An account of why we should get rid of advanced directives

http://www.nytimes.com/2013/07/21/magazine/a-life-or-death-situation.html?pagewanted=all&_rgf=0

This report was published in the New York Times magazine.  It was about Margaret Pabst Battin an academic who has made a very comfortable living by propagandizing pro-choice until she was faced with it with her husband. The future is always unknown.

Maggie has been characterized by the pro-life movement as being a dangerous woman.

Because of Maggie's being acclaimed an expert witness, advance directives and DNRs should be made illegal. No one can foresee the future.Thank you Maggie for making your expert witnessing a lie.

Up to two years ago I did not know what an advanced directive was nor did I understand the DNR.  I though a DNR was only used in advanced causes of terminal illness.  When/why did all this change..  I was of the belief that an advance directive was a directive to your family as to funeral arrangements.  I did not know that it is a directive on how you want to die.  Forgive me for thinking otherwise.

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Confidentiality has gone too far...

I recently phoned Vancouver General Hospital for information on a patient who I was visiting nearly everyday and to whom I was a substitution decision maker..  I was told that she was discharged from ICU.  I asked where to.  I was told such information was confidential.  I asked who made the information confidential, did the patient.  Since this patient could not speak or write because of her illness how could she have asked for such information to be confidential. The hospital did not ask if she wanted this privacy. It just takes it upon itself to impose this restriction.

I received a telephone call saying that Carolanne was at George Pearson Centre.  I contracted the social worker there and he would not confirm if she was there or not as such information was confidential.

Today being Sunday I was told that Carolanne was back at VGH.  I phoned VGH and was told she was now in tower 12C.  I went and saw her and although she was in bad shape she did recognize me.. Apparently within the few short days she was at GPC she gained an infection and she was rushed back to emergency and then to 12C.

Trach patients

I was just told that trach patients are the second most expensive patients for health care cost.  The most expensive are those who have transplants.  Interesting comment.

This must be true for Canada as well.

The Walmart family is the wealthiest family in this country, worth about $100 billion. owning more wealth than the bottom 40 percent of the American people, and yet here's the incredible fact.
Because their wages and benefits are so low, they are the major welfare recipients in America, because many, many of their workers depend on Medicaid, depend on food stamps, depend on government subsidies for housing. So, if the minimum wage went up for Walmart, would be a real cut in their profits, but it would be a real savings by the way for taxpayers, who would not having to subsidize Walmart employees because of their low wages.
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Brain Dead!!!!!

An organ cannot be harvested unless the donor is still alive.  Think about it.  It is after the harvesting that the patient truly dies. A transplant must come from a living person as after death all organs are dead and useless.

LifeNews.com

Patient Wakes Up as Doctors About to Remove Organs for Transplant

by Steven Ertelt | Syracuse, NY | LifeNews.com | 7/9/13 11:34 AM

As some nations move towards presumed consent on organ donations, there are more frequent occupancies of patients who are waking up from presumed death just as doctors are ready to harvest their organs for transplant.
Our of New York state comes this story of a patient who woke up just in time. From ABC News:

It was exactly midnight when Caroline Burns eerily opened her eyes and looked at the operating lights above her, shocking doctors who believed she was dead and were about to remove her organs and donate them to patients on the transplant waiting list.
The Syracuse Post-Standard unearthed a report from the U.S. Department of Health and Human Services that chronicled the series of errors that led to the near-organ removal on a living patient at St. Joseph’s Hospital Health Center in Syracuse, N.Y., in 2009.
“The patient did not suffer a cardiopulmonary arrest (as documented) and did not have irreversible brain damage,” the HHS report concluded. “The patient did not meet criteria for withdrawal of care.”
According to the report, doctors had inaccurately diagnosed Burns with irreversible brain damage and ignored nurses who’d noticed signs that Burns was improving: She curled her toes when touched, flared her nostrils and moved her mouth and tongue. She was also breathing on her own even though she was on a respirator.
Burns, who was 41 at the time, was initially found unresponsive and surrounded by empty bottles of Xanax, Benadryl, a muscle relaxant and an anti-inflammatory drug on Oct.16, 2009, according to the report. She was hypothermic and had a weak pulse, but she was alive.
In the St. Josephs emergency room, doctors performed toxicology tests and determined Burns was suffering from a multidrug overdose, according to the report. She was unresponsive and put on a ventilator.
The family made the decision to take Burns off life support and donate her organs the next day.
Although Burns opened her eyes at the last minute, saving herself from the organ harvest procedure, she committed suicide in 2011. The family never sued, and family members told the Syracuse Post-Standard that Burns was too depressed to be upset about what happened to her at St. Joseph’s.

But this isn’t the first time this has happened.
In what is becoming a more common theme, doctors rushed too fast to attempt to take the organs of a British man who was thought to be “brain dead” but recovered — thanks in part to the dedication of his family.
The case reminds of one that received attention in December in which a 20-year-old man awoke from a coma just hours before doctors were ready to shut off life support and take his organs for donation purposes.
Sam Schmid, an Arizona college student who was thought to be brain dead, recovered from injuries sustained in an automobile accident in October just hours before he was slated to be killed and his organs given to other patients.
The accident took the life of his best friend and college roommate and Schmid’s injuries were thought to be so grievous that a local hospital could not treat him and he was sent to Barrow Neurological Institute at St. Joseph’s Medical Center in Phoenix to receive surgery for a life-threatening aneurysm.
As hospital officials began palliative care and talked with his parents about organ donation, Schmid began to hold up two fingers on command and started walking with the aid of a walker. Now, his speech has improved and doctors say he will have a complete recovery.
The case provides yet another example of what pro-life bioethicists like Wesley J. Smith have warned about misjudging patients as too far gone too soon and relegating them to organ donor status:

For years, organ transplant ethicists and some in the bioethics community have agitated to change the definition of death from a purely biological determination, to one based in utilitarianism and desired sociological narratives. Why mess with death? Too few organs are donated for transplant, leading to long waiting lines and the deaths of some people who might be saved were organs more readily available.
CLICK LIKE IF YOU’RE PRO-LIFE!

But why redefine death? The point of this reckless advocacy — although they don’t put it this bluntly — is that there are thousands of perfectly good organs being used by people who really don’t need them anymore, by which they mean patients with profound cognitive impairments who will remain unconscious or minimally aware for the rest of their lives. Why not harvest such patients, this thinking goes, for the benefit of people who could return to normal lives?
The problem is that would break the “dead donor rule,” the legal and moral pact organ transplant medicine made with society promising that vital organs would only be harvested from patients who are truly dead. Hence, if the definition of death were loosened to include, say, a diagnosis of persistent vegetative state, more organs could be obtained — and the dead donor rule could still appear to be honored, deemed essential for transplant medicine to retain the trust of society.
Of course, that would be fiction, and the redefinition actually a betrayal. What these “ethicists” really propose is killing for organs, a view now being promoted in some of the world’s most prestigious medical, science, and bioethical journals. For example, Nature recently editorialized in favor of liberalizing the rules governing brain death.
Currently, brain death requires the irreversible cessation of all functions of the entire brain and each of its constituent parts. Nature’s editorial claimed — without proof — that doctors obey “the spirit but not the letter, of this law. And many are feeling uncomfortable about it.”

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June 25 2013 VCH Board Meeting

I attended the Vancouver Coastal Health Board Meeting on Tuesday.  I really do not know what VCH is trying to do.  When I attended the first board meeting in 2010 all the board members were there and now only the chair, the chief executive officer Ostrow and the new Operations Manager.  It was as if there was a decision made to hide the Board members so that they could not ask questions from presenters or the public.    It seemed that the audience was packed only by employees of VCH.  Prior to the Board meeting they had a private networking meeting (public not invited) which included a few politicians one of which was the minister for seniors but I didn't see him in the audience. This minister told me before the 2013 election at the Oakridge Seniors Centre that there would be no more money for health care.

I spoke of two items. There was only one other person who had a question.  I had five but Kip ended the meeting twenty minutes early.

I related a discussion I had with the volunteer co-ordinator for VCH.  I asked her what was the number of  professional health care workers  who volunteered with VCH and she said volunteerism by health care professionals were  unheard of.  Those no longer working for VCH  especially those who are retired and have full pensions should be encouraged to engage to volunteer.  They are a human resource which is dearly needed. The least they could do is hang out at health care facilities to act as independent comfort advocates for patients and their families.

Ron Panzer

Quoted by Ron Panzer

The pushing of DNRs on patients will only increase as the culture of death flourishes, making them mandatory in many settings, contrary to patients' wishes.  It was all a stepping stone to legalized euthanasia where the unwanted may be killed against their wishes (all in the name of patients' rights/autonomy!)