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IEET > Rights > Personhood > Life > Health > Staff > Kyle Munkittrick

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We Don’t Know How to Get Old Anymore


Kyle Munkittrick
By Kyle Munkittrick
Pop Bioethics

Posted: Oct 24, 2011

I am an advocate of pursuing anti-aging medicine. But what does that mean?

It means I support research to create medical techniques and pharmaceuticals that would prevent age-related health issues like muscle wasting, mental decay, lowered immune response, and heart disease. It also means I support the right of someone to refuse certain medical treatments based on proper information about their health.

km1

Jane Gross paints a bleak picture of reality:

No one then envisioned the stunning advances in medicine that now keep people alive into advanced old age, often with unintended and unwelcome consequences. Indeed, scientific reports have showed the dangers, not merely the pointlessness and expense, of much of the care Medicare is providing.

Of course, some may actually want everything medical science has to offer. But overwhelmingly, I’ve concluded in a decade of studying America’s elderly, it is fee-for-service doctors and Big Pharma who stand to gain the most, and adult children, with too much emotion and too little information, driving those decisions.

In the last year alone, and this list is far from complete, here is what researchers have found both useless and harmful, according to leading medical journals:

  • Feeding tubes, which can cause infections, nausea and vomiting, rarely prolong life. People with dementia often react with agitation, including pulling out the tubes, and then are either sedated or restrained.
  • Abdominal and gall bladder surgery and joint replacements, for those who rank poorly on a scale that measures frailty, lead to complications, repeat hospital stays and placement in nursing homes.
  • Tight glycemic control for Type 2 diabetes, present in 1 of 4 people over 65, often requires 8 to 10 years before it helps prevent blindness, kidney disease or amputations. Without enough time to reap the benefits, the elderly endure needless dietary limits and needle sticks.

Yet Medicare, which pays for all of the above, does not, except in rare instances, pay for long-term care in a supervised, safe place for frail or demented old people, or for home aides to help with shopping, transportation, bathing and using the toilet. . .

Why is nobody enraged that our taxes are paying for hip replacements, for example, for people with advanced Alzheimer’s disease, who are incapable of physical therapy? Why is nobody saying out loud, like it or not, that one of our great challenges is figuring out what to do about our elderly people, our fastest growing-population cohort, which will grow exponentially when 76 million baby boomers join the ranks?

The current system is unsustainable, but the alternative is the third rail of health care policy. President Obama’s original legislation included Medicare reimbursement to doctors for discussion of end-of-life issues. These are what Sarah Palin called “death panels”; days later, they were cut from the legislation. An Independent Payment Advisory Board will make recommendations to Medicare about what works and what doesn’t, beginning in 2015, but its proposals are not binding, as intended. A long-term-care insurance provision — with an average daily benefit of a mere $50 — is under siege.

It is not just that the health care system is broken – it is, critically – but the way we think about health is broken. Gross’ argument is a big step towards addressing that broken thought process. Our words have lost much of their meaning from a century ago. Happiness is a great example. “I am happy” is a phrase we utter when eating ice cream or watching a good film. That’s not what “happiness” meant when it was written down by the Founding Fathers. “Happiness” in that sense is one of flourishing, that one’s entire life is going in the right general direction, as are the lives of those close to you. Happiness is measured in a moment of reflection and thought, not based on an in-the-moment gut check.

Health also has been so tainted. Health, as we use it, is a broken synonym for well-being. But something is lost. “Health” as we use it is not about the person but the body. There is a great doctor colloquialism that goes, “treat the patient, not the disease.” Such an adage has never been so relevant to our current crisis. Cutting edge technology that can be life-saving is only of value when the person receiving the treatments can recover. Again, I emphasize that my argument is not that the treatments are only worthwhile if the body will repair itself completely, but that they are only worthwhile if the person can recover.

We can now keep a body alive well after the person inside of it has wilted away to nothingness.  Life is priceless, yes, but so is dignity. Our idea of health needs to move beyond the body to a place where a person can, in their last moments, lucidly say, “I’ve had a good life. I’m happy. Goodbye.”


Kyle Munkittrick, IEET Program Director: Envisioning the Future, is a recent graduate of New York University, where he received his Master's in bioethics and critical theory.
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COMMENTS


> “I support the right of someone to refuse certain medical treatments based on proper information about their health.”

How does the patient know it’s based on _proper_ information?

> “I’ve concluded in a decade of studying America’s elderly, it is fee-for-service doctors and Big Pharma who stand to gain the most, and adult children, with too much emotion and too little information, driving those decisions.”

But these adult children often let their emotion, or at least their wallet, drive their decision in the _opposite_ direction, too, in which case the fee-for-service doctors and Big Pharma are _not_ gaining.

> “here is what researchers have found both useless and harmful… agitation… repeat hospital stays… needle sticks…”

“Useless and harmful” are words that must be seen in context. If the alternative to these bothersome things is worse than the bothersome things themselves, then maybe they’re worth it.





Interesting article.  It makes me think about what post-post said about our elders.  If the knowledge and wisdom they have to offer is, as he said, “outdated” and most of them just want to suppress the youth, why do we put so much effort in trying to preserve them?  What is the purpose in trying to keep the older generation if not to learn their experiences and lessons?





The key word in your post, Christian, is the word “if.”
How can anyone generalize about the older generation and claim their wisdom is all outdated?





Ronaldo
Ask post-post. He did.





But you, it appears, gave the generalization credence.





@Ronaldo
that was from a comment debate I had with post-post in the “What the Wall Street Protest is About” section.  forgive me if I sounded like the one who was making those generalizations.  I actually respect my elders (not to sound like I’m bragging) and listen to what the have to offer.  It is just some people seem to think their ideals and thinking is from the 1950’s and irrelevant to today.  If this was the case we would not try to keep our elders alive longer other than to maintain family ties.





Not to say the knowledge and wisdom elders have to offer is entirely outdated; nor do most elders merely want to suppress youth, however much of their knowledge and wisdom can be considered outdated and many elders do manipulate youth to an unacceptable degree. Much tedious and quite negative evidence could be offered to bolster the opinion that many elders who have had time to amass wealth and have acquired the experience to manipulate youth are culpable.
Yet not to deny the culpability of youths.
I originally went into a brief discussion of elder-outdatedness/manipulation prompted by a concern as to why protesters (who are primarily young) are so irate. Right at this moment in time one might hazard a guess youths are angry and anxious because for starters the near future (i.e. the next few years) will be rather unpleasant for them in certain ways.

It is not 100 percent implausible that in a national emergency youths would be conscripted, though the likelihood of a mobilization in today’s conditions being successful is extremely low. Nevertheless, the aggregate number of youths conscripted or coerced into ‘defense’ apparati of many nations in the world is high. Would it be safe to venture that if “Woman Is The [N-word] Of The World” as a Yoko Ono song is titled, then youth is the cannon-fodder of the world?
After all, such has been the case in the past, and in some nations (present nationalities of IEET members excluded naturally) the situation has largely remained the same.





“nor do most elders merely want to suppress youth”

This article is about elderly people who are in advanced old age. They’re too old to be in the position of suppressing youth.





“This article is about elderly people who are in advanced old age.”

My response at this piece was only in reply to Christian’s digression; but while we are at it: are you entirely certain very wealthy elders are not economically suppressing youth in some manner?





Lets say it’s true to some extent. What percentage does it have to be in order for a person to ask the question Christian asked: “why do we put so much effort in trying to preserve them?”





“What percentage does it have to be in order for a person to ask the question Christian asked: ‘why do we put so much effort in trying to preserve them?’ “

Right question, but was afraid you might ask it—wouldn’t want to reply to such a question, Ronaldo, even if I had some idea of the answer.
Some sleeping dogs one likes to leave sleeping.





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