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Re:The death dilemma: Are hospitals overtreating patients ne... by JoshTko on Saturday October 08, 2022 @10:29AM (#33132562)
Blaming just the patients and families is disingenuous. The incentives on the hospital, and doctor to overtreat are large and are an equally contributing factor.
Re:The death dilemma: Are hospitals overtreating patients ne... by lotsofpulp on Saturday October 08, 2022 @10:41AM (#33132682)
The doctors I know (roughly ~10 to ~15) are very much against “overtreatment”. The biggest problem they have is dealing with emotional family members.

There was also huge public fervor when the suggestion of funding mere discussion of end of life options was proposed with the Affordable Care Act:

https://pubmed.ncbi.nlm.nih.gov/26195604/

Re:The death dilemma: Are hospitals overtreating patients ne... by jstanley on Saturday October 08, 2022 @10:57AM (#33132825)
> The doctors I know (roughly ~10 to ~15) are very much against “overtreatment”.

Well of course that's what they think. Everybody is against "overtreatment". If they aren't against a treatment, they don't consider it "overtreatment", they just consider it "treatment".

Different people have different boundaries for what they consider "overtreatment".

Re:The death dilemma: Are hospitals overtreating patients ne... by s1artibartfast on Saturday October 08, 2022 @11:02AM (#33132874)
Yes, but the point is that most doctors would treat less than patients and their families if it were their choice.
Re:The death dilemma: Are hospitals overtreating patients ne... by kennend3 on Saturday October 08, 2022 @10:38AM (#33132652)
You are very much mistaken, it is almost always the family doing this.

As an example:

https://www.canlii.org/en/on/onsc/doc/2017/2017onsc6511/2017...

[2] Following Shalom’s brain death his family had discussions with the staff at Humber River Hospital. They explained that in accordance with Shalom’s and their religious beliefs, Shalom was not considered to be dead under Jewish law until he stopped breathing and his heart stopped beating. Neither had occurred because he was on ventilator life support.

The hospital board ruled he met the guidelines to be considered "dead" - the family went to court to overturn this.

Re:The death dilemma: Are hospitals overtreating patients ne... by Macha on Saturday October 08, 2022 @10:35AM (#33132621)
Even in socialised medicine in western europe, this phenomenon exists, where the financial side of those incentives is much reduced as funding is much less directly tied to treatments.
Re:The death dilemma: Are hospitals overtreating patients ne... by ako on Saturday October 08, 2022 @10:49AM (#33132748)
Hospitals and doctors are already fully booked, they don't need the additional work from overmedicating and overtreating patients in the last weeks of their lives.
Re:The death dilemma: Are hospitals overtreating patients ne... by sandworm101 on Saturday October 08, 2022 @11:39AM (#33133204)
Being overbooked is only the start of profitability. Just like airlines, once you have the customer inside your facility, you upsell. A patient recuperating/dieing in a bed nets only a daily rate. You need to then charge for as many additional treatments as possible.
Re:The death dilemma: Are hospitals overtreating patients ne... by physPop on Saturday October 08, 2022 @11:55AM (#33133355)
Only in broken for-profit systems. This is a non issue in Canada and UK.
Re:The death dilemma: Are hospitals overtreating patients ne... by peyton on Sunday October 09, 2022 @09:20AM (#33140704)
How? Canada is largely fee-for-service AFAIK, and the NHS mainly uses basically a big chargemaster for acute care.
Re:The death dilemma: Are hospitals overtreating patients ne... by _qua on Saturday October 08, 2022 @05:20PM (#33136125)
This is not how hospitals work. There are always outliers that get news stories but most physicians do not wish to torture the dying.
Re:The death dilemma: Are hospitals overtreating patients ne... by ouid on Saturday October 08, 2022 @10:39AM (#33132664)
having been on the family side of this, i can personally guarantee that the people actually performing the procedures are against it. You should draw a distinction between a hospital and its doctors.
Re:The death dilemma: Are hospitals overtreating patients ne... by saiya-jin on Saturday October 08, 2022 @11:11AM (#33132955)
No, wife is a doctor and she faced this many times. Doctors in such places are never working there for the money, if you consider them as such you are just projecting your morals on other people.

Its almost always the family - they just can't let go or have some christian type of excuse. Thus their moral weakness causes tremendous amount of suffering of their closest ones. And doctors have to obey family wishes, even if they personally wouldn't chose to, which is true for most doctors in such situations.

I've been been recently an unfortunate witness to one of the cases when its not closest family - grandmother of my wife was nearing her end, suffering tremendously. Her daughter, my mother in law who is a nurse and teaches nursing too and knows all staff of their hospital very well was looking for some strong painkillers ie morphine to help her with final sufferings, which went on about for a week. As her mom didn't want to die in hospital, nobody was willing to sign receipt, not even close personal friends (mind you we don't have opioids crisis in the country, so its not controversial to give them to 92 year old dying). Some folks from closer family or friends even said its fine to suffer before the end, to shorten/skip purgatory, or some similar religious bullshit. One of those times when I hated christianity and its believers more than ever, you know those. As they say, you will know true friends when you need them the most.

Switzerland is, as usually quite ahead on this - assisted suicide. Folks from all over the world come here to die peacefully, in full control. Ie Alain Delon is going through the process of getting this done right now. It doesn't cover all possible situations, but it gives certain control and dignity in times where most people have none left. Me personally, if facing such a situation, would do grand farewell gathering with all, sign my will and go somewhere in the nature to die quietly, ie jump from some cliff or overdose on heroin (first and last dose, but they say its quite an experience).

Re:The death dilemma: Are hospitals overtreating patients ne... by A4ET8a8uTh0 on Saturday October 08, 2022 @06:04PM (#33136459)
<<As her mom didn't want to die in hospital, nobody was willing to sign receipt, not even close personal friends (mind you we don't have opioids crisis in the country, so its not controversial to give them to 92 year old dying). Some folks from closer family or friends even said its fine to suffer before the end, to shorten/skip purgatory, or some similar religious bullshit. One of those times when I hated christianity and its believers more than ever,

I am not a religious person by anyone's description, but the choice here appears to be that of lesser evil. Final wish of a dying person ( along with their ability to govern their life ) here being that she did not want to die in a hospital. Wouldn't 'helping' her die break that wish? And more importantly, what if the dying person is ok with suffering?

<<Thus their moral weakness

It feels like the sentence is emotionally loaded. Is it a moral weakness to follow one's moral compass? I hear what you are saying, but you may want to consider that they do not want to make that decision, because their moral compass marks it as killing someone ( including some earthly jurisdictions ).

Re:The death dilemma: Are hospitals overtreating patients ne... by s1artibartfast on Saturday October 08, 2022 @08:22PM (#33137278)
Maybe I misread the post above, but it sounds like no one would take her out of the hospital to die at home.

I agree that often times it is a matter of moral weakness. If the family knows what the wishes of the dying are, but are scared or unwilling to carry them out, that is a moral failing. I know many people who have gone through this, and the family often regrets their choices and weaknesses after the death. They wish that they could have been stronger and tell the doctors that they can stop treating the patient.

Re:The death dilemma: Are hospitals overtreating patients ne... by A4ET8a8uTh0 on Sunday October 09, 2022 @11:33PM (#33147488)
It is possible I misread it. If so, I would agree with your interpretation. There is a question of whether dying wish outweighs one's own moral compass ( and therefore is a moral failing ), but I accept your point especially if it is motivated by fear rather than consideration of one's principles ( I was never in that position, and hope I will never be, where I had to make that call ).
Re:The death dilemma: Are hospitals overtreating patients ne... by saiya-jin on Wednesday October 12, 2022 @03:52AM (#33174097)
Sorry if I didn't describe it properly, english is not my native language. Giving of opium wouldn't anyhow shorten her lifespan, which was already on a fast spiral down with various organs shutting down, while causing huge amount of continuous pain, and there was nothing current medicine could do to fix it.

Her being in hospital vs being at home was just decision to not die surrounded by nurses and doctors but by family, which is completely understandable and I would opt for it too in same situation.

The fact that even closest folks refused to ease suffering while shielding themselves with at-best dubious christianity-based moral stance of easing/skipping purgatory is just beyond my comprehension.

And yes I truly consider it their moral weakness and failure. Its not about killing in any way, but sedating enough to have their last moments filled with sanity and focus on family, and not screams of huge pain.

> And more importantly, what if the dying person is ok with suffering?

Now this part is complete bullshit, of course she didn't want to suffer, she had brighter moments when she was begging for painkillers. I presume you were never in situation where you suffered huge amount of pain continuously for at least many hours. I experienced it once, and it completely utterly breaks you down mentally. You are willing to do basically anything to make it stop - there is a reason why it is/was used so much to get any intel, at one point everybody breaks, its so overwhelming that people make up anything to make it stop.

I hope its a bit more clear, it was a complex situation to describe fully in few sentences.