http://video.pbs.org/video/1639625115/
What surprised you? Was there a particular
story/person/situation which moved you or in which you would have acted
differently? I usually show this film at the very beginning of the term. After taking the class, what has changed about your views of what would you
want done at the end of life?
What surprised me is that the ICU was a place where in the past people could go to get better, but now the ICU is where people go to die. It's tragic to see people not getting better even though the doctors are trying to do what they can to help. Its also surprising that people are spending billions of dollars each year on end of life care. The number of patients that cannot communicate due to their illness or sedation was interesting to learn because at 95%, the doctors don't know what the patients wishes are for their treatment. I enjoyed the fact that Dr. Scott Lorin stated that in a perfect world, a patient has already designated a healthcare proxy and had a discussion about their preferences would be at the end of their life. He understands what need to be done before something tragic happens to a person and they cannot communicate their wishes.
ReplyDeleteThe story that moved me the most was Diana because she told her family that she didn't want to be dependent on machines, but they are not ready to let her go. It would be tough, but because I would want someone to follow my wishes, I would follow hers. She knew this would make her suffer and she did not want to have to rely on machines to be alive so she made the decision to not be suffering and dependent. Her major organs are shutting down and her disease is progressive, because I don't see her condition improving, why prolong something she doesn't want anyways?
Megan, I agree with your last question of why prolong something that she doesnt want. I feel like sometimes people dont want somebody to die so they impose their own will upon them even though its not what the person wants. Not to mention the amount of money it cost and the suffering the person has to go through. The loved ones are trying to push off their own suffering by making the person dying suffer longer.
DeleteMegan, I also thought it was interesting that Dr. Lorin talked about how in a perfect world, the patients would have already had the discussions about end of life care, but for patients in the ICU, most of those people have not had those conversations. I thought this was interesting because we have talked about this so much in class and how important it is to have these discussions with family and friends before a horrible situation happens.
DeleteI agree Megan. I don't believe prolonging something terribly difficult, that the patient doesn't want to endure anyway, as the best decision. I understand how hard it is for the family, and I can totally understand keeping the body alive until the family has had a chance to say their goodbyes but ultimately it becomes a bit selfish to keep the patient alive against their wishes just because the family/friends aren't ready to say those goodbyes.
DeleteThis video was really interesting to me because of the fact that I'm looking into becoming an ICU nurse when I graduate. What really surprised me though was the lack of the amount of people who haven't made up their minds when it comes to end of life decisions. It really made me think about how people need to make sure they make these decisions clear before anything bad happens. I also never really thought about the billions and billions of dollars spent on care throughout the world to extend people's lives even though the quality of life is almost nothing. I for one was also surpirsed by the 86 year old dementia patient who was taken off of the ventilator and she immediately started breathing. I guess sometimes you dont really think that people who are on respirators will ever come off especially if they are 86. It also shows that each patient is different and they are never quiet the same.
ReplyDeleteI think after going through this class it made me change my views slightly, I would say that I would want my parents or my healthcare advocate to weigh the options, to see if extending my life would also make my quality of life better and if was all worth it. The video really enforced what we have talked about all semester long and it put it into real world situations.
I was also surprised that she started the breathing because you would think that someone who is that old would have trouble or not even be able to breathe on their own. I think you should become an ICU nurse and use the knowledge you have gained in this class to help people make decisions and better communicate with their loved ones so that there are no issues when it is time to make a decision.
DeleteThis video was extremely sad! A few things were interesting to me from this video. Like Megan said, I think it is very sad that the ICU has transitioned from a place where people came to respond to treatment and get better to a place where people come to die. That if you are in the ICU, there is very little, if any, hope that you will survive and get better. Another thing that I thought was interesting was when the doctor said they can support pretty much every body system for years, and this has made decisions for end of life more complicated for everyone involved. One statement that really surprised me was when the doctor said, “Thirty percent of all care is just waste.” This is surprising to me because I did not realize so much of the treatment that people are getting is really not useful, and is not doing anything to help the patient get better. I know that if I have lost all upper brain function, I do not want to be kept alive by machines. I do not think my views for what I want done at the end of my life have changed, but I now have a better understanding for why people might want certain things done to them. One situation where I would have acted differently was with the 31 year old who had scleroderma. She was in poor nutritional status and had amputations of digits. She had told the doctors that she did not want to be permanently dependent on machines, but her family was not ready to take her off the ventilator. The doctor had to sit down and have a difficult conversation with the family, but the family still wanted to keep her on the respirator. If I were that women’s family, I would take her off of all the life support she was on, no matter how difficult of a decision it is. She had said she did not want to be kept alive by machines, so I would want to honor her wishes.
ReplyDeleteWhat surprised me about this video was how long some of the patients continued to be on life support. Some of the patients knew that their treatments were no longer working and there was no chance is saving their lives. The only thing the treatments were doing was making their lives last a little bit longer. Something else I found interesting was that one of the doctors said about 20 to 25 billion dollars is spent annually on life care support treatments for patients. I feel like I would have acted differently in all of the situations the patients were in. I feel like I would attempt the treatments in hope they would cure the disease I had, but if there was no more hope then I would refuse to receive any more treatment. If I knew I was going to die soon, I would want to spend my last few days to weeks with my family in my own home.
ReplyDeleteCeanna,
DeleteI totally agree with you on how you would like to spend your last few days alone with your family. I am the same way. If my family and I knew that the treatments were not working for me than I would want to stop them, for two reasons. The first is because I wouldn't so much money being spent on something that wasn't helping me because I wouldn't want my parents or loved ones having to pay for all of that. The second is because I would feel better about being in my own home with my family rather than being in a hospital during my final hours that way I would be at peace.
Ceanna,
DeleteI totally agree with you on how you would like to spend your last few days alone with your family. I am the same way. If my family and I knew that the treatments were not working for me than I would want to stop them, for two reasons. The first is because I wouldn't so much money being spent on something that wasn't helping me because I wouldn't want my parents or loved ones having to pay for all of that. The second is because I would feel better about being in my own home with my family rather than being in a hospital during my final hours that way I would be at peace.
I agree with wanting to spend time with my family at the end. I would want to see friends too, but not if I can't communicate with them. I could not see myself doing a treatment if in the end there is little or no benefit because i agree with Eva that I wouldn't want my parents or loved ones to be spending money on something that may not even work. I also agree with Eva that I would want to be home with my family so that I am not dying in a place that doesn't have the comforts of home.
DeleteI agree with you guys, I think it would be a difficult decision regardless, but when the treatment no longer works and I am only getting sicker from it, I would want to stop treatment and live out my final days feeling happy and healthy with my family. I would want my family to remember the happy and healthy person, not the sick and dying person. I would not want the disease to take over my entire life and especially my final days. I would not want to be defined by my disease.
DeleteI first want to say how informing this video was and I believe if many people watched it, it could help with the plans that they might have for when their lives are coming to an end. Saying that, I think it is very important to speak out about what your wishes are about how you die, what you want to happen, vice versa. Much like we discussed in the beginning of the semester. I think having that talk with your family as well as saying to yourself "this is what I want to do" can help a lot of people during that time. Also, it is scary knowing that around 95% of doctors don't truly know what people want for their treatments. which relates back to why it is so important to talk about those things. What I found that was tragic was that so many people are admitted into the ICU and billions of dollars are spent on life care support for treatments for these patients each year, when in reality it might only help lengthen someones life for just a few days or weeks. However, it is interesting how far someone will go and how much someone will do to stretch out their life for a few more days. When in reality most of the patients treatment isn't really working for them. For myself, if I knew that treatments were not working then I would tell the doctors to stop and let me be alone with my family in my final days. My reasoning for this is because I wouldn't want them to be spending more money on hospital bills for treatment that isn't working and I wouldn't want them to be waiting around when something wasn't going to help me. I would rather be at peace than having something that was being done to me that had no use.
ReplyDeleteThroughout the semester I have really thought about some things that I have never began to think about before. How it is very important to have this talk with your family, how one should weigh their options, if extending ones life is useful, how you wish to be buried or not after you die, etc. I think even though this is scary stuff to talk about and it may be uncomfortable it will be helpful in the end and might even make things a bit better on the family.
I believe that this documentary really put things in perspective, or rather... the class itself reminded me of things I had forgotten and seeing this made me see that reality. Things like the money that is spent on treating people, such as the billions of dollars just to prolong life for a short time. Sad not that people die, because people die all the time, but rather the treatment at the ICU is not to save a life, but to basically sedate the patient and let them die more "peacefully". Judith Nelson, one of the doctors on here said the position that patients come in with could remain voiceless at times. Sometimes there is no way of knowing what that particular person wants, so it is left up to the family member or next of kin. To have that weight upon someone's shoulders, I hope to GOD that I, nor my family and friends, nor any of you... are faced with that situation. Sad to say, after hearing of some of your experiences, I know that is not the case. Some of you have already been involved in such things and I for one, respect all of you.
ReplyDeleteChristian Shodahl
This is a topic i struggled with a lot in class, which is would i want a prolonged life with no quality to it. At first i would have said i don't want to just die, because God will decide when it's time for me to die. Now i think that i can live a good quality of life, and i don't have to live to be 100. I can live comfortably during my last days and during that time God can still choose when my time is up. Overall life is about fulfilling our purpose, not spending billions of dollars on healthcare for people who cannot function they just live their life on a respirator and a feeding tube. I agree with you that sedating a patient isn't the answer to save someone's life.
DeleteWhen thinking back to the beginning of this class i feel i have come so far when considering death. This video shows people who have no decided on end of life issues, but we have discussed so many issues in class i think it is shocking for us to think of people who have not given their death all that much consideration. But honestly when i think back to the beginning of the semester i wouldn't have considered too many options about my death. I didn't think of where exactly i would want to die when considering a hospital or a home, or gave consideration about quality of life verses quantity of life. I have given so much thought to these topics, and now i consider these topics very deeply, and i also take in the considerations of others. In the end it is not only my life effected by my death. Like in the video, would i want to stay on life support or a ventilator for years, not really, but then again i have to consider the effect my death has on the people around me. This class has brought me so far in thinking through issues instead of just stating my opinion with absolutely no reasoning behind my beliefs. I'm glad i learned to question life instead of just accepting what could be true.
ReplyDeleteI think more deeply about these topics also, but more along the terms of my family. I want them to know the facts about prolonging life and about death overall. Once they know these facts, they can make the decision on their own and I will not tamper with their wishes. I feel like if they make their decision in their right mind, family should not tamper them, unlike the family in the video. It is just so sad
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ReplyDeleteI was able to watch this video last semester for biomedical ethics and it still surprises me that almost every patient in the video is willing to give up their quality of life in hopes of living a little longer. What is even more surprising is that the doctors cant even be completely sure that the treatment will help. John refused to give up his fight and when he returned back to the hospital days after being released to go home, the doctor said she could do the treatment again but that the problem was the bleeding and not being able to control it, which meant that he would end up right back in the hospital. What is truly saddening to me is that some of the treatments make the end of someones life even worse. Norman died days after receiving his transplant and the same doctor as before said that he would have probably died with it and that he definitely would have died without the transplant, but that she believed he suffered more because of the transplant. I could not imagine having to be the doctor in that situation. This video just further supports my preference of not wanting life sustaining treatment at the end of life. If i am at the end of my life already, i want the least amount of suffering. I do not want my suffering to be prolonged to live an uncertain amount of extra days. Quality, to me, is more important than quantity.
ReplyDeleteI definitely agree, quality over quantity. I would not want to suffer like a lot of these patients did, just to live a couple more days. These patients seemed to be so uncomfortable but were so sure that they wanted to keep living even though there wasn't much left that could be done. It would be so hard to be a doctor caring for someone like Norman and realizing that you made a patient go through more suffering than they needed to. The doctor said she felt guilty and it wasn't something she wanted for Norman, but at the time it could have also been the thing to save his life. You just never know and it is very hard to make an ultimate decision on what to do when the decision could be life or death.
DeleteI never want to be put in a position where is am suffering. Maggie i completely agree with quality of life rather than the quantity of it
DeleteThis video brought tears to my eyes numerous times. I cannot even begin to imagine what the patients and their families were going through during this tragic time. The patient that had my attention the most was Albert. He had two transplants and was on the waiting list for another transplant. He suffered from pneumonia and a stroke and you could tell that he was very weak and fragile. My heart just ached for him because he has three young kids and a wife. He always tried to remain as possible as he could, but you could tell how hard it was. It just breaks my heart that all of these patients are holding out hope that they can be the one person to survive their illness and in the end, they usually end up passing away. It surprised me that the patients were so willing to continue on with their pain and suffering as long as it meant staying alive, especially with the patient John. He was not ready to give up and face death at all, even though his wife continuously told him that there is much more they can do. After watching this video, it definitely made me question what I would do if I were in these people’s situations. Although I don’t think I will ever want to die, I think if I am suffering and the doctor tells me that there is not much else they can do I will sign a DNR and just accept it. I would not want to have my family watching me suffering like in this video. This video was just so eye opening for me cause you really see how hard it is to let someone go, especially if they are your loved one. People don’t want to automatically say just take them off life support because in their mind, there still could be something that can improve their life. If one of my family members were going through something like this, it would be extremely hard to just take them off life support because I would not be ready to let them go. Taking them off life support would mean that they are actually going to be gone and it would be very hard to face that. I was also surprised when they took the patient off the ventilator and she was able to breathe on her own. That was very exciting and I do not think even the doctors were expecting her to be able to do that. However, not too long after she received a tracheostomy and has been on it for over a year and that makes me start to question her quality of life. This video really made me question what I would do in this situation, whether the patient would be myself or a loved one.
ReplyDeleteI though this video was very surprising to me overall. Like Megan said, the ICU is now a place to go to die instead of a place to recover. I work on a Progressive Cardiac unit, which is a set down from ICU. We get patients that range from walking around, to constantly bed ridden. I see and interact with many patient that we send or receive from the ICU. These patients have feeding tubes, rectal tubes, catheters, and possibly more. It is sad to see these people put themselves through these life prolonging measures when they know there isn't much time left.
ReplyDeleteI think I was most surprised about the amount of money that is used in the health care system for prolonging life. To spend 20 billion dollars on machines and measures to prolong life seems a bit ridiculous to me. I dont want to say it is 'wasting' time or resources, but it does take away from people who are more stable and have a better chance.
I think the story that affected me the most was the woman with scleroderma. She did not want life sustaining measures, but her family thought otherwise. I think this is taking away from her freedom in a state where she only has limited choices. The reason this affected me the most is because my sister was diagnosed with scleroderma last year at 29 years old. Luckily the disease has only affected her thigh and part of her calf, but it can easily become systemic and spread to her organs. This is a muscle degenerative disease, where the muscle just deteriorates. This is scary to think about because I dont want to be in that situation with my sister.
After this class, my stance is still at the decision of not being on machines to sustain my life. If the machines can support me for a short term and then I can achieve full function of my brain and body, then that it fine. But I do not want to have my life sustained if it will not recover.
It’s shocking to see the pain and suffering these patients would go through in hope that they would somehow overcome the disease and improve. The man who had multiple transplants and who was waiting on an additional transplant really hit home for me. He had suffered so much but he had three young children and his wife to fight for. He was in so much pain and was suffering but he was relentless and wouldn’t give up. It’s devastating to see family and patients who are so hopeful for a miracle or a cure when in reality, there is little to no hope for them.
ReplyDeleteIt’s interesting to see the various opinions of siblings and parents regarding their loved ones. I definitely agree with the daughter of the older woman who had dementia and who the doctors said would need to get a trach in order to prolong her life. The one daughter was talking about how she did not want to put her mother through that while the other argued who are we to decide when there is no longer hope and their life is not improving just prolonging. I don’t want to end my mother’s life by not giving her every opportunity to potentially improve her life. Miracles happen all of the time so it is very difficult to make the decision of when it is time to take someone off life support. It’s very difficult to stop something that’s already been started because it gives everyone hope that their loved one is improving which isn’t always the case. Most times the machines are what is keeping them alive. Another thing to think about is quality of life. Is the condition that this person is in acceptable to their terms and would they want to further live in this condition? It’s hard to decide for others especially if they never discussed what they would like to happen to them at the end of their life. On the flip side, it’s very difficult to deal with the decision that your loved one makes about the end of their life if it is opposing what you would want to do for them. Having to unplug someone from life support because that is what they want is very difficult, but it may be worse having to decide on your own because they never got the opportunity to explain what they would want to happen.
I think my views have changed in that although it will always be a difficult decision, I would not want my family to have to suffer and keep hoping that my life is going to improve with a miracle. If I am on life support and the doctors don’t see any sign of improvement, after a reasonable amount of time, I would want to be taken off life support. If I can no longer communicate and interact with my family in some kind of way, I do not want to continue living. I never used to think this way, but after taking this class and hearing about these situations and the state that these people are in, I have a new perspective with end of life care. I also see what the families have to go through and I would never want to put my families through that.
My opinion regarding the life of a loved one has not changed however. I could never get myself to take my loved one off life support unless it was harming them or putting them in some kind of pain. Ending the life of a loved one is unimaginable to me. It is honestly something I hope to never be faced with.
I really liked this video. I think it showed many of the hardships that we don't necessarily think of all the time. It was kind of hard to watch at times but overall I really liked it. I really like how the video stressed the relationship between the patients and their families. This really showed me how difficult this time is not just do the patients but everyone involved, It was really cool to see how different everyone's opinions are in dealing with their loved ones. This shows how important it is to talk with the family now instead of waiting for late because we never know what is going to happen.
ReplyDeleteI agree this video is really hard to watch but i think that it definitely opened my eyes to death and knowing that it can occur at any time
DeleteI absolutely love this video. i watched it last year and it real opened up my eyes to what i will witness while being a nurse. It showed me how difficult coping with diseases such as cancer can be but also being the health care provider and helping them cope with such news. I think that this video really opened my eyes to death
ReplyDeleteIm really glad you waited till the end of class to show this, it was quite moving. This class and even my experience outside of class this semester has open my understanding and acceptance of death and life in a whole new manner. Being exposed to a whole other avenue of healing for so long at a young age has made my judgements and opinions of how to treat life threatening illness in a less invasive way. I was so amazed with the doctor's in this film they moved me on there understanding of how poisonous some of these procedures are and how they do advice against pushing the bar. They even admitted at the times where they realized that maybe they choose wrong on the treatment and doing nothing would of at least inproved the quality of life, not necessarily expanding their life. Being a naturalist I am also aware of fighting to the end and trying everything, I guess have seen so much suffering sometimes I just say enjoy what you have and while you have it. That I believe is not the naturalist in me but the Christian that accepts death as not a bad thing but a beautiful peaceful experience and keeping it as noninvasive as possible. I did find it hard to watch the mother with Dementia have the traq put in I found that very selfish of her daughter's. Also that the daughter who was a doctor could not let go. They should of let her go. This class has really challenged my beliefs and have made me understand so much more. I can't thank you enough Dr. Cate and each an everyone of you for your opinions and beliefs to make me grow as a individual. God Bless you all on your journey...
ReplyDeleteIm really glad you waited till the end of class to show this, it was quite moving. This class and even my experience outside of class this semester has open my understanding and acceptance of death and life in a whole new manner. Being exposed to a whole other avenue of healing for so long at a young age has made my judgements and opinions of how to treat life threatening illness in a less invasive way. I was so amazed with the doctor's in this film they moved me on there understanding of how poisonous some of these procedures are and how they do advice against pushing the bar. They even admitted at the times where they realized that maybe they choose wrong on the treatment and doing nothing would of at least inproved the quality of life, not necessarily expanding their life. Being a naturalist I am also aware of fighting to the end and trying everything, I guess have seen so much suffering sometimes I just say enjoy what you have and while you have it. That I believe is not the naturalist in me but the Christian that accepts death as not a bad thing but a beautiful peaceful experience and keeping it as noninvasive as possible. I did find it hard to watch the mother with Dementia have the traq put in I found that very selfish of her daughter's. Also that the daughter who was a doctor could not let go. They should of let her go. This class has really challenged my beliefs and have made me understand so much more. I can't thank you enough Dr. Cate and each an everyone of you for your opinions and beliefs to make me grow as a individual. God Bless you all on your journey...
ReplyDeleteThe person that moved me was the man who was in the hospital for about a year and he finally got to go home for a week, but he ended back in the hospital. He wouldn't accept that he was sick and he kept fighting and telling his wife that he would get better and come home. It was a tough battle for him but he died with dignity. After seeing all the patients who were sick and suffering, i would have taken them off of the ventilators and let them die on their own. I was sad that the one woman was left on life support for a whole year. It was surprising that she could breath on after they took her off the ventilator.
ReplyDeleteNice article. Meanwhilie read entertaining top News stories, entertainment news and school news
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