Should the Government or the Patient Decide What is Medically Necessary

[phil19034]

You are passing judgment. And I resent it, to be honest.

That is not your place. Please refrain from doing so.

The distrust you have displayed for those of us in the profession is nothing short of astounding.

And your conclusions are poorly drawn and flagrantly incorrect.

@Pup7

Euthanasia (whether active euthanasia or passive euthanasia) is a big part of why people have a mistrust today of the medical industry. Whether you like it or not, the hospital administrators, insurance companies, pharma companies, medical technology companies, accountants, etc are all part of the “medical industry.” It’s not just doctors and nurses anymore, and often doctors & nurses are having to justify themselves to non-doctors.

While I 100% agree that the MAJORITY of doctors, nurses, and medical technicians are good people, there for the right reasons; the powerful cabal that controls the medical industry does not care about the individual.

And giving the govt the power, will not solve this. What needs to happen is giving families back their rights.

NOTE: Even though I only know you via CAF, I personally do not distrust of you as a medical professional. However, I am cautious of the medical industry as a whole. My uncle & aunt are both doctors of internal medicine, my cousin an oncologist, (plus a number of other doctors and medical professionals on my mother’s side of the family) and they have all talked about how some members of the industry are - where people are treated as problems instead of as people, and where money controls everything.

Also, it’s sometimes hard to know when doctors will attempt to violate or undermine our Catholic beliefs. For example:

• OG/BYNs who refuse to allow mom in the room with her teenage (or sometimes even tween) daughter, discussing birth control, sex, etc against the wishes of parents – this happened with my sister
• Atheist and/or liberal doctors peer pressuring family members into removing life support - and even worse, when they pressure family members into removing assisted nutrition & hydration
• Atheist and/or liberal doctors who are willing to commit passive euthanasia, esp when family members don’t know what’s truly going on.
• Atheist and/or liberal doctors and consultants who use scare tactics with pregnant mothers, in an attempt to convince the mother to consider an abortion - this happened when my wife was pregnant with my son… It took everything in my power not to start yelling at the young woman on the other side of the desk (who was NOT a doctor or nurse).

Patients and family (esp parents) feel that we are loosing our medical rights, and that the wishes of the family are not always being considered (mostly due to ideological differences).

So yes, there is a growing, natural suspicion of the medical industry.

God Bless.

 

[o_mlly]

Who would be better to make that prognosis than a doctor?

Another doctor?

Is not the implication in the phrase “second opinion,” its equivocal status to the first opinion?
Prognosis is about the future; about which no one knows with certainty.

We say doctors “practice” medicine as medicine is not an exact science. It is not unreasonable to question a doctor’s diagnosis or prognosis. Moreover, if the prognosis of the prescribed treatment (or lack of) is the death of the patient for whom we speak then, I think, we are obliged to seek a second opinion.

 

[phil19034]

No one disputes the issues with moving a patient. What we are saying is this: when a patient has a terminal diagnosis, no one should be allowed to prevent a patient or his/her next of kin from trying alternative care. Whether it be experimental, “alternative medicine,” dangerous, painful, etc.

It doesn’t matter. Patients and next of kin should have the right to do everything possible to extend the life of themselves and/or their loved ones. No one should prevent them from trying.

Doctors should give their opinions, etc. But no one should stand in the way of a patient or parent trying to extend the life of a terminal patient, ESPECIALLY when another doctor / hospital is willing to try.

 

[Shakuhachi]

Absolutely. And what if two, or three or more agree “terminal”?

 

[ConfusedLucy]

I just find the idea of doctors being compelled to please the parents rather than act in the best interests of the patient absolutely terrifying.

 

[TheLittleLady]

hospital administrators, insurance companies, pharma companies, medical technology companies, accountants, etc are all part of the “medical industry.”

All of these above make larger profits when they have a patient receiving meds/treatments/services. They would be cutting off that cash by killing people.

 

[Pup7]

No one disputes the issues with moving a patient. What we are saying is this: when a patient has a terminal diagnosis, no one should be allowed to prevent a patient or his/her next of kin from trying alternative care. Whether it be experimental, “alternative medicine,” dangerous, painful, etc.

It doesn’t matter. Patients and next of kin should have the right to do everything possible to extend the life of themselves and/or their loved ones. No one should prevent them from trying.

Doctors should give their opinions, etc. But no one should stand in the way of a patient or parent trying to extend the life of a terminal patient, ESPECIALLY when another doctor / hospital is willing to try.

It does matter, because the ethical and legal aspects of the doctor’s license DEMAND THAT IT DOES.

Doctors should give their opinions, etc. But no one should stand in the way of a patient or parent trying to extend the life of a terminal patient, ESPECIALLY when another doctor / hospital is willing to try.

Clearly you haven’t researched or have active knowledge of what happens in these situations.

Or are willing to accept that what he was being sent to Italy for was palliative end of life care. It was not to extend his life in the least. It was the same exact level of care.

Exactly how will you extend the life of a patient whose brain on CT and MRI has physically deteriorated and has a terminal diagnosis? The child was at Alder Hey for 18 months. Do you really think the team existed in a vacuum?

 

[Pup7]

Yes.

There will always be the things we can’t explain. Always. There will also be the things that appear unexplainable, but with medical knowledge, are explainable. But we are assuredly not infallible. I’ve seen docs shrug and say - “I have no explanation for how this happened, but consider it a blessing or a miracle or whatever you believe”.

(And no, they don’t say that because they themselves are atheists. They say that because the patient’s beliefs are often unknown to them, and because atheists have been known to lose their minds if you tell them 'the only explanation is ‘it’s a miracle’. Seriously.)

Brain imaging showed marked deterioration of the cerebrum. The brain does not regenerate (if only it could, though). He was (name removed by moderator)atient for 18 months.

Sometimes medicine hits a brick wall. For all we know, we almost know nothing.

 

[phil19034]

True. But there is ordinary care vs. extraordinary palliative care. Providing ordinary care (like assisted nutrition and hydration) are moral norms which should not be stopped under any circumstance AS LONG as the patient’s body can still digest the food.

There are a number of factors that are not public knowledge. For example, what kind of care of required, why was the hospital in Italy willing to take him? Why did the hospital in the UK stop his treatment against parental wishes? And why did they have the right to prevent the transfer (assuming the parents were not trying to have the UK hospital pay for the transfer)? And why did the hospital have the right to take this to the court system to over rule the parent’s wishes?

BTW - I totally agree that there is a point where reality needs to set in rather than looking for false hope. But that should NOT be FORCED on the parents. Parents should be able to run down all opinions, options, etc that they can afford. And then come to a decision that does not violate their conscience.

Here’s my question: which machine did they unplug? If it was a machine that simply assisted with nutrition and hydration, then that’s evil. If it was a true life support, then the parents still should have had the right to either (a) pay to keep their child alive or (b) transfer their child to a facility that was willing.

The issue isn’t whether the parents were right or wrong (we don’t know enough facts). The issue is that end of life decisions should be up to the patient and/or next of kin only. Not hospitals, courts, etc.

 

[Vonsalza]

True. But there is ordinary care vs. extraordinary palliative care.

It’s often the same care under a different prognosis.

What is normal care when you’re stable or recovering is often considered extraordinary when “they’ve done all they can do”.

BTW - I totally agree that there is a point where reality needs to set in rather than looking for false hope. But that should NOT be FORCED on the parents.

I completely agree. Unless well-meaning parents are doing nothing but increasing the suffering of a child they don’t want to let go of.

That’s the problem here, I think. You don’t want to see the “unless” in this case. The kid was gonna die and All the Kings Horses wasn’t going to do anything about it - except make him less comfortable in what is probably a subconscious expression of defiance of their own mortalities.

 

[Pup7]

Keep in mind we have doctors who think they are being ESPECIALLY compassionate by killing disabled babies…let alone healthy ones who might be poor or abused.

You know, if you could offer irrefutable proof of this, I’d back off. But I know for a fact you cannot.

How does it feel to be a keyboard warrior, I ask?

You are addressing someone who watched their OWN FATHER DIE when support was withdrawn out of necessity, the person who made his funeral arrangements at Arlington, the person who sang The Naval Hymn at his graveside. The person who knew he was Catholic and who actually tried - within her limited knowledge back then - to ensure that what was being done would’ve followed what he believed.

I am sorry if her perception was I was judging her immortal soul, but I was not.

Well, then, here’s where that conclusion came from:

There is still time for you to put God’s role and purpose for the family above a public entity.

Still time? Before what?

JUDGE. NOT.

If he died in flight the hospital would not be liable if the parents knew the risk.

Why can you not accept that a parent does not have the power to arbitrarily check a child out AMA, and that they’re not allowed to do that here either - which is how JW and Christian Scientist parents make the 6 o’clock news when they try to keep their child from getting care? Why have you not understood that there was a case in the US just a couple of years ago where a teenager had decided she’d had enough chemotherapy, her cancer was indeed incurable, she was tired of suffering, and fought her parents to be allowed to have hospice over yet another round of chemotherapy? It happened. Here. In the US.

I was in the Army as a medic and occupational therapy assistant.

I am not being disparaging of your role because I routinely defend my techs to the death, but you were a medic, not a licensed RN, not a provider, and my guess is not even an LPN or you would’ve said so. I also owe the return of full range of motion in my right wrist to occ health techs, so I owe them essentially my career.

Until you’ve managed patients in high altitude, sustained flight - which is an Air Force role - or prepared critical care patients for transport in flight - or supported a physician who of their own volition called a family stateside to say “we can’t transfer your husband/child/wife because the flight alone would kill him/her, and here’s why - but let me make arrangements for you to at least talk to him/her one last time because death is imminent” - you don’t have much knowledge of what’s involved.

 

[phil19034]

phil19034:

No one disputes the issues with moving a patient. What we are saying is this: when a patient has a terminal diagnosis, no one should be allowed to prevent a patient or his/her next of kin from trying alternative care. Whether it be experimental, “alternative medicine,” dangerous, painful, etc.

It doesn’t matter. Patients and next of kin should have the right to do everything possible to extend the life of themselves and/or their loved ones. No one should prevent them from trying.

Doctors should give their opinions, etc. But no one should stand in the way of a patient or parent trying to extend the life of a terminal patient, ESPECIALLY when another doctor / hospital is willing to try.

It does matter, because the ethical and legal aspects of the doctor’s license DEMAND THAT IT DOES.

Doctors should give their opinions, etc. But no one should stand in the way of a patient or parent trying to extend the life of a terminal patient, ESPECIALLY when another doctor / hospital is willing to try.

Clearly you haven’t researched or have active knowledge of what happens in these situations.

Or are willing to accept that what he was being sent to Italy for was palliative end of life care. It was not to extend his life in the least. It was the same exact level of care.

Exactly how will you extend the life of a patient whose brain on CT and MRI has physically deteriorated and has a terminal diagnosis? The child was at Alder Hey for 18 months. Do you really think the team existed in a vacuum?

NO. You are not understanding me at all. I am 100% in line with Catholic teaching.

I want this simple question answered.

1. what did they unplug? I am operating under the impression that they unplugged the machine(s) which assisted him with nutrition and hydration.

I agree with EVERYTHING these doctors say in these videos
http://phillycatholiclife.org/life-affirming-choices-3/videos/

If you watch these videos and tell me you 100% agree (you don’t have to watch all of them, just the shorter videos 2, 3, & 4), they we are on the same page.

But if you disagree with these videos, then we do not agree.

So again: I’m questioning whether the UK Hospital ended Ordinary Care vs Extraordinary Care. If they ended ordinary care, then what they did was immoral.

The fact that he’s been at the hospital for 18 months is not relevant. What matters is what happened to end his life and what was their intent?

 

[Pup7]

what did they unplug? I am operating under the impression that they unplugged the machine(s) which assisted him with nutrition and hydration.

Have you read the hospital’s official statements?

Machines aren’t used for hydration, unless you mean an IV pump. They initially stopped tube feeds, and restarted it as he continued to breathe.

Have you read the statement of the British Archbishop?

The fact that he’s been at the hospital for 18 months is not relevant. What matters is what happened to end his life and what was their intent?

I literally cannot deal with that insinuation. I find it abhorrent.

 

[phil19034]

It’s often the same care under a different prognosis.

What is normal care when you’re stable or recovering is often considered extraordinary when “they’ve done all they can do”.

Not true according to Catholic teaching. ordinary care vs extraordinary care can differ between 1st world and 3rd world countries, but what is considered ordinary care when a person is healthy does not become extraordinary when they are at the end of their life. It doesn’t matter if death take 4 days or 4 years to happen, you do not withhold ordinary care for the direct intent of ending the life.

I completely agree. Unless well-meaning parents are doing nothing but increasing the suffering of a child they don’t want to let go of.

That’s the problem here, I think. You don’t want to see the “unless” in this case. The kid was gonna die and All the Kings Horses wasn’t going to do anything about it - except make him less comfortable in what is probably a subconscious expression of defiance of their own mortalities.

No, I’m not ignoring the “unless.” As the Catholic Church teaches, end of life decisions are up to the patient and loved ones. Not the doctors. Just because the doctor feels it’s an increase in suffering is not a reason to deny the patient or next of kin.

Suffering is good, it unites us with Christ. Now, we have the right to limit or eliminate suffering, but not by doing action with the intent of killing the patient.

Again, I’m not talking about pulling the plug on extraordinary means. For example: a machine that is keeping someone’s heart pumping. You can make the decision to turn that off, because that extraordinary.

But providing them food and water (even if it’s via a machine) is ordinary care according to the Catholic Church, and always was until the 1980s.

BUT AGAIN - we don’t have the facts here. However, I find it suspicious that its been twice now that one hospital was willing to take a child and that a UK hospital has taken the parents to court to prevent a transfer from happening.

To me, this is about rights. The parents should have the right to transfer the child, if another doctor was willing to take him. If another doctor says “yes” then you have a difference in medical opinion… in which the patient and/or next of kin should have the right to transfer - regardless if every single other doctor in the entire world says no, if just one licensed doctor says yes, then no one should stand in the patient / next of kin’s way.

 

[HolySpirit]

Has there been studies or polling done to back up this assertion, or are you basing it on your wide experience in Health Care?

 

[SuperLuigi]

Again, sadly, mom and dad don’t always know what’s best.

Neither does the government.

Sorta sounds like the exact critique levied against insurance companies… They vehemently opposed things like the ACA because it meant they had to actually cover someone who had cancer before getting insurance. !!!!!!

As opposed to all these rich urban liberals who say they “care” but give less money to charity than conservatives.

 

[Angannas]

Yes, in British usage the word government refers only to the executive or administration and not to the courts. If the executive loses a vote in parliament we say that the government has been defeated. We even talk of the government losing court cases.

 

[phil19034]

phil19034:

what did they unplug? I am operating under the impression that they unplugged the machine(s) which assisted him with nutrition and hydration.

Have you read the hospital’s official statements?

Machines aren’t used for hydration, unless you mean an IV pump. They initially stopped tube feeds, and restarted it as he continued to breathe.

Have you read the statement of the British Archbishop?

The fact that he’s been at the hospital for 18 months is not relevant. What matters is what happened to end his life and what was their intent?

I literally cannot deal with that insinuation. I find it abhorrent.

@Pup7 did you take a look at any of the three videos I recommended? Do you agree with them? If so, then we are on the same page. http://phillycatholiclife.org/life-affirming-choices-3/videos/

These are the only statements I’ve read: http://www.catholicnews.org.uk/statement-alfie-evans

And this is what was say regarding Charlie Gard when he died by the English bishops: http://www.catholicnews.org.uk/Home/News/2017/Charlie-Gard

The tragic situation of baby Charlie Gard is truly heartrending, not least, of course, for his parents and family. Those responsible for his medical care in the UK believe they have done all they can to help him. It is completely understandable, nonetheless, that his parents should also want to pursue every possible chance of extending his life, even when this carries no guarantee of success and would require transfer to the United States. In this, both sides are seeking to act with integrity and for Charlie’s good as they see it. Parental love will so often want to take every possible extra step and this we support.

Where medical treatment becomes disproportionate to any possible benefit, proper palliative care for a sick person must be maintained. Such care must include the provision of nutrition and hydration which is neither treatment nor medicine, unless this itself becomes overly burdensome. Sadly, prolonged terminal illness is part of the human condition. We should never act with the deliberate intention to end a human life, including the removal of nutrition and hydration so that death might be achieved. We do, sometimes, however, have to recognise the limitations of what can be done, while always acting humanely in the service of the sick person until the time of natural death occurs. Our heartfelt prayers and support are with baby Charlie and his parents and family, as well as with those caring for him.

 

[MonteRCMS]

Patient should decide.

 

[JanetF]

So many Christians are like the Weeping Women unfortunately. They say “so sad. He died” but do not really care. I’ll pray for all the people here who value socialism above helping ALL human life even when it’s not ideal. You are on the road to forced abortions on disabled babies and euthanasia. Change your course!

How on earth do you know that they do not “really” care.