This weekend my brother’s girlfriend arranged for me to visit her best friend’s father, who has lung cancer. It wasn’t as weird as an arrangement as it sounds because I have met this man several times. His wife and daughter had to go to a wedding, and he did not feel up to going. I was told I could be helpful heating some soup for his lunch both days and just keeping him company for an hour or two.
When I arrived at their apartment on the Lower East Side, I was a little nervous because I had seen him about two months ago, and he was walking around and acting normally. He was much thinner now, and he was breathing incredibly heavily. I would have been terrified if I had not been warned about his condition. There was a wheel chair, but he was sitting in a straight backed chair, because he said it sitting up straight helped him breathe more easily. His wife showed me how to heat the soup and give it to him with a straw because that made it easier for him. She said that on of their friends would be coming in two hours and said that it would be great if I could have a conversation with him about sports, which he loves, and what is going on in my life. I asked if he needed any medicine, but she said that had been taken care of and that I didn’t have to worry about him getting to the bathroom on his own or anything like that. Their daughter told me that the doctors had told him that he had about six months to live. He had been operated on for lung cancer a year ago and seemed cured. Sadly, it had come back. I expected him to be in worse shape I guess.
He asked for some water before I sat down so that he could speak more “fluidly” with me. I started by saying I was so sorry that he was having such a bad time. He told me that he had probably smoked one too many cigarettes in his twenties, thirties, and forties, and that he was probably lucky to have made it to the age of 70. He has a great sense of humor which made my visits a thousand percent easier. I asked if he had seen the Jets game. He said he hadn’t because it would hurt too much to watch “that cheat” Bill Belichick win another game versus the Jets. That’s when I knew I had found a friend. I responded that I felt the same way about game 7 of the NBA finals between the Lakers and the Celtics. I knew that if I watched, I would jinx the Lakers and the Celtics would come out on top. I then talked about how the approximately 10 NY Knicks games I’ve been to in my entire life have all been victories. It would only make sense to give me season tickets. He agreed. It was very interesting how he could keep up a conversation for hours about current players when most elderly people I have met seem frozen in the land of Magic and Bird in the 80s as well as Jordan and Pippen in the 90s.
I had another visit with him today, and we began with sports again. He asked me about my soccer, and we started talking about the U.S. looking a lot stronger in the last World Cup. Then he told me that his daughter had mentioned my Illness & Dying Unit at school, and he wondered if he could tell me anything that might be helpful. I must have looked uncomfortable because he said, “Hey, one day you could be in my place. Do you smoke?” I said that my coaches would have kill me if I did. Then he said that it was helpful to him to be helpful to me. The terrible thing about being sick is that you feel you can’t be useful. I told him a little about the class and what we had learned about negative practices in this country concerning death and dying. He said that health care was a racket because of the greed of the insurance and drug companies and that he would never want to be on life support. I asked if he had a Living Will. He said he got one when he was first diagnosed with lung cancer. He also has an organ donation card figuring that some of his organs, especially his eyes, could help someone else. He thinks everyone should have a Living Will and made his wife and daughter get one. Then he had a coughing fit, and I went to get some water and a straw. I asked if he should take a rest from talking, and he asked if I would like to read some sports news to him. I read an article from the news paper and then I went to online to ESPN. His wife returned in time for me to get to soccer training, and they both thanked me profusely. I said that I should be thanking them. I had had a really nice time, and I meant it.
Sunday, January 30, 2011
Tuesday, January 25, 2011
HW # 33 - Comments from T/W teams
For Ben
Your summary of the worst aspects of health care in this country is just right. It seems that that it all comes down to the fact that many Americans are so selfish that they don't want their taxes to go towards helping everyone get better care. Just as you say we should spend money on prevention. For example, spending money on getting people to eat better and get more exercise obviously makes much more sense than huge expenditures on terminally ill patients. The corrupt health care system that is in place in America must be replaced with a system that mirrors that of Canada, France, and England(as you say). I liked the way you presented you findings in a clear & concise manner that made your argument strong. Good job.
For Natalie
I think you've summarized the problem areas concerning death and dying in our culture. You are definitely right that socialized medicine is a hard sell in this country, especially when the Republicans are the majority in the House of Representitives. I still hope we come around to having the government pay for health care instead of having it be a means of insurance and drug companies making huge profits. Your other big point about ideally having people feel that they have had fufilled lives so that when they reach the age of 75 or so, they are more accepting of death and their time to go. Staying alive on life support with no quality of life whatsoever is so depressing and such a waste. People should go home to die. Most of us wouldn't put a dying dog on life support. We would just make it as comfortable as possible. I hope everyone will hold me to this belief when my time comes.
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From Ben
"The way that dominant social practices around illness and dying connect with dominant social practices around dying has to do with making money." This quote from your post does a great job of summing up the American health care system. Although in places like England, the incentives are actually a bit more noble as far as care distribution goes, it is the perfect way to describe health care in America. Nixon said himself that making sure patients get less care is a good thing if it means more profit is getting reeled in. I also liked the way you connected the illness and dying unit to the food unit that we are doing now Good job!
From Natalie
I liked how in your last paragraph you talked about how people should be reacting. I think the big question is, why aren't they? I think though that in America you might come across more people focused on funding the army than their own insurance, because they will take their health for granted. The American mindset at the moment seems to be set more on protecting our "great" country instead of improving it. I wonder if it would be possible to convince the majority otherwise.
From Mom
I think this post captures the main points about what is wrong with health care in this country. You make the case well about its flawed focus on giving the most expensive care to the terminally ill as opposed to investing in prevention measures not only to keep people from getting sick but also to make them have more productive lives. You are obviously referring to your brother’s work in Harlem and Northern Manhattan to try to help reduce epidemic levels of childhood obesity and asthma. The fact that so many poor kids are eating badly and getting almost no exercise shows what an unfair and backwards thinking health care system we have. They are developing health problems that can last their whole lives. I think you should have added that obesity will affect the quality of their lives by making it less likely that they can participate in sports and other activities and more likely that they will be sick more often and require more expensive treatment as they get older.
From Demetri
The part of your post that made the biggest impression on me were the obesity statistics for poor kids in Manhattan. Being obease when your kid marks you for your whole life. I think you are right that it is crazy not to want to spend money to make these kids healthier instead of spending monet on ternminally ill people especiallly old ones.
Your summary of the worst aspects of health care in this country is just right. It seems that that it all comes down to the fact that many Americans are so selfish that they don't want their taxes to go towards helping everyone get better care. Just as you say we should spend money on prevention. For example, spending money on getting people to eat better and get more exercise obviously makes much more sense than huge expenditures on terminally ill patients. The corrupt health care system that is in place in America must be replaced with a system that mirrors that of Canada, France, and England(as you say). I liked the way you presented you findings in a clear & concise manner that made your argument strong. Good job.
For Natalie
I think you've summarized the problem areas concerning death and dying in our culture. You are definitely right that socialized medicine is a hard sell in this country, especially when the Republicans are the majority in the House of Representitives. I still hope we come around to having the government pay for health care instead of having it be a means of insurance and drug companies making huge profits. Your other big point about ideally having people feel that they have had fufilled lives so that when they reach the age of 75 or so, they are more accepting of death and their time to go. Staying alive on life support with no quality of life whatsoever is so depressing and such a waste. People should go home to die. Most of us wouldn't put a dying dog on life support. We would just make it as comfortable as possible. I hope everyone will hold me to this belief when my time comes.
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From Ben
"The way that dominant social practices around illness and dying connect with dominant social practices around dying has to do with making money." This quote from your post does a great job of summing up the American health care system. Although in places like England, the incentives are actually a bit more noble as far as care distribution goes, it is the perfect way to describe health care in America. Nixon said himself that making sure patients get less care is a good thing if it means more profit is getting reeled in. I also liked the way you connected the illness and dying unit to the food unit that we are doing now Good job!
From Natalie
I liked how in your last paragraph you talked about how people should be reacting. I think the big question is, why aren't they? I think though that in America you might come across more people focused on funding the army than their own insurance, because they will take their health for granted. The American mindset at the moment seems to be set more on protecting our "great" country instead of improving it. I wonder if it would be possible to convince the majority otherwise.
From Mom
I think this post captures the main points about what is wrong with health care in this country. You make the case well about its flawed focus on giving the most expensive care to the terminally ill as opposed to investing in prevention measures not only to keep people from getting sick but also to make them have more productive lives. You are obviously referring to your brother’s work in Harlem and Northern Manhattan to try to help reduce epidemic levels of childhood obesity and asthma. The fact that so many poor kids are eating badly and getting almost no exercise shows what an unfair and backwards thinking health care system we have. They are developing health problems that can last their whole lives. I think you should have added that obesity will affect the quality of their lives by making it less likely that they can participate in sports and other activities and more likely that they will be sick more often and require more expensive treatment as they get older.
From Demetri
The part of your post that made the biggest impression on me were the obesity statistics for poor kids in Manhattan. Being obease when your kid marks you for your whole life. I think you are right that it is crazy not to want to spend money to make these kids healthier instead of spending monet on ternminally ill people especiallly old ones.
Saturday, January 22, 2011
HW # 32 - Thoughts following illness & dying unit
The way that dominant social practices around illness and dying connect with dominant social practices around dying has to do with making money. Insurance companies and drug companies and many doctors earn billions with the system the U.S. has now. Many people would not have any health insurance without the Obama plan, which Republicans are busy trying to take away. Many people are spending more than they can afford on insurance and cannot afford to go to the dentist because most health plans don’t have dental coverage. Too may people have to go to the hospital’s emergency room, where the cost of care is hugely expensive. They go there because they don’t have a regular doctor. If they had one, they could get all their shots and have preventive care and they wouldn’t need to go to emergency room except in an emergency, which is the whole idea of having them. Regarding elderly people and dying people, we have learned that too many are kept on expensive life support systems instead of being allowed to die earlier but with a better quality of life at home or in a hospice instead of being drugged up and attached to tubes. Timothy Egan says in “The Way We Die Now” that “1 percent of the population accounts for 35 percent of health card spending.” Health care should not be a business that gives care to a few and not to everybody. It should also not make companies and some doctors so rich. If it’s a for profit system, then it won’t be fair because the cost will be too high for most people.
In the same way that poorer people can’t afford good health care, they also can’t afford good food. In inner cities there are hardly any stores with fresh produce and what there is expensive. Healthy food in general is expensive. Junk food is all that is affordable. We learned about the big industrial food companies that put high fructose corn syrup in most processed foods now even though it is a cause of obesity and diabetes. The corn syrup is government subsidized. If the government is going to subsidize something, it should be something good like health care and green markets in poor neighborhoods. According to the Centers for Disease Control, one in three people in the U.S. will have diabetes by the year 2050 if the food situation stays the way it is. Also in Harlem and Northern Manhattan more than 40% of children are obese or overweight and have asthma which is related to obesity. 27% of pre-school children there are obese. These children also don’t get good health care (New York City Department of Health http://www.nyc.gov/html/doh/downloads/pdf/dpho/dpho-harlem-obesity.pdf )
People should not mind paying taxes to help everyone have good health care. They should be angry at insurance companies and drug companies that are only interested in charging as much as they can. People should not want their taxes to subsidize corn syrup so that huge food companies can get richer. If we think taxes should go for the military to have national security and a safer society, why wouldn’t we want taxes to support health care to make a healthier society.? Even for people who are 100% selfish, shouldn’t they think it would be better to live in a more productive society instead of one where people are diseased and unable to contribute to it?
In the same way that poorer people can’t afford good health care, they also can’t afford good food. In inner cities there are hardly any stores with fresh produce and what there is expensive. Healthy food in general is expensive. Junk food is all that is affordable. We learned about the big industrial food companies that put high fructose corn syrup in most processed foods now even though it is a cause of obesity and diabetes. The corn syrup is government subsidized. If the government is going to subsidize something, it should be something good like health care and green markets in poor neighborhoods. According to the Centers for Disease Control, one in three people in the U.S. will have diabetes by the year 2050 if the food situation stays the way it is. Also in Harlem and Northern Manhattan more than 40% of children are obese or overweight and have asthma which is related to obesity. 27% of pre-school children there are obese. These children also don’t get good health care (New York City Department of Health http://www.nyc.gov/html/doh/downloads/pdf/dpho/dpho-harlem-obesity.pdf )
People should not mind paying taxes to help everyone have good health care. They should be angry at insurance companies and drug companies that are only interested in charging as much as they can. People should not want their taxes to subsidize corn syrup so that huge food companies can get richer. If we think taxes should go for the military to have national security and a safer society, why wouldn’t we want taxes to support health care to make a healthier society.? Even for people who are 100% selfish, shouldn’t they think it would be better to live in a more productive society instead of one where people are diseased and unable to contribute to it?
Friday, January 21, 2011
HW # 31 - Comments 3
For Ben
I think the point you make in your post that there is no such thing as a perfect health care system is a good one. It is important because as you say at the end a system that covers all the people has to be better than America’s system “where approximately 50 million people are not covered by health insurance at all.” It’s also really important because the people in this country who want to shoot down Obama’s health care program always focus on the flaws instead of on the main point which is that it is unjust that certain people can get health care and certain people can’t. Your American friend’s reaction that in England care is better than ours is the reaction I think everyone has who goes there from this country and needs a doctor. Mainly the opponents to Obama’s program just don’t want to have to pay taxes that will help other people. In England and France people don’t feel that way. I read somewhere that they think of “we” and in America we think of “I.” It seems as though it would be dangerous to live in a country where so many people could get really sick and infect other people or make healthy people feel guilty for not helping them. Great job.
For Natalie
I really liked your comment on the sign you saw in the nursing home while you were waiting for the social worker to take you to the two patients. The sign was essentially saying not to be too optimistic or too pessimistic, and that “It is a time for hope.” You said you thought it was a time for acceptance: “For with acceptance they are able to live out the last of their days fully.” At first I thought that actually hope would be good. Hope to get better and out of there as fast as possible. Then I read that the first patient had been in for 13 years and the second for 8 years! Then I had to disagree with acceptance just speaking for myself. I was back to the idea of hope that death would come as quickly as possible. I think you showed courage going into the nursing home to interview two strangers and that you wrote up the interviews in a really interesting way. The first woman seemed to be happy there. I could see that being with people might be better than being stuck at home with one nurse if you couldn’t move around. The second woman was pretty happy too. She even had a job telling others about her religion. They were lucky they had family members to visit. Both stories mad me feel a little glad I am a male and less likely to live longer than a female, only in the sense of not wanting to be stuck in a nursing home for so many years. Excellent job.
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From Natalie
I thought this was really interesting. It's funny how the majority supports euthanasia for those in dire pain, but most states don't allow it. I like how you supported this claim with your own poll. "The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds." I think this is a really good conclusion to your findings. It seems to make sense. Nowadays I believe that people are more content with their lives, making them more ready to accept when their time comes.
From Ben
"The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds."
I think this is an extremely valuable insight, because it also brings up the idea that all human's desire eternal existence, and yet your studies indicate that most people would be willing to give that up just because they are in pain. My favorite part of your project is the amount of evidence you used and how thorough your analysis was. Great job!
From Mom
My husband and I do not have Living Wills and after reading your post about euthenasia in the sense of it meaning a "good death" in ancient Greek, I think we should. I was surprised that so many people living where your grandmother lives have one. That statistic of 72% of Americans being in favor of euthanasia for terminally ill people who want to end their lives was surprising considering how religious this country is. I suppose that most religions think that suicide is a sin and obviously murder (by the doctors giving the injections or the pills) is a sin. Choosing to end your life if it is too painful or too dependent on other people sounds like a reasonable and also unselfish thing to do. Being an organ donor is a generous thing to do, and I understand that many old people's organs can be life saving to younger people.
From Dmitry
I don't know if I knew what euthanasia was befor but I thought what you said was interesting. Even though I might be sad if someone like my aunt got drugs from a doctor to kill herself if she was really in pain and wanted to die I guesss I would understand. What you wrote made me think i would want to get drugs from a doctor if I was in pain and wouldn't get any better.
I think the point you make in your post that there is no such thing as a perfect health care system is a good one. It is important because as you say at the end a system that covers all the people has to be better than America’s system “where approximately 50 million people are not covered by health insurance at all.” It’s also really important because the people in this country who want to shoot down Obama’s health care program always focus on the flaws instead of on the main point which is that it is unjust that certain people can get health care and certain people can’t. Your American friend’s reaction that in England care is better than ours is the reaction I think everyone has who goes there from this country and needs a doctor. Mainly the opponents to Obama’s program just don’t want to have to pay taxes that will help other people. In England and France people don’t feel that way. I read somewhere that they think of “we” and in America we think of “I.” It seems as though it would be dangerous to live in a country where so many people could get really sick and infect other people or make healthy people feel guilty for not helping them. Great job.
For Natalie
I really liked your comment on the sign you saw in the nursing home while you were waiting for the social worker to take you to the two patients. The sign was essentially saying not to be too optimistic or too pessimistic, and that “It is a time for hope.” You said you thought it was a time for acceptance: “For with acceptance they are able to live out the last of their days fully.” At first I thought that actually hope would be good. Hope to get better and out of there as fast as possible. Then I read that the first patient had been in for 13 years and the second for 8 years! Then I had to disagree with acceptance just speaking for myself. I was back to the idea of hope that death would come as quickly as possible. I think you showed courage going into the nursing home to interview two strangers and that you wrote up the interviews in a really interesting way. The first woman seemed to be happy there. I could see that being with people might be better than being stuck at home with one nurse if you couldn’t move around. The second woman was pretty happy too. She even had a job telling others about her religion. They were lucky they had family members to visit. Both stories mad me feel a little glad I am a male and less likely to live longer than a female, only in the sense of not wanting to be stuck in a nursing home for so many years. Excellent job.
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From Natalie
I thought this was really interesting. It's funny how the majority supports euthanasia for those in dire pain, but most states don't allow it. I like how you supported this claim with your own poll. "The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds." I think this is a really good conclusion to your findings. It seems to make sense. Nowadays I believe that people are more content with their lives, making them more ready to accept when their time comes.
From Ben
"The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds."
I think this is an extremely valuable insight, because it also brings up the idea that all human's desire eternal existence, and yet your studies indicate that most people would be willing to give that up just because they are in pain. My favorite part of your project is the amount of evidence you used and how thorough your analysis was. Great job!
From Mom
My husband and I do not have Living Wills and after reading your post about euthenasia in the sense of it meaning a "good death" in ancient Greek, I think we should. I was surprised that so many people living where your grandmother lives have one. That statistic of 72% of Americans being in favor of euthanasia for terminally ill people who want to end their lives was surprising considering how religious this country is. I suppose that most religions think that suicide is a sin and obviously murder (by the doctors giving the injections or the pills) is a sin. Choosing to end your life if it is too painful or too dependent on other people sounds like a reasonable and also unselfish thing to do. Being an organ donor is a generous thing to do, and I understand that many old people's organs can be life saving to younger people.
From Dmitry
I don't know if I knew what euthanasia was befor but I thought what you said was interesting. Even though I might be sad if someone like my aunt got drugs from a doctor to kill herself if she was really in pain and wanted to die I guesss I would understand. What you wrote made me think i would want to get drugs from a doctor if I was in pain and wouldn't get any better.
Monday, January 17, 2011
HW # 30 - Illness & Dying - Culminating Experiential Project
Euthanasia is an ancient Greek word meaning “the good death,” with “eu” meaning good
and “thanatos” meaning death. It was first used by Francis Bacon, the English philosopher who lived in the 16th and 17th centuries and who developed the scientific method, to describe a way to die peacefully and well. The scientific method is a way of investigating anything being observed based on measurable evidence that will lead to a hypothesis that can be tested. It seems to me that observing a dying person who is in physical or mental pain or is in a coma with no hope of coming out of it or whose mind has gone would lead to thinking that giving a lethal injection from a doctor to end suffering is a good thing.
I became interested in euthanasia as a subject to explore when the sick person I had gone to see as an assignment for this course died recently. Gloria was our neighbor and an extremely kind person who bought rocks I painted when I was three and kept them in her room. A week after my visit she went into the hospital because of lung failure. Her daughter told me that she had a Living Will, which said that she did not want to be resuscitated if her heart stopped or if she stopped breathing and put on life support. Gloria was in pain, and the painkillers had bad side effects. She had also been told that she was going to die. She wanted the doctor to stop treating her so that she would die quickly. Her daughter was a Catholic, who believed that any form of unnatural death was a sin.
According to Euthanasiaprocon.org, the reasons that people who are terminally ill like Gloria request physician-assisted death are in three categories:
Illness related, which includes pain, the side effects of painkillers, loss of bodily functions, and exhaustion with pain or discomfort
Loss of sense of self, which includes desire for control over life and body functions and beliefs held for a long time about a good way to die
Fear about the future, which includes fear about the quality of life if dying will take a long period of time, fear of being a burden to family members and friends, and fear of knowing about other negative experiences of dying.
There are several forms of euthanasia: There is active euthanasia when a patient requests that a doctor end his or her life with a lethal injection; there is physician-assisted suicide when a doctor gives a patient drugs to enable the patient to end his or her life; there is passive euthanasia when life support treatment is ended or when drugs or other treatments are no longer given; and there is non-voluntary euthanasia when patients are incapable of expressing a view about having their life ended because they are in a coma, to young (a baby, for example), severely brain damaged, senile or mentally retarded; or severely mentally ill (Euthanasia.com).
At this time euthanasia is illegal in the United States. There are three states that have legalized physician-assisted euthanasia, and they are Oregon, Washington, and Montana. The patient must be the one to administer the lethal drug. The Netherlands and Belgium are the only two countries in the world where euthanasia is legal. Physician-assisted suicide is legal in Albania and Luxembourg. In Switzerland doctors are not punished for assisting with suicide even though euthanasia is illegal (Religioustolerance.org)
Most religions are against euthanasia. In addition to the Catholic Church, the Jewish religion, Islam, and Hinduism are against active euthanasia and physician-assisted euthanasia. They consider active euthanasia to be murder and physician-assisted euthanasia to be suicide with the doctor committing an act of murder. Hindus consider fasting acceptable in extreme cases to be accompanied by spiritual practices that help self-awareness and give strength to help the dying person have a dignified death. In general, they are against euthanasia because it could interfere with reincarnation and hold up the process of the person’s next birth. Buddhists are more lenient than Hindus, but they are also concerned that active or passive euthanasia means that the patient is not in
a good mental place and could be reborn in another state of despair. Buddhist monks who committed suicide to protest the Viet Nam war were not at risk in the next life because they were dying in an enlightened state. In Christian religions most are against euthanasia except for the Methodists and Unitarians, who support physician-assisted euthanasia and are against prosecution of the doctors. In more liberal Episcopal and Presbyterian churches and in Quaker churches, physican-assisted euthanasia can be acceptable if it is the patient’s choice (Euthanasiaprocon.org).
Although a survey by the Pew Research Council in 2002 showed that 87% of Americans
were religious, a 2005 Harris Poll showed that 72% of Americans were in favor of euthanasia for “dying patients in severe distress who wanted their lives ended.” From my research and a conversation with a doctor, I have learned that the discussion of euthanasia is a complicated one because people are so afraid that legalizing it could lead to abuse. For example, it could start to be used too frequently without careful enough checking about what the patient really wants in order to save money on expensive life-support systems. There is also a big moral argument about active and passive euthanasia for terminally ill patients who want to die. Some people believe that active euthanasia is an act of murder by the doctor, but that passive euthanasia where the doctor allows the patient to die from a lack of treatment is not. Other people believe that active euthanasia is a kinder alternative because an injection will end life quickly and stopping treatment can cause a much longer time of suffering. These people feel that withdrawing feeding tubes and starving patients can be crueler that giving a lethal injection or pill.
I decided to ask my grandmother who lives in an assisted living apartment building if she would give a questionnaire I created to people who lived in her building. The questionnaire asked about their feelings on the subject of euthanasia and Living Wills. Here are the results of the questionnaire which 22 people completed.
Quality of Dying Questionnaire completed by 20 people aged 75 and above
1. Do you have a Living Will?
Of the 20 people asked, 18 said yes and 2 said no.
2. If not, would you consider having one?
The 2 who did not have a Living Will said they had been meaning to get one.
3. Do you have a Health Care Power of Attorney?
Of the 20 people asked, 15 said yes.
4. If not, would you consider having one?
3 people said they were planning to get one.
2 people said they had to find out more about what it is.
5. Have you taken any other measures to help you have the end of life you would prefer? If so, what have you done?
9 people said no to the first question.
5 people said they had organ donor cards.
6 people said they had “Do not Resuscitate Bracelets.” These are issued by the state.
6. If you were terminally ill, permanently unconscious, or conscious with irreversible brain damage, and you lived in a state that has legalized active euthanasia, would you want a lethal injection by a doctor? What would be the main reason?
18 said yes (Of these 14 said they did not want to be a burden to their families and friends and 4 said they did not want money to keep being wasted on them.) (Of these 3 said they know of cases where a doctor had given a lethal injection at the patients request even though giving it was against the law.)
2 said they were unsure
7. If you were terminally ill, in pain or great discomfort, but fully conscious with all your mental faculties, and you lived in a state that has legalized physician-assisted suicide would you want your doctor to give you a lethal pill? What would be the main reason?
18 said yes (Of these 14 said again that they did not want to be a burden and 4 said they did not want money to be wasted on them.)
2 said maybe
8. In this country only three states have physician-assisted suicide: Oregon, Washington, and Montana. Would you be in favor of having all the states legalize physician-assisted suicide for terminally ill patients who have requested it?
15 said yes
5 said maybe
9. Would you be in favor of having all the states legalize active euthanasia (lethal injection by a doctor) for terminally ill patients who have requested it?
15 said yes
4 said maybe
1 said no “on religious grounds”
10. Do you have an organ donor card? Did you indicate in your Living Will if you have one that you would like to be an organ donor?
15 said no (of these 7 thought their organs were too old to be good)
5 said yes
From the questionnaire I learned that in my small study a surprisingly high percentage of the elderly people had Living Wills and would be in favor of legalized active euthanasia and physician-assisted suicide because they did not want to be a burden on families or the government. It was also interesting to hear about the “Do not resuscitate bracelets” and the fact that some of them knew of doctors who had assisted illegally in suicides at the patient’s request). I forgot to ask about their religion in the questionnaire. My grandmother said that there are quite a few Catholics and several Jewish people and at least two Buddhists in the group. It was also interesting that quite a few thought their organs were too old to be useful to other people. I believe that my extremely small study goes along with the Harris Poll that showed that 72% of Americans were in favor of euthanasia for “dying patients in severe distress who wanted their lives ended.”
The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds. They are more concerned with their quality of life at the end or “quality of dying”and do not want to be kept alive if they feel they are a burden and cannot have their dignity. Living Wills and Health Care Power of Attorney forms are important to fill out so that we can all keep control over the end of our lives.
and “thanatos” meaning death. It was first used by Francis Bacon, the English philosopher who lived in the 16th and 17th centuries and who developed the scientific method, to describe a way to die peacefully and well. The scientific method is a way of investigating anything being observed based on measurable evidence that will lead to a hypothesis that can be tested. It seems to me that observing a dying person who is in physical or mental pain or is in a coma with no hope of coming out of it or whose mind has gone would lead to thinking that giving a lethal injection from a doctor to end suffering is a good thing.
I became interested in euthanasia as a subject to explore when the sick person I had gone to see as an assignment for this course died recently. Gloria was our neighbor and an extremely kind person who bought rocks I painted when I was three and kept them in her room. A week after my visit she went into the hospital because of lung failure. Her daughter told me that she had a Living Will, which said that she did not want to be resuscitated if her heart stopped or if she stopped breathing and put on life support. Gloria was in pain, and the painkillers had bad side effects. She had also been told that she was going to die. She wanted the doctor to stop treating her so that she would die quickly. Her daughter was a Catholic, who believed that any form of unnatural death was a sin.
According to Euthanasiaprocon.org, the reasons that people who are terminally ill like Gloria request physician-assisted death are in three categories:
Illness related, which includes pain, the side effects of painkillers, loss of bodily functions, and exhaustion with pain or discomfort
Loss of sense of self, which includes desire for control over life and body functions and beliefs held for a long time about a good way to die
Fear about the future, which includes fear about the quality of life if dying will take a long period of time, fear of being a burden to family members and friends, and fear of knowing about other negative experiences of dying.
There are several forms of euthanasia: There is active euthanasia when a patient requests that a doctor end his or her life with a lethal injection; there is physician-assisted suicide when a doctor gives a patient drugs to enable the patient to end his or her life; there is passive euthanasia when life support treatment is ended or when drugs or other treatments are no longer given; and there is non-voluntary euthanasia when patients are incapable of expressing a view about having their life ended because they are in a coma, to young (a baby, for example), severely brain damaged, senile or mentally retarded; or severely mentally ill (Euthanasia.com).
At this time euthanasia is illegal in the United States. There are three states that have legalized physician-assisted euthanasia, and they are Oregon, Washington, and Montana. The patient must be the one to administer the lethal drug. The Netherlands and Belgium are the only two countries in the world where euthanasia is legal. Physician-assisted suicide is legal in Albania and Luxembourg. In Switzerland doctors are not punished for assisting with suicide even though euthanasia is illegal (Religioustolerance.org)
Most religions are against euthanasia. In addition to the Catholic Church, the Jewish religion, Islam, and Hinduism are against active euthanasia and physician-assisted euthanasia. They consider active euthanasia to be murder and physician-assisted euthanasia to be suicide with the doctor committing an act of murder. Hindus consider fasting acceptable in extreme cases to be accompanied by spiritual practices that help self-awareness and give strength to help the dying person have a dignified death. In general, they are against euthanasia because it could interfere with reincarnation and hold up the process of the person’s next birth. Buddhists are more lenient than Hindus, but they are also concerned that active or passive euthanasia means that the patient is not in
a good mental place and could be reborn in another state of despair. Buddhist monks who committed suicide to protest the Viet Nam war were not at risk in the next life because they were dying in an enlightened state. In Christian religions most are against euthanasia except for the Methodists and Unitarians, who support physician-assisted euthanasia and are against prosecution of the doctors. In more liberal Episcopal and Presbyterian churches and in Quaker churches, physican-assisted euthanasia can be acceptable if it is the patient’s choice (Euthanasiaprocon.org).
Although a survey by the Pew Research Council in 2002 showed that 87% of Americans
were religious, a 2005 Harris Poll showed that 72% of Americans were in favor of euthanasia for “dying patients in severe distress who wanted their lives ended.” From my research and a conversation with a doctor, I have learned that the discussion of euthanasia is a complicated one because people are so afraid that legalizing it could lead to abuse. For example, it could start to be used too frequently without careful enough checking about what the patient really wants in order to save money on expensive life-support systems. There is also a big moral argument about active and passive euthanasia for terminally ill patients who want to die. Some people believe that active euthanasia is an act of murder by the doctor, but that passive euthanasia where the doctor allows the patient to die from a lack of treatment is not. Other people believe that active euthanasia is a kinder alternative because an injection will end life quickly and stopping treatment can cause a much longer time of suffering. These people feel that withdrawing feeding tubes and starving patients can be crueler that giving a lethal injection or pill.
I decided to ask my grandmother who lives in an assisted living apartment building if she would give a questionnaire I created to people who lived in her building. The questionnaire asked about their feelings on the subject of euthanasia and Living Wills. Here are the results of the questionnaire which 22 people completed.
Quality of Dying Questionnaire completed by 20 people aged 75 and above
1. Do you have a Living Will?
Of the 20 people asked, 18 said yes and 2 said no.
2. If not, would you consider having one?
The 2 who did not have a Living Will said they had been meaning to get one.
3. Do you have a Health Care Power of Attorney?
Of the 20 people asked, 15 said yes.
4. If not, would you consider having one?
3 people said they were planning to get one.
2 people said they had to find out more about what it is.
5. Have you taken any other measures to help you have the end of life you would prefer? If so, what have you done?
9 people said no to the first question.
5 people said they had organ donor cards.
6 people said they had “Do not Resuscitate Bracelets.” These are issued by the state.
6. If you were terminally ill, permanently unconscious, or conscious with irreversible brain damage, and you lived in a state that has legalized active euthanasia, would you want a lethal injection by a doctor? What would be the main reason?
18 said yes (Of these 14 said they did not want to be a burden to their families and friends and 4 said they did not want money to keep being wasted on them.) (Of these 3 said they know of cases where a doctor had given a lethal injection at the patients request even though giving it was against the law.)
2 said they were unsure
7. If you were terminally ill, in pain or great discomfort, but fully conscious with all your mental faculties, and you lived in a state that has legalized physician-assisted suicide would you want your doctor to give you a lethal pill? What would be the main reason?
18 said yes (Of these 14 said again that they did not want to be a burden and 4 said they did not want money to be wasted on them.)
2 said maybe
8. In this country only three states have physician-assisted suicide: Oregon, Washington, and Montana. Would you be in favor of having all the states legalize physician-assisted suicide for terminally ill patients who have requested it?
15 said yes
5 said maybe
9. Would you be in favor of having all the states legalize active euthanasia (lethal injection by a doctor) for terminally ill patients who have requested it?
15 said yes
4 said maybe
1 said no “on religious grounds”
10. Do you have an organ donor card? Did you indicate in your Living Will if you have one that you would like to be an organ donor?
15 said no (of these 7 thought their organs were too old to be good)
5 said yes
From the questionnaire I learned that in my small study a surprisingly high percentage of the elderly people had Living Wills and would be in favor of legalized active euthanasia and physician-assisted suicide because they did not want to be a burden on families or the government. It was also interesting to hear about the “Do not resuscitate bracelets” and the fact that some of them knew of doctors who had assisted illegally in suicides at the patient’s request). I forgot to ask about their religion in the questionnaire. My grandmother said that there are quite a few Catholics and several Jewish people and at least two Buddhists in the group. It was also interesting that quite a few thought their organs were too old to be useful to other people. I believe that my extremely small study goes along with the Harris Poll that showed that 72% of Americans were in favor of euthanasia for “dying patients in severe distress who wanted their lives ended.”
The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds. They are more concerned with their quality of life at the end or “quality of dying”and do not want to be kept alive if they feel they are a burden and cannot have their dignity. Living Wills and Health Care Power of Attorney forms are important to fill out so that we can all keep control over the end of our lives.
Saturday, January 8, 2011
HW # 29 - Reading and noting basic materials
Illness & Dying in the United States
Facing Terminal Illness
I think that it is true that in spite of what we undeniably know none of us believe we are going to die, which is what Morrie tells his former student Mitch in the book Tuesdays with Morrie. I also believe that none of us believe we are going to grow old. No wonder we are uncomfortable about facing terminal illness. We have to deal with observing the worst thing that can happen while not admitting to ourselves that death could happen to us but knowing that it will. In the book Morrie and Mitch find a way to deal with Morrie’s dying in a positive way by having Morrie give Mitch his lessons for living and Mitch give Morrie a kind of immortality by writing a book. When Morrie says, “The truth is…once you learn how to die, you learn how to live,” he is telling Mitch that it is important for all of us to accept the idea of our own death so we can realize all the gifts we have just by the fact of being alive. We must take advantage of these available gifts and value them so that we will not have a lot of regrets when it is our time to die.
For Beth, whose husband was dying of cancer, the way she helped him, herself, and her family face his dying was by displaying his paintings in order to celebrate his life as an artist. She also displayed photographs of his family to show him and everyone helping him or visiting him that he had had a fulfilled life. This was her way of helping him die, valuing all that had been important in his life so that he would not have regrets.
Isolation
Unlike Morrie in Tuesdays with Morrie and Beth’s real life husband, who both are able to die at home, many elderly people die in hospitals or nursing homes. For those who do not have family members to visit, the experience must be incredibly isolating. According to an intervention study called Quality of life in nursing-home residents, “The prevalence of depression among residents of nursing homes is 30-75%. In spite of good care, residents may feel like inmates and function as isolated individuals.” Now that people are living so much longer, it makes sense that more and more of them will end up in nursing homes because they will not be able to take care of themselves or have family members be able to keep taking care of them. According to an article in the Washington Post called The New Retirement: Getting Old Ain’t What it Used to Be by Douglas J. Besharov and Keith W. Smilt (august 1, 1999), after age 80, many people have trouble performing the ADLs (activities of daily living), which are “eating, bathing, dressing, toileting and getting out of bed.” About 50% of people need help with ADLs after age 85. Also, nearly 20% of people over 85 have problems of dementia, brain damage, or mental retardation.
For people who are ill or dying, they can be made to feel isolated by the rejection of younger and healthier people, who are not comfortable with them. In his work Stigma, the sociologist Erving Goffman talks about all types of people who feel stigmatized by “normals,” and these can include cripples and other handicapped or disfigured people, and members of ethnic and every kind of minority group. He says that interactions between “normals” and the stigmatized are “usually accompanied by one or more of the familiar discomforts and stickiness: the guarded references, the common everyday words suddenly made taboo, the fixed stare elsewhere, the artificial levity, the compulsive loquaciousness, the awkward solemnity.” All of these reactions are ones that are common to have when visiting a dying person: avoiding talking about the future or even next month plans (“the guarded references”), avoiding saying the words death or dying (“the common everyday words suddenly made taboo), not being able to look the dying person in the eye for long (“the fixed stare elsewhere”), having mouths fixed in smiles or laughing in an embarrassed way (the artificial levity), talking on and on just to keep conversation going (the compulsive loquaciousness); acting stiff and serious (the awkward solemnity). In other words the unnatural behavior of others toward sick or dying or elderly people can make them feel extremely isolated.
Paying for Medical Care
According to Sick by Jonathan Cohn, the first insurance company in the U.S. was started by Benjamin Franklin to protect Philadelphia momes from being destroyed by fire. Health insurance to help protect people from the risk of illness did not start until the 20th century. In the 1920s and 1930s many Americans could not afford the cost of health care because doctors expected to be paid a lot for their expensive training and equipment. Hospitals exanded the the 1920s during the boom economy, but then in the 30s when there was the depression there were not enough patients who could pay. In other industrial countries the goverments supported health care, which was becoming “a right, rather than a privilege.” In the U.S. corporations and doctors were against the government handling health care, corporations becaues they wanted a private economy they could control and doctors because they thought the government would pay them less and try to control them. Non-profit health insurance organizations started out collecting contributions from groups of people like employees and then give them hospital care when they needed it. The first one helped Baylor Hospital in Dallas, Texas in 1929 by getting teachers to contribute for hospital care. Then companies started offering health insurance instead of raised during World War II, and they were given tax breads so the whole U.S. system became based on businesses and employers providing health insurance. Unemployed people and elderly people were left out of the system.
In 1965 President Lynden Johnson started Medicare to help the elderly which as paid for out of taxes during the time they worked. He also started Medicaid to help poor people. Medicaid is paid for by the Federal and State governments. Without these programs many people would have become ill and died and still would become ill and die. In 1985 the Consolidated Omnibus Budget Reconciliation Act (COBRA) was enacted so that people who lost their jobs or retired people could keep their health insurance. In 1997 the State Children’sHealth Insurance Program (SCHIP) was enacted for children “at or below 200% of the Fenderal poverty line. Then in 2010 President Obama enacted the Patient Protection and Affordable Care Act to reform U.S. health care by making insurance companies unable to drop people with pre-existing conditions or find other excuses not to pay, and also to have insurance companies charge standard amounts at three different levels so that people can have choices they can afford. There would also be subsidies so that poor people could afford insurance.
In the move Sicko, Michael Moore states that the U.S. health care system costs nearly $7,000 per person a year and that in Cuba the cost is $251 per person. According to the National Health Expenditure Date in 2005, the cost of health care per person in 2005 was $6,697 and according to the 2006 United Nations Development Report, the annual cost in Cuba was $251 per person so Michael Moore was right. Other industrial countries also pay much less per person for health care than the U.S. with a universal health care system. One scene in the movie that stands out is when Michael Moore is interviewing the National Health Service in England and the people there cannot relate to his questions about cost because they only think about providing health care.
In Mountains Beyond Mountains by Tracy Kidder, Paul Farmer also greatly admires Cuba for using its poor resources well enough to have excellent health care and fight the spread of AIDS successfully. He believes that a for profit health system is an unjust system. He says, “ I remember signing the oath to assist the patient and do him no harm. I don’t really remember signing that I would do it in a cost-effective way.” Republicans think that the government cannot run the health care system well because it does not run anything as well as private companies can and it wastes money. Since it is many of the private insurance companies that have been cheating and charging the government millions of dollars illegally for Medicare services, and since the government has run many national programs well like Medicare, Social Security, Clean Water and Clean Air Programs ("The Forgotten Achievements of Governments," by Douglass J. Amy, Professor of Politics at Mount Holyoke College), the Republicans don’t know what they are talking about.
The Process of Dying
Near Death is a documentary filmed in black and white with no narration about doctors, staff, and patients in the intensive care unit of Beth Israel Hospital. From the clips of the movie shown in class, one segment that was as hard to watch as nails on chalkboard are to hear is when a female nurse tries to explain to her elderly male patient the choices he has about dying. “Your lungs are about as bad as they can get,” she says. When she calmly attempts to explain the dying man’s situation to him, he does not answer her and talks about his family instead in a failed attempt to swerve the conversation away from him. The nurse is incredibly persistent in her questions which rattle the old man and seem to confuse him. At one point she says, “I don’t want to keep you alive unless you like living.” The casualness of many of the doctors was also a little unnerving. In one quick scene a doctor checks the patient’s pulse and mouth and when he detects no sign of life, pronounces the patient dead, announces the exact time of death, and then just walks out of the room.
What is happening in this movie is interesting in the context of what Sharon R Kaufman, a medical anthropologist, writes about in the book A Time To Die. Many patients say that under no circumstances do they want to be placed on life support when they enter the hospital. The problem is that when those patients are in a crisis and life support is the only way to keep them alive, relatives and even the patients if they are capable of knowing what is going on will often be so indecisive that the patients end up on life support. When placed in this situation, are the people involved sustaining life or prolonging dying? I heard a reporter say on the National Public Radio morning news a few weeks ago that there are three ways that all of us can prepare for our death:
- Have a Living Will in which we say wheter we want to go on life support
- Designate a particular person to make decisions for us
- Agree to be an organ donor to help save someone else’s life
It seems to me that doing these three things would avoid a lot of the unnecessary cost and torment regarding life support decisions and that deciding to be an organ donor gives a certain value to the death that it would not otherwise have.
Our guest speaker Beth, I believe, gave the best possible care to her husband once she knew he was dying by keeping him at home so he could have a dignified death without any question of putting him on temporary life support to prolong his dying.
Being Sick
Being sick in this country is too tied to health insurance. Last year my brother was in a college basketball game, and an opponent’s elbow came down hard on the top of his gead. There was a big gash, and he was taken to a Boston hospital for stitches. He called my parents for out health insurance information, which he said was needed before he could get any attention even though he was covered in blood. Later my parents received a bill, Since they pay $1,000 a month for health insurance and any emergency that is taken care of in 24 hours issupposed to be covered, they questioned the bil. Then they received a call from the insurance company asking how the injury happened. They explained that their son was hurt in a college basketball game. “And why was he playing basketball? they asked. This situation contrasts with the time when I was in France playing sports and became sick. A doctor drove to come see me in my room late on a Sunday night, gave me a shot, made a call to open up the nearest pharmacy, gave me medicine to keep taking, and charged me nothing.
Another time my soccer team was practicing on the grounds of a monestary on Long Island near the water. We noticed a body floating face down near the shore. One parent who was a foot doctor and my dad pulled him out, pushed the water out of him, and gave him mouth to mouth resusitation. All of us called 911 on our cell phones. When the ambulance came, the medical people said that he had had a massive heart attack and was barely alive. We found out that he was a visiting monk from the Ukraine. The foot doctor parent called the hospital in Hicksville the next morning to find out how the man was doing. He was told that the hospital released him because he had no insurance. The monestary put him on a plane to go home, and he died a week later. This experience made our whole team feel outrage about our health care system. If this poor man had had a heart attack in any other industrialized country, he would have been treated for free.
Facing Terminal Illness
I think that it is true that in spite of what we undeniably know none of us believe we are going to die, which is what Morrie tells his former student Mitch in the book Tuesdays with Morrie. I also believe that none of us believe we are going to grow old. No wonder we are uncomfortable about facing terminal illness. We have to deal with observing the worst thing that can happen while not admitting to ourselves that death could happen to us but knowing that it will. In the book Morrie and Mitch find a way to deal with Morrie’s dying in a positive way by having Morrie give Mitch his lessons for living and Mitch give Morrie a kind of immortality by writing a book. When Morrie says, “The truth is…once you learn how to die, you learn how to live,” he is telling Mitch that it is important for all of us to accept the idea of our own death so we can realize all the gifts we have just by the fact of being alive. We must take advantage of these available gifts and value them so that we will not have a lot of regrets when it is our time to die.
For Beth, whose husband was dying of cancer, the way she helped him, herself, and her family face his dying was by displaying his paintings in order to celebrate his life as an artist. She also displayed photographs of his family to show him and everyone helping him or visiting him that he had had a fulfilled life. This was her way of helping him die, valuing all that had been important in his life so that he would not have regrets.
Isolation
Unlike Morrie in Tuesdays with Morrie and Beth’s real life husband, who both are able to die at home, many elderly people die in hospitals or nursing homes. For those who do not have family members to visit, the experience must be incredibly isolating. According to an intervention study called Quality of life in nursing-home residents, “The prevalence of depression among residents of nursing homes is 30-75%. In spite of good care, residents may feel like inmates and function as isolated individuals.” Now that people are living so much longer, it makes sense that more and more of them will end up in nursing homes because they will not be able to take care of themselves or have family members be able to keep taking care of them. According to an article in the Washington Post called The New Retirement: Getting Old Ain’t What it Used to Be by Douglas J. Besharov and Keith W. Smilt (august 1, 1999), after age 80, many people have trouble performing the ADLs (activities of daily living), which are “eating, bathing, dressing, toileting and getting out of bed.” About 50% of people need help with ADLs after age 85. Also, nearly 20% of people over 85 have problems of dementia, brain damage, or mental retardation.
For people who are ill or dying, they can be made to feel isolated by the rejection of younger and healthier people, who are not comfortable with them. In his work Stigma, the sociologist Erving Goffman talks about all types of people who feel stigmatized by “normals,” and these can include cripples and other handicapped or disfigured people, and members of ethnic and every kind of minority group. He says that interactions between “normals” and the stigmatized are “usually accompanied by one or more of the familiar discomforts and stickiness: the guarded references, the common everyday words suddenly made taboo, the fixed stare elsewhere, the artificial levity, the compulsive loquaciousness, the awkward solemnity.” All of these reactions are ones that are common to have when visiting a dying person: avoiding talking about the future or even next month plans (“the guarded references”), avoiding saying the words death or dying (“the common everyday words suddenly made taboo), not being able to look the dying person in the eye for long (“the fixed stare elsewhere”), having mouths fixed in smiles or laughing in an embarrassed way (the artificial levity), talking on and on just to keep conversation going (the compulsive loquaciousness); acting stiff and serious (the awkward solemnity). In other words the unnatural behavior of others toward sick or dying or elderly people can make them feel extremely isolated.
Paying for Medical Care
According to Sick by Jonathan Cohn, the first insurance company in the U.S. was started by Benjamin Franklin to protect Philadelphia momes from being destroyed by fire. Health insurance to help protect people from the risk of illness did not start until the 20th century. In the 1920s and 1930s many Americans could not afford the cost of health care because doctors expected to be paid a lot for their expensive training and equipment. Hospitals exanded the the 1920s during the boom economy, but then in the 30s when there was the depression there were not enough patients who could pay. In other industrial countries the goverments supported health care, which was becoming “a right, rather than a privilege.” In the U.S. corporations and doctors were against the government handling health care, corporations becaues they wanted a private economy they could control and doctors because they thought the government would pay them less and try to control them. Non-profit health insurance organizations started out collecting contributions from groups of people like employees and then give them hospital care when they needed it. The first one helped Baylor Hospital in Dallas, Texas in 1929 by getting teachers to contribute for hospital care. Then companies started offering health insurance instead of raised during World War II, and they were given tax breads so the whole U.S. system became based on businesses and employers providing health insurance. Unemployed people and elderly people were left out of the system.
In 1965 President Lynden Johnson started Medicare to help the elderly which as paid for out of taxes during the time they worked. He also started Medicaid to help poor people. Medicaid is paid for by the Federal and State governments. Without these programs many people would have become ill and died and still would become ill and die. In 1985 the Consolidated Omnibus Budget Reconciliation Act (COBRA) was enacted so that people who lost their jobs or retired people could keep their health insurance. In 1997 the State Children’sHealth Insurance Program (SCHIP) was enacted for children “at or below 200% of the Fenderal poverty line. Then in 2010 President Obama enacted the Patient Protection and Affordable Care Act to reform U.S. health care by making insurance companies unable to drop people with pre-existing conditions or find other excuses not to pay, and also to have insurance companies charge standard amounts at three different levels so that people can have choices they can afford. There would also be subsidies so that poor people could afford insurance.
In the move Sicko, Michael Moore states that the U.S. health care system costs nearly $7,000 per person a year and that in Cuba the cost is $251 per person. According to the National Health Expenditure Date in 2005, the cost of health care per person in 2005 was $6,697 and according to the 2006 United Nations Development Report, the annual cost in Cuba was $251 per person so Michael Moore was right. Other industrial countries also pay much less per person for health care than the U.S. with a universal health care system. One scene in the movie that stands out is when Michael Moore is interviewing the National Health Service in England and the people there cannot relate to his questions about cost because they only think about providing health care.
In Mountains Beyond Mountains by Tracy Kidder, Paul Farmer also greatly admires Cuba for using its poor resources well enough to have excellent health care and fight the spread of AIDS successfully. He believes that a for profit health system is an unjust system. He says, “ I remember signing the oath to assist the patient and do him no harm. I don’t really remember signing that I would do it in a cost-effective way.” Republicans think that the government cannot run the health care system well because it does not run anything as well as private companies can and it wastes money. Since it is many of the private insurance companies that have been cheating and charging the government millions of dollars illegally for Medicare services, and since the government has run many national programs well like Medicare, Social Security, Clean Water and Clean Air Programs ("The Forgotten Achievements of Governments," by Douglass J. Amy, Professor of Politics at Mount Holyoke College), the Republicans don’t know what they are talking about.
The Process of Dying
Near Death is a documentary filmed in black and white with no narration about doctors, staff, and patients in the intensive care unit of Beth Israel Hospital. From the clips of the movie shown in class, one segment that was as hard to watch as nails on chalkboard are to hear is when a female nurse tries to explain to her elderly male patient the choices he has about dying. “Your lungs are about as bad as they can get,” she says. When she calmly attempts to explain the dying man’s situation to him, he does not answer her and talks about his family instead in a failed attempt to swerve the conversation away from him. The nurse is incredibly persistent in her questions which rattle the old man and seem to confuse him. At one point she says, “I don’t want to keep you alive unless you like living.” The casualness of many of the doctors was also a little unnerving. In one quick scene a doctor checks the patient’s pulse and mouth and when he detects no sign of life, pronounces the patient dead, announces the exact time of death, and then just walks out of the room.
What is happening in this movie is interesting in the context of what Sharon R Kaufman, a medical anthropologist, writes about in the book A Time To Die. Many patients say that under no circumstances do they want to be placed on life support when they enter the hospital. The problem is that when those patients are in a crisis and life support is the only way to keep them alive, relatives and even the patients if they are capable of knowing what is going on will often be so indecisive that the patients end up on life support. When placed in this situation, are the people involved sustaining life or prolonging dying? I heard a reporter say on the National Public Radio morning news a few weeks ago that there are three ways that all of us can prepare for our death:
- Have a Living Will in which we say wheter we want to go on life support
- Designate a particular person to make decisions for us
- Agree to be an organ donor to help save someone else’s life
It seems to me that doing these three things would avoid a lot of the unnecessary cost and torment regarding life support decisions and that deciding to be an organ donor gives a certain value to the death that it would not otherwise have.
Our guest speaker Beth, I believe, gave the best possible care to her husband once she knew he was dying by keeping him at home so he could have a dignified death without any question of putting him on temporary life support to prolong his dying.
Being Sick
Being sick in this country is too tied to health insurance. Last year my brother was in a college basketball game, and an opponent’s elbow came down hard on the top of his gead. There was a big gash, and he was taken to a Boston hospital for stitches. He called my parents for out health insurance information, which he said was needed before he could get any attention even though he was covered in blood. Later my parents received a bill, Since they pay $1,000 a month for health insurance and any emergency that is taken care of in 24 hours issupposed to be covered, they questioned the bil. Then they received a call from the insurance company asking how the injury happened. They explained that their son was hurt in a college basketball game. “And why was he playing basketball? they asked. This situation contrasts with the time when I was in France playing sports and became sick. A doctor drove to come see me in my room late on a Sunday night, gave me a shot, made a call to open up the nearest pharmacy, gave me medicine to keep taking, and charged me nothing.
Another time my soccer team was practicing on the grounds of a monestary on Long Island near the water. We noticed a body floating face down near the shore. One parent who was a foot doctor and my dad pulled him out, pushed the water out of him, and gave him mouth to mouth resusitation. All of us called 911 on our cell phones. When the ambulance came, the medical people said that he had had a massive heart attack and was barely alive. We found out that he was a visiting monk from the Ukraine. The foot doctor parent called the hospital in Hicksville the next morning to find out how the man was doing. He was told that the hospital released him because he had no insurance. The monestary put him on a plane to go home, and he died a week later. This experience made our whole team feel outrage about our health care system. If this poor man had had a heart attack in any other industrialized country, he would have been treated for free.
Sunday, January 2, 2011
HW # 28 - Comments 2
For Ben’s Blog
From your description of visiting your friend who was dying from ALS, I have a picture of your parents with nonstop smiles on their faces, of your friend the patient smiling quite a lot, and of you with a slightly smaller smile wondering why everyone seems to have exaggerated smiles on their faces at such an unsmiley time. Later you explain that keeping a positive attitude results in a patient’s more positive attitude, but I think your observation of the irony of acting almost too happy at such an unhappy time is a great insight. In a way visiting a dying person does require a good acting job because visitors cannot show their depression and make the dying person feel even worse. Smiles are infectious, and smiling at someone almost forces that person to smile back. Smiles can also be a nervous reaction and there is probably some of that going on too. I liked the description of the dying friend describing all the nurses who were taking care of him. They make up his world, and it is great that he could praise some and be critical of others and give you a picture of what was going on in his life especially when it was so hard to talk. It probably took a lot of effort trying to understand your friend speak. I was just curious about what his room was like and whether he had tubes and medical equipment attached to him. I also wondered how old his daughter was. You made me want to know more about him.
For Natalie’s Blog
I really liked the honest way you expressed your feelings about visiting your grandmother in the nursing home. The fact that she wasn’t there because she had scheduled an appointment at the same time as your visit says a lot about how the old are just not living
in the same world, and that this fact makes dealing with them take a lot of effort. It was interesting hearing about what a complicated maze the place is considering it is housing people whose minds aren’t at their peak and about your father’s comments on the pill box being complicated too. Both were good insights on how we don’t seem to design things for the elderly with them in mind. I also liked your line about your grandmother having a boyfriend and there not being any pictures of him among all the pictures of her family. I think the idea was that she would not have thought that it would have been proper to have his picture there. It was also funny that you only found three pictures of yourself, and I think it is just human nature to look for pictures of ourselves in that situation. The best part I thought was your description of how you just wanted to get out of the atmosphere of age and illness and thoughts of dying, even saying that you did not want to touch anything there. I understand completely. You just didn’t want any of that atmosphere to infect you or even rub off on you in any way. Your comments on sitting with her when she was opening her presents were insightful too. But why was she so ignorant when she said she was surprised things weren’t made in China when most things are now? Maybe the presents were expensive ones, and her comments were insulting. Anyway the line about her being left with people “who smirk after her comments and dread going to visit her” made me hope that this is not what is in store for all of us as we get up there in age. It probably is though. Great job.
From Mom
First of all, I am so glad about this assignment because I don’t think Devin would have gone to visit our friend Gloria by himself otherwise. At his age I wouldn’t have wanted to make this visit by myself either. There is nothing appealing about visiting a dying person. I felt proud to read that Devin had touched her hand because I know that must have meant a lot to Gloria and to Maria, and it can be hard to do. I liked the reference he made to what Paul Farmer said about the connection that touching an ill person makes. It’s good that he wasn’t uncomfortable or scared. The best part of his visit was hearing that he took the David Sedaris book I received as a present with him and actually read something from it to Gloria. I have just skimmed through the stories and there really isn’t one that is clean enough to read to Maria yet alone to Gloria. Both are very religious Catholics, who never use bad language. Devin must have looked hard to find the section he read out loud and I am sure that he did some editing. I’m also sure that Gloria heard him and loved the fact that he was reading something funny to her. One last comment I have is about his asking Maria if Gloria would be going to the hospital. He knew that Maria was keeping her at home, but I think when he was there with Gloria that it seemed to him that she should be in a hospital because she looked so ill. This seems like a normal reaction. If someone is very sick and possibly dying, then there should be doctors and nurses to look after this person. The visit to the class from the woman named Beth whose husband died must have made a very positive impression, and I liked the wording Devin used when he said that Maria and Beth were giving “their family member the most dignified dying experience possible.”
From Demetri
This story reminds me of my aunt. I visit her every week in the hospital and i read stories to her. We are now reading the Prophet and im having trouble understanding it but she helps get the meaning of the story. She teaches me things and she tells me story of her wonderful life. And i have a wonderful time visiting her.
From Ben
The part about this post that I enjoyed the most was the way you were able to connect the insights you made from visiting Gloria to the insights you had previously came up with while reading Mountains Beyond Mountains and while listening to Beth. For instance, when you said, "Both of them wanted to give their family member the most dignified dying experience possible. Both also had a lot of pictures in the room to give visitors of sense of the person and also to make the dying person have good memories," you did a great job of connecting to specific things that Beth said when thinking of your own experience in the hospital. I also really liked the way your writing had a very personal touch to it.
From Juggleandhope
I'll be interested to learn how this experience either lives with you or gets buried by your life.
I'll ask you in 3 years.
In the meantime, it sounds like the dance went pretty smoothly - you were helped in the choreography by your mom, by Maria, and by Gloria herself including props (bulbs), key moments (the hand-holding), and task (reading). Lucky! A lot of life feels easier and sweeter when you know the standard steps.
Would you change the general choreography at all when you visit the next ill person?
From Natalie
I enjoyed your post particularly because you did not completely focus on Gloria's current state, but instead reminisced on how she used to be. For example that she was married and how you used to go the store for her. It's apparent that even though she is slowly reaching the end of her life, you are still able to remember that she is a person and lived a fulfilled life. I think a lot of times our society hides the ill and dying and forgets that they too used to carry out a normal, routine life. Overall I really like how you wrote this post, it demonstrated your emotions and internal thoughts throughout the entire experience.
From your description of visiting your friend who was dying from ALS, I have a picture of your parents with nonstop smiles on their faces, of your friend the patient smiling quite a lot, and of you with a slightly smaller smile wondering why everyone seems to have exaggerated smiles on their faces at such an unsmiley time. Later you explain that keeping a positive attitude results in a patient’s more positive attitude, but I think your observation of the irony of acting almost too happy at such an unhappy time is a great insight. In a way visiting a dying person does require a good acting job because visitors cannot show their depression and make the dying person feel even worse. Smiles are infectious, and smiling at someone almost forces that person to smile back. Smiles can also be a nervous reaction and there is probably some of that going on too. I liked the description of the dying friend describing all the nurses who were taking care of him. They make up his world, and it is great that he could praise some and be critical of others and give you a picture of what was going on in his life especially when it was so hard to talk. It probably took a lot of effort trying to understand your friend speak. I was just curious about what his room was like and whether he had tubes and medical equipment attached to him. I also wondered how old his daughter was. You made me want to know more about him.
For Natalie’s Blog
I really liked the honest way you expressed your feelings about visiting your grandmother in the nursing home. The fact that she wasn’t there because she had scheduled an appointment at the same time as your visit says a lot about how the old are just not living
in the same world, and that this fact makes dealing with them take a lot of effort. It was interesting hearing about what a complicated maze the place is considering it is housing people whose minds aren’t at their peak and about your father’s comments on the pill box being complicated too. Both were good insights on how we don’t seem to design things for the elderly with them in mind. I also liked your line about your grandmother having a boyfriend and there not being any pictures of him among all the pictures of her family. I think the idea was that she would not have thought that it would have been proper to have his picture there. It was also funny that you only found three pictures of yourself, and I think it is just human nature to look for pictures of ourselves in that situation. The best part I thought was your description of how you just wanted to get out of the atmosphere of age and illness and thoughts of dying, even saying that you did not want to touch anything there. I understand completely. You just didn’t want any of that atmosphere to infect you or even rub off on you in any way. Your comments on sitting with her when she was opening her presents were insightful too. But why was she so ignorant when she said she was surprised things weren’t made in China when most things are now? Maybe the presents were expensive ones, and her comments were insulting. Anyway the line about her being left with people “who smirk after her comments and dread going to visit her” made me hope that this is not what is in store for all of us as we get up there in age. It probably is though. Great job.
From Mom
First of all, I am so glad about this assignment because I don’t think Devin would have gone to visit our friend Gloria by himself otherwise. At his age I wouldn’t have wanted to make this visit by myself either. There is nothing appealing about visiting a dying person. I felt proud to read that Devin had touched her hand because I know that must have meant a lot to Gloria and to Maria, and it can be hard to do. I liked the reference he made to what Paul Farmer said about the connection that touching an ill person makes. It’s good that he wasn’t uncomfortable or scared. The best part of his visit was hearing that he took the David Sedaris book I received as a present with him and actually read something from it to Gloria. I have just skimmed through the stories and there really isn’t one that is clean enough to read to Maria yet alone to Gloria. Both are very religious Catholics, who never use bad language. Devin must have looked hard to find the section he read out loud and I am sure that he did some editing. I’m also sure that Gloria heard him and loved the fact that he was reading something funny to her. One last comment I have is about his asking Maria if Gloria would be going to the hospital. He knew that Maria was keeping her at home, but I think when he was there with Gloria that it seemed to him that she should be in a hospital because she looked so ill. This seems like a normal reaction. If someone is very sick and possibly dying, then there should be doctors and nurses to look after this person. The visit to the class from the woman named Beth whose husband died must have made a very positive impression, and I liked the wording Devin used when he said that Maria and Beth were giving “their family member the most dignified dying experience possible.”
From Demetri
This story reminds me of my aunt. I visit her every week in the hospital and i read stories to her. We are now reading the Prophet and im having trouble understanding it but she helps get the meaning of the story. She teaches me things and she tells me story of her wonderful life. And i have a wonderful time visiting her.
From Ben
The part about this post that I enjoyed the most was the way you were able to connect the insights you made from visiting Gloria to the insights you had previously came up with while reading Mountains Beyond Mountains and while listening to Beth. For instance, when you said, "Both of them wanted to give their family member the most dignified dying experience possible. Both also had a lot of pictures in the room to give visitors of sense of the person and also to make the dying person have good memories," you did a great job of connecting to specific things that Beth said when thinking of your own experience in the hospital. I also really liked the way your writing had a very personal touch to it.
From Juggleandhope
I'll be interested to learn how this experience either lives with you or gets buried by your life.
I'll ask you in 3 years.
In the meantime, it sounds like the dance went pretty smoothly - you were helped in the choreography by your mom, by Maria, and by Gloria herself including props (bulbs), key moments (the hand-holding), and task (reading). Lucky! A lot of life feels easier and sweeter when you know the standard steps.
Would you change the general choreography at all when you visit the next ill person?
From Natalie
I enjoyed your post particularly because you did not completely focus on Gloria's current state, but instead reminisced on how she used to be. For example that she was married and how you used to go the store for her. It's apparent that even though she is slowly reaching the end of her life, you are still able to remember that she is a person and lived a fulfilled life. I think a lot of times our society hides the ill and dying and forgets that they too used to carry out a normal, routine life. Overall I really like how you wrote this post, it demonstrated your emotions and internal thoughts throughout the entire experience.
HW # 27 - Visiting an unwell person
The first feeling I had when I entered our friend Gloria’s room was a combination of surprise and sadness that she looked so changed in her hospital bed. Her face was thin and her skin looked bluish and see-through. Her white hair looked flattened down and lifeless compared to the healthy thick way it used to look. Her arms looked thin and bluish too and a little bruised. I held her hand for a second because her daughter Maria asked me to. It felt a little cold. When Gloria tried to speak, her mouth could not open very far. She said she hated to have me see her looking the way she did. I said I was just happy to see her. I showed her a pot of some narcissus bulbs my mother gave me to bring to her, and she said they were her favorite flowers. Then her eyes closed suddenly. I thought something terrible was happening, but her daughter said that she gets tired really easily. I said that I should go, but then Gloria opened her eyes again and said I could sit next to her and read something. I had brought this David Sedaris book someone gave my mom for Christmas because it has short, short stories in it, and some of them are pretty funny. After trying to find one without bad language, I read “The Migrating Warblers,” and I still had to edit out words as I read. I came to a part where one warbler was complaining to the other about how backwards and superstitious birds are in Guatemala, and the other one asked “Why not winter in Florida like everybody else? The other one said that even though there were “language barriers and severed heads,” Central America was “Cheap, cheap, cheap.” Gloria smiled the biggest smile I think she could.
Then I was alone in the room except for Gloria. Gloria’s daughter Maria was in the kitchen getting me a drink. I looked around. There were a lot of photos on two tables on either side of the bed. I guess the idea was for Gloria to see pictures of her family and friends and remember happy times. I had not seen them before. Gloria’s house is at the end of our block. She used to sit outside and say hello to me whenever I walked by. Sometimes I would go to the store to get her something or go to the Farmer’s Market a few blocks away to get fruit and vegetables for her. She always wanted to pay me, but I would not let her. Actually, once she gave me $2, and my mother told me never to let her pay me again. She was always smiley and happy. I saw a picture of her when she was married. She looked really young and beautiful. Maria came back with some juice for me, and I was glad it had ice in it because the room was so hot I felt really sweaty. Gloria seemed to have fallen asleep, and Maria told me that she would sleep more and more until the end. I asked if she would go to the hospital soon. Gloria said that she wanted her mother to die at home and that it would not be very long now. She said her
brother was coming tomorrow and that there would be other family members to be with her at the end. She thanked me a lot for coming.
I thought that Maria was handling her mother’s death in the same way that Beth handled her husband’s death. Both of them wanted to give their family member the most dignified dying experience possible. Both also had a lot of pictures in the room to give visitors of sense of the person and also to make the dying person have good memories. When Maria asked me to hold Gloria’s hand, it made me think about how Paul Farmer always made physical contact with his patients because touching made a closer connection with them. I think that is what Maria wanted for her mother too.
Then I was alone in the room except for Gloria. Gloria’s daughter Maria was in the kitchen getting me a drink. I looked around. There were a lot of photos on two tables on either side of the bed. I guess the idea was for Gloria to see pictures of her family and friends and remember happy times. I had not seen them before. Gloria’s house is at the end of our block. She used to sit outside and say hello to me whenever I walked by. Sometimes I would go to the store to get her something or go to the Farmer’s Market a few blocks away to get fruit and vegetables for her. She always wanted to pay me, but I would not let her. Actually, once she gave me $2, and my mother told me never to let her pay me again. She was always smiley and happy. I saw a picture of her when she was married. She looked really young and beautiful. Maria came back with some juice for me, and I was glad it had ice in it because the room was so hot I felt really sweaty. Gloria seemed to have fallen asleep, and Maria told me that she would sleep more and more until the end. I asked if she would go to the hospital soon. Gloria said that she wanted her mother to die at home and that it would not be very long now. She said her
brother was coming tomorrow and that there would be other family members to be with her at the end. She thanked me a lot for coming.
I thought that Maria was handling her mother’s death in the same way that Beth handled her husband’s death. Both of them wanted to give their family member the most dignified dying experience possible. Both also had a lot of pictures in the room to give visitors of sense of the person and also to make the dying person have good memories. When Maria asked me to hold Gloria’s hand, it made me think about how Paul Farmer always made physical contact with his patients because touching made a closer connection with them. I think that is what Maria wanted for her mother too.
HW # 26 - Looking back & forward in unit
1. “It’s a parallel universe. There really is no relation between the massive accumulation of
wealth in one part of the world and abject misery in another.”
(Mountains Beyond Mountains p. 218)
2. Paul Farmer hates the idea that resources are scarce but only when it comes to the poor,
meaning that expensive drugs are available only to those who can pay for them. (Mountains Beyond Mountains)
3. Wild cries erupt from the child: “Li fe-m mal, mwen grangou!’ Farmer looks up, and for a moment he’s narrating Haiti again. “She’s crying, “It hurts, I’m hungry.” Can you believe it? Only in Haiti would a child cry out that she’s hungry during a spinal tap.” (Mountains Beyond Mountains)
4. This fact check from Sicko shows how insurance companies try to cheat with false claims:
Blue Cross/Blue Shield: "Sixty-seven Blue Cross/Blue Shield companies across the nation have paid the United States a total of $117 million to settle government claims that Medicare made primary payments for health care services that should have been paid by the Blue Cross/Blue Shield private insurance companies, the Department of Justice announced today." (Sicko)
5. Beth treated all the people who worked at the hospital with an equal amount of respect no matter what task they performed in treating her husband. She made the effort to get to know them asking about their lives and families in order to build stronger relationships with them and have them care more about her husband. (Visit from Beth)
Mountains Beyond Mountains made the strongest impression on me because it shows how the world seems not to care about the illness and dying of the poorest peoples, and it shows what can be done by one man and others influenced by him to make a huge difference in the lives of people who need the most help. Sicko made a big impression on me about what’s wrong with this country’s health system because it tells who is to blame.
Questions to explore in the final two weeks:
Euthanasia – Physician assisted suicide
We can talk about the reasons people are for it and the reasons people are against it. We could have a debate.
Funerals – Burials vs. cremation
To get started we could show the Mike Nichols and Elaine May video, “$65 Funeral”
and the Carol and Robin Williams one called “The Funeral.”
Then we talk about cost, space and environmental issues, but it would be really good to
show the videos.
The idea that the rich deserve great medical care and living conditions and the poor don’t because they are responsible for their bad luck should make everyone really angry not just Paul Farmer because it is the exploitation of their land and resources by the rich and powerful that has made the poor people poor. We should all hate the fact that so many wealthy corporations and governments take no responsibility for the illness and the dying of desperately poor people.
When poor Haitians didn’t take all their medicine, members of the medical establishment said that they were “non-compliant” and used that as a reason not to give them more medicine especially if it was expensive. Farmer explained that there are many reasons why poor people might not be taking medicine. For example, they might not be able to get to the clinic or they might be selling it because their family is starving. He called the physicians “non-compliant” if they weren’t making sure their patients were taking their medicine. He
conducted a test and found that when patients were given a little cash for food, transportation and child care they did get their medicine.
Sicko should make Americans think about what is wrong with a health care system that is for profit. It is crazy that insurance companies try to cheat people out of the coverage
they have paid for when they get sick, but since they are trying to make big profits, it makes sense why they do. Hospitals and doctors charge way too much for their services and so do
drug companies because they are all trying to make a profit. It makes sense that the government should be running health care setting limits on what all the for profit health
care providers can charge.
wealth in one part of the world and abject misery in another.”
(Mountains Beyond Mountains p. 218)
2. Paul Farmer hates the idea that resources are scarce but only when it comes to the poor,
meaning that expensive drugs are available only to those who can pay for them. (Mountains Beyond Mountains)
3. Wild cries erupt from the child: “Li fe-m mal, mwen grangou!’ Farmer looks up, and for a moment he’s narrating Haiti again. “She’s crying, “It hurts, I’m hungry.” Can you believe it? Only in Haiti would a child cry out that she’s hungry during a spinal tap.” (Mountains Beyond Mountains)
4. This fact check from Sicko shows how insurance companies try to cheat with false claims:
Blue Cross/Blue Shield: "Sixty-seven Blue Cross/Blue Shield companies across the nation have paid the United States a total of $117 million to settle government claims that Medicare made primary payments for health care services that should have been paid by the Blue Cross/Blue Shield private insurance companies, the Department of Justice announced today." (Sicko)
5. Beth treated all the people who worked at the hospital with an equal amount of respect no matter what task they performed in treating her husband. She made the effort to get to know them asking about their lives and families in order to build stronger relationships with them and have them care more about her husband. (Visit from Beth)
Mountains Beyond Mountains made the strongest impression on me because it shows how the world seems not to care about the illness and dying of the poorest peoples, and it shows what can be done by one man and others influenced by him to make a huge difference in the lives of people who need the most help. Sicko made a big impression on me about what’s wrong with this country’s health system because it tells who is to blame.
Questions to explore in the final two weeks:
Euthanasia – Physician assisted suicide
We can talk about the reasons people are for it and the reasons people are against it. We could have a debate.
Funerals – Burials vs. cremation
To get started we could show the Mike Nichols and Elaine May video, “$65 Funeral”
and the Carol and Robin Williams one called “The Funeral.”
Then we talk about cost, space and environmental issues, but it would be really good to
show the videos.
The idea that the rich deserve great medical care and living conditions and the poor don’t because they are responsible for their bad luck should make everyone really angry not just Paul Farmer because it is the exploitation of their land and resources by the rich and powerful that has made the poor people poor. We should all hate the fact that so many wealthy corporations and governments take no responsibility for the illness and the dying of desperately poor people.
When poor Haitians didn’t take all their medicine, members of the medical establishment said that they were “non-compliant” and used that as a reason not to give them more medicine especially if it was expensive. Farmer explained that there are many reasons why poor people might not be taking medicine. For example, they might not be able to get to the clinic or they might be selling it because their family is starving. He called the physicians “non-compliant” if they weren’t making sure their patients were taking their medicine. He
conducted a test and found that when patients were given a little cash for food, transportation and child care they did get their medicine.
Sicko should make Americans think about what is wrong with a health care system that is for profit. It is crazy that insurance companies try to cheat people out of the coverage
they have paid for when they get sick, but since they are trying to make big profits, it makes sense why they do. Hospitals and doctors charge way too much for their services and so do
drug companies because they are all trying to make a profit. It makes sense that the government should be running health care setting limits on what all the for profit health
care providers can charge.
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