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Dateline: March 25, 2008 ... Palmdale, CA
Contact: Suzanne Milano, Assistant to T. L. Kittle
Phone: (323) 843-4200
Fax: (323) 375-0137
Email: management@metalunagroup.com
Web Address: www.awardthemilitary.org
PALMDALE, CA - March 25, 2008 -This is an example of another news
article, in a respected outlet (Yahoo), presenting the argument that
denying people medical care who clinically need it is a good idea.
(I´m not saying Yahoo agrees with this philosophy, but it´s
disgusting to see this argument being presented by ´credible´ members
of the medical profession resulting in an article in a respected news
outlet.)
This time, they´re going after whether or not people dying of
Alzheimer´s should be treated with antibiotics or not even if they
have an infection. This is particularly horrifying, because Alzheimer
patients can't defend themselves the same way 'normal' people can, and
some of these patients probably can't defend themselves at all.
("They", I´m usually generally to refer to *anyone* who *ever* makes
the argument that it´s acceptable to deny someone access to medical care.)
I don´t know how *anyone* who calls themself a medical professional
can even consider for a moment whether or not they should give a
patient all the best medical treatment they have access to, **unless**
the patient him or herself has stated and written down and signed
otherwise. It is their responsibility, their oath, and their contract
with God to give someone another day, another moment, if it is at all
possible.
The answer to curbing drug resistant bacteria is not in denying
treatment to those who need it. The answer is that we need to develop
better antibiotics, get ahead of the game. If the drug companies won´t
do it (because they make so much more money on drugs we have to take
for years, versus ten-fourteen days once in awhile), then we as a
society should allocate resources to develop new drugs in order to
make the development of new antibiotics happen.
It´s rotten to the core that anyone would even *consider* denying
people access to medical care as a ´solution´ to a problem, even to
patients who, "…failed to recognize loved ones, had stopped speaking,
were unable to walk or feed themselves and were incontinent." (Quoted
directly from the article below.) Denying a human being access to
medical care when they need it goes against *everything* the practice
of medicine is supposed to be about. I just don't know how someone
could know someone is suffering, have the tools within reach to relieve
that suffering (the antibiotics), then walk on by, because of what, it's
for 'the greater good'??? (which is basically what they're arguing).
Bruce Johnson, as quoted in the yahoo article below (a bioethicist with
the Hastings Center, a research institute on medical ethics), "But the
extra time you have bought them by that rescue is not beneficial."
It is not up to anyone other than the suffering him or herself or
their loved ones to judge what makes life beneficial and what does
not; it isn´t the medical professional´s role to determine who should
receive care and who should not. It is the medical professional´s
responsibility to save their fellow man to the fullest extent made
possible by technological advances, unconditionally.
It´s amazing how much we need to turn around in this country in
regard to the medical industry, and it begins right here, with the
philosophy of the industry itself. Like the Holocaust, most evil
throughout time has had some kind of philosophy justifying its
existence; it´s time to decode any philosophy that encourages or
promotes denying someone access to medical care, including, "they
can´t afford to pay", or "this test/drug/procedure is ´experimental´
and therefore we won´t authorize it".
I feel very fortunate to have had a number of physicians who have
saved my life, a number of times at this point and I feel very blessed
to live in the 21st century with all the medical tools we have to help
us. The problem is that there are too many of our fellow man who don't
have access to these medical tools when they need them, some of
whom I've met throughout the hospital grounds or spoke to their loved
ones with haunting stories to tell.
There is nothing acceptable about allowing a human being to suffer
when the medical tools are available to relieve that suffering and
philosophies like 'he's close to death anyway so just let him die',
only fosters further denial of care already rampant throughout the
medical community. And anyone who argues otherwise is endorsing a
cruelty on par with the Holocaust.
T. L. Kittle suffers with a chronic illness in the Los Angeles area,
gratefully under the care of a number of extraordinary physicians.
Kittle is currently in the process of establishing a non-profit
specifically designed to address concerns regarding lack of access to
care as well as lack of physician control over medical care. For more
information on this, please visit:
http://news.yahoo.com/s/ap/20080226/ap_on_he_me/dementia_antibiotics
Study Suggests Antibiotics Are Overused
By CARLA K. JOHNSON, Associated Press Writer 1 hour, 52 minutes ago
CHICAGO - A woman dying of Alzheimer´s has a fever. Should she be
given antibiotics? Many people would say yes. But a provocative new
study suggests that antibiotics are overused in people dying of
dementia diseases and should be considered more carefully because of
the growing problem of drug-resistant superbugs.
The study raises ethical questions about when it´s acceptable to
withhold perhaps futile treatment and let people die, and whether
public health issues should ever be considered.
"Advanced dementia is a terminal illness," said study co-author Dr.
Susan Mitchell, a senior scientist with the Harvard-affiliated Hebrew
Senior Life Institute for Aging Research in Boston. "If we substituted
´end-stage cancer´ for ´advanced dementia,´ I don´t think people would
have any problem understanding this."
Many experts, including the Alzheimer´s Association, consider
Alzheimer´s and other dementias to be fatal brain diseases. Patients
die of infections such as pneumonia and other complications, but the
underlying cause is damage to brain cells.
In the study, more than 200 people with advanced dementia from Boston-
area nursing homes were followed for 18 months or until their deaths.
Almost half died during that time. All the patients failed to
recognize loved ones, had stopped speaking, were unable to walk or
feed themselves and were incontinent.
"They were at what anyone would consider the very final stage,"
Mitchell said.
Researchers reviewed medical records to see what kind of care they
were given and found that 42 percent received antibiotics — many
intravenously — within two weeks of their deaths. The closer they were
to death, the more likely they were to receive antibiotics.
The study appears in Monday´s Archives of Internal Medicine.
Antibiotic overuse contributes to the rise of superbugs, so experts
have been calling on doctors to curb the liberal prescribing of
antibiotics in many types of patients, including children with
earaches and adults with sore throats.
Nursing homes often harbor drug-resistant bacteria, prior studies have
shown, and residents can spread dangerous infections when they are
admitted to hospitals.
Dr. Daniel Brauner, a geriatrician and ethicist at the University of
Chicago Medical Center who was not involved in the study, said
cautious use of antibiotics in nursing homes would require doctors to
more closely monitor residents.
"But the standard of care (in nursing homes) is for doctors to see
residents once a month, or once every two months," Brauner said. "I´m
sure a lot of these antibiotics were prescribed over the telephone."
Doctors should discuss antibiotics with family, just as they would
discuss placing a feeding tube, Mitchell said. None of the residents
in the study who received antibiotics had living wills spelling out
their wishes on antibiotic treatment, she said.
If the family´s goal is to keep their loved one comfortable, rather
than to prolong life, alternatives such as oxygen and Tylenol can
help, she said.
Giving antibiotics is sometimes appropriate for such patients, she
acknowledged.
"Maybe it´s important for the family for the patient to live two weeks
longer, or if they have a bad pneumonia and they´re suffering and
they´re coughing," she said.
An accompanying editorial in the journal cautions that public policy
limiting antibiotics to patients with advanced dementia would be
"ethically untenable." But the editorial calls on doctors to consider
the public health ramifications when prescribing antibiotics to such
patients.
Other experts disagreed.
"Until that decision is made that death is imminent, there´s always
hope," said Dr. Eric Tangalos, a geriatrician at Mayo Clinic in
Rochester, Minn., who was not involved in the study. "People do
recover from those infections."
Once called "the old man´s friend," pneumonia can be an acceptable end
when a patient´s quality of life is extremely low and everyone agrees
the patient would want a dignified death, said another expert not
involved in the study.
"You might rescue the patient from life-threatening pneumonia and they
live a few days, weeks or even months longer," said Bruce Jennings, a
bioethicist with the Hastings Center, a research institute on medical
ethics. "But the extra time you have bought them by that rescue is not
beneficial."
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