare are pharmaceutically sustained against
three or more conditions that a generation ago would have killed them),
that kept him alive.   When the end came it was to a man he as he was
when he retired at 62 would not have recognized and for whom he would have had no respect.
I love my father.   We were raised  Roman Catholic and apart from the fear of what death means,
there are all sorts of then inhibitions,
though in my father’s case I think, absent a death in peaceful sleep all of us in our
hearts hope for, he in retirement engaged in
behavior that essentially sought death by
accident, ( I think about  when my time comes taking up again lone diving).  If, the law
allowing, I had shot my father in the head
shortly after 65 when life became nothing
more than a losing holding action, I think
my father knowing my love and out of love
for himself would have blessed me.

My best friend, a man I've known and loved for almost forty years, a man I would have gladly killed as well as died for, has asked me to pull the plug on him when the time comes because despite their
relationship he doesn't trust his children to respect his need for final dignity.  I hope some unknown
doctor will have enough regard for me.


I apologize for the way this appears; I was writing on Word which
has wider margins . . .
.


.

[This message has been edited by Huan Yi (03-17-2012 10:51 PM).]

Ron
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John, it's hard sometimes to make those decisions for someone else, no matter how much we might love them. It's much, much harder, however, to make those decisions for ourselves.

No one I've watched waste away, and there have been far too many of those, has ever convincingly wanted to die. They've had bad moments, of course, when pain drowned all sense of hope, but those moments never lasted beyond the tempering of their immediate discomfort. No one I've ever watched die has lost all semblance of hope.

After all, John, that's exactly what you're describing: A sustained and utter loss of all hope that things might get better, that there might yet remain some few fleeting moments of pleasure and satisfaction to be gained from continued life. Some people think the human condition is defined by love. I think, beyond even love, we are shaped by a nearly unquenchable capacity for hope. Life is hard from the moment we are born -- into pain, discomfort, and hardship -- and it always, always just gets harder and harder. We endure the bad in hope of savoring the good.

Perhaps there comes a time in the life cycle when hope finally dies, when the bad really does outweigh even the remotest possibility for good, but frankly I've never seen it. I've seen scores, maybe even hundreds, of people say they would never want to "live that way," but they always seem to say it when they are younger and "that way" seems far, far removed from their present life. When it comes time to actually make those decisions, though, they always seem to find some reason to want to continue living. That is the essence, I think, of who and what we are.

People who give up easily don't have to worry about getting old. I suspect those have long ago been weeded from our gene pool. We are stubborn, and strong, and in the beautiful words of Dylan Thomas, we shall "not go gentle into that good night," but will instead "Rage, rage against the dying of the light."

Death is not a decision we can ever make for another. Indeed, until our own moment actually and irrevocably arrives, I don't think it's a decision we can even make for ourselves. Were we to know with absolute certainty the day we would die, we still couldn't reliably predict the moment when the smallest sliver of hope would forever disappear from within our heart.

In truth, I suspect it never quite does.


Denise
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17 posted 03-18-2012 12:39 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

That poor woman in Florida was Terry Schiavo.

I've had the honor of meeting her beautiful daughter, after her daughter's mother became a pawn in one of the most painful debates regarding just who is in charge of ultimate life contest of wills which underscored the argument of science vs. divinity, comparable only to to the books of the Old Testament.


Where did this come from Karen? Do you have a link to it? I read the wiki link you provided but didn't see anything in there about it. I guess it was something that referenced Terry Schaivo but was actually talking about someone else? Because it couldn't actually be talking about Terry since she never had any daughters (or children at all for that matter). Am I misreading this?

Bob K
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     The myth of Pandora has several versions.

     The one that I remember from childhood was the version in which Pandora was able to shut the box before Hope escaped, thus preserving this most important resource for humanity.  I was quite happy with this version for many years.  Talking this over with my analyst, a woman who seemed to specialize in making life more complex for the cheerfully minded, my analyst pointed out that the Greek myths are seldom so straightforward.

     The box that Pandora opened was a box that contained all the Evils of life.

     The one that remained in the box, Hope, was reputed to be the greatest evil of them all.  Whether or not the fact that it was kept may have been a triumph or it may have been a curse, and the size of the Curse, if it is a curse, has yet to be determined, doesn't it?

     As for Pandora, what was going on with that woman when she allowed herself to get cornered into a relationship with a God?  You've got to know that when somebody lays conditions like that on you simply to have a relationship that it's not going to be a great idea from the beginning, don't you?

     And yet Pandora still manages to keep Hope in the box, where it presumably has tormented her ever since, and where it's provided us with situations like this ever since, for good and, as Ron perhaps hints, perhaps not for so good.
Stephanos
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19 posted 03-19-2012 12:56 PM       View Profile for Stephanos   Email Stephanos   Edit/Delete Message      Find Poems   Click to visit Stephanos's Home Page   View IP for Stephanos

Karen,

Could you explain how the Shiavo case underscored the "argument of science vs divinity?".  Not sure i'm following you.  Maybe i don't have enough info to understand what you're referring to.

Stephen
Huan Yi
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20 posted 03-19-2012 07:48 PM       View Profile for Huan Yi   Email Huan Yi   Edit/Delete Message      Find Poems  View IP for Huan Yi

.
Ron,


Your argument seems to rely upon the thought
that where there is life there is hope; but
at some point, even for the most optimistic man,
(short of miracle), that is just not true . . .

The problem for our generation in our country
is that it has afforded no way of thinking at the end
that affords a hopeful transition to whatever there actually is
against nothingness, and that for the bravest man
is terrifying.


John


.

[This message has been edited by Huan Yi (03-19-2012 08:19 PM).]

 
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