Nursing Voices

Sunday, July 08, 2007

My Crystal Ball

Check out this nurse’s crystal ball. Nurse Sue Whittier has a dilemma. Should she tell her dying former sweetheart the truth about his scheming wife? Apparently, the evil wife is having an affair, and the other man is the father of her son. Hmmm, decisions, decisions. May I suggest that she just go kick the wife’s butt and be done with it, or is that too un-nurse like for me to say? I guess she’ll just have to gaze into her crystal ball to find the answers to her problems. She also needs to stop pining over her old flame. Nurse Whittier, get a life. He’s married and he’s dying, so get over it. Yes, I’m feeling rather cranky today. I looked into my own crystal ball and I don’t like what I see. America has a growing dilemma. It’s our health care system. The dilemma has to do with the Baby Boomers who will one day overwhelm the health care system.

We geezers are growing older, and as we age, we start outliving our usefulness to the insurance industry. The cost of our health care goes up, and we all know how happy insurance companies are when we ask them to pay our bills. And who can blame them. Health care is expensive, and what good are old people anyway? We just take up valuable space. My crystal ball showed me that the insurance industry is going to solve this dilemma. One day, when you least expect it, the insurance companies will get Congress to pass a law that will legalize assisted suicide in our country.

Science fiction writers have already figured this out. Do you remember a movie called Soylent Green? The movie takes place in the future. It is a dismal time when there are too many people on the planet, and there isn't enough food, water, and housing to go around. There’s a scene in the movie where an old geezer, played by Edward G. Robinson, just can’t take it anymore, so he goes to an euthanasia clinic and is put out of his misery. The scene was disturbing, but I'm sure that his HMO was happy because they didn’t have to pay his expenses anymore. I’m positive that they preauthorized his extermination. I bet you’re thinking, “Life is sacred and this will never happen in America.” I’m sorry, but I have to disagree with you. In the view of the insurance industry, life is sacred as long as it’s not too expensive to keep someone around.

Here’s my suggestion for their future slogan: Say yes to death.


Blogger Aqua said...

I read your column and always enjoy it, but I'm on the side of assissted suicde. I watched my 95 year old Grandma pray everyday of her last 3 years that she would die.

She had lost all her children and her husband and was too ill for any of our family to take care of her properly. My sister tried to take care of her for more than a year after my Mom passed away, but even my Grandma's Dr. said she need 24 hour care and my sister has 2 kids to take care of too and it would have been impossible to do. It was heartwrenching to have to take her to the extended care unit at the hospital.

I saw a huge decline in her will to live after this and especially my Mom passed away 1.5 years ago.

Also,I have been in a Chronic Major Deressive Episode for more than 6 solid unliveable, unexplainable, treatment resistant to meds, ECT and weekly, sometimes twice weekly therapy.

This is only one of many severe Depressive Episodes I have endured over the years.. I know I will never be well. I believe I should be offered a way out where I can chose to both die with dignity and ensure I die in a safe environment, knowing I will indeed pass away. I do not want to make a miscalculation and be left both mentally and physically disabled.

I often believe we treat our ill and dying pets with more dignity than we do our own human race.

11:54 PM  
Blogger Aqua said...

Oh...I companies should definately NOT be the ones to decide who dies.

Either the person themselves, or maybe a tribunal of people, family members, GP's, psychiatrists, etc. if the person cannot make informed consent.

11:59 PM  
Blogger Cliffie said...

I hope you review Michael Moore's film for us.

6:27 AM  
Blogger Someday...Nurse said...

What about Logan's Run? In that film, the government got rid of us at age thirty. Think about the savings of that health care plan!


12:32 PM  
Blogger Kris said...

You know the mess at my job with insurance right now. I shudder to think about those incompetent boobs deciding who lives and who dies any more than they already do.

I also support assisted suicide, at least for those who due to their diseases aren't going to live much longer anyway. After being at the bedside of countless deaths, I'd hope that someday soon people will be able to go out on their own terms in a comfortable fashion.

ANd you are SO right about the shape of health care! Did you know that in patients who have Medicare only, we actually LOSE money treating them with Taxol, which is a gold-standard drug in lung, ovarian, and breast cancers? Glad the government decided how much to reimburse life-saving care.

Great posts, MJ! Some may call it cynicism; I call it realism.

12:41 PM  
Blogger Gerbil said...

Interesting idea... but I had to giggle also at two very Freudian typos at the end of the last paragraph.

Unless, that is, you actually meant to say "life is scared"! :)

eagle-eyed Gerbil

3:39 PM  
Blogger Mother Jones RN said...

This comment has been removed by the author.

5:47 PM  
Blogger FetchingGal said...

I don't get it... animals are often treated better when they suffer than people. People get to stay in hospital, hooked up with tubes, gadgets, monitors, at risk for pressure ulcers, etc. We may not be able to choose when we come into this world but under certain circumstances we ought to be able to choose when and how we will leave it.

5:51 PM  
Blogger Mother Jones RN said...


Damn spellcheck. Thank you so much!

And a note to my proofreader: Mom, you're fired:-)


6:12 PM  
Blogger poody said...

there's worse things than dying I can tell ya that much!

12:03 PM  
Anonymous Counting Sheep said...

What fetchinggal said!

And how did we lose control of medicine to business? How did that happen?

12:46 PM  
Blogger The Curmudgeon said...

A couple of your commenters have suggested that they'd be in favor of legally assisted suicide... but not in favor of insurer-sponsored murder.

Which isn't comforting. Because if you legalize it, the insurers, like it or not, will have a say in who utilizes it. Or, if we go to a single payer, the government will have a say.

I used to joke with my wife that I bought disability insurance along with the life insurance so she wouldn't have so strong a financial incentive to pull the plug on me.... As time has passed, I find this increasingly less funny.

(I wonder why, right?)

The old expression -- 'he turned his face to the wall' -- 'she turned her face to the wall' -- was a way of saying that a person had given up, accepted the inevitable. They didn't need Kevorkian.

What people do need are clear directives, that their families will honor, about when they want heroic measures taken and when they want to depart this world in peace. The rules on these vary from state to state and people should be very cautious about just grabbing some form on line. Dare I suggest that it might be a good thing to consult your lawyer on this? And after you have completed the forms, tell your children what your wishes are.

And, if necessary, threaten to haunt them forever if they don't follow your last directions.

3:23 PM  
Anonymous Anonymous said...

I'm pro-choice. I support individuals having the right to choose, not insurance companies.

I do not fear death and I am a control freak. That pretty much sums it up for me.


2:47 AM  
Blogger Jean-Luc Picard said...

At first, I thought the nurse had a sideline job as a medium.

Back from vacation.

9:19 AM  
Blogger may said...

money is isn't evrything, but as i have seen in this insurance driven healthcare system, most of the times, money is the only thing. sad, but very true.

10:35 AM  
Blogger MadMike said...

This comment has been removed by the author.

4:00 PM  
Blogger MadMike said...

f you are terminally ill, in pain, and otherwise feeling like hell, you should have the right to die with dignity. The government and it's insurance toadies need to keep out of it and worry about those who don't want to die, you know like the almost 1,000,000 Iraqis and almost 4,000 American and allied forces killed because of a president gone mad.

4:03 PM  
Blogger marachne said...

Ah, time to jump on my PAS soapbox.

As a person who lives in the one state that allows physician assisted suicide, as well as someone who has done research on the subject, I have to say my biggest pet peeve about discussions of PAS is that it is so often conflated with euthanasia.

'taint so. Part of the problem is the name. The only part of "physician" in PAS is that the person needs to get a two physicians to agree that you have a terminal condition with a life expectancy of less than 6 months, and one physician who will write a prescription. You have to make two oral requests separated by 15 days, as well as a written request witnessed by two other people. They have to discuss alternatives, which usually includes enrolling in hospice to make sure it is not a matter of symptom control.

You have to be able to make and communicate health decisions...oh and you have to be able to swallow 80 to 90 pills (the most common prescription is for Secobarbital 9 grams which equals 90 capsules; normal adult dose is 100mg. Second most popular is Pentobarbital 9-10 grams which equals 90-100 capsules; normal adult dose is 100mg... a lot of people will open the capsules and mix it with apple sauce but it's still a lot to get down). Technically, you have to be able to self administer, although I'm sure there are some families who help with the process.

As for insurance companies? Well, I don't think they cover the cost of the medication. One of the stories from the study I did talked about a woman who wanted to do PAS and couldn't afford the medication.

That said, the majority of the people who use PAS are white, older, and of a higher education and socio-economic class. Right now (after 9 years of being available), PAS deaths represent about 12 in 10,000 deaths in Oregon or about one-tenth of one percent of all deaths.

What is interesting is that, as the curmudgeon pointed out, there is also VRFF -- voluntary refusal of food and fluids (not to be confused with anorexia related to disease process). It happens more often than people think, and is presented as an option more often than you'd imagine. Also, with good oral and skin care, it is not torture or starving to death. Most VRFF deaths are peaceful and without symptoms.

2:44 PM  
Blogger FetchingGal said...

If assisted suicide were to become more accepted in society I could see physicians giving it up to nurses somehow, like with a Directive, so that it would fall on our shoulders to do the deed... Not quite what I had originally signed up for. Hmm...

12:40 PM  
Anonymous philippinenurses said...

This comment has been removed by a blog administrator.

5:10 AM  

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