From Dr. Kevin's blog; Anesthesiologists are victims of their own success
A lot of this stuff is true for crna's as well. Why do we need exorbitantly paid nurses for sedation? We don't. Most of us don't need sedation either. Anyway, this article is germane to the issue of cost control. Check out the comments at the bottom, where, drum roll please, the crna's pipe up as usual with their arrogant sneering. How in the HELL are patients supposed to be able to interact with these self proclaimed demi-Gods of nurses, when these mid-level providers can't even get along with anesthesiologists, whose education is FAR superior to their own? Haven't we been subjected to enough abuse from these minions yet?
PS a crna admits that people on Versed babble on in the comments section. He says that ortho's don't want to hear it. So, anybody who is telling you that you are not spilling your guts while you're under the influence of Versed is a LIAR! Dan says so. He also told me to "name your poison" so it seems that Dan the crna is cognizant of the fact that Versed is POISON. Imagine that. Yes I know he didn't mean it literally, but I was very interested that he chose that particular phrase. It's a Freudian slip in my opinion. A bubble from his subconscious..
PART 5
By Kelleigh
Nelson
April 10, 2013
NewsWithViews.com
April 10, 2013
NewsWithViews.com
"... we
must be wary of those who are too willing to end the lives of the elderly and
the ill. If we ever decide that a poor quality of life justifies ending that
life, we have taken a step down a slippery slope that places all of us in
danger. There is a difference between allowing nature to take its course and
actively assisting death. The call for euthanasia surfaces in our society
periodically, as it is doing now under the guise of "death with dignity" or
assisted suicide. Euthanasia is a concept, it seems to me, that is in direct
conflict with a religious and ethical tradition in which the human race is
presented with " a blessing and a curse, life and death," and we are instructed
'...therefore, to choose life." I believe 'euthanasia' lies outside the commonly
held life-centered values of the West and cannot be allowed without incurring
great social and personal tragedy. This is not merely an intellectual conundrum.
This issue involves actual human beings at risk..." —C. Everett Koop, M.D.
* *taken from the book KOOP, The Memoirs of America's Family Doctor by C.
Everett Koop, M.D., Random House, 1991
Florence Wald and American
Hospice
Florence Wald
is the most famous leader of the modern American hospice movement. She was born
Florence Sophie Schorske in New York on April 19, 1917. She
received a B.A. from Mount
Holyoke College in 1938 and an M.N. from Yale
School of Nursing in 1941. She received a second master's degree from Yale
University in mental health nursing in 1956, and became an instructor at the
school's nursing program. In 1959, she became Dean of Yale's School of Nursing.
The Yale School of Nursing was founded in 1923 with funding from the Rockefeller Foundation.
Wald's
entrance into hospice came about after she attended a 1963 lecture at Yale by
Dr. Cicely Saunders, founder of St. Christopher's Hospice in London. Saunders'
lecture emphasized minimizing pain in terminal cancer patients so that they
could focus on their relationships and prepare for death. Wald immediately began
reshaping the nursing school curriculum to put more focus on patients and their
families and to emphasize care of the dying. Feeling further effort was
required, Wald resigned as dean and went to London to study at St.
Christopher's. Upon her return, she organized the first U.S. hospice in Branford
in 1971. Connecticut Hospice, which began by offering in-home care but
eventually built its own inpatient facility, became a model for hospice care
here and abroad.
Florence Wald,
an agnostic and secular humanist, was an open advocate of euthanasia and
assisted suicide, while Saunders, a devout Christian, opposed the practice and
believed hospice made it unnecessary.
As productive
and influential as Florence Wald was, she sharply disagreed with Dame Cicely
Saunders' life-affirming approach to end-of-life care and said: "I know
that I differ from Cicely Saunders, who is very much against assisted suicide. I
disagree with her view on the basis that there are cases in which either the
pain or the debilitation the patient is experiencing is more than can be borne,
whether it be economically, physically, emotionally, or socially. For
this reason, I feel a range of options should be available to the patient, and
this should include assisted suicide."
So, is Wald
saying assisted suicide should be made available for society's economic needs?
Or perhaps she's referring to the family's inheritance? Economic because it
costs the family too much or the health care system too much? Social reasons
because a dying family member is a stressful situation on the family?
Wald's
pro-euthanasia type of hospice is what is being delivered in many parts of this
country, though many hospice professionals will strongly deny that. Those who do
remain faithful to Dr. Saunders life-affirming vision, who relieve the suffering
of the dying until a natural death occurs in its own timing, will say they do
not hasten death. Those who do hasten death will say the same. The public often
has no way of knowing which type of hospice their loved one will
experience.
Many hospice
leaders have spoken out against euthanasia and assisted suicide, and the whole
American hospice movement has rapidly expanded since its inception. In 1983,
Congress required Medicare to pay for hospice care, which put the treatment in
mainstream medical practice. According to the Center for Nursing Advocacy, in
2010 over 5,100 hospice programs served nearly 1.6 million patients a year in
the United States.
Hospice was
once a grass-roots, home-based model of end-of-life care, but is now part and
parcel of corporate medicine. In 2005, for-profit organizations accounted for
half of all hospices, and they charted profits of about 12 percent from 2001 to
2005, according to the Medicare Payment Advisory Commission. (MedPAC) [Link]
Hospices that
remain true to the Cicely Saunders' life-affirming mission will not hesitate to
proclaim the sanctity of life, while they intervene to relieve suffering at the
end-of-life. Those for-profit and volunteer hospices that are willing to hasten
death normally do not speak about the sanctity of life, and they do not teach
their staff to never impose death. In fact, their training results in quite the
opposite. The hospice industry has marketed itself as this "compassionate thing"
that exists all over the country and is filled with angelic staff who care and
work the kind of wonders Dame Saunders encouraged.
There are
thousands of stories of wonderful care received from hospices and how the
patient and the family have benefited. There are also thousands of stories of
patients being put to an early death by overdosing with pain cocktails or by
dehydration and starvation. There has been a very slick, sophisticated and
well-financed campaign to completely twist the positive contributions of hospice
into something the public would never openly accept.
To be
perfectly clear, water and sustenance are not heroic efforts to keep the dying
alive. This is keeping the patient comfortable. When sustenance cannot be
delivered, at least hydration can be given to keep the body comfortable.
However, there comes a point where the patient's body shuts down, and neither
food nor water are desired or taken and death is imminent. [Link]
Palliative Care and
Terminal Sedation
Palliative
care is not exclusively practiced in a hospice. It is the specialization in the
field of medicine which relieves the distressing symptoms of any serious illness
at any stage of life, whether terminally ill or not. The
World Health Organization states that:
"Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual."
Terminal or
palliative care is used by a majority of hospices today. This often involves
permanently sedating the patient, allowing the patient to dehydrate and die. It
looks outwardly peaceful as the patient is made to sleep in a medically-induced
coma, but the patient's death is the result.
Terminally-sedating the patient is something that can be done in hospice that doesn't outwardly appear like euthanasia where a lethal agent is given. (Morphine is the potent opiate which directly effects the central nervous system. It has neurotoxic effects on the brain. Overdoses lead to asphyxia and respiratory depression. It slows metabolism, causes incontinence, and has acute and chronic effects on the endocrine system, blood, the heart and lungs. The hospice "cocktail" usually consists of Ativan, Haldol and Morphine). It also doesn't outwardly appear like assisted suicide where a patient takes a lethal medication prescribed by a physician. Terminal sedation is more subtle and deceptive. This is what happened to my friend's relative who I told about in Part 3. The man wanted to be with his family, but food and water was denied by hospice. (Yes, there are hospices that refuse to give any food or water and you must sign on to that when they are hired.) The sedating "cocktails" were given to the point where respiratory function was decreased enough to cause early death.
Terminally-sedating the patient is something that can be done in hospice that doesn't outwardly appear like euthanasia where a lethal agent is given. (Morphine is the potent opiate which directly effects the central nervous system. It has neurotoxic effects on the brain. Overdoses lead to asphyxia and respiratory depression. It slows metabolism, causes incontinence, and has acute and chronic effects on the endocrine system, blood, the heart and lungs. The hospice "cocktail" usually consists of Ativan, Haldol and Morphine). It also doesn't outwardly appear like assisted suicide where a patient takes a lethal medication prescribed by a physician. Terminal sedation is more subtle and deceptive. This is what happened to my friend's relative who I told about in Part 3. The man wanted to be with his family, but food and water was denied by hospice. (Yes, there are hospices that refuse to give any food or water and you must sign on to that when they are hired.) The sedating "cocktails" were given to the point where respiratory function was decreased enough to cause early death.
Palliative
medicine is commonly used by hospice to relieve many symptoms of the dying
patient. It is precise and tuned especially for each patient's illness. However,
there are facilities wherein every patient is sedated because all the patients
are "agitated." It is a perversion of hospice as well as palliative care. It is
a deliberate railroading of patients to an imposed death, a hastened death
through "palliative" or "terminal" sedation.
Surprising to
many, terminal, palliative or "total" sedation is so commonly used today to
hasten death (a method of stealth euthanasia) that it is defined by the
pro-euthanasia Compassion and Choice's "Good to Go Resource Guide" glossary. They define it
as:
"the continuous administration of medication to relieve severe, intractable symptoms that cannot be controlled while keeping the patient conscious. This treatment renders the patient unconscious and relieves suffering by inducing an artificial coma. The unconscious state is maintained until death occurs."
Unfortunately,
it is used way too often on patients who are not having severe, intractable
symptoms that cannot be controlled while they are conscious.
Ron Panzer of
Hospice Patients
Alliance states, "In many cases, the Adult Protective Service system is
even used to intimidate those who truly care about the patient and object to
clinically unnecessary or harmful interventions. These can be as common as
giving morphine when there is no pain, sedating a patient who is not agitated,
depriving the patient of needed medications when they are still benefiting from
them or not providing food and fluids as needed when they patient is still
benefiting from them. We have received many calls from families who tell us the
hospice falsely accused them of being a threat to their own loved one and called
APS when they voiced their objections to the death-protocols being implemented
at the hospice. So we have those who truly care about the patient being accused
of being a threat, and those who hasten death in charge of the agency entrusted
to care for the patient!"
Euthanasia Society and
Hospice
Many
supporters of the sanctity of life simply do not know how deep this all goes and
how successful the heirs of the original Euthanasia Society of America have been
in our nation. They do not know how the Euthanasia Society is connected
with the largest segment of the hospice industry in America, and when
some have finally understood it, they have been shocked. Most of those who
affirm the sanctity of life view hospice as the rightful alternative to
euthanasia and assisted suicide. Sadly, this is becoming a rarity.
The largest
hospice organization in our nation is the successor organization to the
Euthanasia Society of America. According to the most prominent hospice leaders
in the world, many hospices in the United States today have no reservations
about hastening death through "terminal sedation," or "palliative sedation." Federal
regulations governing hospice are far fewer in number than those protecting
patients in nursing homes or hospitals, or that state agencies inspect hospices
less frequently than nursing homes or hospitals. Some hospices may go years
without being inspected at all. Because of the HIPAA privacy regulations, nobody interested in researching
what is actually going on in hospice can get access to the data, so hospices
that have an agenda can act without any outside interference or
supervision.
Unlike Dame
Cicely Saunders, a majority of leaders at the top of today's hospice certainly
look nothing like the sanctity-of-life hospice Dr. Saunders founded, yet they
pretend to be. They are what we call utilitarians, interested in the profits,
and expansion of their influence and business. The leaders at the top of the National Hospice & Palliative
Care Organization ("NHPCO") are the Euthanasia Society of America's heirs
and benefactors philosophically. The NHPCO is legally and corporately the final
successor organization of the Euthanasia Society in the very strictest sense of
the terms.
The Euthanasia
Society of America successors, especially in hospice, are now proceeding with
their plan to implement stealth euthanasia for citizens whose "quality of life"
is deemed "unworthy of life." The elderly and severely disabled are the targets,
which feeds right into Obama Care. They don't and won't have to be the "very"
elderly or "very" disabled. With Obama Care it will be the "not-so-elderly"
(even 60 years old) or disabled, being placed in hospice and dying shortly
thereafter, even though they had no terminal illness at all. Others have warned about these developments:
"In an era
of cost control and managed care, patients with lingering illnesses may be
branded an economic liability, and decisions to encourage death can be driven by
cost. As Acting U.S. Solicitor General Walter Dellinger warned in urging the
Supreme Court to uphold laws against assisted suicide: "The least costly
treatment for any illness is lethal medication."
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Here is the
succession of name changes the Euthanasia Society of America has gone through.
It is from Ron Panzer's book, "Stealth Euthanasia, Health Care Tyranny in
America."
Several people
who work with the elderly and dying have contacted me with first hand stories of
what they've seen with hospice care. Others have been family members who have
witnessed the lack-of-care in nursing homes and hospitals, as well as the
euthanasia tactics of many hospice care givers. Still, some have been treated to
wonderful care, the sanctity-of-life treatment Dame Cicely Saunders wanted for
all of us who will eventually face death.
In Part 6,
we'll look at the origin of "Living Wills," the changes to Medicare/Medicaid,
and the non-profit and for-profit Hospice organizations and salaries.
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