Tuesday, January 31, 2006

Assisted Suicide in Oregon

There's been some talk on the net about the Oregon state assisted suicide law. The Supreme Court seems to have upheld it, but it still bothers me. Mostly I'm concerned for the situation it may put Oregon doctors in.

What happens to a doctor in Oregon that personally opposes assisting a patient in committing suicide? Can he refuse to help the patient kill themselves? I have heard of court cases involving abortion where a doctor was forced, by the courts, to perform a procedure (an abortion) he was personally opposed to, even though the patient could have gone to another doctor for treatment. Are doctors now going to find themselves in situations where, by law, they have to violate the oaths they took when they first became doctors?  Some doctors seem happy to push that oath aside, as if it doesn't matter. I'm not sure I want to go to a doctor that takes his oaths so lightly, but that's another matter. Here's one comment posted in a blog I found interesting.

There was a time in my younger years when I would have objected strenuously and in horror to assisted death. Our duty was to preserve life, not take it. But years of experience caused me to change my mind. ... I have seen my patients welcome death, beg for death. I came to believe that they had a right to be spared the long, drawn out degrading and dehumanizing experience if they so desired. They had a right to die in dignity and peace. ... .One of the best experiences I had with a dying patient came about 3 A.M. when an elderly lady coded and the usual emergency protocol was instituted. We would get her pumped up, then she die off again, over and over. One last time we managed to get her vital signs reinstated and we stood around her, watching her intently in case she coded again. We assumed she was in a coma, unaware of her condition. To our vast astonishment she suddenly opened her eyes, glared at the young attending physician and sternly admonished him, "Young man, why don't you leave me alone and let me die in peace!!" She then coded again but that time we were unable to revive her. She had escaped our well meaning ministrations and died as she wished. To her, death came as a friend.

The example given in the article of a doctor "changing his mind" on assisted suicide doesn't hold water for me. If the woman described in the article would have signed a "Do Not Resuscitate" (DNR) order then, when she first coded, she would not have been worked on and would have been allowed to die. Why was this not brought up to her as an option? The quoted doctor doesn't say. The problem in this case may not be assisted suicide so much as in self-serving doctors and hospital staffers not enforcing a DNR order to ease there own consciences and egos (I've seen that happen as well).

When I first went to college I worked in a nursing home. There I saw people die very painful deaths because of cancer, and yes it is horrible. Many of them just need to know that someone is listening to them, instead of ignoring them, even as they are dying. I worked with one elderly man who had a very sever stroke on his way out. When I went in to see him he kept saying over and over, "I'm dying! I'm dying!" When I held his hand and quietly said, "I know," he calmed down and was able to approach his death with dignity. He just needed someone to validate his experience, instead of lie to him about how he'd "be just fine."

Ending a dying patient's suffering is important, and an aggressive pain management strategy can assist in that. There are problems with balancing dosages of the meds, though. Doctors want to give enough of a drug to relieve suffering, but not enough to kill the patient. Tragically, in the most extreme cases, that isn't always possible.

The problem I see is not in allowing a patient to die, if that is their wish, the problem is in creating laws that makes a doctor become an accessory to their patient's suicide. Allowing a patient to die, because they have consciously chosen it, is very different from forcing a doctor into helping a patient kill themselves.

Bipartisanism = Playground Cliques?

Remember back in grade school when kids would segregate themselves into groups or cliques? You didn’t play with kids in the other cliques because they had some other horrible and indefinable “wrongness” about them. They just weren’t “cool.” Maybe they even had (gasp) cooties.

Looking back at those times we can see how silly they really were. I mean, we all just wanted to go play and have fun, right? Just because this kid wore a Star Wars t-shirt (that was me, by the way), and that kid wore a western shirt (that was my brother) didn’t mean they were bad kids, to be shunned as the devil incarnate. They were just kids with different tastes and backgrounds. Isn’t it nice that as adults we don’t participate in such juvenile discrimination any more?

Yeah, right.

They certainly seem to be participating in that kind of juvenile nonsense in Washington D.C. these days. Just look at the process of appointing our new Supreme Court Justice, Judge (now Justice) Alito. This vote was a perfect example of bipartisan politics in action. Only five senators out of 100 “crossed party lines” with one Republican voting against the nomination and four democrats voting for it. That’s 95% voting a strict party line.

Listening to the hearings prior to the vote I was left with the impression that even though Judge Alito was supposedly the man of interest here, the real man of interest was George W. Bush. I honestly don’t think that any of the senators that voted for or against Alito even bothered to base there judgment on the man himself. Oh, they back-pedal and claim any number of insane things to justify their decisions, but let’s face it, the majority of these folks voted for or against Alito only because Bush nominated him. It had less to do with whether he was the right man for the job than it did that a Republican president nominated him. The right side of the aisle wants to support and praise everything that Bush does, and the left side of the aisle wants to hinder everything he does. It doesn’t matter what it is, or whether it’s good for the country, or even if it’s legal. It’s just playground politics.

Of course I’ve never actually met Justice Alito. Maybe he has cooties.

Thursday, January 26, 2006

More on the Health Care Front

You’ve read me rant about the cost of health care and insurance companies before. This article (by way of Back Talk) is really interesting, though. The author hits several points on the head. This quote is pretty telling:

Americans want more health care for less money, and when they don't get it, they indict drug companies, insurers, trial lawyers and bureaucrats. Although these familiar scapegoats may not be blameless, the real problem is us. We demand the impossible. The changes we truly need are political. We need to reconnect people with the public consequences of their private acts.

While he pays some lip-service to the idea that the drug companies, insurers, et. al. carry some blame, I don’t think he goes far enough in showing how greed oriented these groups seem to have become. When drug companies cover up evidence, or the FDA ignores it, that certain new drugs are potentially more harmful than helpful, there’s got to be a reason, and I think that reason is greed. Odd things seem to happen when greedy people find they have a captive (and sick) audience.

Tuesday, January 24, 2006

Jedi-insurance Mind Tricks

Yesterday morning I had another incident with my gall bladder. Some of your may recall that I had a previous attack, but that I’m putting surgery off. I’m still putting it off because I’m not entirely sure it’s not related to my gastric problems.

As you may recall my doc had prescribed Nexium for me, but I had to go “off” if when my insurance company refused to pay for it. Guess what? More tummy pain and a trip to the emergency room. Here’s the irony for you. The emergency room doctor recommended that I start with Priolsec, and work up from there. That way there’s a history of meds that have failed, and then it’s more likely that the insurance company will pay for the stronger meds, like Nexium. Here’s the kicker, though. Because Priolsec is and over-the-counter drug, the insurance company won’t pay for that either.

I feel like I’m in massive amounts of pain, and the insurance company is trying to get me to believe I don’t have a problem. It’s a scene from a weird corporate based version of Star Wars where Obi-Wan Kenobi tries to tell me, “These aren’t the drugs you’re looking for. You can go about your business. Move along.”

Trouble is, insurance mind-tricks don’t work on me. The pain sure does, though.

Wednesday, January 18, 2006

Keeping America

Over this last week we saw both Martin Luther King Day, and the birthday of Benjamin Franklin. These two important figures helped shape America as we know it today, and I think it’s good to remember them and what they did for us. I’m sure many read reminded themselves of the famous “I have a dream” speech as part of that.

It’s sad to me that the things they helped create, are being squandered by later generations. More and more we find speech that distorts the truth. We find speech that, while is reported to celebrate our “diversity,” only serves to deepen the divide between people in our culture. There are various groups within American that seem more concerned with being celebrated for where they, or their ancestors, came from than they do about where they are now. (I will not give links to such sites that might support them.) They seem to forget why they, or their ancestors, came to America in the first place. Many want us to forget that, whether our ancestors came from Europe, South America, Africa, or the Middle East, we are all still Americans.

Benjamin Franklyn valued personal liberty. He valued it so much that he once said, “Those who give up liberty for the sake of safety deserve neither.” And yet since the tragedy of 9/11, we find our government taking away our liberties and telling us it’s all in the name of creating a safer America.

Civil liberty isn’t and addendum that we’ll “get around too when we can.” It’s a fundamental part of our constitution. If we aren’t vigilant about keeping them, we will cease to have an America at all.

Wednesday, January 11, 2006

Good News on the Anti-Nuclear Waste Front

Here’s some good news for the folks out in the western deserts of Utah. You, people like me and the Goshute Indians. Cedar Mountain, the proposed site for all a trainload of hot nuclear waste material, has been declared as wilderness, and is now protected from certain kinds of building. That means you can’t build railroad lines through it, and PFS (the evil people who want to dump this stuff on us) wanted to use rail.

PFS hasn’t given up the fight just yet, but this is surely a large amount of rain on their nuclear waste dumping parade. This quote from the KSL article is interesting:

But cooperation among lawmakers does not kill the project completely. A longer-term solution could come from a bill sponsored by Nevada Senator Harry Reid, who proposes keeping nuclear waste at or near the place where it's generated.

That’s the most sensible thing I’ve heard coming out of D.C. in a long time. Let the people who make the garbage deal with it.