Wednesday, February 27, 2008

Before getting too excited about 'universal health'

Consider that government-funded (or government 'subsidized') universal health care will have to meet budgeting necessities... and "priorities" will have to be set.

And who will set them?

Harvard researcher Dr. Susan Mitchell? This AP story, by Carla K. Johnson, that I saw yesterday morning in the Chicago Sun-Times, suggests one lovely cost-cutting measure: Just let senile old folks die. Why bother giving Alzheimer's patients antibiotics, Dr. Mitchell argues in a study cited in the AP article, when they have a fever? After all, their disease is "terminal."

The problem with this logic is that we're all terminal. Some have a better idea of when than others, that's all.

There may be reasons why someone chooses to turn their face to the wall and submit to the Inevitable. There are surely valid, moral reasons why loving families will agree not to pursue heroic measures in exchange for merely delaying death... and prolonging agony. I remember my own mother -- my mother who set something of a record for the length of her hospitalization, so rare in the age of Medicare -- I remember my mother showing off her 'DNR' bracelet. "See my new jewelry?" she said. And she wasn't complaining. She was reconciled to her situation; she maintained her good humor to the last.

I was at a wake last night for a neighbor's mother, a woman who made it to 90, though the last few years were clouded by Alzheimer's, eventually to the point where she had to enter a home to receive needed care. At the end, she wound down like a mechanical clock, whose ticking slows... and slows... before it stops. The night before she went the staff called the son in. They offered hospitalization. But she was so peaceful. She was just winding down. Hospitalization was only going to disturb her.

They decided to let her go.

They.

The family.

Not some snot-nosed bureaucrat a thousand miles away setting priorities. Or some Ivy League, ivy tower doctor who thinks antibiotics are wasted on the old.

2 comments:

Patti said...

You can stay on the soapbox as long as you like, Mr. C.
I agree with you about the family making the decision to let a loved one go.

Empress Bee (of the High Sea) said...

yeah. that!

smiles, bee
tyvc