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This is not new and it predates the internet. My wife's aunt died of breast cancer 30 years ago. She decided to not have chemotherapy and instead opted for self

This is not new and it predates the internet. My wife's aunt died of breast cancer 30 years ago. She decided to not have chemotherapy and instead opted for self treatment via a vegan diet even though she was relatively young and had a very treatable cancer. It happened before our relationshp but the utter stupidity of that choice is still used as a cautionary tale among her family. That said, I've seen two family members die from terminal cancer and in both cases, they would have been better served by hospice rather than spending the last year of their life in chemo. I felt like it was a money grab by doctors. Their end of life oncology treatment cost the insurance company a couple hundred thousand dollars each

masklinn 7y ago
> That said, I've seen two family members die from terminal cancer and in both cases, they would have been better served by hospice rather than spending the last year of their life in chemo. I felt like it was a money grab by doctors. Their end of life oncology treatment cost the insurance company a couple hundred thousand dollars each On that subject I very strongly recommend Atul Gawande's "Being Mortal". > I felt like it was a money grab by doctors. I don't think that's what it is, and Gawande's book (where he speaks as both a surgeon and having had relatives — including parents — go through this) comforted me in that opinion. Rather: * doctors generally are not trained in this sort of end-of-life care recommendations * it's easy for a disconnect and misunderstanding to occur between, or for doctors to present alternatives but fail to notice the patient or family doesn't really understand (especially the implications of the various alternative) * it is common for families to try for survival at essentially all costs (including intrusive and uncomfortable), and hard for doctors to disagree, sometimes at the result of (2) above but not always * doctors are human and tend to get blinkered by what they do know, and what they do know is usually treatment One interesting item (of many, the book is barely 200 pages but full of stuff) is Gawande's mention of Ezekiel J. Emanuel and Linda L. Emanuel's "Four Models of the Physician-Patient Relationship." which basically identifies a range from "paternalistic" (doctor knows best and takes all decisions) to "informative" (where the doctor is provides facts & figures and possibly options but no insight).
- DataWorker 7y ago
  This might be the best post in this thread. I think you can see a lot of the paternalistic orientation on display even in this thread. I think it’s that sort of hubris which causes people to react in the opposite direction and reject the whole thing. So who to blame for me is clear, it’s the doctors.
sgt101 7y ago
I've seen the opposite - someone choose to step away from treatment because it wasn't worth it. It was a very, very hard decision. They faced a lot of pressure from others (who they loved) but they did it. Subsequently some of their friends even questioned the proberty of the people involved - the implication was that they shouldn't have died so easily, that there were things that could have been done. But this was a man in his late 70's, with two degenerative diseases and an advanced hard to treat cancer (on top of a long standing easy to treat managable one). So - it's always hard, one way or the other.

masklinn 7y ago

> That said, I've seen two family members die from terminal cancer and in both cases, they would have been better served by hospice rather than spending the last year of their life in chemo. I felt like it was a money grab by doctors. Their end of life oncology treatment cost the insurance company a couple hundred thousand dollars each On that subject I very strongly recommend Atul Gawande's "Being Mortal". > I felt like it was a money grab by doctors. I don't think that's what it is, and Gawande's book (where he speaks as both a surgeon and having had relatives — including parents — go through this) comforted me in that opinion. Rather: * doctors generally are not trained in this sort of end-of-life care recommendations * it's easy for a disconnect and misunderstanding to occur between, or for doctors to present alternatives but fail to notice the patient or family doesn't really understand (especially the implications of the various alternative) * it is common for families to try for survival at essentially all costs (including intrusive and uncomfortable), and hard for doctors to disagree, sometimes at the result of (2) above but not always * doctors are human and tend to get blinkered by what they do know, and what they do know is usually treatment One interesting item (of many, the book is barely 200 pages but full of stuff) is Gawande's mention of Ezekiel J. Emanuel and Linda L. Emanuel's "Four Models of the Physician-Patient Relationship." which basically identifies a range from "paternalistic" (doctor knows best and takes all decisions) to "informative" (where the doctor is provides facts & figures and possibly options but no insight).

DataWorker 7y ago
This might be the best post in this thread. I think you can see a lot of the paternalistic orientation on display even in this thread. I think it’s that sort of hubris which causes people to react in the opposite direction and reject the whole thing. So who to blame for me is clear, it’s the doctors.

sgt101 7y ago

I've seen the opposite - someone choose to step away from treatment because it wasn't worth it. It was a very, very hard decision. They faced a lot of pressure from others (who they loved) but they did it. Subsequently some of their friends even questioned the proberty of the people involved - the implication was that they shouldn't have died so easily, that there were things that could have been done. But this was a man in his late 70's, with two degenerative diseases and an advanced hard to treat cancer (on top of a long standing easy to treat managable one). So - it's always hard, one way or the other.