[Link] How doctors die
I’m reposting this from HN’s front page, because it brought up a non-cached thought on cryonics:
The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” [...] I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital.
In short, end-of-life medical care is often pointless, painful and costly; doctors and ER personnel know this so well that they go to great lengths to ensure it doesn’t happen to them.
It seems as if our systems and conventions around end of life are designed to not let people have a say in how they spend their final moments, even when letting them have their way would result in significant savings (note the dollar figures quoted above). I’ve already speculated on why that might be, but I keep seeing that turn up in unexpected ways.
I suspect that this is the bigger obstacle to cryonics, not so much e.g. the lack of scientific proof. “Freeze me cheaply instead of spending insane amounts of money on brutal attempts at keeping me alive” sounds like a sensible thing to tattoo on your chest, but the evidence suggests that it wouldn’t be honored any more than “DNR” tattoos.
Minor quibble, just saying something like “Promise me if you find me like this that you’ll kill me.” does not constitute ‘great lengths’. Depending on tone and context it may not even be meant seriously, and if it is its still not a lot of effort to put towards to goal of not ending up in intensive care.
At least we know croynics promoters tend to take their own medicine.
Would you describe doctors as “medicine promoters”?
You’re asking someone who reads a lot of Robin Hanson.
The success rate for out-of-hospital cardiac arrest (measured as survival until discharge) is about 10% in the US, much higher than the quoted person’s experience of <1%. (I’m not sure if this figure counts all arrests or only arrests that make it to the ER; since survival is lower for arrests that don’t make it to the, 10% may be an underestimate depending on what’s counted and what’s not).
I was told, when I learned CPR, that accidental causes of heart stoppage, electric shock and drowning for examples, had a good recovery rate with CPR, but that was decades ago and they never presented any evidence I could check.
Learning CPR within the past year, the 10% estimate sounds similar to what i was taught, although we were also taught that the main difference is the length of time until CPR and defibrillation are applied. I can’t find any of those outcome numbers in my classroom texts, so here’s what Wikipedia summarizes: link. One or Two percent is about right, when there’s no bystander nearby to give CPR or (especially) defibrillate. With immediate access to medical treatment survival to discharge can be 20 or 30%. Regardless, it is true that anybody who goes into cardiac arrest is more likely to die than to survive. The citations on Wikipedia point to multiple countries so i don’t know how much any numbers may apply to various regions.
The author of “How Doctors Die” states: “I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one… walked out of the hospital.” That does seem unusually low.
Only if you assume “didn’t walk out of the hospital” means “didn’t survive until discharge”. I assumed he meant that most of those people never fully recovered, left in a wheelchair, or spent the rest of their lives in a nursing home.
That is how I read it too but it is unnecessarily vague. Also, many conditions of being weak or in a wheelchair is preferable to death in my opinion.
I wonder if it’s possible to get cryonics as a form of euthanasia. I would suspect that it would be easier to wake you up if you were alive when you were frozen.
This would be an excellent thing to be able to do, especially if you were slowly dying of something painful or something brain-erasing like Alzheimer’s. Unfortunately American society likely does not allow people the right to do this currently.
Does anyone know how US-centric this is, or whether it also applies in places with more liberal views on euthanasia?
I think this can be extended at least to Germany and probably also to more European countries.
They are much liberal on those issues in the Netherlands. They allow euthanasia for people terminally ill. But I don’t know if it goes as far as allowing cryonics.
Euthanasia by cryonics, or euthanasia in general? I’m pretty certain that euthanasia isn’t illegal in parts of the US, and if you’re careful you can make it count as suicide.
If people started having themselves euthanized by cryonics I’m pretty sure there would be efforts to outlaw this even in states where euthanasia is legal. They would be “concerned” about a Cryonics company selling this “solution” to people who are healthier than would normally opt for the straight-up death kind of suicide.
By cryonics, I understood.
So, why would specific methods of euthanasia be illegal?
A very good question. It could be that specific “humane” methods are mandated, or there might be specific criteria as to circumstance which might proscribe applying it to some situations that might warrant it (perhaps there are requirements of significant, imminent threat that early or middle stages of a degenerative cognitive ailment fail to meet, while one might prefer to be preserved while still more functional depending just how one judges the odds).
I am not sure what the actual legal landscape looks like.
Not upvoted because it the post title uses the article title when the article title was a poor description of the article content. Editors/authors choose titles that poorly match article content for many reasons, most prominent of which is sensationalism, so links listed here should do better and accurately describe articles’ content.
Than you for the link. See also many Overcoming Bias Robin Hanson posts on signaling.
Is it the same in France? Isn’t this part of the reason the US spends twice as much on health care as France?
AFAIK in France you can ask the doctors to stop trying to revive you, but not to actively kill you. But the law changes quite frequently so I’m not very sure of that.
Edit : I was also told that it’s not very uncommon for doctors to “overdose” terminal ill patients (especially those with terminal cancer) with morphine or other opiate derivative—they give a dose high enough to stop pain, even if it can lead to death. But I’m not sure how legal it is, nor exactly how common.
Hmm, I don’t know, to be honest.
If anything, I think that signing up for cryonics is considerably lower status than a personal refusal to be resuscitated. Refusal to be kept alive through extensive medical intervention at a low quality of life or with poor prospects for success is widely viewed as respectable, whereas supporting a policy of not attempting resuscitation for others is widely regarded as immoral.
Learning about this (several years ago) has caused me grievous emotional harm. I feel like I am surrounded by people who would happily torture me at no direct increase in utility to themselves and that it is illegal not to mention considered insane for me to protest this. In my mind it is summarized as “I am afraid of death, therefore I will torture people who are dying.”
Has anyone else had this response to learning about how medicine currently works?
I wish the article had explained in more detail what is so awful about these medical interventions. What kind of misery, caused specifically by what treatments.