DEATH & MEDICINE. Late modern societies’ frontline in the war against death. MEDICINE TAKES CONTROL. Reflecting on the successes of the 20 th century Medicine inherits from religion the cultural responsibility to oversee final passage Death prevention as the primary goal of medicine
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Late modern societies’ frontline in the war against death
Franz Glaubacker, “The Physician” (1923)
In 1163, the Council of Tours banned the clergy from practicing surgery.
The shift in control from clergy to physician can be argued to have occurred in 1879, when it became mandatory that a doctor certify death before a death certificate could be issued.
Now that fewer people, especially those in the Western, believe that life is a transitional phase leading to immortality, they are left with nothing after death to believe in. So their faith is placed in technology and physicians who, ironically, have become decreasingly equipped to deal with patients as humans.
The state protected professional titles and markets while, in turn, the professions undertook the provision of welfare state services for citizens.
So, why haven't the media picked up on it?
Here's the deal. Researchers at the University of Alberta in Edmonton, Canada found a cheap and easy to produce drug that kills almost all cancers. The drug is dichloroacetate, and since it is already used to treat metabolic disorders, we know it should be no problem to use it for other purposes.
Doesn't this sound like the kind of news you see on the front page of every paper?
The drug also has no patent, which means it could be produced for bargain basement prices in comparison to what drug companies research and develop.
Scientists tested DCA on human cells cultured outside the body where it killed lung, breast and brain cancer cells, but left healthy cells alone. Rats plump with tumors shrank when they were fed water supplemented with DCA.
In November 2007, two research teams reported making ordinary human skin cells take on the chameleon-like powers of embryonic stem cells. The "direct reprogramming" technique avoids the swarm of ethical, political and practical obstacles that have stymied attempts to produce human stem cells by cloning embryos.
The biotechnology company Tengion has since 1999 been selling new bladders made out of the customer’s own cells. From biopsy to surgery, the process takes six to eight weeks.
There remains in the medical arts the Cartesian model of man, which only recently has been challenged by more holistic conceptions.
In 1926, Fritz Kahn illustrated man as a working factory in his famous poster, Man as Industrial Palace. Tiny guys in each body system perform their own specific job. A camera man controls the eyes, groups of thinkers sit up top, and the guys at the bottom handle the dirty work.
Contender for the 2010 Oscar for Best Animated Short Film: “The Lady and the Reaper” (Spanish)
Chances that a U.S. adult does not want to live to be 120 under any circumstances: 2 in 3
--Harper’s Index, Jan. 2003; ABC News (N.Y.C.)
In 2008, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives - that's more than the budget of the Department of Homeland Security or the Department of Education.
--CBS “60 Minutes.” “Cost of Dying” (Nov. 22, 2009)
A study of nursing home patients, by Dr. Susan Mitchell of Harvard and the Hebrew Rehabilitation Home for the Aged, found that those with end-stage Alzheimer's received more aggressive medical treatment — including feeding tubes, intravenous fluids and antibiotics and hospitalizations — than cancer patients at the end of their lives.
Thirty-four percent of US nursing home patients who suffer from Alzheimer's disease and other forms of dementia receive their food through a stomach tube, even though the practice is of dubious medical value, according to a study published in the Journal of the American Medical Association.
“Effective at the beginning of October, Arizona stopped financing certain transplant operations under the state’s version of Medicaid. Many doctors say the decision amounts to a death sentence for some low-income patients, …”
Apple’s Steve Jobs had a liver transplant in 2009. The billionaire’s story became a parable of class privilege and the inequities of the nation's transplant system. Jobs relocated from his home in California to Tennessee, where there is much less competition for vital organs.
Avastin, which costs about $100,000 a year, was in 2008 one of the most popular anti-cancer drugs in the world. Studies showed that it extends life by only a few months.
In 2008 the city council of Salford, Lancashire, UK printed these wallet "right-to-die" cards. They're freely available in pubs, banks, hospitals, libraries, and other public places. They're sort of like a living will combined with an organ donor card. If you don't have the mental capacity to tell doctors how far they should go to save your life, this card lets them know you've already planned ahead for just such a situation.
Though most euthanasia cases involve the elderly, it is interesting to note how often the right-to-die campaign has been dramatized in the cases of brain-damaged young women: Karen Ann Quinlan (1975-1985), Nancy Cruzan (1983-1990), and Terri Schiavo (1990-2003 ).
Unlike the young women who had become the poster children of the right-to-die movement, in the Fall of 2009 the focus shifted to a 76-year-old retired truck driver from Billings, Montana. Now, in death, Mr. Baxter could make Montana the first state in the country to declare that medical aid in dying is a protected right under a state constitution. His claim is that a doctor’s refusal to help him die violated his rights under Montana’s Constitution
According to a Pew 2005 survey, 35% said they've given their end-of-life medical wishes a great deal of thought and 36% said they've given it some thought. Only 27% said they have put their wishes in writing and 29% said they have a living will.
The National Hospice and Palliative Care Organization reported that 1.3 million patients received care from one of the nation’s 4,500 hospice providers in 2006. This represents a steady increase of more than 100,000 patients than the previous year. Approximately 39 percent of all deaths in the US were under the care of a hospice program in 2008.
Researchers at the Dana-Farber Cancer Institute in Boston interviewed 603 patients with advanced cancer. They asked the patients, who had about six months left to live, whether their doctors had discussed their wishes for end-of-life care. The majority — 69 percent — said those conversations had not taken place. And in their last weeks of life, those patients who had talked with their doctors wound up with medical bills that were on average 36 percent lower — $1,876 compared to $2,917 — than those of patients who did not have end-of-life conversations with their doctors.
A feeding tube was removed from Terri Schiavo, the severely brain-damaged Florida woman, after her husband won a court ruling allowing her to die, despite her parents' plea to continue life support, October 15, 2003. She had been in a vegetative state since 1990, when her heart stopped because of what doctors said may have been a chemical imbalance. Photo by Reuters
When a person has a disease that cannot be cured, do you think that doctors should be allowed by law to end the patient’s life by some painless means if the patient and his family request it?
Do you believe that one has the right to end own life if he or she has an incurable disease?
Britain's most notorious serial killer, former family doctor Harold Shipman, has been found hanging in his prison cell after an apparent suicide.
Shipman. known as “Dr. Death,” was serving life imprisonment for murdering 15 elderly women with lethal doses of heroin. A subsequent judicial inquiry found him responsible for another 215 deaths over a 24-year medical career in Britain's north. A further 45 patients died in “suspicious” ways.
"A doctor can bury his mistakes, but an architect can only advise his clients to plant vines." - Frank Lloyd Wright
According to the most respected medical publication in the world, The Journal of the American Medical Association,the third leading cause of death in the US after heart disease and cancer is doctor-induced or iatrogenic.
--David Phillips, “Doctors: the Third Leading Cause of Death in the US?”
"The United States loses more American lives to patient safety incidents every six months than it did in the entire Vietnam war. This also equates to three fully loaded jumbo jets crashing every other day for the last five years."
--The 2004 HealthGrades Patient Safety in American Hospitals study
In Europe, where hospital surveys have been conducted, Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year caused by some of the most troublesome hospital-acquired infections, according to a report released in September 2009 by health authorities there.
Cell death is a part of life; apoptosis
Somatic death: heart and breathing stops and anoxia (tissues become oxygen deprived) sets in. “Point of no return.”
Clinical death: heart and lungs stop but vital organs not yet damaged (~ 6 minutes)
Brain-stem death: begins about 2-3 minutes after somatic cessation; potentially stoppable and reversible; has replaced somatic death as definition of death
The first successful organ transplant took place on Dec. 23, 1954, when Richard Herrick received a kidney from his healthy identical twin brother, Ronald. Richard survived for eight years until the original kidney disease struck again.
Over six years, a UCLA medical school official sold 496 cadavers for $704,600, according to invoices that provide the first evidence of the scope of the scandal in the school's body donor program.
A 2008 investigative story of the Los Angeles Times reported on how four members of the yakuza, the Japanese mafia, received liver transplants at the UCLA medical center between 2000 and 2004. Two of the four men later gave a $100,000 contribution to the medical center.
A Peruvian gang operating out of Huánuco allegedly killed people and drained fat from their corpses. The amber liquid, worth up to £36,000 a gallon, was exported to Europe as anti-wrinkle cream.
Republican former South Dakota lieutenant governor and potential Senate candidate Steve Kirby made his fortune running a scandal-wracked business that harvested collagen from corpses donated for medical research and using it for cosmetic products and penis-enlargements.
Kirby’s niche industry had proven financially lucrative. Collagenesis could take the skin off one cadaver and convert it into $36,000 of a gel injected to smooth wrinkles and inflate lips. Its lone competitor, a firm called LifeCell, estimated its potential revenues from such skin at $200 million a year — 10 times what it would earn if it focused on life-saving burn applications instead of cosmetic surgery.
The tsunami that hit South Asia in 2004 left many destitute, including thousands Indians. As many as 150 women near Chennai are known to have sold one of their kidneys for a large sum of money.
Farhat Moazam of the Sindh Institute of Urology and Transplantation in Karachi, Pakistan, said "There are villages … in the poorer parts of Pakistan where as many as 40 to 50 percent of the population of the village we know only has one kidney.“
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