Marisa, Megan, & Jenna questions for discussion
All: pick 2-3 to discuss; respond to 2-3 posts from your peers. due by 18th.
1. Do you believe that a patient has the decision to compel treatment at
the end of their life, even if the physician believes it is medically
worthless? Why do you believe that?
2. Should treatment be ended
if the physician thinks that would be best? Or should it be continued
until the patient, or surrogate says, "Enough"?
3. Do you, like Hardwig, believe that we have a duty to die?
4. Do you believe that we have a responsibility to protect our family even if it costs us our own lives?
5.
When creating a will, should we make decisions about how to handle end
of life situations together with family and loved ones, like Hardwig
suggests?
6. When there is lack of social agreement, how should society determine which policies/decisions are correct to adopt?
7. Should society favor the patient/surrogate's autonomy or the physician's in cases where the two clash?
8. Would you be willing to die if you knew your illness was a burden on your family? Why or why not?
Here are 8 Questions from Marisa, Jenna and I
ReplyDelete1. Do you believe that a patient has the decision to compel treatment at the end of their life, even if the physician believes it is medically worthless? Why do you believe that?
2. Should treatment be ended if the physician thinks that would be best? Or should it be continued until the patient, or surrogate says, "Enough"?
3. Do you, like Hardwig, believe that we have a duty to die?
4. Do you believe that we have a responsibility to protect our family even if it costs us our own lives?
5. When creating a will, should we make decisions about how to handle end of life situations together with family and loved ones, like Hardwig suggests?
6. When there is lack of social agreement, how should society determine which policies/decisions are correct to adopt?
7. Should society favor the patient/surrogate's autonomy or the physician's in cases where the two clash?
8. Would you be willing to die if you knew your illness was a burden on your family? Why or why not?
I'm going to reflect on questions 1 and 2 together. Because I want to be a physician assistant, I'm going to approach this from a health care provider's standpoint. I think it would be hard for me to give a patient a treatment that I know wouldn't help them, but it would be even more difficult to do so if I knew they would suffer because of it. I think it's the physician's duty to communicate their opinion and all the pros and cons that they're aware of, and like the Hippocratic oath says, "I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism." I think it would be against a physician's duty to give them a treatment that would be pointless. It seems to me that the only reason a person would be willing to undergo medically worthless treatment and suffer even more would be because they have no other hope to hold on to. Although it would very hard for the physician to do so, they have to be honest and not sugar coat the situation. I think a good example of this was the doctor in "Being Mortal" who didn't know how to tell his patient that she was dying and there wasn't much else they could do, and the new mother who had terminal cancer but underwent treatments that made her sicker and weaker to the point of not being able to hold her newborn baby. In both situations, though it would be difficult, I believe the physician's duty is to be honest.
ReplyDeleteNothing in medicine is guaranteed so it would be hard to know whether or not a medical treatment is completely worthless or not. Sometimes it is just worth a try, but I can see how hard it would be to give a patient treatment that could further their pain. That's when the medical field becomes very difficult because the physician obviously knows what is best for the patient, however, the patient always has the ultimate decision, no matter what the consequences.
DeleteI agree with you both, I think it would be terrible to have to give a patient treatment when there is little to no hope that it will help while also putting them in pain. Although it may be painful and not what the physician would recommend, the patient ultimately makes the decision and they have to provide them with what they ask. I think this would be when being a physician is extra hard because you know what would be best for the patient, but it is ultimately their decision.
DeleteI am going to comment on question 2 "Should treatment be ended if the physician thinks that would be best? Or should it be continued until the patient, or surrogate says, "Enough"? I think that every patient has the right to decide if they want to continue with treatment of to end treatment. The thing that is complicated here is that people have different pain levels and we don't know how pain affects each person. However, I believe that the patient should be informed by the physician on if the treatment will be effective to continue or not. The patient should always be informed and then have the right to decided if he/she wants to continue. Also, sometimes it isn't just the patients decision either. There are the immediate families in which will have a say too as well. For example, my mother and father both had cancer when I was growing up. My father had it when I was younger and my mother had it when I was a freshman in high school so I had more say in what I wished and wanted. My mom had some chemo. done as well as other treatment, but that made her very weak and sick. We listened to what the doctors and physicians had to tell us and the cancer was mostly treated to where she would be okay if she wanted to stop treatment. So we all got together and decided and now she has been cancer free for quite some time. So, it all depends on many different factors in which should be taken place and also should be up to the patient.
ReplyDeleteI am going to comment on question 2 "Should treatment be ended if the physician thinks that would be best? Or should it be continued until the patient, or surrogate says, "Enough"? I think that every patient has the right to decide if they want to continue with treatment of to end treatment. The thing that is complicated here is that people have different pain levels and we don't know how pain affects each person. However, I believe that the patient should be informed by the physician on if the treatment will be effective to continue or not. The patient should always be informed and then have the right to decided if he/she wants to continue. Also, sometimes it isn't just the patients decision either. There are the immediate families in which will have a say too as well. For example, my mother and father both had cancer when I was growing up. My father had it when I was younger and my mother had it when I was a freshman in high school so I had more say in what I wished and wanted. My mom had some chemo. done as well as other treatment, but that made her very weak and sick. We listened to what the doctors and physicians had to tell us and the cancer was mostly treated to where she would be okay if she wanted to stop treatment. So we all got together and decided and now she has been cancer free for quite some time. So, it all depends on many different factors in which should be taken place and also should be up to the patient.
ReplyDeleteI completely agree that the physician should inform the patient of their knowledge and beliefs about whether or not the treatment will do any good. The patient should be the ultimate person who decides what they want to do about their life, but it is definitely good if the physician gives his input to the patient and helps them along the journey no matter what.
DeleteThat's neat that you were able to be a part of that decision! I think the family's role in helping decide on the course of treatment is often overlooked because most people just think that it's between the physician and patient, but the role of the family is hugely important.
DeleteIt is the patient's right to know what the options are for treatment and whether to deny any further treatment. But I do agree that the patient should discuss these options with family members so that everyone is on the same page.
Delete"Do you believe that we have a responsibility to protect our family even if it costs us our own lives?"
ReplyDeleteI don't think there is necessarily a responsibility to protect our family, especially in certain cases. You can look at this questions in the terms of 'would you take a bullet for this person'. I definitely have some family members I would instantly jump in front of a bullet for, while others I would probably hesitate. It is selfless love for these people that would drive me to sacrifice my life in order to save theirs. We dont have a 'responsibility' to die for another person, but instead it is selflessness and love that drives us to the thought of dying for another person.
"When creating a will, should we make decisions about how to handle end of life situations together with family and loved ones, like Hardwig suggests?"
I do not think we should involve family members when creating a will on end of life situations. I think this should be a personal time where you can reflect and process what you would like, without the voices and opinions of other people. Once you have come to a conclusion on your end of life decision, you can then share it with your family. In this way, the family cannot change your mind at the time you are writing it, you have had time to think and process it, and they can understand that these are your personal wishes.
Concerning your second response, I disagree. I think it's important for each individual to know where they stand on different end of life situations, but I also think that each person should value the opinions of their loved ones because they are a part of the process as well.
DeleteI agree with your second opinion that a will is your time to decide what you want, but I also believe that your families opinions are important. Even thought the families opinion is important, I don't believe that their opinion should be followed unless their is an agreement. It is your decision an opinions that are being written down therefore the will should follow what you believe and not the opinions of others..
DeleteIn my opinion to your second response, I would want loved ones around me to help make the decision. I really respect my mother's opinion and it would help me in the end to make the right choice. But it all depends on if your family members have the same outlook as you.
Delete1) 3. No matter what, I think the patient always has the ultimate say in their treatment. If they believe that trying a new treatment may open new doors, then the physician should still allow the patient to at least try the treatment, even if all it does is eases the patient’s mind. I believe that because everyone’s life has meaning and is worth something. They have a say in what happens with their life and if they want to do something that could potentially make them feel better, then they should be allowed to do it.
ReplyDelete2) I think that if the physician thinks that ending treatment would be best , then the physician should suggest that to the patient. If the patient does not want to end treatment and wants to continue to be treated, then they should be. Once again, it is the patient’s decision as to whether or not they want to continue on with their life. I absolutely believe that the patient should continue to be treated until the patient says they have had enough. If the patient is incapable of making a decision due to medical reasons, then I believe it is the surrogate’s decision.
Here is some info on the patient's rights and informed consent on treatment!
DeleteIf the patient simply consents to treatment, it is not enough. A patient must give informed consent. In essence, informed consent means that before a doctor can treat or touch a patient, the patient must be given some basic information about what the doctor proposes to do. Informed consent has been called the most important legal doctrine in patients' rights. Informed consent is required not only in life-or-death situations but also in clinic and outpatient settings as well.
A healthcare provider must first present information regarding risks, alternatives, and success rates. The information must be presented in language the patient can understand and typically should include the following:
- A description of the recommended treatment or procedure;
- A description of the risks and benefits—particularly exploring the risk of serious bodily disability or death;
- A description of alternative treatments and the risks and benefits of alternatives;
- The probable results if no treatment is undertaken;
- The probability of success and a definition of what the doctor means by success;
- Length and challenges of recuperation; and
- Any other information generally provided to patients in this situation by other qualified physicians.
1. I believe that it is worth trying to continue with treatment, but if the person requesting this treatment is too weak to survive it then it is not worth it. The doctor knows what he is talking about and he knows if the patient is too weak to try to save the patient. This is an issue when older people request a heart transplant. Are they healthy enough to recover on their own and will they survive after the surgery?
ReplyDelete2. I believe that patient has the say on whether to end treatment because it is up to them if they want to be sick when they die or if they want to live a normal life and just die that way. If the treatment is making the patient feel worse then it’s not worth continuing the treatment and making them suffer even more.
8. If my illness was a burden to my family, I would want to do what’s best for them. I would be willing to die because I know there is a better place out there and I would want to go to heaven. Plus is would allow my family to get back to their daily lives.
I agree that if I was a burden, I would want to try and make the life of my family easier. I wouldn't want them to worry about financials, especially if I was continuing a treatment that was medically worthless. All I would be doing is prolonging my own suffering and a growing financial situation.
DeleteIf my illness was a burden to my family, I would be willing to die. But even if my illness was a burden, I do not think my family would ever tell me that and I do not think they would really want me to die. If it was burden, I think my family would still be very supportive and try their best to take care of me. I would want what is best for them, however, so I would be willing to die, but I do not think that is what my family would want.
DeleteEven if I was truly a burden to my family, I hope that they would still take care of me and enjoy being with me. I would be willing to die when the time came, but I would want to do what was best for my family
Delete1. I agree with Maggie that a patient has the ultimate decision to decide if they want treatment. If the physician believes it is medically worthless, they can talk to the patient and let them know their professional opinions. Patents can also talk to friends and family to get their opinion if continuing with treatment is the best option. I believe that everyone is entitled to their own opinion so they should have a say in what happens to them. Doctors are also people and have their own opinion but they should only voice the medical facts about what is beneficial and what is not.
ReplyDelete5. When creating a will, I believe that we should make the decisions on our own. A will is a legal document that can help resolve future conflict if the person is physically unable to do so later. The person who is creating the will can discuss with their family and loved ones on what their opinion is, but those opinions should not be the final say. The final decision of what goes into the will should be the belief of the person writing it and not the sole opinion of their loved ones.
I agree with your response to #5. I think families opinions are important to take into consideration, but ultimately it is your decision. Everyone has different opinions, and wills can be quite complicated. I think you should make it on your own and hopefully it will avoid conflict.
DeleteI also agree with your thoughts on creating a will, it should be what we want done and not what your family wants done, thats the reason we have it made. It will help make the final decision on other issues as well that the family may have.
DeleteI think this answers question #1 and question #2. I believe that the patient should have the right to decide what he or she wants to do when it comes to treatment. I think the physician should give his recommendation, but ultimately I believe the patient should be able to decide if he or she wants to continue treatment. It is the patient’s body, so he should be able to decide what is done to it. Even if the treatment is not going to work, it is ultimately the patient’s choice.
ReplyDelete4. I believe that we should do everything we can to protect our family, but I do not think we should be looked down upon if we do not risk our own lives for our family. I think in many cases, we would protect our family even if it did cost us our own life just because of how much we love our family. Even though I think we would, I do not think we have a duty to risk our own life to protect our family.
5. I believe that what goes in the will is the decision of that person and that person only. Yes, we can take into consideration what our family may want, but the decision is ultimately your own. It is your life, so I think you should be able to decide what happens once you have died.
I agree with #4 that has to be an incredibly difficult decision that i hope i am never faced with. Our family is so important , but how do we decide between our life and the life of someone we love. And the will is about the individuals wants and needs. The families opinions are crucial, but in the end it is not their opinion that matters.
DeleteI like both of your opinions regarding the will. I took a different approach to the question but I definitely agree that it is our opinion of what we want at the end of our life. Having family there is for them to be aware of what it is we want at the end of our life. Our opinion of what happens is ultimately what matters.
Delete5. When creating a will, should we make decisions about how to handle end of life situations together with family and loved ones, like Hardwig suggests?
ReplyDeleteI believe that the decision about final arrangements should be made by the person alone. They can talk with their family and take their opinions into consideration but the final decision should be made by the person it is affecting.
8. Would you be willing to die if you knew your illness was a burden on your family? Why or why not?
I would not want to be a burden to my family so I guess I would be willing to die when the time came, but I would never do anything to hurry death along.
I agree that you should not hurry your death along. I think my death would outweigh the heartbreak that i hope my family would feel when i die. I don't think it's about rushing death to help the family not be burdened, but more about the quality of the time we spend with them. I would rather hire a home nurse to take care of me and avoid family on the really bad days when i'm sick. it won't be easy but i would rather have the extra time with my family and be a little selfish and my last days.
DeleteI agree that I would never do anything to hurry death along. If we are meant to live longer than the doctors gave us, then there is a reason for that. That means our time on earth isn't supposed to be up yet. However if it were specific circumstances where my living was such a burden on my family, then I would not want them to suffer any longer than they had to. But I definitely would never hurry along my death.
Delete#1 I do believe that a patient has the right to compel medical treatment even though the physician says it is worthless. If the patient wants the treatment and they are dying, then give that to them. It may give the patient the sense that they did everything they could all the way through the very end.
ReplyDeleteWould I be wiling to die if I knew my illness was a burden to my family? This question is a difficult one, but I would have to say no. The reason I say this is because I know that even though my illness may be a large burden for my family to bare, my parents would rather have me here on earth and with them than anything else they are giving up to take care of me and my illness. They are the type of people who would give up their normal life to take care of any of their children. I would also think that me dying would have a large impact on their life, worse than having to take care of me, however selfish that sounds
1. I think it is so improtant for a patient to have control over any medical treatment and decisions. It could stress a patient out if they think they are having treatment withheld that could save their life. Doctors know a lot obviously, but i don't believe they are always right. Patients should have all their options explained to them and have the consequences laid out about each medical decision. Maybe the treatment is worthless, but in a terminal diagnosis is any treatment really worthless?
ReplyDelete5. I believe when creating a will that family should be present to go over end of life decisions. It is improtant to explain to the family the reasons for your decision. If a family understands the reasoning behind your end of life decisions then i believe they are more likely to follow your choices. I will be a hard conversation because they may not agree with all your decisions, but in the end the family deserves to know why they are making the choices that they are with your life. This needs to be put in a will so it can be assured that your wishes are followed whether agreed with or not by your family members.
I do believe that a patient has the decision to compel treatment because the physician took an oath to fight for their patient and to take all measures possible to doing what the patient asks. If treatment seems to have no effect, the physician cannot simply just stop it unless the patient asks them to. I believe that the patient has the right to any kind of medical treatment until they can no longer make the decision for themselves, then it is up to family members to make that decision.
ReplyDeleteI do believe that we have a responsibility to protect our family, even if it means losing our own life. If they were in our shoes, wouldn’t they do the same? What it comes down to is that we must protect our family with all we have because they are who raised us, they are who cared for us and made us into the person we are today. We have the responsibility to look out for them no matter what the circumstance is, in my own personal opinion. I would take a bullet for my family because they would do the same for me. That’s what family means. We always stick together.
I definitely think we should sit down and discuss my will with family and loved ones because if something were to happen and everything hadn’t be done yet, they can at least get an understanding of what I would like for to happen. I can explain what I would like with my money, what kind of funeral, if I wanted to be buried or cremated, etc. These are very important conversations that need to be made with family present because they can make sure everything is done as I would like.
I would be willing to die if my illness was such a burden on my family because I would not want them to suffer because of me. Depending on the situation and how they treat me of course, I would be willing to give up my life. Sometimes people drag on a lot longer than usual and if I am in pain and unresponsive I would rather they just end my life instead of having to be a burden on my family.
i think that the patient does have the opinion to compel treatment because i know that sometimes the suffering just becomes unbearable, and when there is nothing else for a cure that is sometimes the better option. Ever since i have taken this class i have been wanting to discuss my will with my family, ultimately i want my brother and sister to make the decision about what happens to me. I know that there are certain ways that i would like my funeral and certain ways that i want treatment done when i am getting ready to die. I would be willing to die if i was a burden to my family but i know that my family loves me enough that they would never treat me as a burden.
ReplyDelete4 In most cases, I would say yes. It would have to depend what is going and whether it is a benefit or burden.
ReplyDelete5. When creating a Will it is a good idea to have what to do with end of life wishes. In order, to prevent family rifts and nasty court battles that have made news in the past