Sticky ethical question

[Microbiodude]

If that is the case, I would direct that all these patients receive treatment immediately, there would be a political and financial crisis, the citizens would agree with this, heads might role including mine, if the Cabinet tried to reverse me, I would go to Court and this debate would be read by all citizens every day until it was resolved quickly.

 

lol, that's very NDP of you. As for the citizens would agree with this...well how many times has the NDP won a federal election?

 

I was really trying to get the answer to two questions from you:

 

1) How much is too much in terms of funding?

2) Which side would you take if you had to choose one?

 

I think the answer to the the first question was there is no limit to the amount of resources that can be devoted to a patient in need.

 

As for the second question, I don't think you would choose a side but would argue that both sides should get what they need.

 

I think these are the same stances I would take if resources were unlimited which of course they are not. But that pretty much concludes this discussion for me.

[NewfieMike]

lol, that's very NDP of you. As for the citizens would agree with this...well how many times has the NDP won a federal election?

 

I was really trying to get the answer to two questions from you:

 

1) How much is too much in terms of funding?

2) Which side would you take if you had to choose one?

 

I think the answer to the the first question was there is no limit to the amount of resources that can be devoted to a patient in need.

 

As for the second question, I don't think you would choose a side but would argue that both sides should get what they need.

 

I think these are the same stances I would take if resources were unlimited which of course they are not. But that pretty much concludes this discussion for me.

 

 

this same conclusion was already established at about page 3 of this **** storm

[Microbiodude]

perhaps, but it didn't really feel like a conclusion for me. So thank-you Future_doc for humoring me with this debate. It helped me review the charter of rights and gave some interesting case studies to examine further.

[future_doc]

Done then

[Rayven]

I am sure you noticed that each post was in a different time frame and covered differing topics. Therefore, it is reasonable that they should not be placed together in one post, however, I am prepared to leave it to a poll decision, lol.

 

This post is entirely unrelated to my post immediately above as a simple example.

It's common forum etiquette not to double (or in your case sextuple) post. The timing between most of your posts are only a few minutes apart (~5-10 minutes) which would suggest you posted one right after the other. =.=

 

If that is the case, I would direct that all these patients receive treatment immediately, there would be a political and financial crisis, the citizens would agree with this, heads might role including mine, if the Cabinet tried to reverse me, I would go to Court and this debate would be read by all citizens every day until it was resolved quickly.

Ughhh.. you CAN'T treat ALL patients! That's why this is a QUESTION. This is why there's a DEBATE. Ughhhhhhhhhhhhhhhhhhhhhhh!

 

lol, that's very NDP of you. As for the citizens would agree with this...well how many times has the NDP won a federal election?

 

I was really trying to get the answer to two questions from you:

 

1) How much is too much in terms of funding?

2) Which side would you take if you had to choose one?

 

I think the answer to the the first question was there is no limit to the amount of resources that can be devoted to a patient in need.

 

As for the second question, I don't think you would choose a side but would argue that both sides should get what they need.

 

I think these are the same stances I would take if resources were unlimited which of course they are not. But that pretty much concludes this discussion for me.

But if we had infinite resources then we wouldn't have be here in the first place... =_____________=

[Microbiodude]

...until the next poster...lol

[future_doc]

It's common forum etiquette not to double (or in your case sextuple) post. The timing between most of your posts are only a few minutes apart (~5-10 minutes) which would suggest you posted one right after the other. =.=

 

Only the first two

 

 

Ughhh.. you CAN'T treat ALL patients!

 

Have you ever heard of Superwoman:p , sister of Superman.

 

 

But if we had infinite resources then we wouldn't have be here in the first place... =_____________=

 

Canada is the landof abundance, abundant natural resources, this means human resources and money.

 

Sorry for the delay in my reply.

[Rayven]

LOL @ this. This is rather hilarious. The question still goes unanswered and yet you're both walking away as if some meaningful conclusion was found.

 

Person 1: "If we only have $30 to spend on dinner.. should I order the lobster ($24.00) or the steak ($21.00)?"

 

Person 2: "Welllll, if I won the lottery I'd buy both."

 

Person 1: "Okay lets do that then!"

 

Headacheeeeeeeeeeeeeeeeeeee... >____<!!

 

Only the first two

Try like most of them... >.>

 

Have you ever heard of Superwoman:p , sister of Superman.

No, I haven't actually. I didn't think Superman had a sister.

 

But seriously... you're avoiding the fact that you can't treat all patients.

 

Canada is the landof abundance, abundant natural resources, this means human resources and money.

 

Sorry for the delay in my reply.

Abundant is not the same as unlimited resources. You should know that. That's why we have wait times to see a specialist or get an MRI, why we can't hire more teachers to lower classroom sizes, why people are always going on strike because they don't feel like they're getting paid enough, etc.

 

Just because I have a whopping $30 to spend on dinner (which is a lot for a student like me) does not mean I can get everything and anything I want.

 

I wish you'd just either answer the questions directly instead of deflecting or just admit that you don't have an answer and move on. This thread is getting to be almost 20 pages long just because you keep side-stepping and avoiding the question.

[future_doc]

...until the next poster...lol

 

It ain't over until the (politically incorrect;) ) sings, lol.

[future_doc]

The question still goes unanswered and yet you're both walking away as if some meaningful conclusion was found.

 

This has been and remains a tremendous learning experience. I have learned much about the Canadian Charter and have reviewed websites with worthwhile information. Moreover, you will become a member of my Cabinet in the future. Many answers in life remain unanswered. I do know what I would do and informed you.

 

Moreover, one us has been accepted into med school. We are just growing our teeth so to speak. And the upcoming MCAT is our first hurdle.

[Microbiodude]

LOL @ this. This is rather hilarious. The question still goes unanswered and yet you're both walking away as if some meaningful conclusion was found.

 

Person 1: "If we only have $30 to spend on dinner.. should I order the lobster ($24.00) or the steak ($21.00)?"

 

Person 2: "Welllll, if I won the lottery I'd buy both."

 

Person 1: "Okay lets do that then!"

 

Headacheeeeeeeeeeeeeeeeeeee... >____<!!

 

lol which is why I decided to just conclude it for me. Future_doc is not going to take a side but treat both at the cost of raising national debt. Which is actually an option that can be taken though it may not be the best option (just look south of the border to see what happens when you have rising debt) but is still an option.

[future_doc]

lol which is why I decided to just conclude it for me. Future_doc is not going to take a side but treat both at the cost of raising national debt. Which is actually an option that can be taken though it may not be the best option (just look south of the border to see what happens when you have rising debt) but is still an option.

 

 

I will likely be applying @ Queen's this cycle and perhaps, we will meet soon enough.

[future_doc]

LOL @ this. This is rather hilarious. The question still goes unanswered and yet you're both walking away as if some meaningful conclusion was found.

 

Person 1: "If we only have $30 to spend on dinner.. should I order the lobster ($24.00) or the steak ($21.00)?"

 

 

Person 2: "Welllll, I am vegan, no cruelty to animals please.

 

 

I didn't think Superman had a sister.

 

You have heard of Superwoman? And yes, they are brother and sister.

 

 

Abundant is not the same as unlimited resources. You should know that. That's why we have wait times to see a specialist or get an MRI....

 

The government can be forced to speed things up, politically and legally. It is not an issue of money.

[Mourning Cloak]

If you're interested in the answer:

 

http://www.lawrence.edu/dept/Bioethics/Appleton_Consensus.html

 

see part II #13

 

or Ch 11 of Beyond the Hippocratic Oath by Dossetor.

[LostLamb]

If you're interested in the answer:

 

http://www.lawrence.edu/dept/Bioethics/Appleton_Consensus.html

 

see part II #13

 

or Ch 11 of Beyond the Hippocratic Oath by Dossetor.

 

I think the individual from post 1 would actually fit under part III, not part II. And, of course, just as we have concluded in this thread (I think), there is no definitive answer. I have not checked out Dossetor but will at a later time.

 

"WEIGHING BENEFITS AND BURDENS

 

6. When patients lack a surrogate, little difficulty arises when the benefit-burden ratio clearly favors administration and continuation of life-prolonging treatment. When the benefit-burden ratio is less certain or reversed, a wide variety of mechanisms have been proposed to aid or to review the physician's decision making.[8]

 

7. The physician may appropriately withdraw or withhold life-prolonging treatment when, in the view of the informed surrogate and physician, continued treatment would lead to unacceptable burdens without sufficient compensating benefits. What counts as a benefit and a burden and the relative ratio between them depend on specific situational factors and, therefore, good decisions in this category of patients demand individual discretion. While these patients possess a vulnerability which makes them frequently subject to social discrimination and stigmatization, their interests are not protected by the elimination of decisional discretion. On the contrary, a trustworthy physician and the processes of appropriate audit are better means of protecting the interests of vulnerable patients

 

Note how the consensus is that if someone doesnt have a substitute decision maker of their own, then they could be SOL.

 

Additionally, the end decision must be made by a team of decision makers, not left solely at a physician's discretion.

 

It's a tough question, no doubt about it. As more and more children are brought up in their family's care, there will definitely be more and more demand on the system to provide for their needs. Keep in mind that as families take on the care of such individuals, they are undertaking a significant burden themselves--for instance, one parent may give up their career--and they are doing this at a huge savings to the taxpayer.

[Rayven]

It ain't over until the (politically incorrect ) sings, lol.

You mean until someone gives a real answer... >_>

 

This has been and remains a tremendous learning experience. I have learned much about the Canadian Charter and have reviewed websites with worthwhile information. Moreover, you will become a member of my Cabinet in the future. Many answers in life remain unanswered. I do know what I would do and informed you.

 

Moreover, one us has been accepted into med school. We are just growing our teeth so to speak. And the upcoming MCAT is our first hurdle.

There really isn't all that much to learn about the Canadian Charter unless you were going to amend it in some way... essentially, it protects our rights and freedoms from discrimination as long as we don't intrude or impose onto the rights and freedoms of others.

 

You don't know what you'd do. Otherwise I wouldn't be having a headache right now trying to explain to you that "treating everyone" isn't an option.

 

If you only had enough money to buy either a new fridge or a new washer saying that you're not a politician who deals with finances or that you're not the supreme court who has to make the really hard decisions is not a defense for you to somehow now be able to afford to buy BOTH the fridge and the washer. -.-

 

Seriously, right now a seat in "your" cabinet is becoming less and less appealing to me.

 

lol which is why I decided to just conclude it for me. Future_doc is not going to take a side but treat both at the cost of raising national debt. Which is actually an option that can be taken though it may not be the best option (just look south of the border to see what happens when you have rising debt) but is still an option.

Raising taxes only works so much in this country (see NDP) and letting us get more and more into the red with our national debt is also not an answer. Even the US dollar is beginning to lose faith. And unlike the US, Canada sadly does not have such a global dominance with our loonies and twoonies.

 

I just get this overwhelming feeling that future_doc isn't just avoiding directly answering anyyy questions or scenarios we've given but also answering really reeeally poorly.

 

Basically future_doc's answers have generally been:

 

Q: Do you think it's ethical that this one patient is taking $300,000/year away from potential helping and saving the lives of many more people?

A: I'd do everything in my power to save my patient. The other patients aren't my problem.

 

*The problem with this is that you're clearly avoiding the question. That $300,000/year has to come out of somewhere where it could've been used possibly for the "other" patients. Saying that it's not your problem isn't addressing the main point of this debate at all. We all know full well that a physician's job is to treat their patients but we're not asking that here.

 

Q: But lets assume that they are all your patients, what would you do?

A: I'd save them all and let the government or supreme court deal with the finances.

 

*Again, like above, there's no point in telling us what you'd do as a physician.

 

Q: If we only only had enough money to sustain either one patient or buy the hundred dialysis machines to save the one hundred renal patients what would you do?

A: I'd save them all by paying for the dialysis machines myself.

 

*The scenario was basically used to illustrate limited resources which you totally ignored by saying you'd just pay for it and thus introducing foreign resources. Even you have limited resources so saying that you'd pay for it is only good for so long.

 

Q: How much is too much for one patient?

A: I'd run for prime minister and jack up taxes.

 

*Completely avoided the question again and proposing a party run on the campaign platform of raising more and more taxes to pay for everything that comes to mind that you can't make the hard decisions for is a party that is not likely to get elected into office.

 

Q: If we only have $30 to spend on dinner.. should I order the lobster ($24.00) or the steak ($21.00)?

A: Welllll, I am vegan, no cruelty to animals please.

 

*Sigh...

 

Really if you don't have an answer then just admit that you don't. Having no answer sometimes is better than giving bad ones.

 

It is a tough decision and personally I'm finding myself more aligned with the snippet LostLamb just posted.

[future_doc]

In USA, the answer is simple. Hospitals are required to accept and treat emergency patients, regardless of their ability to pay. Otherwise, no ability to pay, get lost.

 

Luckily, we live in Canada where basic human rights are enshrined and where the government has undertaken universality of medical care, with the law providing that the government needs to perform their obligations. I admit that I am a student and not a physician, politician, economist or jurist. I intend to be a physician and to give my patients the best care and treatment without consideration to cost, unless there is an equally effective treatment at less cost. Rayven, depending upon my specialty and your potential future ailments, you may want to be one of my patients simply b/c you know I will leave no stone unturned to ensure you receive the best medical treatment then available. As the newly appointed Supreme Court Jusstice of the US Supreme Court said during the Hearings for her confirmation, I will not now decide on a future problem that will come before me. I vote for sanctity of life as coming before any other factor, no matter how compelling the argument.

[Microbiodude]

I don't think anyone is questioning the sanctity of life, but rather which life/ lives to save. If there was an innocent man who would be shot in Singapore and a train derailment in Moscow that will kill 100s and you could only stop one of those events from occuring. Which event would you stop? Not choosing means they both happen.

[future_doc]

The answer is easy, stop the derailment in Moscow.

 

My particular answer to any question is irrelevant, what is important is that we are all seriously considering the issues. Only tonite I was watching "60 Minutes" where recent advances have made possible hitherto locked-in persons, i.e., persons without the ability to communicate in any fashion, to be able to communicate their thoughts to others by BCI, brain computer interphase. Ther is one scientist previously incapable of any communication and living with a ventilator now able to communicate his thoughts. He sees letters, e.g., A, B, etc. and w hen he focuses on one particular letter it instantly appears in writing; each letter takes about 20 seconds but he can now write out his words asnd thoughts by thinking them o ne letter at a time. Another lady has had her brained literally connected to a computer, electrodes have been implanted into her cortex for 3 years now, the system is called braingate, and we are on the verge of opening a new world to those locked-in, those totally paralized or having lost multiple limbs, allowing them nmovement they never dreamed of. My point is that their quality of life is dramatically improving and about to improve and so the benefit vs. cost equation changes substantially in faovur of benefit. Accordingly, each life so long as alive has tremendous potential whether recoginzed or not today and we all need to fight for life and treatment. Yes, I know there are certain so-called financial realities that we should treat as obstacles only.

[Rayven]

You have heard of Superwoman? And yes, they are brother and sister.

I don't think so. Source please.

 

"Abundant is not the same as unlimited resources. You should know that. That's why we have wait times to see a specialist or get an MRI...."

 

The government can be forced to speed things up, politically and legally. It is not an issue of money.

Oh okay. So basically you're saying the health care system wait times in Canada (the ones that pundits in the US keep taking shots at us for) could easily be sped up by the government but for some unknown reason they just don't want to?

 

Interesting.

 

In USA, the answer is simple. Hospitals are required to accept and treat emergency patients, regardless of their ability to pay. Otherwise, no ability to pay, get lost.

 

Luckily, we live in Canada where basic human rights are enshrined and where the government has undertaken universality of medical care, with the law providing that the government needs to perform their obligations. I admit that I am a student and not a physician, politician, economist or jurist. I intend to be a physician and to give my patients the best care and treatment without consideration to cost, unless there is an equally effective treatment at less cost.

Againnnn... as a doctor, if a patient comes to you seeking treatment it's expected of you to give them the best treatment you can. I don't understand why you keep bringing this up as it has no bearing on this debate. It's obvious. This is like the 5th time you've brought this up...

 

What we're asking in regards to "cost" is if for example there are 100 patients that require dialysis machines but you've only got enough funding to either get the 100 dialysis machines (and save 100 lives) or would you use that funding instead to keep one patient alive (ie the $300,000/year patient in this scenario)? So what do you do if these 101 people are all your patients? Just telling them you're going to give them the best treatment possible is meaningless.

 

Rayven, depending upon my specialty and your potential future ailments, you may want to be one of my patients simply b/c you know I will leave no stone unturned to ensure you receive the best medical treatment then available.

I certainly hope no doctor out there would purposely leave any tests un-run that actually had a reasonable chance of affecting the outcome of my health. However, at the same time, "leaving no stone unturn" I hope does not mean you'd run every test under the sun. It's costly to the system and would cause even more wait times for other patients who might actually have a greater need for the tests.

 

As the newly appointed Supreme Court Jusstice of the US Supreme Court said during the Hearings for her confirmation, I will not now decide on a future problem that will come before me.

If you're referring to Sonia Sotomayor then that's a much different situation. I'd like you to post a link to her speech so I can get the context of where it's coming from. But in any case, a judge deals with cases as they are presented. They don't make the laws but instead they are only there to interpret them. It really is a bad example to draw upon because our debate is so much more than just interpreting the law. Each case is different but may share similar qualities. But not making a decision now we're in fact letting other people suffer and possibly even die because of lack of funding.

 

I vote for sanctity of life as coming before any other factor, no matter how compelling the argument.

Yes.. sanctity of life of your one patient over the sanctity of life of a hundred other people? You're way oversimplifying arguments by just saying that you're pro-life when it should be clear by now that we're dealing lives on both sides of the equation.

[avenir001]

avenir and The Law made their occasional contribution by adding to the light side on this thread.

 

However, somehow we avoided a hijacking.

 

law and i would like to believe we've matured a little bit over time

[future_doc]

I had thought you went to sleep early tonite Rayven.

 

Welcome back avenir, you make this thread lighter, which is necessary at times. We missed you here.

[NewfieMike]

@ Rayven and Microbiodude:

 

why are you wasting your time? Future_doc is obviously never going to answer your questions with realistic answers, so you're just wasting your time trying. This thread has turned into what happens when an unstoppable force meets and immovable object

[Rayven]

@ Rayven and Microbiodude:

 

why are you wasting your time? Future_doc is obviously never going to answer your questions with realistic answers, so you're just wasting your time trying. This thread has turned into what happens when an unstoppable force meets and immovable object

 

Yeah.. like a rock.

 

Just forget about it, future_doc. If you can't answer the questions with realistic answer then just don't. Just stop filibustering pleeeeeease.

[future_doc]

Just forget about it, future_doc.

 

I was in the process of a reply which I just deleted.