[Dixonary] OT: Dr. Kevorkian

[Judy Madnick]

From: waynescottmd (AT) earthlink (DOT) net

<< I would be glad to have someone
<< available to
<< set up a fatal drip for for hopeless patients, but it shouldn't be a
<< physician! We physicians should not be killers. . . that's not
<< what we were
<< trained for and what we should do for society. That's my
<< arrogant opinion.

Hope it's okay to respond to this comment (since I first mentioned Kevorkian).

You certainly have a right to your opinion, and I can see where assisted suicide is contrary to the original Hippocratic Oath -- as is abortion. And here comes the "but" (There's always a "but," isn't there?) more modern versions of the Oath avoid mentioning assisted suicide and abortion. It is my believe that individuals have a right to determine whether they wish to live or die, and that doctors who share that belief and who are the best judges of a person's health/pain status should be allowed to meet their needs without social or legal penalty. I wonder how much the Hippocratic Oath depended upon religious beliefs? Whatever the case, all I want is the personal choice.

JMO . . .

Judy Madnick
Jacksonville, FL

[Judy Madnick]

From: waynescottmd (AT) earthlink (DOT) net

<< I would be glad to have someone
<< available to
<< set up a fatal drip for for hopeless patients, but it shouldn't be a
<< physician! We physicians should not be killers. . . that's not
<< what we were
<< trained for and what we should do for society. That's my
<< arrogant opinion.

Hope it's okay to respond to this comment (since I first mentioned Kevorkian).

You certainly have a right to your opinion, and I can see where assisted suicide is contrary to the original Hippocratic Oath -- as is abortion. And here comes the "but" (There's always a "but," isn't there?) more modern versions of the Oath avoid mentioning assisted suicide and abortion. It is my believe that individuals have a right to determine whether they wish to live or die, and that doctors who share that belief and who are the best judges of a person's health/pain status should be allowed to meet their needs without social or legal penalty. I wonder how much the Hippocratic Oath depended upon religious beliefs? Whatever the case, all I want is the personal choice.

JMO . . .

Judy Madnick
Jacksonville, FL

[waynescottmd@earthlink.net]

You might or might not be interested to know that I never took the
"Hippocratic Oath." At our muedical school (USC) it was considered to be
antiquated and was not part of our graduation. I totally agree that there
should be available to suffering people the right to die. . . I just don't
think that a physician should do it. We're not trained or supposed to be
killers.

I've already said all of this, and I don't think I'm getting my point
across, so I'll give up. You may call me Kevorkian if you want to do so.


> [Original Message]
> From: Judy Madnick <jmadnick (AT) gmail (DOT) com>
> To: <Dixonary (AT) googlegroups (DOT) com>
> Date: 4/22/2008 10:58:02 AM
> Subject: [Dixonary] OT: Dr. Kevorkian
>
>
> From: waynescottmd (AT) earthlink (DOT) net
>
> << I would be glad to have someone
> << available to
> << set up a fatal drip for for hopeless patients, but it
shouldn't be a
> << physician! We physicians should not be killers. . .
that's not
> << what we were
> << trained for and what we should do for society. That's
my
> << arrogant opinion.
>
> Hope it's okay to respond to this comment (since I first mentioned
Kevorkian).
>
> You certainly have a right to your opinion, and I can see where assisted
suicide is contrary to the original Hippocratic Oath -- as is abortion. And
here comes the "but" (There's always a "but," isn't there?) more modern
versions of the Oath avoid mentioning assisted suicide and abortion. It is
my believe that individuals have a right to determine whether they wish to
live or die, and that doctors who share that belief and who are the best
judges of a person's health/pain status should be allowed to meet their
needs without social or legal penalty. I wonder how much the Hippocratic
Oath depended upon religious beliefs? Whatever the case, all I want is the
personal choice.
>
> JMO . . .
>
> Judy Madnick
> Jacksonville, FL
>
>

[Judy Madnick]

From: waynescottmd (AT) earthlink (DOT) net

<< I've already said all of this, and I don't think I'm getting my point
<< across, so I'll give up.

I do get the point that doctors are "not trained or supposed to be killers." But I would rather have a medical doctor assist me than someone who might not use appropriate medical methods and not achieve the desired result. So I'm looking at this from *my* point of view.

I suppose one might argue that "killers" is the wrong term. For example, if a patient is given morphine at increasing doses to control pain, even if those doses are going to eventually cause death, is that considered "assisted suicide"? I hope not. If someone is suffering and can be relieved of that suffering, I don't think of relieving pain and suffering as "killing."

I promise I won't call you when and if the time comes . . . <G> But, again, I do understand what you are saying, and you are certainly entitled to your opinion!

Judy

[waynescottmd@earthlink.net]

Judy, I think that we are closer to the same opinion in many ways. First, I
think that if a patient is in pain, it is not only permissible but
obligatory to do everything we can to alleviate the pain, including giving
as much morphine as is necessary even if it reaches fatal levels. When I
was an intern (58 years ago!) a 280 pound patient came into the emergency
room after dropping a 100# anvil on his foot and breaking almost every bone
in the foot. The usual dose of morphine is 1/8 to 1/3 grain, occasionally
up to 1/2 grain. I ordered 1 grain for him. The nurse refused to administer
that dose. I filled a syringe with 1 grain of morphine and injected it. In
about 5 minutes he was beginning to get relief and in 15 minutes he was
almost comfortable. This is different from a patient with chronic pain such
as cancer or whatever. The same applies there. Especially if the patient
has a fatal disease, I would give him what would make him as comfortable as
possible.
I fear that I'm not fluent enough to explain what I think are my ethical
and legal obligations.In medicine, we often cannot choose the better of the
alternatives, but must choose the least rotten alternative. The one part of
the Hippocratic Oath that I truly believe in is, "First, do no harm."

Wayne


> [Original Message]
> From: Judy Madnick <jmadnick (AT) gmail (DOT) com>
> To: <Dixonary (AT) googlegroups (DOT) com>
> Date: 4/22/2008 5:58:04 PM
> Subject: [Dixonary] Re: OT: Dr. Kevorkian
>
>
> From: waynescottmd (AT) earthlink (DOT) net
>
> << I've already said all of this, and I don't think I'm
getting my point
> << across, so I'll give up.
>
> I do get the point that doctors are "not trained or supposed to be
killers." But I would rather have a medical doctor assist me than someone
who might not use appropriate medical methods and not achieve the desired
result. So I'm looking at this from *my* point of view.
>
> I suppose one might argue that "killers" is the wrong term. For example,
if a patient is given morphine at increasing doses to control pain, even if
those doses are going to eventually cause death, is that considered
"assisted suicide"? I hope not. If someone is suffering and can be
relieved of that suffering, I don't think of relieving pain and suffering
as "killing."
>
> I promise I won't call you when and if the time comes . . . <G> But,
again, I do understand what you are saying, and you are certainly entitled
to your opinion!
>
> Judy

[Judy Madnick]

From: waynescottmd (AT) earthlink (DOT) net

<< Judy, I think that we are closer to the same opinion in many
<< ways.

Oh, I definitely agree that there's a huge difference between severe pain from an injury (or similar) and the suffering of "a patient with chronic pain such as cancer or whatever."

<< The
<< one part of
<< the Hippocratic Oath that I truly believe in is, "First, do no
<< harm." >>

And I suppose that the definition of "harm" may vary from person to person.

Interesting discussion. Thanks for not beating me up. <G>

We're leaving Albany early tomorrow (Wednesday) and will be home in Jacksonville Thursday evening. So two long days of travel and little time for email access.

Judy

[Paul Keating]

I am very glad that I live in Holland, so that if I should ever be in the
dreadful position of having to ask a sympathetic physician for assistance in
this way, he or she would not be in the dreadful position of risking
reputation, career and even liberty to help me.

--
Paul Keating
The Hague

[Toni Savage]

After my experience of last week (and ongoing now at a distance), I very much wish I were in a country that had the same attitude.

-- Toni Savage


--- On Wed, 4/23/08, Paul Keating <keating (AT) acm (DOT) org> wrote:

> From: Paul Keating <keating (AT) acm (DOT) org>
> Subject: [Dixonary] Re: OT: Dr. Kevorkian
> To: Dixonary (AT) googlegroups (DOT) com
> Date: Wednesday, April 23, 2008, 4:46 PM
> I am very glad that I live in Holland, so that if I should
> ever be in the
> dreadful position of having to ask a sympathetic physician
> for assistance in
> this way, he or she would not be in the dreadful position
> of risking
> reputation, career and even liberty to help me.
>
> --
> Paul Keating
> The Hague

[Toni Savage]

Absolutely. If you believe that death is ALWAYS "harm", then it would be against the Oath.

Being under morphine for a day after my gall bladder operation, I believe that even morphine is not the answer to alleviating pain. I couldn't FEEL anything, but I couldn't move anything either. I felt like I was in a straight jacket. It was worse than pain. (OK, not worse than level 10 pain, but worse than level 5, for sure.)


-- Toni Savage


--- On Tue, 4/22/08, waynescottmd (AT) earthlink (DOT) net <waynescottmd (AT) earthlink (DOT) net> wrote:

> From: waynescottmd (AT) earthlink (DOT) net <waynescottmd (AT) earthlink (DOT) net>
> Subject: [Dixonary] Re: OT: Dr. Kevorkian
> To: Dixonary (AT) googlegroups (DOT) com
> Date: Tuesday, April 22, 2008, 9:37 PM
> Judy, I think that we are closer to the same opinion in many
> ways. First, I
> think that if a patient is in pain, it is not only
> permissible but
> obligatory to do everything we can to alleviate the pain,
> including giving
> as much morphine as is necessary even if it reaches fatal
> levels. When I
> was an intern (58 years ago!) a 280 pound patient came into
> the emergency
> room after dropping a 100# anvil on his foot and breaking
> almost every bone
> in the foot. The usual dose of morphine is 1/8 to 1/3
> grain, occasionally
> up to 1/2 grain. I ordered 1 grain for him. The nurse
> refused to administer
> that dose. I filled a syringe with 1 grain of morphine and
> injected it. In
> about 5 minutes he was beginning to get relief and in 15
> minutes he was
> almost comfortable. This is different from a patient with
> chronic pain such
> as cancer or whatever. The same applies there. Especially
> if the patient
> has a fatal disease, I would give him what would make him
> as comfortable as
> possible.
> I fear that I'm not fluent enough to explain what I
> think are my ethical
> and legal obligations.In medicine, we often cannot choose
> the better of the
> alternatives, but must choose the least rotten alternative.
> The one part of
> the Hippocratic Oath that I truly believe in is,
> "First, do no harm."
>
> Wayne
>
>
> > [Original Message]
> > From: Judy Madnick <jmadnick (AT) gmail (DOT) com>
> > To: <Dixonary (AT) googlegroups (DOT) com>
> > Date: 4/22/2008 5:58:04 PM
> > Subject: [Dixonary] Re: OT: Dr. Kevorkian
> >
> >
> > From: waynescottmd (AT) earthlink (DOT) net
> >
> > << I've already said all of
> this, and I don't think I'm
> getting my point
> > << across, so I'll give up.
> >
> > I do get the point that doctors are "not trained
> or supposed to be
> killers." But I would rather have a medical doctor
> assist me than someone
> who might not use appropriate medical methods and not
> achieve the desired
> result. So I'm looking at this from *my* point of view.
>
> >
> > I suppose one might argue that "killers" is
> the wrong term. For example,
> if a patient is given morphine at increasing doses to
> control pain, even if
> those doses are going to eventually cause death, is that
> considered
> "assisted suicide"? I hope not. If someone is
> suffering and can be
> relieved of that suffering, I don't think of relieving
> pain and suffering
> as "killing."
> >
> > I promise I won't call you when and if the time
> comes . . . <G> But,
> again, I do understand what you are saying, and you are
> certainly entitled
> to your opinion!
> >
> > Judy

[waynescottmd@earthlink.net]

Toni: I DON'T believe that death is always harm. Morphine, by the way,
often has more effect in letting the patient ignore the pain even tho
he/she still is aware it is there.
When I said I believe in "first do no harm" I consider that allowing a
patient to be in pain without doing one's best to alleviate that pain with
M. S. or whatever is doing harm and must be avoided.

Wayne


> [Original Message]
> From: Toni Savage <tonicsavage (AT) yahoo (DOT) com>
> To: <Dixonary (AT) googlegroups (DOT) com>
> Date: 4/24/2008 4:33:20 AM
> Subject: [Dixonary] Re: OT: Dr. Kevorkian
>
>
> Absolutely. If you believe that death is ALWAYS "harm", then it would be
against the Oath.
>
> Being under morphine for a day after my gall bladder operation, I believe
that even morphine is not the answer to alleviating pain. I couldn't FEEL
anything, but I couldn't move anything either. I felt like I was in a
straight jacket. It was worse than pain. (OK, not worse than level 10
pain, but worse than level 5, for sure.)
>
>
> -- Toni Savage
>
>
> --- On Tue, 4/22/08, waynescottmd (AT) earthlink (DOT) net
<waynescottmd (AT) earthlink (DOT) net> wrote:
>
> > From: waynescottmd (AT) earthlink (DOT) net <waynescottmd (AT) earthlink (DOT) net>
> > Subject: [Dixonary] Re: OT: Dr. Kevorkian
> > To: Dixonary (AT) googlegroups (DOT) com
> > Date: Tuesday, April 22, 2008, 9:37 PM
> > Judy, I think that we are closer to the same opinion in many
> > ways. First, I
> > think that if a patient is in pain, it is not only
> > permissible but
> > obligatory to do everything we can to alleviate the pain,
> > including giving
> > as much morphine as is necessary even if it reaches fatal
> > levels. When I
> > was an intern (58 years ago!) a 280 pound patient came into
> > the emergency
> > room after dropping a 100# anvil on his foot and breaking
> > almost every bone
> > in the foot. The usual dose of morphine is 1/8 to 1/3
> > grain, occasionally
> > up to 1/2 grain. I ordered 1 grain for him. The nurse
> > refused to administer
> > that dose. I filled a syringe with 1 grain of morphine and
> > injected it. In
> > about 5 minutes he was beginning to get relief and in 15
> > minutes he was
> > almost comfortable. This is different from a patient with
> > chronic pain such
> > as cancer or whatever. The same applies there. Especially
> > if the patient
> > has a fatal disease, I would give him what would make him
> > as comfortable as
> > possible.
> > I fear that I'm not fluent enough to explain what I
> > think are my ethical
> > and legal obligations.In medicine, we often cannot choose
> > the better of the
> > alternatives, but must choose the least rotten alternative.
> > The one part of
> > the Hippocratic Oath that I truly believe in is,
> > "First, do no harm."
> >
> > Wayne
> >
> >
> > > [Original Message]
> > > From: Judy Madnick <jmadnick (AT) gmail (DOT) com>
> > > To: <Dixonary (AT) googlegroups (DOT) com>
> > > Date: 4/22/2008 5:58:04 PM
> > > Subject: [Dixonary] Re: OT: Dr. Kevorkian
> > >
> > >
> > > From: waynescottmd (AT) earthlink (DOT) net
> > >
> > > << I've already said all of
> > this, and I don't think I'm
> > getting my point
> > > << across, so I'll give up.
> > >
> > > I do get the point that doctors are "not trained
> > or supposed to be
> > killers." But I would rather have a medical doctor
> > assist me than someone
> > who might not use appropriate medical methods and not
> > achieve the desired
> > result. So I'm looking at this from *my* point of view.
> >
> > >
> > > I suppose one might argue that "killers" is
> > the wrong term. For example,
> > if a patient is given morphine at increasing doses to
> > control pain, even if
> > those doses are going to eventually cause death, is that
> > considered
> > "assisted suicide"? I hope not. If someone is
> > suffering and can be
> > relieved of that suffering, I don't think of relieving
> > pain and suffering
> > as "killing."
> > >
> > > I promise I won't call you when and if the time
> > comes . . . <G> But,
> > again, I do understand what you are saying, and you are
> > certainly entitled
> > to your opinion!
> > >
> > > Judy