Posted tagged ‘death panels’

Blank Mind – DNRs

September 3, 2009

What to write about when your mind is blank and Robert Pattinson is managing to keep out of the lime light?  (It seems that Vancouver, where Pattinson is now filming, is somehow a more polite city than New York.  Who woulda thunk it?)

How about DNRs?  Do Not Resuscitate orders.

Now there’s a subject for the brain dead.  (Sorry.)

What do they mean exactly?

Does putting in a DNR mean that they won’t put those duckfeet paddles to some one’s heart if it’s just missed a bit or two?

Or do the DNRs only come into force after death has held sway for a full two or three minutes?

(Do those paddles even work after two or three minutes?)

In other words, how open to interpretation is a document like that?  Do hospital staff obey it as a matter of rote?  Is it a bright line?  Black and white?

Or can it become applicable only when the person will no longer be himself if resuscitated?  Or is already not himself?   Or is being tortured?  Or is really really likely to be tortured?

I have read that an extremely significant portion of medicare payments goes to the payment of health care costs incurred in the last month of life.

On the one hand, this makes perfect sense.  The last month of life falls at just about the time someone is sickest.

But some studies (such as the one discussed below by the National Hospice and Palliative Care Organization) also seem to indicate that a portion of these expenses result from patients not having discussed their “end of life wishes” with their doctors, (of not having, for example, a DNR).  This type of discussion would ostensibly allow doctors to avoid a situation of having the patient suffer a medically-extended death (rather than life).

I’ve talked to many people about health care proxies, living wills, final wishes.   At least 95% of the ones I’ve talked to say that they do not want their lives to be extended when there is no chance of recovery to a meaningful life.   (There’s also the occasional person, sometimes a medical professional who is insured by and employed by the hospital in which they expect to receive treatment, who says that they want to be kept alive at all cost, with every possible form of treatment, and collecting their full salary.)

Weirdly, it’s not even clear that all the extra treatments do prolong life.  A study of advanced cancer patients by the National Hospice and Palliative Care Organization reported in the March Archives of Internal Medicine, suggested that people who receive less invasive and aggressive treatment live longer than those who receive the more “comprehensive” care.

I have to say that I’ve never heard of the National Hospice and Palliative Care Organization and that such an organization may well have a bias against aggressive care.   Still, the study makes a lot of sense to me (a confirmed disbeliever in advanced institutional medical care).  My dad, for example, hospitalized at the moment, is in danger of being sent to rehab (for who knows how long) to recover from the damage that a day in the ER and a day and a half of hospital care have done.  The hospital’s occupational therapist said that they wanted him to get back to “where he was” before he started their treatment, which consisted almost solely of tests.  I, however, do not believe that rehab is the place for this; “where he was” before they started “treatment” was at home.

Still, it’s all very confusing.   Especially the bit about the DNR.   The doctor asked me about one.   “I’m not saying it’s likely to happen right now,” he said, “but what should the staff do if they go into his room and find that he’s died?”

It’s a harder question to answer than one might think.  First there’s the whole problem of finding one’s voice.

Maybe a little counseling would help.

Except, wait a second.  Aren’t the counselors on these issues the notorious “death panels?”

Scratch that.

Robsten and Government “Death Panels”

September 2, 2009

Until recently, I’ve never focused much on celebrities.  Even recently, I’ve only focused on one celebrity.  (If you’ve followed this blog at all, you know which celebrity that is.)

My biggest number of posts on a single subject have probably been about him (Robert Pattinson, if you are new to this blog.)  The second largest number has probably centered  on the stress and isolation of modern life.  (I’m including in this number some of the ones not technically categorized under stress, but which probably should be, i.e. those on single parenting, marriage, Friday night gym, even some on writer’s block.)   I’m guessing that there’s a link there.  (Yes, between parenting and stress, but what I’m really talking about is stress and a friendly, middle-aged interest in Robert Pattinson.)

But although both stress and my Manic D personality continue in full force, my interest in RPatz is slowly beginning to fade.  (My family members will soon be able to breathe a collective sigh of relief.)

(Of course, Rob’s next movie is due out in November.  Who knows what that will inspire?)

But putting Pattinson himself aside—(by the way, he just gave a really very charming interview in—STOP IT RIGHT NOW!)

But (ahem) putting Pattinson himself aside, what continues to fascinate me is the coverage of him by the blogosphere, the little internet “news” outlets, the entertainment weeklies.

It’s really quite amazing.

The stories remind me of a big supernova daisy where one little comment by Pattinson,  Kristen Stewart (his co-star), an “insider”, or some other celebrity who has never actually met Pattinson, will generate huge petal-ly loops of increasingly remote speculation.

When Rob has managed to evade the paparazzi for some time (as has happened recently), the celebrity “news” media even stoops to openly fictional stories based upon the activities of the character he portrays.  See, e.g. the recent cover of one entertainment rag which proclaims him and Stewart to be “ENGAGED!” on the set of third Twilight movie.  What I believe the story is about (I really really really have not actually read it) is the engagement of Pattinson’s and Stewart’s characters.

The whole celebrity daisy phenomenon has set me to wondering how mainstream news is reported.

And, frankly, the reporting of the health care debate has led me to believe that the mainstream news world is really not that different from the fantastical Twilight realm of Pattinson and the paparazzi.

The furor over government “death panels” comes especially to mind.   This uproar, which has no basis in reality, seems especially ironic given that currently much medical care for the elderly and the disabled is already provided by the government in the form of medicare and Medicaid.  (The number of persons in nursing homes and disabled adults supported by Medicaid is already legion.  Medicaid planning is a huge and accepted area of the law.  Reports of Medicare and Medicaid recipients being denied care by government panels are relatively small, certainly as compared to reports of non-Medicaid patients denied private insurance coverage.)

The death panel outcry reminds me of last summer’s netroar over Kristen Stewart’s alleged pregnancy (with RPatz as father, of course.)  The seed for this was apparently a blog in Australia (Stewart was in L.A. at the time) which reported that Stewart had asked a friend to purchase a pregnancy test for her.  Dozens (maybe even hundreds) of  headlines inquiring into Stewart’s childbearing status immediately followed.  Soon, they featured photos of Stewart in skin tight pants which were magnified to huge blurry proportions.  Arrows were drawn on the photos to point out a supposed tummy bump.  (The slender Kristen was not only supposed to be pregnant but showing.)  Pictures of Rob Pattinson wearing a sheepish, guilty father, expression were posted at the side.

Of course, the death panel rumors really are somewhat different.  They originated in Alaska.

I love Alaska; I love Australia; I love the Mississippi.  Check out 1 Mississippi (Karin Gustafson) at the link above.