Should illegitimate children be denied insurance coverage from Catholic institutions?

[AdamP88]

So there is a lot of talk about the mandate making Catholic institutions cover birth control for employees. This is because Catholicism views birth control as a sin. Having a child outside of wedlock is also a sin, so should illegitimate children be denied insurance coverage? What about treatments for STI’s or other sexual related diseases? What about ED medicine for people that are not married?

If you say that birth control should be denied but illegitimate children should be covered, why? What is the distinction? Where do you draw the line?

I think you know the answer to this.

This is just a ridiculous argument and does not warrant a response.

 

[JimG]

I’m not sure one can justify mandating coverage for Viagra or contraceptives or abortifacients from a secular standpoint. They increase the cost of insurance for everyone, but not to save lives or improve health. They are all manipulations of the normal functions of the human body, (which includes aging in the case of Viagra, and aging is normal) using medically-tested chemicals to do it, and in a medical setting. And both are designed to enhance totally voluntary activity. Disease is not voluntary. It imposes itself. So, to the extent scarce resources are used to enhance voluntary activity, they reduce resources for things that really do save lives or improve health, for conditions that are not voluntary.

It seems to me, then, that if a man wants Viagra, he ought to pay for it, 100%. If a woman wants to have sex without conception, she should pay for that 100% as well. If, by doing that, the overall cost of insurance goes down by any amount, a secular purpose is served, which is increasing resources available for things that really do save lives or improve health, and which people otherwise cannot, themselves, control.

What all of this healthcare debate does not seem to take into account is the fact that resources for healthcare, as with all other good things, are limited. As a consequence of our seeming refusal to accept the fact that resources are limited, we find ever greater portions of national income going to debt service, thus reducing limited resources even more.

I agree with this. Health insurance pays for way too much–including Medicare, and in doing so drives up the cost of health care. It ought to pay for a lot less. “Preventive” services are mostly pointless. Even the medical community is now recommending less routine medical screening. It drives up costs for little benefit.

Someone on Medicare with a supplemental policy can walk into a medical facility and end up paying nothing–no copay. So nobody is watching the cost. There should be a copay for nearly everthing, and insurance should cover the catastrophic, not the routine.

 

[Ridgerunner]

I agree with this. Health insurance pays for way too much–including Medicare, and in doing so drives up the cost of health care. It ought to pay for a lot less. “Preventive” services are mostly pointless. Even the medical community is now recommending less routine medical screening. It drives up costs for little benefit.

Someone on Medicare with a supplemental policy can walk into a medical facility and end up paying nothing–no copay. So nobody is watching the cost. There should be a copay for nearly everthing, and insurance should cover the catastrophic, not the routine.

One little recognized aspect of Obamacare is worrisome, or ought to be. By 2016, all medical records have to be on one electronic system. Right now, providers are “rewarded” for doing certain things that are deemed preventive, but probably aren’t, in the main. Among them are recording admonitions to people to, e.g., lose weight, eat healthier foods, stop smoking, be more compliant with prescribed meds, to see to conditions with a chronic potential, and executing advanced directives. Right now, providers are rewarded by the government for doing those things and recording them. The percentages required for provider compliance are high. Obviously, this is an incentive to “dump” patients who are deemed “noncompliant”, and they’re doing it.

In 2016, they will, instead, be penalized if they don’t do those things and record them. Remember that all of those records will be open to the government. Physicians, then, will be penalized in their reimbursements if they do not, for example, tell that hefty teenager every so often that she has to lose, say, 30 pounds or get an advanced directive on file for Mr. Jones saying he doesn’t want CPR or whatever if he has a heart attack and he’s in poor health anyway.

In addition to encouraging patient dumping, it will provide statistical grist for the bureaucratic mill concerning allowable care. If Mrs. Smith won’t lose weight after being admonished 5 times to do it, will Obamacare pay for her discectomy or her diabetes medication? What if Suzy is told, five times that three children is enough? Will she receive Gyn care even if she has six despite admonitions against it? What if she’s advised to abort, but doesn’t?

When the time comes for rationing care, and it will come, those statistics will come to haunt patients, and perhaps not just for medical noncompliance. Why does the government want to know if I have filed an advanced directive? What will it do if I don’t fill out the formulary one that says “Withdraw all care if you just don’t think my life is worth living”?

 

[JimG]

. . . Why does the government want to know if I have filed an advanced directive? What will it do if I don’t fill out the formulary one that says “Withdraw all care if you just don’t think my life is worth living”?

I absolutely hate that the first thing one gets asked on nearly any medical admission is whether or not you have an advance directive. Before I’m even in the door, they want to know when they can pull the plug. I’m always tempted to reply “Hey, you’re the medical experts here, not me. Just do the best you can and try not to kill me.” But that would probably go into my medical file as non-compliance as well!

 

[Rence]

I absolutely hate that the first thing one gets asked on nearly any medical admission is whether or not you have an advance directive. Before I’m even in the door, they want to know when they can pull the plug. I’m always tempted to reply “Hey, you’re the medical experts here, not me. Just do the best you can and try not to kill me.” But that would probably go into my medical file as non-compliance as well!

It’s not so that they can pull the plug. It’s so that if you code, and they revive you and you’re disgruntled about that revival (maybe, for example, you end up paralysed on one side, or have some brain damage), you don’t sue them. OR, if you choke on sputum and your family wants you to be a DNR (do not resuscitate), your healtcare provider will know already that you don’t want to die over something as stupid as choking on sputum because they will already have your directives.

 

[Ridgerunner]

I absolutely hate that the first thing one gets asked on nearly any medical admission is whether or not you have an advance directive. Before I’m even in the door, they want to know when they can pull the plug. I’m always tempted to reply “Hey, you’re the medical experts here, not me. Just do the best you can and try not to kill me.” But that would probably go into my medical file as non-compliance as well!

To qualify for the “reward” (and later to avoid the penalty) they have to record it, yes.

It’s possible (probably with legal help) to craft an advanced directive so restrictively that it’s not contrary to the teachings of the Church. But will that do? And will it be honored as intended? One has to remember that such things are subjectively interpreted by providers. I recall one physician (on the ethics board of a hospital, no less) who opined that one should be unplugged from care if it seems evident he can no longer do what he enjoys most in life. When asked if that included the ability to play golf, he responsed affirmatively.

I can’t speak for others, but I suspect that if I could no longer play golf, I could find something else I would enjoy doing. But if, say, I am disabled to the extent that I can’t play golf and if I get pneumonia, that particular doctor would presumably not give me antibiotics if he knew playing golf was my favorite pastime.

 

[Ridgerunner]

It’s not so that they can pull the plug. It’s so that if you code, and they revive you and you’re disgruntled about that revival (maybe, for example, you end up paralysed on one side, or have some brain damage), you don’t sue them. OR, if you choke on sputum and your family wants you to be a DNR (do not resuscitate), your healtcare provider will know already that you don’t want to die over something as stupid as choking on sputum because they will already have your directives.

But you see, such purposes can be served if the FAMILY has the directive. But that’s not the way the thing works. The PROVIDERS are the ones who are required to solicit them.

Now, if I code, how in the world is any doctor going to know I’m not going to be able to swallow my spit, or for how long, and how does he/she know I would rather die than be unable to swallow my spit? Advance directives don’t talk about not rescuscitating people if the doctor THINKS MAYBE I won’t be able to swallow spit. They’re terribly, terribly general and people are presented with “canned” ones that don’t go into “spit detail”.

 

[Do_Good_Then_Go]

I absolutely hate that the first thing one gets asked on nearly any medical admission is whether or not you have an advance directive. Before I’m even in the door, they want to know when they can pull the plug. I’m always tempted to reply “Hey, you’re the medical experts here, not me. Just do the best you can and try not to kill me.” But that would probably go into my medical file as non-compliance as well!

I think you have this backwards. Advance Health Directives are designed to ensure that your wishes ARE followed, not that they’re NOT followed.

Just do the the best you can and try not to kill me sounds perfect to me. If someone really does want ‘everything’ done, that’s fine, but unfortunately there are too many people who say ‘do everything’ without really knowing what that means. They mean what you mean, use your best judgement and do everything that’s reasonable but because they said do everything you find 95-year-olds with advanced dementia on a ventilator when they develop pneumonia or have a massive stroke. In the good old days, the best thing to do would have been seen as treat the pneumonia with antibiotics and give normal supportive treatment, and wait and see. It’s very sad to see what happens a lot of the time now.

An Advance Health Directive can be changed or revoked verbally at any time should you change your mind.

 

[Rence]

But you see, such purposes can be served if the FAMILY has the directive. But that’s not the way the thing works. The PROVIDERS are the ones who are required to solicit them.

Now, if I code, how in the world is any doctor going to know I’m not going to be able to swallow my spit, or for how long, and how does he/she know I would rather die than be unable to swallow my spit? Advance directives don’t talk about not rescuscitating people if the doctor THINKS MAYBE I won’t be able to swallow spit. They’re terribly, terribly general and people are presented with “canned” ones that don’t go into “spit detail”.

An advanced directive will help you if you have one and make sure it gets to your doctor/nurses. For example, if you have stroke, and are on a ventilator, and your doctor thinks you have a chance to come back, but your family is afraid and wants you a DNR, your advanced directive will be used. That way, if you do code from sputum getting lodged in your trach, your healhcare providers know to call a code and get that sputum plug out. Whereas, there is no advanced directive in place, and you code, and your family makes you a DNR, you will die without a code being called to help you. It’s your responsibility to make your advanced directive as you want it to be. If you use a generic one, you will get a generic one.

Many times family members lack the knowledge and are scared and make decisions with that fear and lack of knowledge. It’s your responsibility, especially today, that your wants are made clear and given to someone who will bring your advanced directive to the ones who need it, when they need it.

 

[Rence]

I think you have this backwards. Advance Health Directives are designed to ensure that your wishes ARE followed, not that they’re NOT followed.

Just do the the best you can and try not to kill me sounds perfect to me. If someone really does want ‘everything’ done, that’s fine, but unfortunately there are too many people who say ‘do everything’ without really knowing what that means. They mean what you mean, use your best judgement and do everything that’s reasonable but because they said do everything you find 95-year-olds with advanced dementia on a ventilator when they develop pneumonia or have a massive stroke. In the good old days, the best thing to do would have been seen as treat the pneumonia with antibiotics and give normal supportive treatment, and wait and see. It’s very sad to see what happens a lot of the time now.

An Advance Health Directive can be changed or revoked verbally at any time should you change your mind.

This too.

 

[JimG]

An advanced directive will help you if you have one and make sure it gets to your doctor/nurses. For example, if you have stroke, and are on a ventilator, and your doctor thinks you have a chance to come back, but your family is afraid and wants you a DNR, your advanced directive will be used. That way, if you do code from sputum getting lodged in your trach, your healhcare providers know to call a code and get that sputum plug out. Whereas, there is no advanced directive in place, and you code, and your family makes you a DNR, you will die without a code being called to help you. It’s your responsibility to make your advanced directive as you want it to be. If you use a generic one, you will get a generic one.

Many times family members lack the knowledge and are scared and make decisions with that fear and lack of knowledge. It’s your responsibility, especially today, that your wants are made clear and given to someone who will bring your advanced directive to the ones who need it, when they need it.

Reading all these posts, it seems to me that the situation is worse than I thought. An advance directive essentially says, “If this, then that.” The "if’s involve a variety of potential medical emergencies, some of which are more dire than others.

The medical profession did not use to ask me or any patient to consider all these alternatives ahead of time, because I trusted the judgment of physicians. But they no longer trust their own medical judgment; instead, they fear the lawyers. And they seem to have lost whatever moral bearings they used to have as a matter of basic medical ethics, instead wanting the patient to write it all out ahead of time, even when patients are really not good at figuring medical outcomes and making medical decisions on matters which may never happen, or if they do, will be circumscribed with numerous unforseen circumstances.

Yes, I did do a medical directive at the same time I did a will. And after reading it over with my good Catholic lawyer looking on, I said, “You know, this whole thing seems heavily weighted toward death. Yet, putting in all the various possible qualifiers is just not worth the effort, and would probably confuse the docs even more.”

I gave a copy to my brother and said, here it is, but you should probably never use it. Instead, YOU make whatever decisions need to be made.

I hope never to use either the directive or the will. They just complicate things.

 

[Do_Good_Then_Go]

Reading all these posts, it seems to me that the situation is worse than I thought. An advance directive essentially says, “If this, then that.” The "if’s involve a variety of potential medical emergencies, some of which are more dire than others.

The medical profession did not use to ask me or any patient to consider all these alternatives ahead of time, because I trusted the judgment of physicians. But they no longer trust their own medical judgment; instead, they fear the lawyers. And they seem to have lost whatever moral bearings they used to have as a matter of basic medical ethics, instead wanting the patient to write it all out ahead of time, even when patients are really not good at figuring medical outcomes and making medical decisions on matters which may never happen, or if they do, will be circumscribed with numerous unforseen circumstances.

Yes, I did do a medical directive at the same time I did a will. And after reading it over with my good Catholic lawyer looking on, I said, “You know, this whole thing seems heavily weighted toward death. Yet, putting in all the various possible qualifiers is just not worth the effort, and would probably confuse the docs even more.”

I gave a copy to my brother and said, here it is, but you should probably never use it. Instead, YOU make whatever decisions need to be made.

I hope never to use either the directive or the will. They just complicate things.

I think sadly you’re right about some of that, especially in the US. Doctors do fear the lawyers and there is a lot of what is called defensive medicine rather than good old common sense and doing what seems in the patient’s best interests at the time. I’m not a doctor but I don’t think it’s fair to say that doctors have lost their moral compass, I think it’s that they’re not allowed to use it because, as you say, they fear the lawyers and losing their livelihood. This isn’t entirely the fault of the lawyers either (although personally I’d give them some of the blame - sorry any lawyers who are reading), it’s more that the public has somehow come to believe that a doctor or nurse or other health professional should never ever under any circumstances make a mistake or error of judgement. Everyone makes mistakes, even the best doctor in the world. Sometimes the results of these mistakes are tragic. People want to believe this shouldn’t happen though.

Also, all medical treatment has risks and benefits and sometimes things just go wrong with no warning and sometimes things just go wrong out of the blue for no reason that can be found, and sometimes that causes a tragic outcome too. The public generally doesn’t want to believe that either though - there is this pervasive idea that if something goes wrong it is because someone has done something wrong. People are increasing ready to sue, and increasing they threaten to sue during their treatment somehow thinking that this will make mistakes or adverse outcomes less likely.

I do take your point about the if then nature of some AHRs (although they’re not all like that) and obviously they’re not perfect but if there is no AHR it will be assumed that everything must be done and that means things like futile treatments and CPR on people with absolutely no hope of recovery. These things aren’t benign. Ribs get broken in CPR. Medications and other treatments have horrible side effects. You can accept that when there’s a chance that it’s going to be successful, but when it’s someone who’s been through more than enough already and is not a candidate for all this sort of thing and even 10 or 15 years ago would have already died relatively peacefully, and everyone standing there knows that, but they are forced to start CPR anyway, it’s very very hard to accept.

I’m sorry to derail the thread, but this is something that I wish everyone would think about a bit more.

 

[Ridgerunner]

An advanced directive will help you if you have one and make sure it gets to your doctor/nurses. For example, if you have stroke, and are on a ventilator, and your doctor thinks you have a chance to come back, but your family is afraid and wants you a DNR, your advanced directive will be used. That way, if you do code from sputum getting lodged in your trach, your healhcare providers know to call a code and get that sputum plug out. Whereas, there is no advanced directive in place, and you code, and your family makes you a DNR, you will die without a code being called to help you. It’s your responsibility to make your advanced directive as you want it to be. If you use a generic one, you will get a generic one.

Many times family members lack the knowledge and are scared and make decisions with that fear and lack of knowledge. It’s your responsibility, especially today, that your wants are made clear and given to someone who will bring your advanced directive to the ones who need it, when they need it.

Personally, I would rather my family, who are Catholics and follow Church teachings, make such decisions than some charge nurse or “rent-a-doc” who, for all I know, might be into mercy killing.

 

[Seeker1961]

Personally, I would rather my family, who are Catholics and follow Church teachings, make such decisions than some charge nurse or “rent-a-doc” who, for all I know, might be into mercy killing.

If your advance directive was drawn up with a Catholic lawyer, you should have no issues. That was how our family did it. We asked our Pastor to recommend someone. I recommend that everyone do the same, it will keep your healthcare decisions from being made by anyone else. One thing hospitals today fear is lawsuits, and going against an advanced directive would lead directly to a winning lawsuit.

 

[Ridgerunner]

If your advance directive was drawn up with a Catholic lawyer, you should have no issues. That was how our family did it. We asked our Pastor to recommend someone. I recommend that everyone do the same, it will keep your healthcare decisions from being made by anyone else. One thing hospitals today fear is lawsuits, and going against an advanced directive would lead directly to a winning lawsuit.

I agree with what you’re saying. Still, I would caution against putting it in your patient chart as long as you’re allowed not to do it. Give it to your family members. If it’s in your chart, you’re opening it to the interpretation of someone who might be euthanasia-oriented. That’s what I was told by a Catholic lawyer who does write them for people. It’s impossible to write one without using at least some generalities. Interestingly, he said advance directives are neither quite medical documents or legal documents because it’s impossible to do one with the precision demanded by either medicine or the law unless one already knows what condition will result in his death and knows what measures are or can be employed. Almost nobody can know that.

In his version, the authorized persons are advised to consult with a priest before making a decision, if possible.

 

[Seeker1961]

I agree with what you’re saying. Still, I would caution against putting it in your patient chart as long as you’re allowed not to do it. Give it to your family members. If it’s in your chart, you’re opening it to the interpretation of someone who might be euthanasia-oriented. That’s what I was told by a Catholic lawyer who does write them for people. It’s impossible to write one without using at least some generalities. Interestingly, he said advance directives are neither quite medical documents or legal documents because it’s impossible to do one with the precision demanded by either medicine or the law unless one already knows what condition will result in his death and knows what measures are or can be employed. Almost nobody can know that.

In his version, the authorized persons are advised to consult with a priest before making a decision, if possible.

That’s in ours as well, that if there is a question or doubt a priest should be consulted.

 

[Do_Good_Then_Go]

Personally, I would rather my family, who are Catholics and follow Church teachings, make such decisions than some charge nurse or “rent-a-doc” who, for all I know, might be into mercy killing.

That’s fine, just make sure the person or persons you choose has the legal authority to make those decisions, and make sure they will do what you want! Rence’s point is that family members who are likely to be distressed, shocked and sometimes not thinking straight can struggle if it’s never been discussed.

Doctors and nurses (99.99999% of them) aren’t into mercy killings or euthanasia or anything like that, they want to do the best thing by the patient, that’s what they do all day every day. It’s when wishes aren’t documented or when there’s conflict between family members or when the family think of what they want rather than what the patient would want that things don’t go well.

You’d be surprised how many people refuse to even discuss the subject.

 

[fix]

Those involved in the medical community (Doctors, nurses, medical researchers, etc.) and the insurance companies decide what counts as legitimate medical care.

Yes, they can claim all sorts of things. Just like the government can declare some persons are not fully human. The power to do something does not make it true.

 

[fix]

I agree with Rence’s post #4 but like I said in my post #16: The court system, not the medical system, decided birth control was medical care. Medical care is maintaining the body to operate as designed. This definition held until viagra came to market. Then the legal system decided having sex without babies was also medicine.

Basically a feminist political push to do what men can do: have sex without getting pregnant.(birth control and abortion)

You cannot separate medicine, legality, and politics out in this issue. That is why I cannot accept the argument that legitimate medical care is defined as anything that is done.

 

[fix]

It does surprise me when people look to the government as the source of reason and morals.

Once you take out moral truth and logic all you have is credentialed people telling you what reality is regardless of what is true.