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Discussion (43 Comments)Read Original on HackerNews
This is not abstract for me. I have not one, but two forms of cancer.
Both were considered incurable when I was diagnosed.
Both have treatments now that, IN SOME PEOPLE, lead to remission.
I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat.
New treatments, for SOME cancers are literally coming out monthly.
So the fact that you can't be cured today, does mean there won't be a better treatment by next year, if you can hang on.
I should find out soon on my more aggressive one. Either way, I plan on continuing to try.
> Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it.
It's interesting that our laws punish homicide with maximum criminal penalties, but the opposite (keeping someone alive against their wishes) seems to be assault and battery at worst, with much much lighter punishment.
Granted, my sample size of 6 isn't great, and 3 were in terrible pain so it made sense for them, but they had ALL the opiates. . . One had liquid injectable morphine in case he couldn't swallow. He had no issues with swallowing and wasn't in pain.
I wanted to ask the doctor if the intent was to allow a calm end, but chickened out.
Amazing and appreciated.
Cowardice of the system, society, that doesn’t allow practitioners to discuss this.
Leads to scary grey areas, actually.
He described how he's arranged to end his own life should he get alzheimer's or dementia as he didn't want to waste away. But he explained that he has access to knowledge and things ordinary people don't.
If one lives in the US and feels strongly about it, they should file an Out-of-Hospital DNR and POLST with every local hospital. Also consider wearing or carrying official bracelets/necklaces (varies state to state).
I'm neither a lawyer nor a doctor. :)
DNR means let me die and do not intervene in that process. Which is what hospitals would want if they were secretly killing people to harvest organs, right?
Don't know what happens elsewhere, but every time I see a doctor someone asks if I have a signed, notarized directive. Yes, I've done that, but so should everybody else concerned about the issue.
I have asked aged patients the same question. More than not the answer is "no". Why haven't you? Various versions of "on my list of things to do". We can't really predict future events, in our own interests best to be prepared. Some will take the hint, more than not, people procrastinate.
At least I've done what I can do, but we can't save people from themselves. Maybe people in healthcare are more aware of what's at stake, but everyone has the option to make it as clear as possible their wish (no, their demand) to die in peace.
This point has been made by many medically trained people over decades. It's a very energetic intensive process, it cracks ribs. If it's not done promptly the brain has been starved of oxygen.
While I understand people not wanting to drag politics into everything I invite you to think about this and the situation of the senior senator for Kentucky.
I feel like lately this is becoming more common knowledge - but still something most people don't realize.
Part of it is probably the fact that it's impossible to depict "real" CPR in popular culture (movies, TV shows, etc) unless the production goes to extreme lengths to use a fake dummy. Even on The Pitt (which seems to make a point of being hyper realistic) I've seen them do "fake" CPR with shallow compressions.
I myself punctured and collapsed both lungs. My thinking is: if there's a reasonable chance I'll survive, go for it. If there's not, stop trying to prolong the inevitable. That said, when I had the accident they told my wife to get there as fast as she could because I was likely not going to make it, and that was thirty years ago. So: if they're confident I'm going to die, don't try to prolong it :-)
Overly aggressive resuscitation attempts are definitely a problem but context matters
You have to provide a denominator to make this statement. 30-day survival for out-of-hospital CPR is 10%, and discharge from the hospital (let alone functional status) is even lower.
CPR is thus a great example of the OP's thesis that doctors refuse certain things based on their poor efficacy.
https://www.redcross.org/take-a-class/resources/articles/cpr...
>Survival chances decrease by 10% for every minute that immediate CPR and use of an AED is delayed.
https://newsroom.heart.org/news/bystander-cpr-up-to-10-minut...
https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010...
It's important to get people to realize the benefits of early CPR and more people should be trained on how to do it, or else it won't be prompt and the outcomes will be worse. That's what the Red Cross and AHA promulgate to the public, in so many words.
Did you internalize Claude terminology, use Claude to write/translate your post, or lead Claude into temptation by being the OG?
Asking out of genuine curiosity and not at all trying to throw shade.
The person closest to me was saved by CPR after cardiac arrest (and cooling at the hospital), with no neurological deficits
In 2021, a drone-delivered AED was used to successfully shock a 71-year-old man back into a stable rhythm in Sweden. The drone delivered the AED in just over three minutes from a 911 call.
Studying years of emergency drone data back up the anecdotes. The AED gets there 10-15 min ahead of medics and boosts survival 70%.