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Rev. Dr. Martha R. Jacobs

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What's More Important to You, Quality or Quantity of Life?

Posted: 04/06/11 05:18 PM ET

I have been following with interest the story of Desmond Watson, an 87-year-old who has advanced dementia and has been in the hospital in Canada for 14 months. He was admitted to the hospital in January 2010 with pneumonia. His wife of 69 years told doctors that he would want to keep living as long as possible. As a Roman Catholic, she says that he "would have wanted to be given every chance at life despite any suffering he may be enduring."

"Desmond is suffering without any prospect of long-term improvement," said one of Mr. Watson's doctors. This doctor is quoted as saying: "Prolonging life and living are two totally different things ... being kept alive in this way, I can't imagine anybody would wish this ... Mrs. Watson is entitled to her opinion but we need to be satisfied for ourselves that we're doing the right thing ... (We're) not satisfied."

In Ontario, they have a Consent and Capacity Board (CCB) that reviews cases like Mr. Watson's. ("The CCB's mission is the fair and accessible adjudication of consent and capacity issues, balancing the rights of vulnerable individuals with public safety.") The CCB ruled that because Mrs. Watson (and her two daughters) expressed what she said were her husband's beliefs, the hospital is required to continue treatment. Unfortunately, none of those caring form Mr. Watson ever asked him what his beliefs and values were even though the Consent and Capacity Board weighs the patients' beliefs and values in their decisions.

Some of the questions that families have struggled with in situations such as this are: What is "living"? And is this a quality of life that would be acceptable to the patient? As the hospital's doctor said, "prolonging life and living are two totally different things."

I mentioned in my last posting that we need to determine for ourselves what our "bottom line" is. The question becomes: When is enough, enough?

And while money should not play a part in the decisions people make, we should at least be aware of the costs to our health system. For example, "Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months. Forty percent of Medicare dollars cover care for people in the last month." This is amazing considering that when asked, most people say that they would prefer to die at home and not in a hospital. And yet, 56 percent die in a hospital and 19 percent in nursing homes. (Read more.)

What is more important to you: quality of life or quantity of life? And where do your religious beliefs come into this consideration?

 
 
 
 
 
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HUFFPOST SUPER USER
cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:14 PM on 04/08/2011
I had a brother who did well in life. And retired at 45 and did not smoke or drink. Yet he died and luckly he could afford enought morphine to end his life.

Me I could go tomorrow and with 4% blood evacuation a week ago it may be sooner than is is later. But the $26,000 they spent shockimg my heart back into rythem and montoring me for a week to get it to beat steady and the right meds. Maybe Market Share expense thing far more than the 45 minues the Doctors and Expert spent and the 3 times a day it took to dump my pea jug.

The problem is we float throught space in an island of humanity is that it is MUCH MORE important we understand what we owe allegence too. We did not create life. We simply live life. Rather than creating a make believe senerio that it is OK for some esobee to say when my life should end. Because of the price of wages and technology and how they are accounted for.

You don't have the right to kill some one else for the convenience of yourself. No matter how you cut the cake for a crooked deal..
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bobclapp1936
11:17 AM on 04/07/2011
After witnessing the extreme downside of quality at its worse, quanity on average is the winner.
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Cool Bam
10:56 AM on 04/07/2011
Good thoughtful piece. I will disagree with "money should not play a part in the decisions people make". Really it should. There is no justification for 40% of Medicare dollars being spent in the last 30 days of a life. This country needs to grow up, not only on EOL but on all the HC decisions. Some form of rational HC choices need to be made whether through an org like NICE or some invention of our. We can not have basic health care for everyone without it. We need to choose and not run from the concept of rationing.
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HUFFPOST SUPER USER
cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:19 PM on 04/08/2011
Thoughtful. Sounds to me like taking abortion as a contriception all over again.

Where do you get these rights. No one I know create life here on earth. Who the hell do you think you are taking it away. Let it be. That is nature.

If you can make that choice you might as well say I can take your life because I dislike you. Return to the cave. Sounds like it is better than claiming your GOD when you are not. Me I would start with Stock Traders and work toward the inherited wealth.
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Cool Bam
12:42 PM on 04/08/2011
We can't give everyone HC and provide every possible service, drug or cure that could possibly extend life whether it be for a minute or 40 years. There is not enough money in the entire U.S. economy. We are choosing to let people die that otherwise could live long productive life in favor of granting people a couple weeks at EOL.
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Ralph Perman
Unapologetic Progressive Liberal
10:05 AM on 04/07/2011
It is said " Where there is Life, There is Hope".

Everyone Needs to have a Living Will! So that your loved ones know what You consider Life to be. And Quality of life should be considered when making those decisions.
07:54 AM on 04/07/2011
Quality.
06:36 AM on 04/07/2011
I think it is worth noting in the case of Mr. Watson cited in this article: We would not treat a dog this way.

I read a recent article in the New Yorker that over 50% of people over the age of 85 are suffering from dementia.
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HUFFPOST SUPER USER
cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:23 PM on 04/08/2011
I do not think any one qualifies as Master. And the master I know all believe in Free Will.

This mob rull mass trumps the individual reeks of secular, atheist, Community Organization and nothing our forefather put into writing on individual rights and free choice.

It is not communism it is survival of the few organism over any other ogranism. Cannibalism
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warloch2
Spraying cold reality from the hose of truth.
06:30 AM on 04/07/2011
Consent and Capacity Board AKA Death Panel. :-)
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cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:23 PM on 04/08/2011
Cannibalism I call it
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french queen13
my beloved is mine and I am his
11:45 PM on 04/06/2011
Quality over quantity for me, that's for sure. And quality, for me - I do not mean for anyone else, just for MY life - precludes physical incapacity such as a vegetative state or quadriplegia, or mental incapacity, such as any sort of dementia or brain damage that prevents me from thinking and speaking.
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cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:25 PM on 04/08/2011
Guess what, there are no gaurenties and expectation in this life. Become spirit and you cannot take anothers life. That is their life.

If we are going to wish over the centuries I would choose Rothschld. Since I cannot I want them gone
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HUFFPOST COMMUNITY MODERATOR
NoraHuffposter
Liberal socialist
11:14 PM on 04/06/2011
Rev. Dr. Jacobs, this is an important (and difficult) discussion that so few people wish to engage in. In the case of Mr. Watson, it is almost unconscionable that the family would consider a loved one in that condition to be 'living'. Perhaps 'existing' is a better word. And while no one wishes to enter dollars and cents in a discussion of life, how can the family and hospital justify high institutionalization costs for someone with advanced dementia not to mention other serious/comorbid conditions? Suffering when there is some quality of life expected despite of it is one thing but suffering with no hope at all seems especially cruel.
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HUFFPOST SUPER USER
cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:27 PM on 04/08/2011
Nothing difficult here. Simple Risk Management. I by associating a cost to caring for others or the anti-caring killin of others you take away the individuals right to choose. You or any human do not have that right.

Non-violence can be sacrificed for such action. You know killing for killing
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HUFFPOST COMMUNITY MODERATOR
NoraHuffposter
Liberal socialist
12:57 PM on 04/08/2011
Individuals like Mr. Watson can certainly choose. What happens when there is no cost or cost must be rationed? Is it still considered killing?
09:23 PM on 04/06/2011
Rev.Jacobs,this makes me nervous..I have CP and have never worked,I support myself by drawing off my dad's Social Security.I would hate it if I got sick and was refused treatment because someone who did not know me said I was just A burden,
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french queen13
my beloved is mine and I am his
11:42 PM on 04/06/2011
Get a living will organised if you can, Laura. Whichever way one leans, it's important to have your wishes clearly recorded!
11:53 PM on 04/06/2011
HI Laura - as long as you make your wishes known and have advocates who can speak for you if you can't speak yourself, you should be protected. I did not consider Mr. Watson to be a "burden" to anyone, nor do I think the doctors think he is a "burden." That should NEVER enter the conversation - but sometimes people say they don't want to be a burden and so they make decisions about the end of their life based on that instead of talking with their family/friends to see if their own perception is wrong or right. Sometimes the best gift you can give is allowing someone to die when the natural course of the illness goes in that direction instead of using artificial means to prolong their life. Sometimes the family needs that time to adjust - there are so many different factors that have to be taken into consideration - and no decision like this should be made in haste or without knowing as much as possible about the possible outcomes. As a chaplain, I try to ensure that a patient does not make a decision based on whether or not he/she was going to be a burden to family.
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HUFFPOST SUPER USER
cayuse
Soaring Eagle, soaring to Spirit from the ego self
12:31 PM on 04/08/2011
As a non-violent Yogi, I might have to through away my lifes worked to protect you. Form these vulchers, but I will. Just inform me when it gets to that first so I can help. Have respect for human will and free choice.

Life, Liberty and the pursuit of happiness or punish ment for anyone taking it away. Don't punch those of need