[Home] [Headlines] [Latest Articles] [Latest Comments] [Post] [Sign-in] [Mail] [Setup] [Help]
Status: Not Logged In; Sign In
|
Health See other Health Articles Title: Dr Emanuel's Death Wish Harms Rather Than Helps Medscape The thing about being a physician writer is that you have a responsibility to be self-aware. Like it or not, as a doctor, people will listen to you. You can do a lot of good, but you can also cause harm. Indeed, the challenge in writing in the public forum is the same as practicing medicine: balancing benefit with harm. In writing the controversial essay,[1] "Why I Hope to Die at 75," I believe Dr Ezekiel Emanuel worsened the current crisis in end-of-life care in the US. His words caused harm; they empowered those who oppose common sense and humanity in the way we treat the elderly. Emanuel is no ordinary doctor or writer. He is an influential health-policy leader. His words matter—a lot. It was a bad idea to write the essay in the manner he did. Related Links New End-of-Life Discussion Codes a Step Toward Reimbursement? Doctors Nix Heroic End-of-Life Measures for Themselves 'Scaremongering' on End-of-Life Care in UK Media, Says Doc There are many barriers to improving the nonsensical inhumane way American patients and doctors approach death. Perhaps the biggest of these is the fear that policy makers equate the value of life, and hence, how much we should spend on one's healthcare, with productivity. This is the "death-panel" fear, and Dr Emanuel, of all people, should understand its power. When he writes that having "an [age 75] deadline forces each of us to ask whether our consumption is worth our contribution," Dr Emanuel creates fear. It's like Drs Joseph Mercola and Mehmet Oz . Most of what these guys avow is really good—exercise, sleep, nutritious food, and the like. But you can negate your message with just a couple of transgressions. Eighteen of 20 things you say can make perfect sense. But the two nutty ones ruin the entire message. And worse, the mistakes give fodder to your opposition. The dilemma with Dr Emanuel's piece and his positions on US healthcare is that he makes important points, many of which I agree with. He is against euthanasia and physician-assisted suicide. He argues that appropriate end-of-life care, with its attention to relief of symptoms, renders these slippery-slope policies unnecessary. That's spot on. He emphasizes that prolonging death is not the same as extending life. Recent gains in lifespan, he points out, have come by extending the period of illness at end of life. Living longer is not the same as living better. Yes, of course. Emanuel also highlights the dreadfulness of living with cognitive decline—an increasingly relevant problem these days. The risk of technologies that support organ function is that human beings can end up in diapers, imprisoned in nursing homes, poisoned by loneliness. Is that living? Does anyone want that? Emanuel has also called US healthcare "spectacularly wasteful." Exactly. Wasteful medical care may be the major problem in US healthcare. He says once he reaches 75, preventive medicine, such as colonoscopy, prostate cancer screening, and regular check-ups, are out. This, too, is reasonable—as there is little to no evidence that screening procedures improve outcomes in the elderly. But then, like Mercola and Oz, he ruins good arguments with hubris and nonsense. First, Emanuel tells us (at age 57) he won't take antibiotics after age 75. Why? Because Sir William Osler once said death from infection was quick and relatively painless. He would also refuse heart surgery, even a pacemaker. To say you would allow a simple scratch on a leg to fester into a gangrenous infection is nutty. Also, it is not uncommon for an otherwise-healthy older person to develop a sudden loss of conduction of electrical impulses in the heart. It might be just a fleck of calcium in the wrong place. Decades of normal life could be restored with a 30-minute pacemaker implant. To say you would refuse a simple surgery 18 years from now strains credibility. It scares people. 1 of 2 Post Comment Private Reply Ignore Thread
|
||
|
[Home]
[Headlines]
[Latest Articles]
[Latest Comments]
[Post]
[Sign-in]
[Mail]
[Setup]
[Help]
|
||