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Well either way the man was going to be in a fatal position, they tried treating the brain tumor which meant operating. It's just as horrible to leave the man with the brain tumor than to take it out. He would still need someone with the right resources to care for him eventually, with or without the tumor, it's just that the process was accelerated by removing it. He was destined to wind up in hospital care, he is/was a very sick man and as horrible as this sounds, there isn't anything his wife could do for him...it's beyond that. I'm sorry for the two of them, don't get me wrong, but the man was always going to end up in hospital care. Visiting constantly is all his wife can do.

You're right, it is a no-win situation for this unfortunate couple, but that is exactly why dignified palliative care may have been a better option - perhaps in a hospice. I don't know how these things work in the States, but in the UK, a hospice can provide a much more individual level of care for a terminally ill patient, and has the resources to care for family too - an aspect which is so often overlooked in the adult sector of the hard-pressed NHS.

Well, that sort of stuff, like the level and type of care that could have been considered, is way beyond my knowledge so I answered Hil the best I could. I don't know, I don't think the doctors particularly went for the patient or the disease in that situation... It's true, they treated the disease, but they were helping the man in turn. He doesn't have a brain tumor now.

Sadly, the situation Hil described is, indeed, a no-win one, but I think that the idea was that if doctors care about their patients' well-being, they should conduct a patient global assessment and try to adapt treatments to individual needs/situations in a "do no harm" logic.

But it's harming him to leave him though, you can't just leave a patient with a brain tumor. In that situation, I'd do the same as the doctors involved. It's a brain tumor! Maybe that means I'm a disease person more than a patient one but honestly, I don't see how leaving a man with a brain tumor is going to help him. Could you imagine how it would be to live with a brain tumor.

How much quality time would I be adding to his/her life by operating him/her? Frankly, none. In this situation there is no "right" answer, nor is there a "wrong" answer. But depending upon all circumstances, there are answers that are "more right" than wrong. This is a perfect example to show how doctors act upon the disease. These doctors are very good people doing exactly what they were trained to do. In reality, it's up to the patient and family to step up to the plate and say "Wait a minute ..." which didn't happen in this case because of a number of different reasons. The patient's mental status was altered and the family were behaving like wimps according to a close mutual friend. Kaitlyn, your answers and discussion here are a telling sign that you should pursue being a doctor. And that is a GOOD THING! You will make an excellent doctor (once you get the math conquered, and I believe in you ... you will prevail). Let me be crystal clear, I do not think doctors are cold-hearted individuals that ignore the humanity of the patient. But because of their position, work-load, and the circumstances of the health-care industry, at least here in the US, in general they look more at the disease as something to be fought and conquered rather than the overall, life-encompassing consequences with which the patient will be faced. Doctors take an oath to "do no further harm" which means that not operating is a valid option, provided the patient is kept comfortable.

Actually, my uncle is a doctor and while he admits that it often because of the circumstances of the health care system if doctors are or seems to be disease orientated rather than patient orientated, he sayas that it is a limitation for a doctor to look at at the disease as something to be fought and conquered at all cost, overlooking the overall, life-encompassing consequences with which the patient will be faced. Perhaps it's a difference of culture. Our doctors here have the cloud of mal-practice hanging over their heads at every turn. I'm sure that affects their judgement on a sub-conscious level. People sue over the smallest of things, imagine the threat over something as looming and large as life itself. Fewer doctors are opting to become Ob/Gyn's because of this, especially the Ob part. There's an interesting book that just came out about the "overtreatment" of patients here in the US. It's on my "to find" list. I heard the author speaking on National Public Radio and she brought up some very interesting food for thought. Her bottom line, and I suppose all of us here would agree, is that the ultimate responsibility is on the patient to get informed of all options and make a rational decision based on all the information. I've dealt with a few doctors myself where I made myself informed and we found it to be a mutually satisfying experience. Another thing we do (if we're on top of things!) is have a durable medical power of attorney ready to go at a moment's notice.

Medical malpractice is a relatively new concept here and it is only recently that claims started being filed against doctors. In fact, since the cloud of malpractice hangs over their heads, doctors tend to prescribe miles-long lists of -*test*-('")s to reduce the risk of getting diagnoses wrong and they have the obligation to illustrate all the options patients have for treatments so that they can make an informed choice.

I can imagine how it is to live with a brain tumour, I've met people who lived with one and they were all much younger than the man Hil was talking about and otherwise healthy (and they all died of brain tumours in spite of treatments). In general, I'd also advise a patient with a brain tumour to undergo an operation to remove the tumour, if I were a doctor, but since brain surgery is not exactly like an appendicetomy, if my patient were a man or a woman in his/her 80s with an incurable lung disease, I'd think about whether brain surgery is the right choice. How much quality time would I be adding to his/her life by operating him/her? Right, so if you can imagine how it is to live with a brain tumor why allow someone else to live with one when it can be removed? Take out the man's age and you are left with a very sick person of whom I would like to bet you would have agreed to operate on and I think that is unfair. It's not as if the man's age doesn't allow him to speak up and say if he wants the surgery or not, I'm fairly sure doctor's aren't allowed to operate without the patient's consent therefore they had his support in the operation. If they sat there and went into every single detail about what life after the operation was going to be like for the man, they would most likely have not been allowed to operate but his life would have been even worse had they left the tumor except he'd have another fatal disease on his head. My grandmother was in her mid-seventies when she had to have a heart operation. Seeing as she was an elderly woman, would you have left her considering she wasn't going to be left with any 'quality time'? What's the difference in her case compared to the man's? She needed a serious operation to and she was in hospital care for a long time because my grandfather didn't have the resources to care for her but she is still living now. Who's to say it won't be the same case for this man after his brain surgery? He still has the lung cancer and the emphysema but the surgery on his brain has bought him some time.

Sorry to change the subject, but --- :mrgreen: I have started work at the hotel and worked this morning learning how to service a room should I ever need to do this. This evening I go back and will be trained on the turndown service. I think working in about 4 heritage B&B's in the past has helped me understand the work practise and work load as I found it very easy this morning. I also discovered, I have 4 days work in Jan. I only work a rostered 4 days out of 5 at the moment as the turndown service is only for corporate clients, but this will be extended later for all guests. I also had my first experience with a pc room this morning :mrgreen: pc = party central!! I also heard from the B&B I will be working at until March. Initially I was working 27 & 30 Dec, then 2 Jan. Now I am working those days plus 3-7th Jan. Also C who owns the B&B has recommended me to her neighbour who wants 2 hrs per week, esp when she starts at polytech in Jan. The neighbour has 5 kids, but they are all house trained! :applaud: My interview at the B&B was quite funny. C asked my sister if she would like to help in the garden or house and my sister recommended me by saying I had been in the Navy and loved ironing. At the interview, C told me that she wanted me because her hubby was x-navy and she knew how fussy the Navy was in teaching personnel to clean house/ship, but when she discovered I had worked in a certain B&B with a certain very, very fussy lady, she told me I definitely had the job, which is why she recommended me for the neighbour too. By the end of Jan, I will have no bills, and more money I can count - AND I will be working there for 2 more months - the busiest of the season. I am not sure if I can get back here before Christmas, so to all, BE SAFE and dont drive faster than your Guardian Angel can fly! HAPPY HOLIDAYS

Right, so if you can imagine how it is to live with a brain tumor why allow someone else to live with one when it can be removed? Take out the man's age and you are left with a very sick person ... Just a short note on this subject - my grandmother (who was living in England at the time) was 80 and had a hip replacement because catching her husband who fell broke the bone as it joins to the ball joint. She had been telling drs for ages something was wrong but nothing was done because the drs thought she was old and batty!! It took a year for the operation because the hosptial had overspent it's budget for orthopedic surgery. When she did get the op, and the scar was healing nicely, the drs discovered she had skin cancer along the wound edge, so instead of treating the cancer - they removed the new hip. :angry2: Again she suffered for 18 months because again the hospital was out of money for ortho surgery and she ended up at a hosptial miles from home - and died 5 days later never regaining consiousness. My uncle who is an ambulanece officer in England could never get a straight answer as to why the first hip joint was removed becasue of the skin cancer and what happened in the second operation - the ward nurses told him that something must have gone wrong in the OR as patients would normally wake up within 3 hours - even older patients, but she never did!!

Right, so if you can imagine how it is to live with a brain tumor why allow someone else to live with one when it can be removed? Take out the man's age and you are left with a very sick person of whom I would like to bet you would have agreed to operate on and I think that is unfair. It's not as if the man's age doesn't allow him to speak up and say if he wants the surgery or not, I'm fairly sure doctor's aren't allowed to operate without the patient's consent therefore they had his support in the operation. If they sat there and went into every single detail about what life after the operation was going to be like for the man, they would most likely have not been allowed to operate but his life would have been even worse had they left the tumor except he'd have another fatal disease on his head. Kaitlyn, there is obviously no right or wrong answer to the question of whether it was better to operate this person or not, but you can't start taking variables away from the equation. As Hilary said the patient's mental status was altered and the family were behaving like wimps, so they may have given their consent but I'm not sure that theirs was really an informed choice. Then, perhaps my judgement is not objective because the people that I know had to live with a brain cancer all died within less than a year after their tumour had been diagnosed in spite of their undergoing surgery. My grandmother was in her mid-seventies when she had to have a heart operation. Seeing as she was an elderly woman, would you have left her considering she wasn't going to be left with any 'quality time'? What's the difference in her case compared to the man's? She needed a serious operation to and she was in hospital care for a long time because my grandfather didn't have the resources to care for her but she is still living now. Well, I have a relative who was refused a liver transplant that he desperately needed because he was 65 and at 65 he was considered too old for that kind of procedure.

Just a short note on this subject - my grandmother (who was living in England at the time) was 80 and had a hip replacement because catching her husband who fell broke the bone as it joins to the ball joint. She had been telling drs for ages something was wrong but nothing was done because the drs thought she was old and batty!! Honestly, I noticed it, too, that doctors/hospitals can neglect the elderly. I can recall my grandmother had been complaining that something was wrong with her for long but her family doctor did not pay attention to her. So she was diagnosed diabetes only after she had a stroke (one of the possible complications of diabetes) at 81 from which she never fully recovered. Good luck with your present job in a hotel and your forthcoming job in a B&B, Marian.

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