5 ms·
So, couple of things. Just had my wife read this (she is a doc) and we chatted about this. We are in our mid-30s and several years ago she was admitted to the
by fingerprinter 15y ago
So, couple of things. Just had my wife read this (she is a doc) and we chatted about this.
We are in our mid-30s and several years ago she was admitted to the ER and then ICU for 7 days for an obviously life threatening situation. (She has a near blanket NO CODE, FYI). She recovered, but there was at least 48 hours where her odds were "much worse than a coin flip" as on of her colleagues told me.
So people distinguish the different situations, in that situation she and her colleagues (she was treated at her own hospital...given that it was the best hosp in the country) knew about her NO CODE and still treated her. The reason being that medical intervention was near 100% likely to produce a positive outcome and bring her back to a normal quality of life.
However, if given a terminal diagnosis such as in the story, my wife, without hesitation, said she would choose to go without treatment. She went further and wished that this type of article could make its way to the NYT or some other outlet to get normal folks to think about. She, like most doctors, has seen way too many people "try to live" only to saddle their family with huge expenses, not dramatically effect their prognosis and basically make the rest of their lives as painful as possible.
Obviously not a fun conversation to have with your SO, but I for sure know exactly what she wants and how to ask the right questions at the hospital just in case. She also knows what I would want and how to make the right decisions.
- celticninja 15y agoRe:saddling their family with huge expenses, this is a fairly unique problem in 1st world healthcare situations, in that it mainly applies to people in the US. In most other developed nations healthcare and bankruptcy do not go hand in hand.
- dmgottlieb 15y agoBut the money is just as wasted no matter who pays it.
- ahi 15y agoIt's not nearly as much money in other countries. 5 figures on bad odds vs 6 or 7 figures on bad odds. If it's cheap maybe it's worth a shot?
- mdda 15y agoMaybe think of this as one of the burdens that civilization handles for you : One never has to mix the emotional trauma of losing a loved one with the cold facts of how much money they'd save you by dying before tea-time.
- waqf 15y agoThat's true of the actual cost of the service. For the 1000% markup that U.S. hospitals take, it's more arguable.
- lmkg 15y agoThis statement is both true, and irrelevant, because who bears the burden is very important for the individual making the decision. What's being weighed is not "are the resources used to keep me alive being efficiently allocated," but rather, "will my spouse and children be irrevocably bankrupted."
- dmgottlieb 15y agoWhat a strange thing to say. It is irrelevant from the myopic point of view of a patient receiving care, at the moment they are receiving the care. It is far from irrelevant as a matter of social policy, because society has to pay the cost even if a particular individual gets off free. Cf. negative externality [http://en.wikipedia.org/wiki/Externality#Negative http://en.wikipedia.org/wiki/Externality#Negative].
- juanre 15y agoMy spouse is also a doctor, and she also went through a life threatening illness. For several days her odds were poor, but full recovery was one of the options. She pulled it through and was lucky. We have had this conversation as well, and her answer is unequivocal: do let me go.
- z2amiller 15y agoIs there a good way to phrase (i.e. "Doctor Speak") for something like "No Code unless a probably positive outcome with intervention"?
- jcitme 15y agoIf there isn't, can I suggest "No Code++"? Tech humor/references aside, this is actually an effective way to explain intentions if it becomes ubiquitous enough.
- larrys 15y agoAgree. My wife is a MD also (internal medicine) and the only time I saw her cry was when she received a call in the middle of the night and found out that one of her patients that was dnr/dni (an elderly lady) had exactly that done to her. The staff at the hospital where she was off shift had overlooked the directive.