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| "St. Francis in Ecstasy" (a.k.a. "The Praying Monk and the Dying Monk") 1640 by Georges de la Tour |
Given these economic factors and the possibility of saving huge amounts of money on care that “is of little apparent benefit,” do you think the government would be wise to consider reducing funding for such care or would such an effort be rightly compared to euthanasia?
No, I don't think that the government should reduce funding. In the final months of a person's life, the last thing they want to think is "Maybe I would have lived if I had more money" or "How will my family afford my expenses? Maybe I should give up and die." The last thing a terminal person should have to worry about is money. They should instead be with their family, with as little burden as possible during these circumstances. As suggested in this reading, an alternative to cutting funding was the offering of hospice care with continued hospital visits. Discussing end-of-life wishes had also led to a decrease in Medicare use in La Crosse, Wisconsin. For these reasons, I think that the government shouldn't reduce funding in the last months of a person's life, but instead give more options (as discussed in the chapter) that can both reduce Medicare spending while increasing the patient's and family's acceptance at death. However, patients should still have the option to continue treatments.
ReplyDeleteI agree with Lenzi; the government should not reduce the funding of medical care in the final months of a person's life. A person should not have to think about finances during such a delicate time in their life. They should be allowed to enjoy their final moments with their family and without worry. I believe that if families were better informed about what taking aggressive action against these illnesses would mean, they would choose to forgo the expensive medical treatments and receive no medical interventions. As Gawande put it, "You lie attached to a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place." When faced with the option of having a final week with their ill loved one that is filled with coherent "Goodbyes" or having a month of watching their loved one drift deliriously in and out of consciousness, I believe many families would choose the former. Not only is this option ideal because it allows the family to have closure, but the quality of life for the ill is significantly better. I believe that this option would also allow the expenses of medical care during the final phase of a person's life to drop drastically, but ultimately, such a decision should still be determined at the discretion of the patient and their family.
DeleteThis one is difficult. From a completely pragmatic, dehumanized perspective, yes. There is a huge deficit in cost vs. benefit. It could be said that by reducing funding, we might actually increase the quality of an individual's final days, due to their inability to opt for invasive, potentially traumatic procedures and treatments. However it is imperative that they have the choice to continue treatment for as long as they wish. I do agree with Bethany on the subject of being informative. Perhaps if physicians were more interpretive with their patients, as Gawande outlined, the patients would see that aggressive treatment does not always guarantee in an increase of quality of life at the end, but rather a decrease. From an economical standpoint, it would be justifiable, but if the health industry was just more informative reducing funding could become unnecessary.
ReplyDeleteI don't think they should, as when does a human life become a dollar amount? Comparing money to a life just isn't justifiable. Economically, cutting spending to these types of patients makes sense, but there are things in the world that are more important than money. People willingly go into thousands of dollars of debt just to have their loved ones for any extra amount of time, no matter how short. I personally can't imagine living with the thought that if they hadn't cut the spending and allowed my relative to have the care they wanted/needed, they might have lived longer. I'd give up a lot to have had my grandma live even a little bit longer, so we could be with her for even a short time more. I understand that life doesn't seem worth living at a certain point near the end, but who are we to judge?
ReplyDeleteKyle Bailey
My grandmother lived in a retirement home when I was younger. I would go visit sometimes and she would say things like "Well maybe I should just die so you don't have to pay for this stupid place." I remember she hated it. The food was disgusting, she didn't have a lot of friends, and she started going downhill. Before she was push mowing the lawn, gardening, feeding the chickens and much more. Now she was confined to a tiny space and would beg to have a room that was near a garden I think that if anything they should put more money into those last years. Saying that these people are going to die anyways is like looking at a person diagnosed with cancer and saying well, we can try to help you, but I really don't think it will be worth it. Just because these people are older does not make the value of their lives any less.
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