Re: A nothing-complicated Sunday

On Mon, 9 Aug 2010 18:40:48 -0700, Miss Elaine Eos wrote:

On 2010-08-09 16:29:27 -0700, "Alex W." <ingilt@xxxxxxxxxxx> said:

So whose should it be -- the doctors and pharmaceutical companies
and pacemaker manufacturers, all of them with a vested interest
in having as much done as possible without regard to value or
usefulness or pain or dignity?

My [admittedly limited] experience in this area is that the doctors
have the lowest corruption factor of the group. Not that all doctors
are completely without corruption or bias, but I believe that their
training largely emphasises human life and dignity, and there's ALWAYS
another sick-or-dying person, so it's not as if they gain anything by
keeping this particular bed full.

Of course, doctors work for hospitals, and now you start working your
way up the corruption scale, and the pressure *does* trickle down.

Now throw into the mix a situation where patients are desperately
afraid and hence have a very hard time keeping a straight head to
make the right decision for them and their family.

That's why I'm saying that the patient, and their chosen advisors
(presumably, but not necessarily friends, family and doctors) should
make theh choice. It's not perfect, but it's far better than any of
the alternatives, on a nearly logarithmic scale.

Someone ought to make sure that those chosen advisors have their
heads screwed on right, and that the advice given is genuinely
comprehensive and expert. In such an extreme situation, I am not
certain at all that the patient can be relied upon to make this
selection unaided.

The problem with involving the government and, in particular,
"ObamaCare", is that this is a very individualized judgement call, but
they (you know: *them*!) want to reduce it to a series of calculations.
You cannot legistlate good judgement, and every attempt to do so in
the past has resulted in reduction in quality.

It seems to me that much depends on the exact nature of
government involvement. A professional panel of civil servants
directly appointed by government would be one thing;

By which you mean "horribly bad", right?

Something like that.

quiteanother would be legislation requiring the consultation of
certain parties of useful qualifications and expertise before
end-of-life and terminal illness decisions are made.

By which you mean "every bit as horribly bad", right?

If Tony were to be diagnosed with end-stage cancer (perish the
thought), I would hate for him to rely only on the guidance of
his parish priest. I would want for him to be able to draw on
the experience and expertise of a panel to give him the
comprehensive information -- medical, ethical, legal,
psychological -- to take decisions and make plans with all the
relevant input.

With one, you get a batch of state-employed bureaucrats parachuted in to
deliver a verdict based on files and the needs and priorities of
the state.

(Which one was that, again? Sounds like "both" to me.)

With the other, the state does not directly involve
itself beyond ensuring that any decision is made after truly
comprehensive advice from all possible angles given by experts
nominated by the patient or his family. See the difference?

Hmmm. I think you're advocating that the state demand that you use
common sense. I think that this can't help but end poorly. I'll grant
that it might even have an early sucess or two but, once the state
starts telling the citizens -- via leglistation -- what good common
sense they must exercise, things will go downhill very quickly.

Fuck common sense.
It is neither common nor sensible.
Phrases like "it stands to reason" or "it's only common sense"
are only ever uttered by people who have no actual expertise of

You want an expert in financial and estate planning, to figure
exactly how much you can spend, how much you can afford to spend,
how to order your affairs (cancel that CA subscription!) to make
all the inutterably tedious legal crap as unbothersome as

You want a lawyer to tell you what you, your doctors and your
family can and cannot do, either to end or to prolong life.

You want a psychologist to help you understand how far the
realisation of your imminent demise is skewing your thinking --
which it will -- and to help yu work through it.

You may want some sort of spiritual counsellor.

You will want a doctor to double-check the attending.

You want a second psychologist to help your family cope.

You want an insurance expert to deal with all the claim forms,
refusals, exeptions, policies and the other crapp they will
insist on inflicting you to make your last days a foretaste of

And when they have all said and done their thing, you will be in
a position to make your decisions and get on with it.

What if a state-sanctioned doctor advises me one way and my friends and
I decide something else? Can we be deemed "unfit to make the decision"
by demonstration of our clear lack of collective common sense?!

In such a situation, I would assume that it goes to court (enter
the ghost of Terry Schiavo, stage left).