Interesting Medical Ethics Story

(Posted by Patrick Sullivan Jr.)

Long, but interesting questions about medical ethics.  From MedpageToday: 

Dr. DeBakey was 97-years-old and had decided that he didn't want to endure the surgery necessary to repair the defect. With an irony worthy of Greek tragedy, Dr. DeBakey himself had helped to develop the procedure and vascular graft in 1953, using a Dacron sheath he devised at home on his wife's sewing machine.                            

                           

Yet Dr. DeBakey eventually underwent the grueling seven-hour procedure. "If they hadn't done it, I'd be dead," he said.                            

                           

The surgery, performed in early February 2006, bought Dr. DeBakey at least one more year, but at the cost of a long, painful, and difficult recovery marked by kidney failure and dialysis, a tracheostomy, six weeks of mechanical ventilation, parenteral feedings, and the possibility -- although not the eventuality -- of brain damage.                            

                           

The bill -- no one is quite sure of the amount, and Methodist Hospital here won't comment -- is estimated to be well more than $1 million.                            

                           

Few would argue that the world is richer for the presence of Dr. DeBakey, a man who comes as close as any to the status of a deity in the pantheon of modern medicine and surgery.                            

                           

But the facts of his case, which he and his physicians agreed to share with the public via a detailed article in the New York Times by Lawrence K. Altman, M.D., raise questions about end-of-life care, patient rights, and the use of limited medical resources.

Comments

[Richard Smith]

Recommend consulting:

Trust in a Medical Setting.

Experience dealing with a host of difficult to impossible situations may help others in their encounters with these difficult and distrusting patients. These individuals may make up a small per cent of patients and family members, probably less than 2 per cent, but take up 90 per cent of energy in coping with day-to-day conflicts that arise from their behavior. Difficulties managing distrustful patients and family members must be dealt with on the spot, and they don’t go away.
Examples come from office experiences or wards, including situations that keep doctors and nurses and therapists awake at night, aggravate waking hours and poison leisure, that is, empirical, based upon experience and observation alone without science or theory. To survive an outrageous patient or relative requires resourcefulness, patience and imagination. Street wisdom learned the hard way is what I present, and without a guide or mentor to soften the bewilderment and sense of failure and frustration that accompanies these individuals. We seldom talk about these difficult, distrustful and sometimes threatening individuals amongst ourselves; rather we suffer and endure them silently, by ourselves. The problem is timeless as recorded in the world’s literature.
Out of the wreckage of human behavior comes valued experience leading to maneuvers and tactics of survival that are appropriate to almost all aspects and settings of human interaction including day-to-day medical care.

Links:
Trust in a Medical Setting. Hauppauge, NY: Novinka Books, Nova Science Publishers, 2006.
www.novapublishers.com
richardsmithmd.com

[seduction]

so funny, I can't help laughing

[Agnes]

What are the consequence of bad decision? What if the patient will choose death over treatment? What if the patient says : "Please don't tell"?