PHOTOS, PAGE 1

       Editor and prime reporter is Doug Terry, a veteran television and radio reporter in   Washington, DC, (details below)

The quotes just below are from an NY Times magazine article about treatment of people who are dying, followed by a commentary from The TerryReport

I watched them lose control of their lives to a set of perverse financial incentives ” for cardiologists, hospitals and especially the manufacturers of advanced medical devices” skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said,”To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors ” perhaps with the exception of Fales” as healers or her fiduciaries. They were now skilled technicians with their own agendas

It is important that people receiving treatment, what we called patients, become the primary decision makers about health care choices in non-emergency situations. Most people will, lacking a full picture, choose intervention and even a modest extension of life when faced with the prospect of \"do this, or else\". In addition to responding to pressures from the makers of medical technology and drugs, the medical profession is responding to the wishes of families and the pressure to extend life at whatever cost. Most people have not faced these difficult choices previously and who wants to say they didn't do the best they could for Uncle Charlie?

I believe this when it comes to major, life changing procedures: first, say no. If you have the time, say no and wait, either a few days, a week or even longer. Use this time to gather information, get a second opinion, assess the risks and benefits.

There is a fundamental truth about nature, and the human body, which we should all understand: nothing comes for free. When you poke nature in the eye or push it in the side, something pops out on the other side. When you push the body out of order with drugs or drastic interventions, there is always a price to pay. Nature seeks to restore order, but, working with and against the drugs, the illness and technology, can never right the listing ship. The forces set in motion invariably cause harm as well as benefit.

The professional prejudice of the entire medical profession is toward intervention. Do something. Studies show that \"five per cent of the patients treated with X or Y experience a better life\" or whatever. Who spends millions of dollars to learn the consequences of failed procedures or those which work fairly well, but not well enough?

We are not lab rats. We should not allow ourselves to be treated to death, bit by bit. If studies show that 40 percent of patients have a full and productive life after a procedure, what about the rest? The article mentioned that a significant number of post operative by-pass patients experience a 20% decline is cognitive function. Is this acceptable? By whom? For whom?

The medical profession doesn't have to live with the results of their handy work. We do. Doctors and others go peacefully to bed, believing that they have done something good for their patients, according to the best studies, scientific papers and recommendations of experts. Here is a fundamental problem: we can never know, for a given patient, what would have happened had nothing been done.

We need to slow down the onslaught of medical \"progress\". There is too much innovation and not enough careful consideration. We need to face the simple fact that, between the ages of 70 and 80, almost everyone is going to die. They are going to die because they should die, because the body has, by that point, accumulated enough problems and break points that nothing can save it for very long and nothing can ever make it fully functional as it once was.

There might certainly come a time when people are living healthfully into their 90s and beyond. When that day arrives, it will not be because of some new drastic intervention in the life process. It will likely be from small changes, like diet, consistently applied over decades combined with less invasive, less drastic treatments that have a much lower prospect of sending the body out of balance.

A final thought: even though dire treatments in the final months of life are seldom a good idea, never give up. Never give up on a love one who is suffering, never back away from asking sharp questions of doctors and nurses and never stop trying to help, in whatever way you can. If that results in longer life, rather than a more peaceful death, so much the better. Doctors and others can give care, as they see it. Only we, the sons or daughters, the brothers or sisters or other family members, can give love and care.

Doug Terry

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