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Nimue (Nimue)
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Posted on Sunday, March 13, 2011 - 7:00 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

End-of-life care in the U.S. is very expensive, which is part of why there's a whole movement dedicated to inducing patients to bow out gracefully. One particularly questionable tactic is sometimes used to get sick old people to sign a "DNR" directive, which means that they will not be resuscitated if they stop breathing. What is it?
Balin (Balin)
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Posted on Sunday, March 13, 2011 - 7:17 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Saying that the family will be suffering if the patient has to continually be cared for? So the DNR will "reduce the family's suffering"?
Nimue (Nimue)
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Posted on Sunday, March 13, 2011 - 7:32 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Balin (Balin)
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Posted on Sunday, March 13, 2011 - 7:17 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Saying that the family will be suffering if the patient has to continually be cared for? That's not itSo the DNR will "reduce the family's suffering"? Ditto. I should add that this technique is particularly applicable to DNR orders.
Noel (Noel)
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Posted on Sunday, March 13, 2011 - 7:58 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Who uses the technique: family members? insurance companies? medical care providers?
Nimue (Nimue)
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Posted on Sunday, March 13, 2011 - 8:16 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Noel (Noel)
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Posted on Sunday, March 13, 2011 - 7:58 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Who uses the technique: family members? no insurance companies? nomedical care providers? no
Nimue (Nimue)
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Posted on Sunday, March 13, 2011 - 8:18 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

BLOOOPERRRRRRRRRRALERT!!!!!!!!
Posted on Sunday, March 13, 2011 - 7:58 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Who uses the technique: family members? no insurance companies? no medical care providers? no The answer to 'medical care providers'? should be yes
Noel (Noel)
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Posted on Sunday, March 13, 2011 - 10:30 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Do they frequently take the patients past other patients who are comatose/hooked up to tubes/otherwise on life support?
Nimue (Nimue)
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Posted on Sunday, March 13, 2011 - 11:26 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Noel (Noel)
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Posted on Sunday, March 13, 2011 - 10:30 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Do they frequently take the patients past other patients who are comatose/hooked up to tubes/otherwise on life support? no, but you're very ORT
Balin (Balin)
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Posted on Sunday, March 13, 2011 - 11:55 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Insurance costs relevant? Cost of the medical care itself?
Noel (Noel)
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Posted on Monday, March 14, 2011 - 1:35 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Do the staff talk about patients that are on life support in front of them? to them?
Nimue (Nimue)
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Posted on Monday, March 14, 2011 - 8:18 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Balin (Balin)
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Posted on Sunday, March 13, 2011 - 11:55 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Insurance costs relevant?only as an underlying motivation for wanting patients to agree to DNR Cost of the medical care itself? ditto
Noel (Noel)
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Posted on Monday, March 14, 2011 - 1:35 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Do the staff talk about patients that are on life support in front of them?yesish or yope to them? ditto
Balin (Balin)
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Posted on Monday, March 14, 2011 - 9:48 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Length of time for palliative care/hospice care relevant?
Redwine (Redwine)
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Posted on Wednesday, March 16, 2011 - 10:27 am:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Do they offer cheaper insurances if someone signs the DNR consent?
Nimue (Nimue)
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Posted on Thursday, March 17, 2011 - 10:47 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Balin (Balin)
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Posted on Monday, March 14, 2011 - 9:48 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Length of time for palliative care/hospice care relevant? no
Redwine (Redwine)
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Posted on Wednesday, March 16, 2011 - 10:27 am: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Do they offer cheaper insurances if someone signs the DNR consent? no
Kdoc (Kdoc)
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Posted on Saturday, March 19, 2011 - 11:37 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

is the thing they do: describing the way the patient might be hooked up to equipment? saying that they may be in pain? saying that they will die soon anyway even if resuscitation then intensive care is given? that it will just extend their discomfort? saying that the intensive care could otherwise be used for people with a greater chance of life? or younger people?
Nimue (Nimue)
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Posted on Sunday, March 20, 2011 - 12:00 am:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Kdoc (Kdoc)
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Posted on Saturday, March 19, 2011 - 11:37 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
is the thing they do: describing the way the patient might be hooked up to equipment? saying that they may be in pain? saying that they will die soon anyway even if resuscitation then intensive care is given? that it will just extend their discomfort? saying that the intensive care could otherwise be used for people with a greater chance of life? or younger people? no to all, but your first guess is closest
Noel (Noel)
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Posted on Sunday, March 20, 2011 - 10:57 am:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Do they somehow let the patients experience what being hooked up to certain equipment is like? Do they ask about friends or family members of the patient who have been on life support?
Nimue (Nimue)
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Posted on Monday, March 21, 2011 - 8:47 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Noel (Noel)
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Posted on Sunday, March 20, 2011 - 10:57 am: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Do they somehow let the patients experience what being hooked up to certain equipment is like? no or noish, but you're very ORTDo they ask about friends or family members of the patient who have been on life support? no
Redwine (Redwine)
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Posted on Tuesday, March 22, 2011 - 3:24 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Could the same tactic be used to make a healthy young person to sign a DNR directive?
Nimue (Nimue)
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Posted on Tuesday, March 22, 2011 - 7:18 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Redwine (Redwine)
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Posted on Tuesday, March 22, 2011 - 3:24 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Could the same tactic be used to make a healthy young person to sign a DNR directive? Possibly, in the unlikely event that health professionals were as eager for the deaths of young, healthy people as for sick, old ones.
Vesica (Vesica)
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Posted on Monday, March 28, 2011 - 11:57 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Is this "encouragement" to sign a DNR presented to the ailing, elderly:
Directly?
Indirectly (such as overheard conversations, walking them through a certain ward)?
Visual?
Spoken to them?
In writing?

Specific choice of words used important?
Do they make them sign any additional form?
Life insurance relevant?
Nimue (Nimue)
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Posted on Wednesday, March 30, 2011 - 8:56 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Vesica (Vesica)
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Posted on Monday, March 28, 2011 - 11:57 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Is this "encouragement" to sign a DNR presented to the ailing, elderly:
Directly? yes
Indirectly (such as overheard conversations, walking them through a certain ward)? no
Visual? yes
Spoken to them? yes
In writing? no

Specific choice of words used important? no
Do they make them sign any additional form? no
Life insurance relevant? no
Nimue (Nimue)
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Username: Nimue

Post Number: 6528
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Posted on Monday, April 04, 2011 - 11:04 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

HINT: You've established that the "encouragement" that health professionals gave patients to sign DNR's was something visual. So just figure out what!
Noel (Noel)
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Posted on Monday, April 04, 2011 - 11:37 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Is the visual encouragement an object? A person/people?
Vesica (Vesica)
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Posted on Tuesday, April 05, 2011 - 3:32 am:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

A picture?
Do they show them the equipment for life support?
Do they "pull a plug" in front of them?
Show them someone on lift support?
X-ray of broken ribs from CPR?
Show them a bill for life-support care for, say, a month?
Show them a chart of how long the average person spends on life support?
Nimue (Nimue)
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Posted on Wednesday, April 06, 2011 - 11:12 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Noel (Noel)
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Posted on Monday, April 04, 2011 - 11:37 pm: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
Is the visual encouragement an object? see below A person/people? see below
Vesica (Vesica)
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Post Number: 512
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Posted on Tuesday, April 05, 2011 - 3:32 am: Edit PostDelete PostView Post/Check IPPrint Post Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)
A picture? see below
Do they show them the equipment for life support? see below
Do they "pull a plug" in front of them? no
Show them someone on lift support? see below
X-ray of broken ribs from CPR? no
Show them a bill for life-support care for, say, a month? no
Show them a chart of how long the average person spends on life support? no

These suggestions are close enough for me to declare a

******** SPOILER **********

A bioethicist recently told me that her hospital was increasing the rate at which sick old people signed DNR orders by showing them videos of resuscitation. She did not say whether the hospital discouraged surgery by showing videos of surgery or discouraged abortions by showing videos of abortion. Many medical procedures & virtually all surgical procedures look pretty gruesome; how many people would have root canal surgery if dentist showed them videos? The hospital's bias is particularly evident in its failure to show sick old people videos of people dying of heart attacks without resuscitation! Please see the bottom of the page for my new, less gruesome puzzle!
Vesica (Vesica)
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Username: Vesica

Post Number: 532
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Posted on Thursday, April 07, 2011 - 1:29 am:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Oh my word!! That's awful. So is that actually ethical?

Great puzzle! I was excited to see you were still active here. You always have really unique puzzles, often based on facts. Very enjoyable!
Nimue (Nimue)
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Posted on Friday, April 08, 2011 - 10:39 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

No, it's not ethical. But it's done! I'm glad you like my puzzles! I like your questions!
Gregoryuconn (Gregoryuconn)
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Posted on Saturday, April 09, 2011 - 9:04 pm:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Does anyone really WANT to get root canal?
Nimue (Nimue)
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Post Number: 6545
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Posted on Sunday, April 10, 2011 - 12:03 am:   Edit PostDelete PostView Post/Check IPPrint Post   Move Post (Moderator/Admin Only)Ban Poster IP (Moderator/Admin only)

Only to end the pain of the condition that makes you need one!

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