Towards rationing for older Cancer patients?

[NormanH]

Until now we oldies in France have enjoyed wonderful access to very good Cancer care, irrespective of age or previous medical history. I in particular have been lucky in this respect.

It looks however as if budget considerations are finally about to hit.

This study ( at the centre where I am treated) suggests an approach where the over 75s have 'un traitement adapté' that is to say a less aggressive approach, at the risk of not, in fact, trying hard enough.

http://www.midilibre.fr/2012/10/09/cancer-une-filiere-de-soin-pour-les-75-ans,575463.php

 

[woolybanana]

Kill the old. HITLER had it right. Euthanasia for the old. My real comments are beyond the rules of the forum

[idun]

As would my comments Wooly. This post sort of mirrors yours, was it last week? And I feel very very strongly about it.

It isn't a case of killing the old, more of letting nature take it's course. Who has suggested that people get killed off apart from Hitl er, no one ever has. But for me there comes a time when Doctors should just leave well alone.

At my age, and having had the risk of a very early death, I am already living on time that I never thought I would have. It's meant that  I ask my self this question, IF I get something awful, just how much would I want to be treated at my age. And I think that I wouldn't want much. I do not fancy chemo and radio therapy. I really do not like the idea of having major surgery. Give me the pain killers, because they are kind and let me on my way.

I have already seen my mother in a state that I wouldn't have left an animal in and yet she was 'kept' alive, only it was not life. A nightmare surely for her, in the end unable to speak or do much else.

 

And re France, well my neighbour's Grandmother was dying of cancer. At over 80 they kepy operating and doing everything to her until they could do little else and she'd get pneumonia and they'd treat it and treat it, in spite of her agony which in the end they couldn't deal with. Her end was delayed and her daughter decided that the doctors prefered to let people suffer and keep treating because they get more money.

 

If Doctors should do no harm, leaving someone suffering and tormented is not only doing harm, but is cruel.

 

And if it was between me and the generations above me and the young and the working, my priority would always be for the future, not the past. It isn't euthanasia, just life and it's consequent end.

 

 

 

[woolybanana]

The only dictum can be 'do no harm' the rest is murder.

[idun]

No, ofcourse it isn't murder. Doctors can let people die, they don't have to be injecting them, cutting them up, shoving tubes in them and messing them around when they are in actual fact dying. In fact a Professor I have seen in the NE of England stated recently that there is a real problem of doctors prolonging life and causing terrible and unnecessary distress to very ill people, and I was glad to hear him say such things as those have been my thoughts on this for many years. Doctors cannot make any of us live forever. And lots of us older people do not want any of the things I have mentioned, do not touch is just how we want it.

What you want Wooly is obviously very different from what I want or expect.

 

There are many ways of looking at this and the biggest problem as far as I can see is that most of us are frightened of dying. I am, I admit it, and I know it has to happen. I would rather it happen whilst I slept than whilst I was in agony and perhaps in no control of my body any more and worse still my mind was no longer functionning.

 

And then there is the other problem of just what do we do to old folks when all medical systems are struggling to cope financially. If it was between my or anyone else's children or any grandchildren or future grandchildren getting good and proper treatment or say a pensioner? Who should the surgeon operate on?  for me there is no choice, it has to be the young.

 

 As I said, I feel very strongly about this. The only death I have seen in the last few years, is my dog. The vet was lovely, he gave her a quick injection and she went to sleep and then gave a lethal injection. It was calm and I held her whilst she went. Just very kind and caring. My mother didn't go so well, gasping for air, how cruel is that and letting her suffer as she died was doing harm as far as I am concerned, not murder just legal cruelty.

 

I would rather have a discussion about this than not have a discussion about this.

 

 

[nomoss]

[quote user="idun"]

No, ofcourse it isn't murder. Doctors can let people die, they don't have to be injecting them, cutting them up, shoving tubes in them and messing them around when they are in actual fact dying. In fact a Professor I have seen in the NE of England stated recently that there is a real problem of doctors prolonging life and causing terrible and unnecessary distress to very ill people, and I was glad to hear him say such things as those have been my thoughts on this for many years. Doctors cannot make any of us live forever. And lots of us older people do not want any of the things I have mentioned, do not touch is just how we want it.

What you want Wooly is obviously very different from what I want or expect.

 

There are many ways of looking at this and the biggest problem as far as I can see is that most of us are frightened of dying. I am, I admit it, and I know it has to happen. I would rather it happen whilst I slept than whilst I was in agony and perhaps in no control of my body any more and worse still my mind was no longer functionning.

 

And then there is the other problem of just what do we do to old folks when all medical systems are struggling to cope financially. If it was between my or anyone else's children or any grandchildren or future grandchildren getting good and proper treatment or say a pensioner? Who should the surgeon operate on?  for me there is no choice, it has to be the young.

 

 As I said, I feel very strongly about this. The only death I have seen in the last few years, is my dog. The vet was lovely, he gave her a quick injection and she went to sleep and then gave a lethal injection. It was calm and I held her whilst she went. Just very kind and caring. My mother didn't go so well, gasping for air, how cruel is that and letting her suffer as she died was doing harm as far as I am concerned, not murder just legal cruelty.

 

I would rather have a discussion about this than not have a discussion about this.

[/quote]

 

I couldn't agree more, idun, having had a similar experience.

It seems to me british people have come to thnk of death as an illness, and wrong.

[woolybanana]

Perhaps I was not subtle enough, idun. By "do not harm", I assume that the qualities of mercy and care are paramount with the patients' best interests being put ahead of medical or economic pressures, which would mean, in some cases, that treatment should be given and in other cases withheld. But there should not be blanket policies concerning life and death, treatment and revival - those can amount to murder in my view.

The worst case scenario, as I see it, is where an account tells a doctor to withhold treatment because it is cheaper to let people die. Unlikely? Hmmm, I dunno!

[Pickles]

[quote user="woolybanana"]The worst case scenario, as I see it, is where an account tells a doctor to withhold treatment because it is cheaper to let people die. Unlikely? Hmmm, I dunno![/quote]

Being cynical, and stretching a point only a very little, this is what some HMOs do in the US ...

[idun]

And there we agree, mercy and care are paramount to the patients best interests. And the mercy part has to be taken into account.

Revival, what a subject, and my feeling is rather for not reviving as a basic blanket policy after a certain age. That's the trouble isn't it, what life awaits the revived patient?

And please please let us never forget the carers, the unsung heroes when someone needs/demands their undivided attention, but not 'just' attention, this can be hard physical work and it is 24 hours a day, every single day. There is some help available, but really it is little, especially these days. Don't they deserve a life, because I have seen it first hand, a full time carer has no life either. They become slaves to the patient's needs, duty? love? and guilt/damned if they don't. And no one really cares one hoot about the carers and their health.

And next time I am at my Doctors, I am going to discuss a living will. I'm relatively young, but IF I have a severe stroke or heart attack, I would like nature to decide and not doctors.