Health care reform: What is costly overuse, what is humane?

Health care reform: What is costly overuse, what is humane?:

This is the piece Betsy McCaughey read from on The Daily Show last night, regarding EOL care and the horrors of HR 3200.

"My problem, as a physician who has practiced medicine for decades, is that I just can't predict with certainty what is end-of-life care, nor can I determine for another individual the meaning of 'quality of life.'"

Well that's the whole point, isn't it? It s not the physicians choice it is the patient's choice, the patient's wishes that count. It is entirely the point of advance care planning and advance directives that it is up to the patient to decide what he or she wants. Our responsibility a physicians is to give them the best information that we can, imperfect as it is, and help them come to decisions that best reflect their wishes and goals.

And, no, we cannot predict with certainty when a person is exactly at the end of life - and I suspect that this author and Ms. M. would only except a definition of end of life as minutes away - but I do have a wealth of experience to go on, and I think it is unprofessional to allow families to cling to miracle scenarios for survival.


And here's another gem:
"I would be loath to talk a person on dialysis or in a wheelchair from a stroke into forgoing antibiotics for a pneumonia that may itself be treatable."

Well, so would I, because that is not the role of a physician, is it? Jeebus. Jude the Obtuse.

Ms. M. read this part:
"These and other provisions of the health choices act frankly scare me. As a physician, I took an oath long ago to put my patient's interests above all else, but provisions in the bill have a quality of coerciveness that make me wonder if I can fulfill my oath."

You have a higher duty to be honest with your patients and not blow smoke up their rears, telling them that this next chemo, this next procedure, this next indignity, is always worth it.

As I'm putting together this post, it infuriates me to consider countering this stupid, stupid, stupid, uninformed, heartless, obtuse rhetoric yet again.

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