Bioethics, end of life, Futility, Medical Futility, Texas Advance Directive Act

Answer 3

From Jerri:

Your personalizing of this makes no sense. It’s as if you are saying that–if the medical community’s ethics are questioned in any way–that’s an attack on the community.

We live in a free society and everyone is entitled to their opinion on what medical ethics should be. That said, the medical profession’s opinion should not be the final word. If they can’t stand the heat of having their positions challenged, I suggest they go somewhere and set up a dictatorship. Otherwise, complaining about others challenging their positions is just whining.

I think the AP reporter is the origin of the several quotes about freeing the bed and “mad dash.” But, there are so many copies of each quote, that I don’t think you’re going to be able to get everyone to pull them.

Can you convince Melanie Childers to stop saying the Bishop is helping to murder Emilio?

There are consequences to your words.

We all do this for the love of the cure, of caring, and because it makes us feel like good people – it soothes our consciences.

I strongly disagree that ethics are a matter of opinion – that one person’s opinion is as good as anyone else’s. I certainly don’t agree that docs who don’t want to prolong dying in children with collapsing lungs or to perform abortions are simply expressing an opinion. There is a definite right and wrong, here: First do no harm. Sometimes judgment is needed to weigh the harm vs. benefit. However, the doc is the one who will be forced to act. The option is to have the oversite committee and to offer a time to transfer to someone else.

Can you imagine if a trial continued 24/7/365? That’s family medicine – even when we’re not on call, we are responsible for our patients. In a small town, everyone knows where you live, go to church and what’s in your grocery cart. Family docs who deliver babies are on 5 “call lists” at our hospital. The ER or Deliver can assign a patient who had no prior doc in town from the OB, Gynecology, Medicine, Trauma/Surgery, Pediatrics and Newborn “lists.” Why would anyone continue hospital care plus office care if any patient’s family could insist on repeat aggressive treatments like Emilio’s treatment for pneumothorax or even constant, repeat CPR?

How long would a doc be able to keep a good conscience if this happened a couple of times?

As I said, read what people say about doctors (and by extension, the nurses and everyone else who would have to support the lie) after one of these posts and consider the effect on the patient and family of the family doc in New Braunfels, Texas.

Or consider the LVN who works a 12 hour shift and whose patients now question her complicity with the conspiracy — her job is even more on the line that the doc, who can go down the street to the next hospital or quit hospital practice all together.

And I’m afraid that that is what is going to happen: more family docs will decide to admit to hospitalists rather than admit their patients to the hospital. Fewer will enter hospital work and geriatricians will become even more scarce.

Especially: more small town docs will find it difficult to transfer their sickest patients to the tertiary centers.

About bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)


6 thoughts on “Answer 3

  1. >I am not advocating moral relativism. I am saying that people can debate what the truth is.I have no compunction about saying that doctors have no business forcing a view that the clinical outcome of a treatment, which is life, is too burdensome to the patient. They are not in a position to know that.By the way, you don't know what the status of his lungs is right now.I totally agree that doctors should not be forced to do abortions. To me the distinguishing factor should be that life should always be favored over death when it comes to conflicts.

    Posted by Jerri Lynn Ward, J.D. | March 22, 2007, 7:03 pm
  2. >Here I'm probably showing my own preoccupation with this particular issue, but when Jerri talks about representing the child's situation as worse than it is, what springs to my mind is the stuff several posts down about necrosis of the gut, inability to process feedings, being harmed even by NG tube feedings, and the like. Now, I admit you qualified those with words like "probably," but then several paragraphs down you begin a paragraph by saying, "The doctors laid this out for the Committee. The Committee's report laid it out for us." And that's just balderdash concerning the stuff about the lining of the gut being "mostly dead" and his being harmed by feeding, because the committee report didn't say *anything like this*. That was your guesswork based on your own past experience and on no examination of the child. And it's closely related to the recommendation you give in another post that the ventilator should be continued but that tube feeding should be discontinued and the child's mouth simply kept moist with droppers of fluid. That's almost worse than what the Committee recommended, to my mind.That's what I suppose is part of what Jerri has in mind when she talks about your representing the child's condition in such a way as to make it even harder to find a transferring facility.

    Posted by Lydia McGrew | March 22, 2007, 7:46 pm
  3. >Lydia, I'm afraid that the point Jerri made was that she knows more than I do and that she can sue me any time she wants, along with the hospital, the several pediatricians, etc.

    Posted by | March 23, 2007, 1:48 am
  4. >"Lydia, I'm afraid that the point Jerri made was that she knows more than I do and that she can sue me any time she wants, along with the hospital, the several pediatricians, etc."This is absurd. I have no intention of suing you. I am asking you to quit making representations about Emilio's condition on the internet that are based on speculation so that the difficulty of transfering him is not increased. Lydia has more eloquently described my problem with your posts than I did.You don't have copies of the records and don't know what they say. And, I'm not depending on my reading of them–I'm depending on other professionals.By the way, if you want to bring religion into this (as is fully appropriate) this crap I'm hearing that we are playing God by keeping Emilio on a respirator is just that, crap. If it's God's will that Emilio die at a certain point, no amount of high tech equipment will prevent that. After all God is God and He decides, not us.

    Posted by Jerri Lynn Ward, J.D. | March 23, 2007, 3:35 am
  5. >I've great confidence in the intelligent and educated layman. It seems to me not far-fetched at all that a layman closely associated with the child, his mother, and his doctors, consulting professionals directly about the patient, might indeed know more about his condition than even a highly-qualified professional who did not have these direct connections to the situation.Suing anyone, of course, is a different matter altogether, as Jerri's said.

    Posted by Lydia McGrew | March 23, 2007, 4:32 am
  6. >I would still like to know how the North Country Gazette got the Ethics Committee Report. That report covers several doctors' reports on the progressive deterioration of Emilio. As I said, any of the times that Emilio had a lung collapse would have been a "natural" death, if there ever could be such a thing in the ICU.My commenting on Leigh's syndrome, the report of the Ethics Committee and what I know of the course of progressive multi organ failure will not mean anything to another doctor contemplating coming on the case. The derogatory comments about hospitals and doctors with God complexes who want to free up beds probably do, though, even without all the phone calls, accusations about the Bishop. I know the legal terms, discussion about HIPPA and Human Rights investigations and the fact of legal action does.

    Posted by | March 23, 2007, 7:14 am

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