Posted on 01/21/2019 4:30:54 PM PST by Kaslin
The wife of a retired periodontist suffering from Alzheimer’s, Dr. Gerald Greenberg, has filed a lawsuit against a New York hospital claiming that doctors violated his last wishes. As the New York Post reports, Mrs. Elaine Greenberg’s husband was diagnosed with early onset Alzheimer’s in his fifties and by the age of 63 was completely disconnected from the real world. But shortly after finding out about his condition and while still in a sound state of mind he had drawn up a living will which effectively established a Do Not Resuscitate (DNR) order. When Dr. Greenberg fell seriously ill and was estimated to only have a few days to live, his wife spoke to the medical team and provided them with the living will.
One doctor ignored those instructions and kept Greenberg alive for more than an additional month, moaning in pain until he finally passed away.
A Westchester County doctor ignored an ailing Alzheimer’s patient’s last wishes by callously prolonging his painful final days, a new lawsuit charges.
“There are times when Gerry was crying. He was not a man who cried, but he was suffering,” Elaine Greenberg told The Post of her retired periodontist husband, Dr. Gerald Greenberg, 63.
Gerald had been diagnosed with early-onset Alzheimer’s in 2010, and by 2016 couldn’t recognize or communicate with his wife and two sons, according to the family’s Bronx Supreme Court lawsuit.
But before being completely incapacitated, the Roslyn, LI, man wrote in a 2011 living will that he was to be given “comfort measures only, no intravenous fluids and no antibiotics,’’ if his condition became incurable, the suit says.
This is a particularly difficult story to write about for me because my mother suffered from advanced dementia and finally succumbed to it, but only after nearly a decade under medical care where she couldn’t recognize any of her family most of the time and couldn’t even communicate toward the end. She had no living will, and we all waited for nature to take its long, painful course.
Greenberg’s case should have been far simpler. I’ve written here on many occasions about end of life issues and I understand why many conservatives are opposed to assisted suicide and other end of life intervention choices. I may not agree, but I understand many of the objections. Personally, I believe that how we choose to face death, fully as much as how we deal with life, is one of the most personal decisions an individual or family can make and the government has no business being involved provided all facilities are competently run.
But Dr. Greenberg and his wife weren’t asking for assisted suicide or an intervention. She simply wanted the doctors to let her husband go as his time had clearly arrived. One doctor took matters into his own hands and denied Greenberg a death with whatever dignity remained to him. This should be considered malpractice in my opinion.
These are hard subjects to tackle, but the majority of us will either have to deal with them ourselves when the time comes or our lives will be touched by others who do. We all make our own choices in life. As free citizens we should be able to make those choices about death as well.
I know what a DNR is. Thanks. While I know she had one on file with the facility, I’ll concede they may not have given it to the hospital. She stopped breathing and was intubated and then moved to another hospital. It just seems excessive when you hope your loved one will die peacefully.
By basing the decision “solely” on money, you mean considering money at all. Or, do you have an idea of how to balance money and other considerations in spending money on prolonging life? Don’t merely play the role of critic. Offer guidance so that other people can make actual decisions.
Hubby started out as a seasonal on the county fire crew. Those were different times and a different department. His badge number is in the 100’s. Now the county has over 400 or 500 (can’t remember) firefighters working. Good luck to your grandson!
My point was our healthcare system as a whole not individual cases. You mentioned spending our societies wealth through medicare. This of course is the big problem with socialized medicine or anything socialist. So in a nutshell you can't worry about the cost to medicare. We are stuck with this system for now but we would be wise to head back in the direction of free market solutions. We make more than enough throughout our lives to pay for our own healthcare directly, through medical savings and of course catastrophic insurance. We don't however make enough money to pay for our medical expenses and subsidize dozens of others who are not paying. This is the reason "money" is fast becoming the primary criteria for treatment and that is bad news indeed.
I have personally seen (family) illness that was considered terminal and instead of having the mindset of treatment the medical profession is pushing towards "hospice". In other words "giving up" on the extension of life and any hope of cure or even remission of disease. Again, how are we going to find cures for these diseases if our solution is "give up"?
A related topic is the rise of the "assisted suicide" laws. This is some serious backwards, dangerous and outright evil thinking. Oppose this in every way possible. We must not allow even debate on this issue. It's an outright abomination.
“...A related topic is the rise of the “assisted suicide” laws. This is some serious backwards, dangerous and outright evil thinking. Oppose this in every way possible...”
It is shocking that countries like Holland and states like Oregon are so taken with “quality of life” arguments that they now ignore the spiritual nature of life. This is leading to a cynical depressing culture of feel good materialism devoid of God.
I’m very sorry about what happened to your mother, but most hospitals lose money on Medicaid patients; they just don’t pay much.
DNR does not mean “do not provide care”. It means do not resuscitate. In other words, if I die, or my heart stops or I stop breathing, do not perform cpr or intubate me.
Saw a documentary, a good twenty years ago, about Denmark, and euthanasia. It focused on an elderly patient who had had a stroke. She wasn’t a “vegetable” , just old and debilitated. The doctor talked the family into euthanizing her. The whole program was devoted to the fact that it was legal in Denmark, and everybody was better off to euthanize patients such as this one, to spare the monetary, physical,and emotional stress that would be incurred if they chose to treat the patient. I cannot remember if the old lady had any say in the matter; I only remember being outraged.
The nursing home is protecting itself. They could be sued if they didn’t send your mother in to get checked out, and she got sicker, or died because of the incident. You may not be a person who would sue, but there are plenty who would. And when a family sues, they don’t just sue the nursing home. They sue the nurse on duty, plus the DON, and administrator, both of whom may not even be present.
A DNR doesn’t mean...”do not treat”. She might have been flown to a hospital equipped for trauma treatment at a level 2 or level 1 trauma center and advanced neuro interventions. If she fell and hit her head but still had spontaneous pulse and respirations then she still would need to be treated. If however had she had been deemed “not likely to recover” then hospice type “comfort measures” only could have been ordered and then she could have been allowed to die with dignity. That would explain the week delay before the inevitable.
You are doing as a first responder what you need to do, following protocols in an objective manner to establish ROSC and then get the patient to an appropriate level of care. As soon as enough of you get infected with PC thinking and start second guessing what you are doing...and debating quality of life vs’s level of effort..then the role of the first responders will have been destroyed.
Since you cannot deal with the money issue, and few people can, here is the criteria: the expected benefit in terms of years of life extended along with happiness and productivity. This is why terminal patients, especially those with diminished capacity to enjoy life, themselves, post DNR. This is why Aristotle Onasis, for whom money was no object, pulled the plug on his own son.
Money is an abstraction. What is represents is work. With increasingly high tax rates, government money represents serfdom. One naturally considers the spending of one’s own money in extending life, because that money can be willed to one’s children or to make benefactions such as museums, education, and clean water for the people of poor countries. But, government money isn’t for free either.
Many people in their old age or in other infirmities join Jesus on the cross. Our hope is to join him in the resurrection. This life is but a moment, and dying is part of it. The next is eternal.
I can deal with the money issue but not for others, thats up to them. I think you forgot I said anyone but the patient themselves ushers in the problems.
I considered what you said about individuals spending their own money to be insufficient. Obviously, people often act as guardians for others. All of us entered the world in guardianship, usually of our natural parents. Almost all of us, from time to time, depend on guardianship, usually of our life partner. And, if we are lucky to make it to old age, our life ends in guardianship. If you total up all these times, we may spend more time in guardianship than we spend as self-responsible adults. While I am generally a libertarian and, so, agree with you that what people do with their own money is their business, it is simplistic and in many cases wrong to think we can organize society solely on the basis of self-responsible adults. The Ten Commandments covers this, “honor your father and your mother, so that your days will be lengthened.” My mother used to needle me about this. She said I know why you’re taking me in, so your children will take you in. Funny, isn’t it, that God affirms the goodness of self-interest in this particular commandment. Usually, the love of people for their own family will motivate them to be careful in balancing cost and benefit. I know there will be some people who will be bereft of family or other private support during their time of need, so some people will fall into the guardian of the state. But, I don’t think we can presume that faceless bureaucrats will ever exercise guardianship in love. The family and church and private charity are all at risk in this country, as is providing for life’s contingencies through saving and insurance. We are an increasing me- and now-oriented society, juvenile, spoiled and selfish. Socialism won’t save us from these sins, but promotes these sins and destroys the meaningfulness of life and well as impoverishes us economically.
(While this is not good, I would much rather them to be keeping people alive than the other way around. Be careful what we wish for. Life is sacred.)
That’s a strawman. That choice is not in front of us. The choice that is in front of us is whether doctors’ choices should trump the person’s own choice in terms of artificially be kept alive.
I can assure you that your fears are completely overblown and unrealistic. I am not suggesting that what we did was morally wrong in the cases of people who were “revived” who had no real hope of ever making what any reasonable person would consider an actual recovery. I am making a simple observation, one which the vast majority of the public has no clue about.
My wife spent her career as a nurse and department head working in long term multilevel care facilities. She set up classes specifically about DNRs where she invited paramedics, nurses, doctors, and legal professionals to come and talk with residents about what it actually means to have CPR and other “heroic” methods used on fragile elderly people and people with terminal conditions. In order to make an actual informed decision about this people should be educated. Very, very few actually have any understanding of the brutality involved when someone such as a fragile old lady has CPR performed correctly on them. I can assure you that it is not a pretty sight, and the chances that this will have a positive impact on this type of individual’s outcome are typically near zero.
This isn't being “infected” with “PC thinking” these are simple observations made by reasonable people and medical professionals from their actual experiences. My assumption is that this is something that you have never participated in or even witnessed in real life. The Hollywood version of CPR doesn't “save” anyone. Most of the CPR I have seen performed by people who have received poor or no training does not “save” anyone. It is a feel good exercise, along the same lines as the TSA checks by government goons at the airport, it fails to do anything worthwhile 95% of the time. Real CPR often does a lot of damage to the chests of brittle, fragile old people.
eg....if you have a bad heart condition,the dnr would apply with your wishes not to be treated for a heart attack,but it would not mean that if you had a bad cut to your leg the docs would let you bleed to death.
i would bet that there are questions about the man with alzeimers having been of sound mind when signing the living will and the doc and hospital had to be sure because they would get sued and sent to jail themselves.
We don't know every detail of the case. I'm betting the doctors had a very good reason why they did not follow a DNR.
I’ve been an RN for 33 years working in ICU’s for 20 years...lately in a trauma unit. My fears are not “overblown or misinformed”! Discussions about “quality of life...why can’t we just let Meemaw die” are happening all the time with these younger kids(meemaw is often 70 years old or less who might have been walking her dog just yesterday before her heart went into flutter then asystole, was coded and revived with ROSC(with afib and intermittent rvr) and went back to her life a few days later (albeit with a post code sore chest) after she was cardioverted and put on rate control meds). It’s the slippery slope, with folks making value judgments about folks’ lives who aren’t really qualified or experienced enough about life yet to make those judgments, that has me concerned.
Stick to your first responder protocols, these are generally good ones...I do think work needs to be done about end of life care including documents that might absolve a rescue unit from any issues should the elder customer have not wanted to be coded anyway if he was not breathing with no pulse and this condition was a witnessed event.
PS: I use Sousa’s “Stars and Stripes” forever or “Onward Christian Soldiers” to keep the beat when I CPR. The quarter note speeds are 100 to 118 beats a minute.
“Another One Bites the Dust” is such a downer!(though I get the “gallows humor”)
Cheers....
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