SoylentNews is people
SoylentNews
Arthur T Knackerbracket has found the following story:
Since Canada legalized Medical Assistance in Dying (MAiD) in 2016, as of Oct. 31, 2018, more than 6,700 Canadians have chosen medications to end their life.
Canadians who meet eligibility requirements can opt to self-administer or have a clinician administer these medications; the vast majority of people choosing MAiD have had their medications delivered by physicians or nurse practitioners. Canada is the first country to permit nurse practitioners to assess for medically assisted dying eligibility and to provide it.
The precise meaning and implications of MAiD—in particular, who can request medical assistance in dying in Canada—is still evolving through court rulings. Québec's Supreme Court recently struck down the reasonably foreseeable death requirement under the Criminal Code and the end-of-life requirement under Québec's Act Respecting End-of-Life Care.
Without the requirement of a reasonably foreseeable death, it is likely that other legal challenges will occur to extend assisted dying to other groups such as those whose sole underlying condition is severe mental illness.
Our research has explored how the nursing profession is regulating the new area of responsibility towards medically assisted dying and how nursing ethics might guide policy and practical implications of nurses' experiences.
Current legislation guards the right of health-care providers to conscientiously object to participation in MAiD. Nurses who do conscientiously object have a professional obligation to inform their employers of that objection, to report requests for MAiD, and to not abandon their clients. They also must ensure that their choices are based on "informed, reflective choice and are not based on prejudice, fear or convenience."
The nurses who surround the process of medically assisted dying are an important source of insight into the complex and nuanced conversations our society needs to have about what it is like to choose, or be involved with, this new option at the end of life, and to be involved in supporting patients and their families toward death with compassion.
Our most recent research involved interviews with 59 nurse practitioners or registered nurses across Canada who accompanied patients and families along the journey of medically assisted dying or who had chosen to conscientiously object. Nurses worked across the spectrum of care in acute, residential and home-care settings.
[...] With the changing landscape of medically assisted dying in Canada, the need for reflective conversations becomes ever more urgent. We need to better understand how medically assisted dying changes the nature of death to which we have become accustomed and how those changes impact all those involved.
(Score: 2) by JoeMerchant on Sunday September 29 2019, @03:05PM
I don't see it that way, at all, and most nurses and other sub-M.D. medical staff I have interacted with concur: they are only Gods in their own minds, otherwise they're pretty much PHBs blind to their own shortcomings - but with the one power: to utterly destroy your career, so you might as well play along with their delusions if you want to be able to pay your rent.
I have noticed a severe reduction in the seeking of second opinions over the decades, and I believe the insurance based reimbursement structure has heavily contributed to that. IMO, as insured patients, any time a procedure with potential for negative effects and outcomes is recommended, it should be our covered by insurance right to seek a second, and possibly third opinion when the situation calls for it. But, with 6+ week delays involved in seeing specialists and astronomical (5x, 20x, 200x) costs of "not covered" anything in the medical profession... we seem to be being steered into accepting whatever the first doc tells us. Attribute some of the time delay to the AMA again, and their inadequate residency capacity leading to undersupply of little gods-in-their-own-minds, but the insurance oriented billing farce where private pay can literally be more than 100x as expensive as "allowed" charges under insurance, that is just a disconnect from all reason. By the way, I don't hate all doctors, I worked for a very good man (who the staff literally nicknamed God) for 12 years - chief of medicine at a major hospital, top of his field, etc. I've known many good pediatricians and primary care docs. But, so many quacks, so many ego cases, and to stretch the field a bit, so so many greed based dental practices.
Fun recent case in point for insanity rooted in the insurance reimbursement model: a drug company has discovered that compounding of dextromethorphan and quinadine has beneficial effects for brain chemistry of a fairly wide spectrum of patients, but so far they have only sought approval under the Dx of PBA. They did three PBA studies (a very easy to study condition), maybe a couple of hundred patients enrolled, and now they're approved to market the drug. Know what old cough syrup + more or less tonic water goes for in a pill these days? $1200 per month. That system is broken, and, luckily in this case, I believe easily circumvented with a compounding pharmacy - though we haven't verified that yet, still evaluating the drug's effects so far it seems good.
Yes, basically as soon as the M.D. accepted my grandfather's wishes he was transferred to an in-hospital hospice wing. The condition that got him was an aneurysm in his femoral artery, all other arteries to that leg had already shut down and when this one clotted and didn't respond to treatment, that was it, no circulation to the leg. The condition was present a year earlier and they were able to treat it with clotbusters, eventually, but not the next time. The hospice care was good, the only complaint we had was that the final week was just pointless - the decisions all made, everybody at peace with what was coming, just having to live through it for a week with him in such a bad state and no real chance of recovery other than him changing his mind to take off the leg, anyone who knew him knew he was far too stubborn to change that decision, and he was in such an altered state from the pain meds that he really couldn't make any decisions anyway. If he weren't so stubborn it would have been even more agonizing if he flip-flopped while on the meds and started asking to be saved, only to change his mind back after he was lucid again, and utterly tragic if they did take his leg off and save his life just for him to commit suicide on his own later.
🌻🌻 [google.com]