[lam]

Just some food for thought, comments appreciated.

Is it ethical to deny medical care to one person so the money can be used to help some one else?

Is it ethical to just go with the families wishes even if the patient is capable of making those decisions and by doing so increase the patients pain or hasten their demise?

Is it ethical for persons in the medical profession to be making those decisions?

Is it ethical to use a person against their will, disregard their safety and well being to help some one else?

[cassioo]

no, no, no, no pretty much my opinion

[lam]

So, what do you do when you are faced with these decisions and every one else just wants to " Go with the flow"

[cassioo]

I haven't really encountered those problems but there is an ethics committee where I work that those problems can be taken to.

[lam]

I think all hospitals have them, but nursing homes don't

[cassioo]

maybe they should have them. Approach administration about getting one put together

[jmc]

it all sounds unethical, but is this a real situation, if so what are the details. is it all that black and white

[lam]

Actually they are from different situations that I have encountered over the years and yes I put up a stink and even left jobs because of this. One case was an alert and oriented resident of a LTC facility signed for cpr if needed, doctor orders reflected this. I was told that we don't do cpr because the facility was a no code facility and the family didn't want it. They were just humoring the resident.
Another example: Social worker has a resident put onto hospice, order from the doctor was for social worker to have the family talk to him the doctor first. Hospice shows up at the facility and D/C's all meds.
Another example: Same social worker gets another resident put onto hospice after she has a tumor removed and chart indicates that the surgeon got it all. I point out to hospice nurse that there is no dx to support her being on hospice, so she talks to the doc and they come up with failure to thrive. Which was true prior to the surgery. The tumor was on her bowel. So now she had been treated and was on Hospice. I could go on with these cases, but I was looking more for support and agreement that some of this is unethical.

[Old_School]

Does the word GOMER mean anything to you? You start doing CPR on some of these folks and they still wind up dead, eventually. Only now, you've spent $50,000. For what? Did you in any way improve their QOL? Did you ever have to look at the face of that old frail person on a vent, ngt, 3-L CVC, foley for 12 hours? Did you ever have to run multiple drips on them? One to bring up their BP the other to bring down their HR. Multiple antibiotics to turn them into petri dishes. Then antifungals because they are loaded with Candida? Don't even get me started on daily labs and x-rays. Personally, I think it's almost criminal what we subject some of our older citizens to. Yeah Iam, it's real easy to 911 that person but you never see what you have done to them.

O_S

[lam]

I think you missed the point entirely. I don't think any one is talking about putting the tubes in. I am talking about pulling them out. I agree the decision should be the patients. and these decisions should be made prior to that stage. But if we are going to ignore the patients wishes then none of those Living Wills mean any thing. I would not want you in my corner. What hospital do you work in so I make sure I don't go there or any one else I know. I could come back with some names of my own for you like Jethro. I don't think he can read very well nor does he understand simple principles. I agree that it is traumatic for the elderly to go through that it is also traumatic to send them to the hospital just to treat pneumonias also. But untill some one can get the laws changed and allow nursing homes to either do more or make sure that nothing is to be done we are stuck with what we have. I don't want to be working along side a nurse that goes along with things just because everyone else is. I think this forum has a section for name calling post in there I don't bother reading those childish ones.