10:34pm May 31, 2014

“I work in an ICU in New York. The scenario described here is the standard practice at my hospital. In fact, the palliative care doctor not only tries to talk patients into dying; she is just one member of an extensive, unofficial tag-team that includes almost every nurse who cares for the ICU patient. These workers file through the patient’s room around the clock, repeating the same, dire litanies of scary predictions in the effort to coax the patient to give up and request a DNR. If the patient is sedated or unconscious for other reasons, the nurses and doctors focus their coercive behavior on the family. It doesn’t matter if the family or the patient requests a DNR–as long as it gets requested, the patient can be moved out of the ICU and allowed to die in a cheaper room. Meanwhile, whichever nurse finally gets the family or patient to “make a decision” brags about it, and is respected by the other ICU nurses as a hero (note: if a patient makes a decision to stay alive and continue being treated, the nurses do not consider this “a decision.” As long as a patient or family keeps deciding to keep the patient alive, the nurses and doctors keep pressing them to “make a decision.”) Meanwhile, the palliative care doctor is cherished and loved by the ICU staff for her ability to sweet-talk almost any family into ordering withdrawal of treatment so the patient “can go to Heaven.” A few weeks after the palliative care doctor began her practice at my hospital, the CEO mentioned her in a memo to all of the staff, thanking her for helping to shorten the average length of time patients were in the ICU and in the hospital. “Length of Stay” is a central measure of a hospital’s potential to make or lose money. The shorter the average patient’s Length of Stay, the better it is for the budget.”

Comment on “Bill’s Story“ on Not Dead Yet (via gotta-block-em-all)

Something to keep in mind if you’re thinking about the “right to die.”

In theory, it sounds very high-minded.  In practice it will not be a free choice. People will be coerced to “freely” die. And as this sort of thing is hard to catch, this sort of coercion will be legal.

(via neurodiversitysci)

I’ve heard of this from other ICU nurses across the country.  It’s absolutely real.  And to some extent this is what I faced when people were busy trying to convince me not to get a feeding tube – they knew I needed one, knew I’d die without one, but just wanted me out of their hospital even if that meant dying.

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