Comments for Berg end-of-life information bill goes to governor at http://lakeconews.com , comment 1 to 5 out of 5 comments http://lakeconews.com Sat, 07 Nov 2009 18:34:43 +0100 FeedCreator 1.7.2 http://lakeconews.com/content/view/5551/919/#comment-7699 I have not read the bill, but wish to comment on your approach to practicing medicine. Treat the patient like a person, be as specific as possible and give the multiple treatment options which are available. It is fair to say which one of the options you would do for yourself, but there are always other options. For example: \"Mrs. Jones, your lymph node biopsy came back as a very aggressive form of lymphoma. I think you should talk with an oncologist about current chemotherapy options, but I can give you some broad numbers. Without any treatment the mean survival time is 6 months. With the more aggressive chemotherapy protocols the mean survival time is 3 years with an x% chance of living 5 years...\" Then you talk about the side effects, risks, and other downsides to treatment. If there are other treatment options which aren\'t main stream, but may have merit, bring them up, give them your opinion but offer to refer them to someone who may know more. If they end up deciding that they just want to drink \'Mona Vis\' or Noni Juice, thinking that it cures everything, give them your honest opinion. When there are NO good treatment options left, or the patient chooses not to be treated, just tell them what to expect. Let them know about hospice, pain management, end of life decisions to be made. Don\'t sugar coat it. Be honest but compassionate. Answer questions accurately, not just to make them feel good. You are right. You don\'t know WHEN exactly an individual will die, but you do know the likely progression of disease and can generalize. - jmadison Tue, 09 Sep 2008 16:16:56 +0100 http://lakeconews.com/content/view/5551/919/#comment-7698 telling me that Hospice will be closing if this bill passes? If a doctor is not allowed to discuss Hospice then there is no way they can refer a patient to Hospice and to my knowledge and experience and Dr recommendation is how you get Hospice. - Donna Christopher Tue, 09 Sep 2008 15:26:20 +0100 http://lakeconews.com/content/view/5551/919/#comment-7696 If you do not have a good enough relationship with your doctor to get the truth from them then you need to find a better doctor. Read the fine print in the bill instead of being spoonfed party politics and the world will be much clearer. - bearer Tue, 09 Sep 2008 14:48:14 +0100 http://lakeconews.com/content/view/5551/919/#comment-7692 I regret the sarcasm with which Mr. Shuck treats Senator Sam Aanestad, the oral surgeon who is only one among many who oppose this bill. If Mr. Shuck\'s criteria for legitimate criticism of AB 2747 is that it can\'t come from those \"who may never have to tell a patient they have a terminal illness,\" I guess he would consider me qualified to comment. I spent five years as a Spanish-speaking surgeon in a rural California town caring for women with breast cancer. Because of cultural views on illness, language barriers and lack of resources, many of my patients did not seek medical attention until after the cancer had spread outside of the breast. I was the one in the exam room with women, some in their thirties and forties with young children. I had to find a way to make the worst news of her life somehow less painful--or at least not add to her pain. To do this, I had to learn about who she was and what she valued and loved. I had to treat her physical and emotional pain, to answer her questions, to sit with her through a terrifying and lonely time. But AB 2747 says that the California Legislature knows better what she needs than she does. The text of AB 2747 mandates a list of \"legal options\" she has to get from her doctor at the time she is diagnosed and asks, \"What can I do?\" The language of the bill says it all. As her doctor, I have to tell her that she can choose death by starvation or dehydration. I have to tell her she has a \"right\" to chemotherapy whether or not it will help her feel better or live longer--even if the treatment itself is likely to kill her. I can\'t, as her doctor, offer hospice care when she would benefit from it. Instead, I have to tell her about her death while she\'s still in shock and denial of the news she just heard for the first time. The bill doesn\'t admit that doctors can be wrong about terminal illness, that a judgement of \"how long\" a person has is just a guess and that patients defy the odds and enjoy years of life after the diagnosis. I have seen this so many times that I can\'t justify robbing hope from any patient. As doctors, we just don\'t know. Unbelievably, AB 2747 says that the cost of treatment should be included in the discussion. The impact of this type of discussion on the treatment decisions of my patients would be devastating. No State Legislator or staffer with taxpayer-funded Cadillac health insurance should ever have the right to coerce vulnerable low-income patients into giving up on treatment solely because of cost. That, by itself, is reason enough to reject AB 2747. I regret that Mr. Shuck failed to mention (among his mention of \"all the other health organizations in support\") the massive opposition that testified against this bill. Disability and minority rights groups, patient advocates, doctors and nurses (including hospice nurses), faith communities and organizations representing the terminally ill are unified in opposing this bill. They continue to reject the denial of patient choice and the ugly lack of compassion in AB 2747. This bill is a painful example of the consequences of bad legislation from those with a hidden agenda disguised as \"just information.\" The Governor may be contacted to request a veto: Governor Arnold Schwarzenegger State Capitol Building Sacramento, CA 95814 Phone: 916-445-2841 Fax: 916-558-3160 (new number) - PatientsFirst Tue, 09 Sep 2008 10:02:35 +0100 http://lakeconews.com/content/view/5551/919/#comment-7680 would think knowing all your options is a bad thing. - Donna Christopher Tue, 09 Sep 2008 07:39:36 +0100