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Saturday, August 15, 2009

Barack Obama Has it Wrong on End of Life Care


Photo by Ashley Rose CC BY-NC-ND

Barack Obama talks about end of life care in an interview with David Leonhardt of the New York Times. Published: April 28, 2009.
THE PRESIDENT: Exactly. And I just recently went through this. I mean, I’ve told this story, maybe not publicly, but when my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.

So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.

And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart.

I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.
With only months to live, electing to have hip replacement surgery seems illogical to me.

If you have a terminal illness, and your health starts failing, there needs to be an end of life option for patients.

With all the controversy around allowing doctors to talk to patients about end of life care, I'm wondering how euthenasia will ever be able to be discussed.

1 comment:

  1. Observation of human beings proves we cling to life—and what we simplistically categorize as "quality of life"—at every point of our existence.

    Life IS illogical. When we are young and look toward the assumed end of life, we apply logic and a narrow-minded position that "life is good now and I want to live now, but I don't want to grow old." That delusion is not borne out by reality. Human beings become old. They fight to lead the best lives possible every day they breathe.

    The delusion that utopia can be achieved by terminating life or diminishing physical function at some, to us, "future point" is difficult to sustain. Observing human beings, we see that the future comes to all of us—barring a sudden end—and then we change our minds about that myth that life is no longer worth living. (Although our society is leading the elderly toward suicide, those suicides are still the minority of human experience.)

    Society is predicated on the position that it is one's own moral code that determines if one's life is worth living—except if their choice is suicide. When society takes it upon itself to decide that others' lives are no longer useful, that society unravels.

    We should open up discussions about the morality of euthanasia and suicide and other termination philosophies. However, those doors, when other societies have opened them, invite demons to run rampant because the tendency to "apply logic" almost always serves only the young, vibrant, and rich.

    Besides, our society kills lots of human beings already, even with our moral proscriptions surrounding the value of life.

    Ultimately, health care for only the young, vibrant, and rich is a sure plan for the destruction of our society.

    As Obama and everyone else will say, it is difficult to see one's way through these decisions. In his case, what if his grandmother lived a lot longer? What would be the appropriate “lot longer” to then justify the surgery? What if we go the route of reality and ignore the silly assumptions: what if the woman were only 20 years old, needed the surgery, but died a week later from some accident?

    It’s curious that we are such self-serving human beings, living our lives day-by-day while thinking that everyone else’s lives are merely some predictable long-term package. The definition of society is to allow everyone to live such a self-serving life.

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