Death panels

No, Obama is not setting up death panels.  He is just creating rules that hospitals can only comply with if they quietly and unofficially have death panels for medicare patients.

If a hospital discharges a patient who lingers on for years sucking up lots of expensive services outside the hospital, the hospital is penalized.  If, however, the potentially expensive patient should conveniently croak while in hospital …

In a number of European countries, quite a lot of patients die “under deep sedation”– in other words, medically administered barbiturate overdose, murdered.

If the patient is dead of IV drug overdose with a drug clicker in his hand that controls the amount of fentanyl in the IV, then that is suicide or death by misadventure.

If the patient is dead of IV drug overdose with no clicker in his hand, murder.  And that is the way patients in Europe die when they die “under deep sedation”.

Pain control is morphine or fentanyl.  “Deep sedation” is lots of barbiturates.  Barbiturates are deadly in large doses.

Barbiturates are not to prevent pain, but to prevent the patient from making a fuss about his medical treatment, or making a fuss about dying – or from making a fuss about lack of medical treatment, lack of food, and lack of water, hence given with IV, but without clicker.

There are legitimate medical uses of barbiturates, typically to keep patients from making trouble when the doctor is giving them an examination that is painful and embarrassing, for example a colonoscopy.  But there are seldom legitimate reasons to give barbiturates to a patient lying in a hospital bed, and there are never legitimate reasons for a patient to die “under deep sedation” while lying in bed.  Yet somehow quite a lot European patients do die “under deep sedation”.

The usual procedure for extreme pain control is to give the patient a clicker, whereby the patient directly controls the level of morphine or fentanyl, up to a limit.  If no limit, this also gives the patient the option of voluntary euthanasia, by clicking hard enough.

“Sedation” means barbiturates, which means not controlling the patients pain, but rather controlling the patient.

These barbiturates are applied through the IV, without the patients knowledge, consent, or control, thus death during deep sedation is involuntary euthanasia: murder of the inconvenient and unwanted.

If the patient is dead with a lethal quantity of fentanyl inside him, and fentanyl clicker in his dead hand, obviously voluntary euthanasia or death by misadventure.

If the patient is dead with a lethal quantity of barbiturates inside him, the barbiturates administered by IV with no barbiturate clicker, obviously involuntary euthanasia:  murder.

“Deep sedation” is never given with a clicker, therefore always involuntary euthanasia, murder.  There is a lot of medical murder in Denmark and many other European countries, and now hospitals in the US have a compelling financial incentive to do the same with potentially expensive medicare patients, including medicare patients that have something expensive but not swiftly lethal wrong with them that will create endless expenses after they are discharged from hospital.

8 Responses to “Death panels”

  1. Ann says:

    Death by sedation especially for the hapless terminal cancer patient is rife in the Uk. A previous post was correct, If you are in a terminal condition and even if the doctors have given a year or more to live and you go for to A&E for just about anything and if you also run into difficulties while you are there with pain control or have a spot of difficulty breathing then midazolam will be whipped out and the chances of being terminally sedated are very high in deed. The situation is preposterous.

    • jim says:

      Legitimate use of Midazolam is, like most barbiturates, to keep the patient quiet during an unpleasant and humiliating procedure and prevent him from remembering the disturbing experience. Midazolam is inappropriate for pain control, and likely to be deadly if applied for breathing difficulties. The patient has trouble breathing, so you give him something that depresses breathing!

  2. Bill says:

    You don’t actually believe that “accidental” morphine overdoses are uncommon in the US, do you? Old people, stroke victims, and people with serious brain injuries are routinely euthanized here. Terry Schiavo was a prominent example: she was dehydrated, starved, and dosed to the sky with barbiturates. That’s how they did her in. You should start reading pro-life news sources if this issue interests you. There are many shocking cases in the US and Canada. Providing stronger incentives will undoubtedly make things worse, but they are plenty bad now. Nursing homes have strong incentives, right now, to kill long-term residents.

    It is a detail, but accidental, appropriate morphine overdoses are also pretty common. Some people have chronic, severe pain. Barbiturates generate tolerance. The lethal dose does not go up (or go up as fast) as the effective dose as tolerance builds. The two eventually cross, and people die because in seeking pain relief they or their doctors kill them. The older and sicker you are, the lower the lethal dose. Old, sick people are therefore most likely to die this way, even when nobody is contemplating homicide. It’s an exaggeration to say it, but the hospice industry pretty much does this as its business—keep you comfortable until the lethal dose is higher than the effective dose, whereupon you die.

    In a world where docs are not guided by morality or strong professional ethics, it is a hard problem to get the incentives right.

    • jim says:

      You don’t actually believe that “accidental” morphine overdoses are uncommon in the US, do you? Old people, stroke victims, and people with serious brain injuries are routinely euthanized here. Terry Schiavo was a prominent example: she was dehydrated, starved, and dosed to the sky with barbiturates.

      “Accidental” morphine and fentanyl overdoses are plausibly deniable – they are suicide or death by misadventure. Terry Schiavo was murder. Outright murder is generally done with barbiturates, to prevent the person who dying of thirst from making a fuss, or just to kill them with overdose. Murder of expensive, brain damaged, people is difficult to avoid. Murder of people who are sane and competent, or would be sane and competent if they were not basted to the gills on barbiturates, is difficult to accomplish.

      A lot of old people’s homes offer the deal that you pay them a large sum up front, and they will look after you till you die – which tends to be remarkably soon. But at least that is not the only deal on offer.

  3. Alrenous says:

    Hospital: place with doctors who want to make you better.

    Government Hospital: place to avoid if you wish to remain alive.

    Right to not be prevented from being treated: obvious, common-sense truth.

    Right to treatment: results in murder.

  4. sconzey says:

    To quote the great Omar Little: Shiiiiiiiiiiiiiit…

    One good thing about the NHS: keeps the regulators distracted from British private hospitals, which are fairly unregulated.

    If you’ve got any figures on death “under deep sedation” in British public vs. private hospitals, I’d be real interested to see them.

    • jim says:

      I don’t know much about British health care. I have not heard of this problem with Britain. I hear about this problem with the Netherlands. What I have heard about British health care is that the most menial tasks are the tasks that get neglected. The greatest advance in health and health care was soap, hot water, and bleach, which is the aspect of health care most infamously neglected in Britain – also feeding patients that have difficulty feeding themselves, or going to the toilet by themselves. This suggests that British cuts are applied to the lowest status people, and thus the lowest status activities, in the hospital. If, however, one tries to keep the hospital all clean, nice and shiny, then the cuts are going to show up elsewhere, such as “sedating”those patients who are most apt to expensively undermine the cleanliness and shininess. So in a bad smelling British hospital, one is likely croak from diseases transmitted for lack of hot water and bleach, or starve to death because you cannot sit up and get stuck in with a knife and fork, whereas in a nice shiny Netherlands hospital, they are likely to “sedate” you as necessary to control costs, and prevent you from fussing about cost controls, and you die of thirst because you are too deeply sedated to complain that you are thirsty. Supposedly deep sedation is to control pain, but barbiturates are not a pain control drug. They are a patient control drug. If you want an incurable dying patient to die pleasantly, you give them food, water, and as much fentanyl as needed to relieve the pain, you give them a clicker. If you want them to die in a hurry, you give them barbiturates and no food or water..

      So my guess, based on horror stories of British hospitals smelling of death, and horror stories as in the link above of Netherlands patients being hurried along to death with barbiturates, I would suspect that Netherlands hospitals are a lot cleaner and nicer than British hospitals, and less deadly if one has a cheap disease, but more deadly if one has an expensive disease.

      • Karim says:

        If a person dies from an over dose of morphine and if the the nurse or doctor are aware that the dosage will cause death (they say “hastening death”), this is murder under English Law. Thousands of people (mostly elderly) are being murdered in our hospitals every year and the CPS will do nothing. I telephoned the JR hospital in Oxford 2 weeks ago and said bluntly ‘You murdered my mother by giving her an overdose of murder’. They said that I should put my complaint in writing. I said that I was not in the habit of writing to murderers. They did nothing. I was hoping they would sue me for slander but they know that murder is taking place regularly. In a month or so I will be standing outside the JR hospital in Oxford with a banner saying ‘This hospital murders people’. They had better take me to court or accept this is true. The local newspapers are already asking to be involved in the campaign. Interested? email me on esc09@btinternet.com

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