Thursday, December 10, 2015

Death panel update

NotDeadYet (a disability rights organization) gives the background on a "futile care" case in Texas:

(in Texas a hospital panel can remove"futile care" for anyone. Family cannot stop them albeit they are allowed to transfer the person to another facility).

Unlike most cases, this person is not unconscious, and is not elderly: He just is dying, on a breathing machine, and lacks health insurance. There is a cellphone video where he was asked if he wants to live, and he motioned "yes".

ABC story here.

It's not clear if the pancreatic mass is cancer or a severe case of pancreatitis, or maybe a pancreatic pseudocyst. Privacy law means the hospital won't release the information and the family is too vague to let us figure it out.

Respiratory failure requiring a respirator is not unknown in cases of severe pancreatitis, and pancreatitis can be caused by gall stones, alcoholism, or some medicines such as Depakote.

I had a fellow doc who died of pancreatitis related to gallstone surgery and it was a horror story. He died after a month of every complication in the book....

the pancreatitis can release digestive enzymes into the abodomen, and eat holes in your intestines and blood vessels. The metabolic problems (including high blood sugar, since the pancreas also is the source of insulin) make the care of such patients even more complicated.

So is this man's care "futile"? Well, probably, but in a young person one could argue that this is a case where "never say no" might apply.

But one suspects the huge cost might have something to do with it.


update: NHS failed to investigate unexpected deaths of some patients.

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