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NPR Audience Wants End of Life Care Rationed for the Elderly

Discussion in 'News & Current Events' started by Revmitchell, Oct 20, 2012.

  1. Revmitchell

    Revmitchell Well-Known Member
    Site Supporter

    Feb 18, 2006
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    ...It’s a long transcript. But here are a few samples of the advocacy. Dr. Kellerman, yes:

    So the question is not whether we’re going to live or die. The question is where and how we’ll die and who will be with us when we do. Most of us don’t want to die in an intensive care unit strapped to a bed under fluorescent lights separated from our loved ones. Yet that’s precisely what happens to too many of us because all too often our healthcare system is too focused on making money, too preoccupied with its technical prowess and too busy to sit down with a patient and have an honest, thoughtful, candid conversation about prognosis and the patient’s wishes at the end of life.

    That’s very misleading. First, ICUs are money losers for hospitals these days because of capitated payment systems under Medicare and HMOs. Second, many terminally ill patients voluntarily choose hospice care, which means they refuse ICU life-extension in advance. Third, what is really being debated is refusing ICU when it is wanted. That is rationing and creates an invidious distinction between and among patients based on quality of life.