Originally posted by: O2bnVegas
What number? Worth it to whom? Your granny or my granny? Who is "we"? Do you, Boilerman, have a "granny" or other loved one facing expensive life-sustaining treatments?
For the living, yes it can be worth it, if granny's choice. Or your choice if faced with it. Regardless of outcome.
In one of my working roles I was coordinator of a clinical ethics consultation committee, in a government hospital. Here are some of our considerations in providing an opinion if consulted (Ethics committees do not say yes or no--that would be for the patient/family/or medical team to consider.)
1. What treatments are needed/being debated to keep granny "alive" for another year.
2. What does granny have to say about it?
3. What is granny's understanding about her condition? What is her current condition?
4. Does granny have decision-making capacity? If not, who is representing her in such decisions, and what do they have to say? Is there likelihood of granny regaining this capacity?
5. What do the doctor's say about her condition/capacity, her prognosis given this or that treatment, this or that degree of medical/mechanical life support?
6. What are the risks and benefits of continuing treatment? Of stopping treatment?
Age is not a determinant. The patient or his NOK makes that decision (called Informed Consent, decision maker is advised of risks and benefits of treatments; actually of all medical treatment, e.g. surgery.
Cost is not a determinant, other than the patient or family may decline treatments based on cost. Many end of life decisions are made by patients in consideration of burden on family.
Fortunately, in this country decisions regarding medical treatment are mostly left to the patient or NOK/representative. I can recall only one condition whereby the NOK cannot force the medical team to continue treatment: Brain death requiring mechanical ventilation, certified by neurologists. Lay people use the term "brain dead" casually but not always correctly. The diagnosis of brain death must meet specific clinical criteria (tests) defined by the American Academy of Neurology (or other Neurological board) of the state where the issue is being considered.
Is it a cost issue? Yes, of course it is. Ten million is a high number, though some newer cancer treatments (immunotherapies, different from chemotherapy) can be that expensive. Former President Jimmy Carter had brain cancer in his 80s, at least, maybe 90s, underwent one of those type treatments, which can either help for a short time, or cure it, or kill the patient. Carter had a full recovery, very unusual, resumed doing things he enjoys and is loved for, including teaching Sunday School at this church. I read recently he has resigned from the teaching, but still enjoying family and church. Whatever it cost, it was worth it.
My 21 y/o nephew, wonderful young man with great future had the same cancer (sarcoma, lungs, brain, all over really), was accepted for a clinical trial for treatments. Not every case is accepted, and the experts couldn't in give a guarantee of a cure, or that he wouldn't suffer harsh side effects, but left it to him and parents to decide. He lived maybe 9 months, on very high% oxygen and not much mobility. Unable to "walk" at graduation though he did finish his last courses at OU, graduated top of his class. Had momentary improvements (in labs, MRIs etc., a little walking) but eventually turned for the worse. Had at least two cardiac/resp. arrests at home, made it to hospital both times, got tuned up, discharged home. The mother vehemently fought letting him go, even when he was begging to at the end (in awful pain). It about bankrupted them despite the clinical trial being paid for, still many expenses. Was it worth it? Yes, because now they know they did all they could for him. Can we say he deserved the $$$ trial because of being a person outstanding in effort and morals and all that? (From what I was told it was a close call. The disease had already spread when found, but youth was on his side.) But our system of medical care gives everyone consideration, and I'm glad of that. (Clinical trials don't always accept a person, based on it being medically intolerable and very unlikely to succeed--risk vs benefit. Expertise kind of stuff.)
For granny? All those questions above have to be answered.
See, the Nazi system of determining who lived or died gave the individual no choice, no say, just Hitler's own bias against Jews. In the US we have a say, and if in doubt there are ethics considerations that reduce the likelihood of provider (doctor) bias.
I'm not answering from a "liberal" or "Liberal" perspective (whichever one Kevin approves of), just life experience.
Ask me the time, I'll build you a clock. LOL.
Candy
O2bn, if you had exactly $1 million in the bank (total assets), would you spend it to keep your granny alive for another second, another minute, another hour, another day, another week, another month, another year?
Give me your number.