There’s a must-read article over at the New York Times today, though honestly the comments make for more engrossing reading than the article itself.

The subject is dialysis, the treatment that people with end-stage kidney disease need to stay alive (I’m sure you know this, but it involves going to a dialysis center three times per week to have your blood cycled out of your body and cleansed), and the fact that for 39 years the US government has made it free for anybody who needs it. 

When the law was initially passed it was designed to benefit otherwise-healthy people at midlife and younger, who would have died without dialysis.  But due to the aging of our population and the increase in diseases such as diabetes and hypertension, a big chunk of the people who receive dialysis now are very elderly patients who suffer from other medical conditions. The Times article focuses on how some members of the medical community are encouraging doctors to give their patients an alternative to dialysis, called “medical management without dialysis”—which means certain death, but probably a less protracted and painful death than they’d inevitably experience after going through dialysis.  So the “medical management” option would save the patients pain while also, naturally, saving the taxpayers a big chunk of change.

Ordinarily, I have a strong opinion on any topic that you can name. All of my life friends have described me as “opinionated,” (I like to think that they’re saying it affectionately . . ).  But after reading the comments section after this Times article I was struck by the very unfamiliar feeling of being unable to form an opinion.

Some people argue that as a civilized society we should have free healthcare for all, and that it’s outrageous that anybody is even questioning whether these old, sick people should receive dialysis for free. But then there’s a comment from a woman who encouraged her sick father to go on dialysis at 87, only to watch him “suffer increasing dementia, incontinence, heart attacks, etc.”  The commenter writes, “this once proud, independent man became a shadow of his former self and suffered all of those indignities that we all hope and pray to avoid. In the end, he had a staph infection that led to a stroke that led to a heart attack while on dialysis.” And it’s hard to ignore this comment from a kidney doctor, “The fact is life is finite. We will all die at some point in time. If we have unlimited resources, sure let’s keep everyone alive for as long as possible. But the fact is that, we do not.”

Both points of view seem inarguable: We should take care of our sick for as long as they need and want that care (who can argue with that?) but we can’t afford to keep everybody alive forever (a simple fact, right?).

What do you think about this controversial issue? 

Share Strong! Email this story to a friend

Similar Posts:

• Kidney Transplant Patients Urged to Keep Fit to Survive
• Are ‘Patients’ the Same as ‘Consumers’?
• New Treatment for Chronic Pain after Spinal Cord Injury
• Sensa for Men
• A.M. Vitals: ASCO Abstract Dump Includes Data From AstraZeneca, Exelixis