... no matter how much you might agree with the sentiment, it's just a little too would you like some cannnndy? to have one that says:
I [HEART] GIRL SCOUTS
firmly attached to the posterior of your minivan.
It's like the scary (badly) hand-painted ice-cream van.
Wednesday, August 03, 2005
Wednesday, March 23, 2005
Terri Schiavo
Okay, essentials first: nobody really knows what she wanted.
Second, the law: a judge was convinced by testimony that she would not have wanted to live this way, and on appeal he was found to have made no error at law.
Third, the result: we have a great many people very disturbed over the fact that she will die of hunger or thirst, that it is indeed too cruel an end. They demand that life should be the default option because it seems likely to them that she is at least the equivalent of a severely retarded child, and we don't kill them.
Well, within the confines of my knowledge of the case - which is quite limited, as is that of everyone else on the outside - it's different. See, the thing is, people stop feeding themselves all the time. It's virtually universal in terminal cancer patients, and not uncommon in other chronic states. We have no problem letting them do so. So, in full recognition that this is a slightly different medical condition:
Would those who oppose removing Mrs. Schiavo's feeding tube on the grounds that the resultant death would be more cruel than, say, suffocation (because of its duration), and would in fact be murder as she's otherwise healthy, support the prosecution of people with terminal illnesses who reject tube feeding when they are too nauseous to eat normal food? Should they too be forced to feed? Suicide is, after all, illegal in most if not all US jurisdictions.
Honestly, the way that medical ethics are held, a competent person can make a decision to revert to stone-age treatment if they so choose. By any account I've seen, Mrs. Schiavo would die with stone-age treatment, because she could not be fed. So why is this murder? Indeed, why are conservatives who have watched the liberal establishment use special pleading in legislatures and courts to push horrible precedents through now so eager to use the full power of the nation-state to force a medical treatment? Is there no sanctity of oneself?
Or is it that they just don't like the decision that was reached?
I've been deeply disappointed by this whole matter. I wholly understand those who believe, deeply, that she would want to remain this way. I think you're wrong - the comments to her husband may have been a meaningless aside, but they probably weren't. Until they have seen an elderly family member in that state, most people have never considered whether they would consider life worth living if they were incontinent of urine and feces, unable to swallow (and therefore drooling), and with nil to minimal consciousness of the world. By age 28, she was very unlikely to do so.
I've seen those people. I never want to be one. (Ed: but this is an anonymous blog! How will they ever know?--Good question, time to write the living will.) I've got other reasons for thinking differently about the matter. I'm estranged from my family for matters not worth repeating here, but I can honestly say that I trust none of them to make rational, informed decisions in line with my wishes. I've left my wife in charge; in her absence, taking a detailed list of my wishes, her parents are to carry out my wishes in consultation with the ethics board of whatever hospital I'm in.
So, until we have euthanasia legalized - something that, for several reasons, I'm not particularly enthusiastic about - that means that we have to do things like pull the feeding tube. But don't tell me it's cruel; just don't. Forty years trapped in a mind that can no longer think, no longer move, no longer communicate. Forty years alone with what little remains of your thoughts, watching your family slowly drift along trying to keep you going. That's cruel.
Second, the law: a judge was convinced by testimony that she would not have wanted to live this way, and on appeal he was found to have made no error at law.
Third, the result: we have a great many people very disturbed over the fact that she will die of hunger or thirst, that it is indeed too cruel an end. They demand that life should be the default option because it seems likely to them that she is at least the equivalent of a severely retarded child, and we don't kill them.
Well, within the confines of my knowledge of the case - which is quite limited, as is that of everyone else on the outside - it's different. See, the thing is, people stop feeding themselves all the time. It's virtually universal in terminal cancer patients, and not uncommon in other chronic states. We have no problem letting them do so. So, in full recognition that this is a slightly different medical condition:
Would those who oppose removing Mrs. Schiavo's feeding tube on the grounds that the resultant death would be more cruel than, say, suffocation (because of its duration), and would in fact be murder as she's otherwise healthy, support the prosecution of people with terminal illnesses who reject tube feeding when they are too nauseous to eat normal food? Should they too be forced to feed? Suicide is, after all, illegal in most if not all US jurisdictions.
Honestly, the way that medical ethics are held, a competent person can make a decision to revert to stone-age treatment if they so choose. By any account I've seen, Mrs. Schiavo would die with stone-age treatment, because she could not be fed. So why is this murder? Indeed, why are conservatives who have watched the liberal establishment use special pleading in legislatures and courts to push horrible precedents through now so eager to use the full power of the nation-state to force a medical treatment? Is there no sanctity of oneself?
Or is it that they just don't like the decision that was reached?
I've been deeply disappointed by this whole matter. I wholly understand those who believe, deeply, that she would want to remain this way. I think you're wrong - the comments to her husband may have been a meaningless aside, but they probably weren't. Until they have seen an elderly family member in that state, most people have never considered whether they would consider life worth living if they were incontinent of urine and feces, unable to swallow (and therefore drooling), and with nil to minimal consciousness of the world. By age 28, she was very unlikely to do so.
I've seen those people. I never want to be one. (Ed: but this is an anonymous blog! How will they ever know?--Good question, time to write the living will.) I've got other reasons for thinking differently about the matter. I'm estranged from my family for matters not worth repeating here, but I can honestly say that I trust none of them to make rational, informed decisions in line with my wishes. I've left my wife in charge; in her absence, taking a detailed list of my wishes, her parents are to carry out my wishes in consultation with the ethics board of whatever hospital I'm in.
So, until we have euthanasia legalized - something that, for several reasons, I'm not particularly enthusiastic about - that means that we have to do things like pull the feeding tube. But don't tell me it's cruel; just don't. Forty years trapped in a mind that can no longer think, no longer move, no longer communicate. Forty years alone with what little remains of your thoughts, watching your family slowly drift along trying to keep you going. That's cruel.
Tuesday, March 15, 2005
Woo hoo!
I matched!
Bunny Powered, MD, anesthesiology.
Mrs. Bunny Powered is still thinking, but she has another year to go.
Bunny Powered, MD, anesthesiology.
Mrs. Bunny Powered is still thinking, but she has another year to go.
Wednesday, March 09, 2005
Hey, it's March!
March! Not yet March 17, Match Day! But March!
Grooving to a bit of Solar Power Sessions at the moment. Good station, if you're into trance. They have a prog channel too, just haven't really listened to it much.
Took the USMLE Step 2 CS last Friday; those who have it waiting, beware. It's a total waste of your time and money. One case I just couldn't figure out. Two others were, well, a little curious. But the other nine were so clear-cut (at least, once you asked The Right Question) that the diagnosis was easy. Coming up with a big differential was somewhat difficult for some problems, but that's life. Anyway, got there at 8, was out by 4:30. Layout: Orientation - 5 cases - 30 min lunch (sandwiches, chips, drinks provided) - 4 cases - 15 min break - 3 cases - final survey - out of there. I'm just hoping I passed; it really seems like the sort of situation where making the correct diagnosis still isn't enough to guarantee success, as your eval is dependent on what the patient remembers your asking or not. I will say this: from past experience with similar situations at my school, if you can charm a simulated patient they will likely think that you did more than you actually did. Don't be smarmy, but if you've got it, use it. Little old ladies, for example, are butter in my hands.
Grooving to a bit of Solar Power Sessions at the moment. Good station, if you're into trance. They have a prog channel too, just haven't really listened to it much.
Took the USMLE Step 2 CS last Friday; those who have it waiting, beware. It's a total waste of your time and money. One case I just couldn't figure out. Two others were, well, a little curious. But the other nine were so clear-cut (at least, once you asked The Right Question) that the diagnosis was easy. Coming up with a big differential was somewhat difficult for some problems, but that's life. Anyway, got there at 8, was out by 4:30. Layout: Orientation - 5 cases - 30 min lunch (sandwiches, chips, drinks provided) - 4 cases - 15 min break - 3 cases - final survey - out of there. I'm just hoping I passed; it really seems like the sort of situation where making the correct diagnosis still isn't enough to guarantee success, as your eval is dependent on what the patient remembers your asking or not. I will say this: from past experience with similar situations at my school, if you can charm a simulated patient they will likely think that you did more than you actually did. Don't be smarmy, but if you've got it, use it. Little old ladies, for example, are butter in my hands.
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