Saturday, February 13, 2010
Valentine's Day
Friday, February 12, 2010
Psychosis
Tuesday, February 9, 2010
School Again.
Friday, February 5, 2010
50th Post!
Thursday, February 4, 2010
Sick
Tuesday, February 2, 2010
Science
Friend 1: We're not using Sandals.
Friend 2: Ahhh! Why not?
Friend 1: Because apparently Sandals is only for ridiculously hot people.
Me: (*wheeze* which you are.)
Friend 2: Which I am.
Silence, scribbling.
Friend 2: But we're not going to Germany!
Friend 1: Why not?!
Friend 2: Have you ever heard of ANYONE having --
Teacher: ALL RIGHT YOU GUYS, STFU.
Silence, more scribbling.
Me: I love science, because when you talk about it, it sounds trippy.
Teacher: RAAAAAAAWRRL. *huffs and searches for stocks*
I lol'ed.
It's shit like this that gets me addicted to chemistry.
Inspiration
Remember how your mom never got past geometry and your dad never got above a C in math until his junior year of college? Look at you. An 87 in precalculus. Girl, every step you take breaks stereotypes.
It was only then that I found the courage to get up and get dressed.
I am the next Woodrow Wilson.
Monday, February 1, 2010
Don't read this if you don't like curse words
Fuck. My. Life. -.-
HORMONES!!!!
RAAAAAAGE!
-sigh-
Friday, January 29, 2010
J.D. Salinger
"You take a really sleepy man, Esme, and he always stands a chance of again becoming a man with all his fac -- with all his f-a-c-u-l-t-i-e-s intact."
Monday, January 25, 2010
Before Basketball
Sunday, January 24, 2010
Dreaming
Tuesday, January 12, 2010
Scrap
Thursday, January 7, 2010
Medical Futility
A 65-year-old woman was driving to work when she was hit by another car. The accident resulted in her being left completely brain-dead, with no capacity left to think or interact with other people. “Still,” her daughter insisted, “I want everything done to keep her alive.”
Out of curiosity, one of the doctors asked, “Would you want your children to keep you alive, if something like this happened to you one day?”
“Hell, no,” said the woman. “I'd just want to die naturally.”
Welcome to the world of medical futility, where doctors are unfortunately pitted against patients' families when deciding what treatment to give the terminally ill. These days, I and many others think that doctors should no longer be forced to provide medically futile treatment.
When a situation like the one I've just described happens, solving it seems like a simple matter at first: just follow the patient's advance instructions regarding treatment. But what if it was a young person or a teenager? Very few healthy teenagers I know dwell long enough on their own death to write a will or advance instructions, and in fact, if they did, that would be a little scary. So, the worst happens, spinning towards someone's life at an ungodly speed, and suddenly they're lying in a hospital bed hooked up to a dozen machines with their family on one side and the doctor on another. At a time like that, a thousand questions come up, but one of the most pressing is: what do we do now?
The issue of medical futility has really only come up in the past 20 or so years, because new technology and treatments have been developed that have the capacity to extend someone's life past the time when they naturally would have died. Doctors, wielding all of this new weaponry, are now expected to work against nature instead of with it. When someone dies these days, it's not an “act of God” anymore; it's a failure. Someone has to be responsible for it, and that someone is usually sued until they're up to their well-schooled eyebrows in litigation, because they failed to do the impossible. Doctors don't just tack on the label of “medically futile” to any treatment they feel like. They don't like patients to die either. If something is considered medically futile, there's a darn good reason for it. Most likely – not always, but almost always – the treatment will either make the patient's quality of life unacceptably low, or it will provide almost no benefit in regards to lifespan, or both. Families have to consider this carefully when they are deciding for or against futile treatment. Is it really worth it?
Sometimes the line between right and wrong is very thin. One man had written in his advance instructions that he did not want antibiotics or resuscitation in the case of a fatal illness. Now, years later, he suffered from Alzheimer's disease. When he contracted pneumonia, a nurse asked if he wanted antibiotics, and he appeared to nod. Even so, the doctors decided not to give him antibiotics because his quality of life was so low in general that it was doubtful he enjoyed anything at all anymore. The man's family then accused the doctors of “playing God” even though they would be “playing God” much more if they did give him the antibiotics. The man was already ill from a natural and untreatable illness. In this case, the doctors decided to work with nature instead of against it and followed the man's advance instructions. Did they do the right thing? No one knows for sure, but I think they did because they acted in the best interest of the patient.
In the field of medical ethics, a question often comes up that is otherwise only heard in drug-induced mumblings: what is a person? All of us in this room are people, of course – unless I am wrong, in which case, hello...aliens! But if we were brain-dead, would we still be the same people we are today? Our bodies would still be alive, but would we? The goal of medicine – or what is supposed to be the goal of medicine – is to treat people. When someone is brain-dead or otherwise forever robbed of the true capacity of consciousness, they are still human, and as such, they should be treated with respect. But are doctors required to treat such patients? According to the definition of medicine, no. According to most doctors' consciences, no. There is no value – to anyone – in treating the shell of what was once a person. As one doctor said, “The wheel may be spinning, but the hamster is gone.”
The esteemed philosopher, epic musician, and alleged physician Gregory House claims that “there is never any dignity in death.” That may be true, but neither is there any dignity in medically futile treatment. Life is short – maybe too short, in some cases – but all life has to end, and once that truth is faced, the patient's wishes and comfort can be addressed. Medicine isn't always about saving someone's life, fighting nature, or performing miracles. However, it is always, always about the patient. Because in the transition from life to death, the only person who matters is the person who's making the journey. There are some situations when doctors and families must look up from the bed where their patient and their loved one is lying and work together to find the best answer to the all-important question: What do we do now?
Euthanasia
The patient's family gathers around his bedside. He is a healthy-looking man in his forties, but he is quiet and pale. His doctor has just told him that he has metastatic lung cancer. “I want to die,” he says, and his family murmurs in dismay. “There's nothing they can do for me except keep me alive to suffer.”
“That's not true,” says his wife, putting a reassuring hand on his. “Miracles happen all the time.” The doctor, standing in the doorway, shakes his head. He's seen this before, and he knows what will happen. The patient will waste away, racked by palliative chemotherapy and radiation, destroyed by pain, slowly suffocating until at last he is mercifully taken by a coma, and then death. Every step of the way, he will beg the doctor and his family to help end his suffering. This is what will and does happen, and the doctor and I watch in despair and anger. This patient, you see, was my uncle.
What my uncle wanted can be described in many different ways – a mercy killing or assisted suicide, among other terms. However, the scientific community usually refers to it as euthanasia. Euthanasia is illegal in all areas of the world except Belgium, the Netherlands, and Oregon. Denying a mentally competent, terminally ill patient the right to choose how and when he or she will die is a violation of the ethical principles of innate human dignity and personal choice. Allowing someone to suffer is not, contrary to the belief of some, dignified or holy. It is needless agony that affects not only the patient, but also his or her loved ones and caregivers. We allow people to make the choice to smoke, to abort their pregnancies, to marry whomever they choose and live in whatever way they want. Doctors can save people from death. Is it so wrong to deny them this most personal of all choices and to save them from life when life is no longer worth living?
As someone who is interested in a medical career, and as someone who has worked and lived with the severely ill and the dying, I can well appreciate their courage. As much as I admire their faith and perseverance in the face of certain defeat, I can't help but think that some of them must want a way out. Plenty of people consider suicide; what makes this group of people special is that their problem is not only depression. Their problem is that they must make a very clear decision: to die naturally, or to die by euthanasia. Unfortunately, this is usually a decision with only one answer. A mentally competent, adult patient should not have to suffer needlessly with no escape. To me, it signifies more respect for human life to assist that life's end if the patient makes that choice, than to refuse his or her plea for assistance.
In the end, it all boils down to the patient's view on euthanasia. Various religious and other groups have argued that there are ways to alleviate someone's pain and improve their quality of life. A patient's loved ones may cling to these resources, such as narcotics and comforting hospice care. This argument fails to recognize that there are drawbacks to such alternatives. By the time my uncle died, he was on such a large amount of narcotics that he existed in a stupor twenty-four hours a day. He did not experience an improvement in his quality of life, as all of his personal needs had to be handled by others. He could not eat anymore, and was nourished by an IV. He could still interact with us, one benefit, but it was hard for us to see him reduced to such a state.
As I have said before, if we claim to value human life so highly, why do we not value humans' opinions as highly? Perhaps there is fear that euthanasia will be abused. Critics point to instances in Oregon where physicians have offered dying patients death-dealing pills, but not proper treatment for their condition, because the pills were cheaper. All laws can be abused; this is one of the drawbacks of living in a democratic society. If proper restraints were put on euthanasia, such as requiring the doctor to have a permit and having the patient go through a strict physical and psychological examination to determine if there are any factors that might cloud his or her judgment, euthanasia would be much less likely to be abused.
Since I do not have any power in the medical field, I plan to go to my acquaintances at the hospital where I work and ask them for their opinion on euthanasia. To those who support it, I would ask for reasons why. Then, we could spread awareness in the community by talking to community doctors and lawyers, sending letters to local newspapers, and publishing articles in medical newsletters arguing the case for euthanasia. The Internet, a great tool for spreading information, could also be used. In the debate over euthanasia, many people have forgotten about those whom it affects directly – the patients. They do not understand that not all people would be forced to be euthanized, as that also interferes with free choice. This is one aspect of the issue that I would like to focus on, so that maybe in 100 years when people look back and think, “How could they not have allowed euthanasia?” they can also think, “At least we have it now.”