Palliative Care can have Grave Shortcomings

   When it comes to palliative care, hospice and Do Not Resuscitate, we buy the sales pitch much too quickly.
   Of course, we want our family member to have a dignified death. Of course, we want them to be comfortable. So, we say, Give us the papers, and let us sign on the dotted line.
   Often -- well, make that pretty much always -- if it is not the hospice company, itself, then it is the insurance company, or medical provider, or someone responsible for seeing that the medical provider gets paid, that  is coaxing us into palliative care, and selling it as the humane option.
   But, we should be wary to know, what's in it for them, Not always, perhaps, but often it is in the best financial interest of the medical provider to get the patient on hospice or Do Not Resuscitate.
Our emergency rooms are expensive, yet law does not allow hospitals to turn patients away -- regardless whether they can pay. So, if hospitals can get the most expensive of those patients on palliative care, they can prevent some of them from returning to the emergency room time after time.
   Likewise, cancer treatments, heart replacements, and such can be very expensive. And so, often, it is in the best interest of the medical provider to let the patient know the treatments can be painful, or even damaging, and despite all that, not do any good, anyway.
  Insurance companies, likewise, can dodge expenses if they can get some of their clients on palliative care, steering them clear of expensive procedures for which they would have to foot the bill.
   There is a saying: Follow the money. While I would guess those who pitch hospice and Do Not Resuscitate are honestly and earnestly offering what they think best for the patient, I think we would be wise to realize medical providers and insurance companies often benefit financially by having us sign on for hospice and/or Do Not Resuscitate. These programs can be good, but there are dangers in them.
   Indeed, a person should have the right to say "No" to having his life dragged out. Quality of life can, indeed, be more important than life stretched beyond its worth. But, life still remains precious. We should not too quickly sign it away.
  Consider the requirements for getting on hospice. First, the person's doctor, and a doctor from the hospice program, must certify the person will die in six months or less. Second, the patient and family must opt for comfort care instead of curative care. In exchange for signing up, what does the patient get? A company sends a hospice worker to visit, to provide comfort care. That worker or team of workers can visit with the family, as well, helping them through the impending loss of a loved one.
  The word "hospice" might once have meant no more than offering comfort and peace to those going to their deaths. These days, however, hospice is an industry. Companies are created to get paid to come in and provide this comfort care. Often, it is government money, Medicaid, that pays the bill.
   There are surely times when hospice is beneficial, when the love provided by the hospice workers makes a difference in whether the person goes to death in peace, and whether the family is comforted. Still, clearly, the program has its shortcomings.
   Palliative care can have grave shortcomings, and I use the word "grave" knowing it can have a double meaning.

What of they Who Despise Government, Who Speak Evil of Dignitaries?

   I do wonder at this scripture, 2 Peter 2:10.
   A number of verse before, it speaks of false teachers. (There might be no connection to that and the verse we shall refer to, though.) In the verse before, it speaks of the day of judgement being reserved for some. Then, our verse: "But chiefly them that walk after the flesh in the lust of uncleanness, and despise government. Presumptuous are they, selfwilled, they are not afraid to speak evil of dignitaries."
  I follow down the verses from there, and there are indications they speak of the same set of people. Then, in Verse 19 (already a favorite scripture of mine), it says, "While they promise them liberty, they themselves are servants of corruption."
  I do not know that this scripture refers to anyone but someone back in New Testament times, but I cannot help but see a likeness to many in our day. The scripture might not the least be intended for them. Still, today, we do have people who despise government, who speak evil of dignitaries, who promise liberty to those who will follow them.

We can Wonder about the Tsarnaev Brothers

   When we suggest Islam preaches the killing of disbelievers, we might be setting in motion a self-fulfilling prophecy.
   If they hear that this is what they believe often enough, some of them will begin to believe it is what they believe. While they might grow up and go for years without believing they should kill non-believers, if they are told it is what they believe, do they sometimes come to the conclusion it is?
  It is like with a child. If you tell him he is stupid, he comes to believe it. The harm you sow, is the harm you have.
   One might wonder if the Tsarnaev brothers are examples of this. They lived in the states with no harm for years. Then, Tamerlan and Dzhokhar pulled off the Boston Marathon Bombing. Did one or both of them become disgruntled with America, and reflect on the suggestion that their religion teaches to kill disbelievers, and conclude they would do just that, kill the disbelievers?
   Most Muslims do not believe they should go out and kill disbelievers. That is a belief only of the radical members of the religion. But, we as a society, sometimes parrot the thought that it is a tenet of Islam that they should kill disbelievers. The Muslims who have not been taught in their own mosques to believe this hear it from us, and can come to believe it, and can come to act on it.
   The harm we sow, is the harm we reap.

 

University Hospital Bending Costs Downward

  I looked down the line of stories trending on my Xfinity home page and saw one on how a hospital was holding down costs. Hospital costs being a topic of much interest to me, I clicked on the news item. To my surprise, the hospital getting national attention turned out to be none other than University Hospital, right here in Salt Lake City.
  Listening to it once, but not absorbing it, I did some Facebooking and news reading, then attempted to come back to the story later. But, it was gone. The Xfinity page no longer featured it, and I couldn't find it with a word search.
   But, I did find a story, from back in September, from the New York Times. It quoted Michael Porter, an economist at Harvard School of Business, as saying University Hospital's program was making, "epic progress," and I assume that means epic progress in the effort to reduce hospital costs.
   It noted the secretary of health and human services, Sylvia Mathews Burwell, came to Salt Lake in August to see what is being done.
  The CEO at the hospital, Dr. Vivian Lee, has set in motion a program in which a computer program has 200 million rows accounting for the various possible expenses -- medicines, tests, personnel time, etc.
   Then, they look at what procedures and things are taking place, and question whether they are needed. For example, they've found so much unnecessary blood work was being done, patients were actually getting anemic. So, they cut back, saving the hospital $200 million a year.
   Since starting the program, the cost of hospital care has actually been slightly reduced, dropping 0.5 percent, while other area academic hospitals have increased 2.9 percent a year.
   I don't know if the hospital will continue to bend expenses down. That would be wonderful. Hopefully, we can check in on University Hospital's program, again, in the future.

We Need Sound Bites Preaching Against the Jihad

   The voice of the imam needs to be heard. When there is a leader of Islam, condemning violence, condemning attacks by those of radical Islam, that voice should be heard.
   Would be well if such things were blared loud and often on the news. "Imam Muhumed al-Dagen responded to the shootings with swift words of displeasure . . ." Whenever, a Muslim leader says his religion does not call for violence, does not call for killing those who do not believe in Islam, that leader should make the news.
    There is a principle we should worry about. When we tell a person what they are, it affects what they become. If a person is told their people kill Christians, if they are told they believe they should go to war against unbelievers, some of them are eventually going to sign on. It doesn't matter if the message is coming from those who fear Islam and attribute the belief to Islam, or if it comes from those of radical Islam, itself, the message remains the same. Sooner or later, some Muslims who hear the message so many times start to wonder if that is, indeed, what they should believe. The meaning of "jihud," is that it is a war or struggle against unbelievers. If a person is told enough times that that a jihad is what they believe in, eventually they might decide it is true.
   It is much like screaming at a child, telling him he is stupid. If the child hears it, it can affect who he becomes. Telling the Muslims they are Jihadists is no different. Eventually, some of them will say, "It must be so."
   What you teach, is what you get, often. So, it becomes important to have voices that are teaching what is right, it becomes important to have Muslim leaders teaching against jihudist thought. And, if those voices are to reach the populace, they need to be picked up and quoted in the media. We need sound bites that teach peace, if we are to have peace.
   Plant a thought, and reap an action, it is said. And, we better believe that is what can happen, lest we reap the whirlwind.
 

The God-fearing Response is not to take Another's Life Unnecessarily

   I wish somebody could reach out to the Israelis and say, "Hey, this might not be perfectly right, what you are doing."
   I speak of the number of Palestinians who are being killed while attacking and protesting against the Israelis. I just wonder if death is so often the necessary end result. Any time you can spare a life, you should.
   Look at the numbers. Nineteen Israelis have been killed since mid-September as the Palestinians have been attacking the Israelis. But, 94 Palestinians have died, only 58 of which were attackers, the rest being people who died in clashes with Israeli authorities. I wonder if more of the Palestinian attackers could have been stopped without use of lethal force. And, I wonder if the three dozen who were killed in the clashes, could have had their lives spared. If they were not attacking, what was the need to kill them?
   In the U.S., we currently have a big spotlight on police violence. But, that does not seem to be so much the case in Israel, although the Palestinians are saying the Israelis are using excessive force.
   A God-fearing response is not the taking of life at the least of provocations. Life is precious, all life. A God-fearing person spares another's life whenever he can.

Let the Cuban Migrants Come -- Even if it's 44,000 Per Year

   Which refugee crisis impacts us more, in terms of numbers? Is it be the 10,000 Syrian refugees that might come in a year's time, which we are hearing so much about, or the 44,000 Cuban that came in a year's span, which we didn't hear so much about?
   I wonder at a news story I did see on the Cubans. It said they are coming overland, by traveling to Ecuador, then through Central America. Excuse me? That makes it sound like Ecuador is the starting point. How does that work? Ecuador is on the opposite side of South America and south of Cuba.
   At any rate, whereas Cubans came via boats to Florida all these years, now they are taking a much more circuitous route. Why? It might be because the Coast Guard is intercepting them if they come straight up to Florida. The Wet Foot, Dry Foot policy says that if they reach our borders, they will be accepted, but if they are caught at sea, they are sent home.
   So, with the Coast Guard catching them at sea, they are swinging through a different route.
   At any rate, now we have a second group of migrants to decide if we should accept. Now that we have normalized our relations with Cuba, do we change our policy of allowing any who reach our shores (our borders) entry?
   Off top, I would like to see us continue to accept the Cubans. Of course, though, I would like to see us accept migrants from any country. Some argue we cannot sustain unlimited entry of migrants. I wonder.
   Then, there is the question of what might become of Cuba. If we let as many in as want to come, does that somewhat empty that country out? If a Cuban is given the choice of living in terrible economic conditions in Cuba, or coming to the U.S. where things are better, how many stay in Cuba? It's a country of more than 11 million. The upswing in migrants from Cuba is due to their concern that the policy of being accepted if they reach our border is going to end. For all these years that we've had the Wet Foot, Dry Foot policy, it never resulted in emptying the bulk of Cuba. So, it shouldn't now, either.
    There is also the question of why they are coming to the U.S., as opposed to stopping once they've reached Ecuador, Costa Rica, Mexico, or wherever. Do they simply want to come to America because, like immigrants all along, they cherish America is cherished as the land of liberty, opportunity and prosperity?
   Or, are they eyeballing our social services? I say, let them come. But, we should revamp our social services programs to allow people to work for what they get, and to use more private charity help rather than government payments. The programs need to be more self-sustaining.