Going Gentle Into That Good Night

[Los Feliz Slim]

My Nana (actually my wife's Nana, but whatever) is in the hospital. She's got all kinds of problems, but likely pancreatic cancer is at the top of the list. So, it probably won't be long now. Machiavellian family politics were screwing with her comfort and medical care, which led to a one-man mutiny by me to seize control of Nana's treatment and make sure she was being properly cared for. I was telling Anacardo about this, and he said:

"You realise (sic) the ninety-odd are supposed to be dead and or dying?"

I initially agreed, but have been thinking about it and disagree. Yes, we eventually die when we get old. Medical technology has definitely extended our lives a great deal, often at the expense of quality of life. But isn't that what medical technology is for? Relatively simple injuries and illnesses (broken legs, appendicitis, etc) that barely require hospitalization would have meant almost certain death not all that long ago. So what's the difference between that and treating an old person for old age?

This leads us into a look at our health-care system in general, on which subject Anacardo offers:

"Just that trying to extend the life of, say, a ninety-plus-year-old woman with pancreatic cancer is a pretty standard reflection of our oddball health care system.

We call health care a public good, and say that nobody should die for lack of capacity to pay for treatment, but then we also try to make the process as capitalist and market-like as possible..

Which produces some odd inefficiencies and contradictions."

and

"We'll invent and use any number of superexpensive new tests, and save the lives of twenty-week-old fetuses, and perform new miracles of in vitro fertilization, and spend over a quarter of all public health dollars keeping the elderly alive as long as possible in perhaps the worst two percent of their existence.

While making any number of relatively mundane procedures prohibitively expensive for the uninsured."

I'm undecided about much of this, but think several of you must have perspectives to offer. Interested to hear thoughts on the matter.

[Shadowrun]

I agree with Anacardo in the sense that prolonging Nana's life is pointless (no offense).

In reality she is at a age where she doesn't really contribute anything to society and is more of a burden.

However, if it was my Nana i would do the same and try my hardest to get her the best care. Even though it might be "pointless" i feel like every second of life is precious.

I mean i would want my Nana to be alive as long as humanly possible, so me/kids/family could hug her before she finally has to go.

[Colt McCoy]

What does Nana think about all this? Most older people I've talked to have a pretty realistic approach to death. We tend to want to keep them alive for ourselves regardless of whether they're ready to go or not.

[Los Feliz Slim]

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What does Nana think about all this? Most older people I've talked to have a pretty realistic approach to death. We tend to want to keep them alive for ourselves regardless of whether they're ready to go or not.

[/ QUOTE ]

Nana is ready to go, but isn't going to up and quit. She will not consent to surgery or chemo, but if there are treatments that would maintain or improve her quality of life while extending it, she's all about that.

I agree with you that it's up to her. The idea I guess I'm objecting to is that we're all "supposed" to die at a certain point. Nana may not be contributing to the GDP, but I don't think that makes her life less valuable.

[The Ocho]

[ QUOTE ]

Nana is ready to go, but isn't going to up and quit. She will not consent to surgery or chemo, but if there are treatments that would maintain or improve her quality of life while extending it, she's all about that...


The idea I guess I'm objecting to is that we're all "supposed" to die at a certain point.

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well, i'd say 2 basic conditions need to be met to objectively determine whether you are "supposed" to die:

-your body stops working
-you no longer have the will/desire/means to do whatever it takes to keep yourself alive

nana meets both, so gg.

[yad]

[ QUOTE ]

I agree with you that it's up to her. The idea I guess I'm objecting to is that we're all "supposed" to die at a certain point. Nana may not be contributing to the GDP, but I don't think that makes her life less valuable.

[/ QUOTE ]

Of course her life has value. But that's not the question. There is only so much money that society can afford to devote to health care. The question is: Would it be better to divert those resources away from your Nana and towards some uninsured 25-year old who just got diagnosed with a treatable form of cancer? Or should we spend them to give your grandmother another year of life, while leaving the 25-year old to die untreated?

Obviously if you answer yes, there are pretty huge practical issues that would be involved in implementing such a shift, and it's not going to happen anytime soon in this country. But I think most people would still say the answer is yes.

[ChicagoTroy]

There is all sorts of end of life care that is designed not to extend life, but to minimize discomfort during someone's last weeks/months. Regardless of whether she "should be dying," there is medical care that it makes perfect sense to be providing.

[dizong]

[ QUOTE ]
[ QUOTE ]
What does Nana think about all this? Most older people I've talked to have a pretty realistic approach to death. We tend to want to keep them alive for ourselves regardless of whether they're ready to go or not.

[/ QUOTE ]

Nana is ready to go, but isn't going to up and quit. She will not consent to surgery or chemo, but if there are treatments that would maintain or improve her quality of life while extending it, she's all about that.

I agree with you that it's up to her. The idea I guess I'm objecting to is that we're all "supposed" to die at a certain point. Nana may not be contributing to the GDP, but I don't think that makes her life less valuable.

[/ QUOTE ]

If no surgery or chemo, then essentially she is destined to succumb to her cancer. Does not mean she is to be ignored... rather the focus on her care is different. Many people think that medicine is all about diagnosis and cure but it's a bit more complex, especially in the elderly and terminal. For someone like Nana, I think the idea of hospice care needs to be discussed. It's not a quarantine for the dying but it's changing gears for the patient (and those who care about her) from cure and prolonging life to comfort, dignity, and preparation for the inevitable. It's worth it because dying happens, and from your description, it sounds like she's headed there without question.

[Anacardo]

[ QUOTE ]
I agree with Anacardo in the sense that prolonging Nana's life is pointless (no offense).

In reality she is at a age where she doesn't really contribute anything to society and is more of a burden.

However, if it was my Nana i would do the same and try my hardest to get her the best care. Even though it might be "pointless" i feel like every second of life is precious.

I mean i would want my Nana to be alive as long as humanly possible, so me/kids/family could hug her before she finally has to go.

[/ QUOTE ]

Choose a position here and live your life with some shred of intellectual consistency, for the love of our merciless Christian God.

[Shadowrun]

[ QUOTE ]
[ QUOTE ]
I agree with Anacardo in the sense that prolonging Nana's life is pointless (no offense).

In reality she is at a age where she doesn't really contribute anything to society and is more of a burden.

However, if it was my Nana i would do the same and try my hardest to get her the best care. Even though it might be "pointless" i feel like every second of life is precious.

I mean i would want my Nana to be alive as long as humanly possible, so me/kids/family could hug her before she finally has to go.

[/ QUOTE ]

Choose a position here and live your life with some shred of intellectual consistency, for the love of our merciless Christian God.

[/ QUOTE ]

My position is that yes, you are most likely right and normally i would agree.

However, i cant accept that because i know that i would react the same way as the OP, in other words my emotion gets the better of me here.