Cream-de-la-Peach t1_j4ygu76 wrote on January 19, 2023 at 3:21 AM

Reply to comment by blatantninja in Family Dynamics and Doctors' Emotions Drive Useless End-of-Life Care. Surveys repeatedly indicate that nearly all people would rather die peacefully at home, yet painful, long-shot treatments remain common, and efforts to reduce usage have failed by Wagamaga

Well that’s half the issue with healthcare is that insurance dictates what care patients get and that’s not how it should work. What really needs to change is that patient’s advance directives should be followed according to their wishes and we shouldn’t let family member’s wishes supersede those of the patient when they no longer have capacity to make decisions. A lot of families that will continue life sustaining measures when the patient clearly wrote they did not want it in their advance directive or they never had one.

blatantninja t1_j505epb wrote on January 19, 2023 at 2:05 PM

I agree on the second part but not the first. There has to be a gatekeeper if you want healthcare that's affordable. Doctors don't want to be it (understandably) and patients will abuse the hell out of it. If a patient has met their deductible/out of pocket they don't even blink an eye if a treat is $100 or $1000000. That's a big part of our cost over overruns.

In a perfect world, sure cost shouldn't determine care, but unfortunately it's something that has to be considered in the real world. If it's not the doctors and if the patients won't do it themselves, that leaves either insurance or the government.