That suffering, as unpleasant as it is, often also has a bright side to which research has paid less attention: Human suffering is often accompanied by beautiful acts of compassion by others wishing to help relieve it. What propels someone to serve food at a homeless shelter, pull over on the highway in the rain to help someone with a broken down vehicle, or feed a stray cat? What is compassion and how is it different from empathy or altruism?
Breslow Digital Editor For doctors, there are rarely easy decisions to be made when it comes to the care of someone who is critically ill. Other times, they may see cause for optimism, however remote it may seem.
Knowing how or when to make that determination is the tricky part. In his best-selling book of the same name, he notes that 40 percent of oncologists have admitted to offering treatments they believe are unlikely to work.
It is hard to know how to start this discussion, but I thought it would be fruitful to go back to my beginnings as a physician. As a medical student, I had meticulously avoided the ICU and the sick patients to be found there. I thought them to be too complicated and was intimidated by the high-stakes decisions and interventions they required.
It was ironic then that I found myself assigned to the ICU for my first month of internship; I was petrified.
I quickly became enamored of the pace, the procedures and ultimately even the sense of the stakes. All of the physiology and pharmacology I learned in medical school was suddenly richly relevant and constantly subject to our monitoring, interventions and manipulations.
I loved that we could seemingly snatch patients back from the brink of death, and then with the correct support and treatments, restore them to a functional life. There were few experiences as gratifying as having a patient, previously gravely ill, come walking back through the doors of the ICU to visit and offer thanks.
But even as I celebrated our successes that first month, I also saw that there were patients whom we simply could not save. They remained perched perilously on the precipice of life and death. With our life-sustaining interventions, we could keep some from falling off, but we could not pull them back safely to higher ground.
And even when we did manage to get them well enough to leave the ICU for a regular hospital bed, they would be back a few days or weeks later, with either a recurrence of their problem or a new complication. They are often consigned for weeks or even months to a sort of medical purgatory, attached by tubes in their tracheas to ventilators, with catheters protruding from their necks, chests, abdomens or bladders.
When awake they are in constant discomfort, chronically deprived of sleep, and stripped of any dignity, so we often sedate them to the point that they are no longer in communication with their environment.
In that heady heyday of the newly hatched specialty of critical care — this was mids — no one much questioned whether we were doing the right thing when applying all of these life-sustaining interventions, but I could see clearly that this was not an end of life I would fancy for myself or for a loved one.
Thirty years later, things have evolved. Unfortunately profound disagreements sometimes still arise in cases where prognosis is poor, and this can be distressing and morally wrenching to all involved.
This seems like a good point to pause — I am interested in your thoughts and reflections on this topic. I really cannot argue with any of the points you made in your note.
As our ability to support life through improved monitoring, advanced pharmacology and more effective life-support techniques has grown, we increasingly run into the dilemma of whether we are prolonging life or prolonging death in the most critically ill patients.
Clinicians like me who admit patients to the ICU after a significant surgery often have a different perspective than the ICU doctors who rotate in and out of the service on a weekly basis. In most cases, as admitting surgeons, we have had the privilege of having in-depth preoperative conversations with the patient and family about their problems and proposed surgery.
As you point out, it is also our charge to get to know the patient and their desires and fears about their management during a critical illness.
Our personal contract with the patient is to give them the very best surgical and medical care we can to bring them through the surgery with the best possible outcome we can achieve. Thus, when patients become desperately ill, we face an internal conflict.
On the one hand, we want to do our very best to pull the patient through to recovery. In many cases, our relationships with patients and their families and our understanding about them can temper this decision. Unfortunately, intensivists who rotate in and out of service on a weekly basis only to be confronted with a critically ill patient on a ventilator and other forms of life support do not have this understanding about the patient or the relationships that we have developed.Three arguments against extending the human lifespan.
Martien A M Pijnenburg one can distinguish between research that is first and foremost aimed at prolonging life by slowing or even arresting ageing processes and research that is directed at combating the diseases that seem to be With regard to the benefits for me as a human being.
This account is based on a belief that human life is precious, the desire to preserve life is inherent in human nature and the impulse to go on living as long as we can is a basic instinct (#37, +5; #16, +3).
Perhaps human culture is problematic because the very highest characteristics innate in every child, empathy, compassion, love for non-humans, is carved out and replaced with a desensitized, callous, lack of reverence for life, including a child’s own body that is compromised by the current “food” system which relies upon a view of.
Nowadays, technology all around humans' life, and become a part of daily life which cannot lose. Most people, such as teenagers, adults, and even some elderly, are using the technology. In its purely secular form, transhumanists are those who see technology as an important part of improving the world, enhancing human physiology, prolonging life, and even leading us into a.
In order to avoid the shortcomings of scenario 1, the technology for prolonging human lifespan would have to have the same utility to all people, regardless of their age, and it would need to be a technology that does not have to be applied constantly.