Posted by violette on June 20, 2010, at 20:39:22
In reply to Re: Rejection of Meds Gives me Hope » Conundrum, posted by chujoe on June 20, 2010, at 12:44:29
I don't consider myself an "anti-med person", but I really like this thread (thanks Huxley!). I also think this is the most appropriate place for the discussion.
Chujoe, in reference to the cancer scenerio you described, like Phillipa said, it's difficult to say w/o having had been in that specific situation. But I have just as good of an imagination as anyone else I suppose...
First, (probably after recovering from possible shock from learning of the diagnosis) I would compare the benefits and risks of getting treatment vs. not getting treatment. If I was 95 years old and had other medical problems, knowing I was going to die soon anyway, I might not wish to go through chemotherapy. What if I had no family to help me through it? Family issues would be a huge concern-what if my child, who traveled weekly for her dream job, had to give up s career to take me to all my appointments and checkups and tests? What is the probability of success after chemoteraphy, and projected lifespan for those who undergo the treatment successfully? If it is not successful, do I have a hospice option or will I end up in a shady nursing home left unattended much of time time, eating green jello? Do I have retirement savings or someone who will provide me with money to get the treatment; if not, am I willing to file bankruptcy or not pay the bills? If I don't pay my medical bills, will all, none, or just some of my doctors still treat me if I had no money to pay what Medicaid did not cover?
Quality of life would be an important factor. If I was going blind from macular degeneration and was in pain every day, maybe I would want to forgoe chemotherapy and die. Would I have to wear one of those bags for the rest of my life, unable to use a toilet? What if I had COPD (or another illness) and was highly susceptible to pneumonia-will I die sooner from chemotherapy destroying my immune system?
Is the cancer still localized, or spread throughout my body? If it had spread throughout my body, maybe I could experience a bit more life enjoyment during the last year of my life by foregoing chemotherapy and spending time with my family or traveling the world until I was no longer able to walk.
I'd have to get 2nd and 3rd opinions from other oncologists or specialists, and see if there are research trials or other treatment options available. Of course, the latest treatment options would be an option only if I could afford them-Medicare likely will only cover conventional treatments.
etc. etc. etc.
Even without further rambling, it becomes more apparent that the issue becomes less black and white and turns grey.
There are some notable differences if you look at a psychiatric scenerio - Many of us initially start medications at a young age...If I was 18, I probably would not ask all of these questions (was this before or after Al Gore invented the internet?) because I wouldn't have had years of medical experiences or life experiences to consider to assist me in decision making. I might be dependent on my parents who insist I take medications--maybe I have no choice at all. Worse, I probably would not be thinking clearly at the time. Or maybe I am trusting of authority figures since I am 18 and had not yet been burnt by a professional before?
What is my degree of depression? Moderate; severe? If my general practitioner noticed depression, I would likely be referred to a psychiatrist who would ask me a few questions then prescribe me an anti-depressant. The other treatment options available would not be discussed with me and I would not be prescribed me medical tests to rule out other things. I would also not be informed about most of the side effects. Everyone would ask, though, if I have a family history of mental illness.
etc. etc. etc.
I am not referring to the ideal-this was my experience with 5 psychiatrists. Having no health insurance for years at a time affected my treatment as well. People should be informed of all their options and likelihood of recovery with or without the medications. People should be assessed for psychological issues in case psychotherapy would be more appropriate and effective than medications. Unfortunately, it didn't happen this way for me and I regret it.
Of course, if the I was suicidal in this scenerio, the treatment decision would be more clear.
poster:violette
thread:951199
URL: http://www.dr-bob.org/babble/20100615/msgs/951675.html