> Zim wrote-
>  The decision on when enough is enough when it comes to medical spending is 
a 
>  huge ethical issue bound up in politics and science changing every day.

(ramble warning)
The range of this discussion was even broadened this week with research that 
doctors avoid telling ill people and their families when a case is terminal.  
In concept, it seems remarkably easy to see when benefits of care may be 
limited, but when it comes to matters of the heart and possibilities it all 
gets thrown to the wind in some ways.  I have met families that do not want a 
dying person told they are dying, so why should it surprise me when doctors 
want to protect patients/families, or are just plain uncomfortable.  

Research shows that at some point the benefits of care in many areas do start 
to plateau, but this cannot be the purest decision making process.  What 
would you want in a terminal situation- brute honesty? Now think about how 
you would feel being on the survivor side of things and see if your ideas on 
what should happen still agree.  Would you wish for an extra day to help the 
family say good-bye to a loved one?  For some people things are consistent, 
others see a big discrepancy.  Add into all that how remarkable the human 
body can be.... people surviving for days in Hospice situations until the 
whole family has accepted death... and you can begin to see how complicated 
it all is.

Just to illustrate the difficulties on a simplistic level, think about organ 
donation.  I had a major time of just helping my parents to understand the 
organ donor clause on my first license, and when I was married my husband 
never did agree to accept my desires in that area.  

Dee 


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