Everybody but a few enthusiasts refuse to treat ageing instead of cancer or heart diseases. People in general refuse to treat ageing as a disease, thinking it is something natural.
I would not want a couple more miserable years on earth, I want a few million years of a healthy young life.
"Be fine with dying of old age or else you're a villain" is this weird, fundamental, Christian part of our common mythos/ethics/stories. The evil villain seeks immortality. The kindly old witch or wizard or Pope dies peacefully because it is right.
Aging is bad. We might be able to fix it. There are a thousand downsides and challenges that come with a solution to old age, but that doesn't mean leaving aging in place is better.
Would you be comfortable slamming other religions in the same causal way? If not, why not?
If there is a tiger chasing you, wouldn't you try to escape or fight? Or just give up and let the tiger eat you? It is natural, tiger also want to eat, right?
Sure, not by default, but on the merits of those downside, you probably should conclude that it is in fact better to have people age. Especially if it serves to only be available to the rich and powerful. That's just a shortcut to utter dystopia.
Following the First Council of Nicaea in 325 AD, Christianity became the official religion of the Roman Empire, leading to an expansion of the provision of care. Among the earliest were those built ca. 370 by St. Basil the Great, bishop of Caesarea Mazaca in Cappadocia in Asia Minor (modern-day Turkey), by Saint Fabiola in Rome ca. 390, and by the physician-priest Saint Sampson (d. 530) in Constantinople, Called the Basiliad, St. Basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients.[7] There was a separate section for lepers.[8] Eventually construction of a hospital in every cathedral town was begun.
Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church.[9] Ancient church leaders like St. Benedict of Nursia (480-547) emphasized medicine as an aid to the provision of hospitality.[10] 12th century Roman Catholic orders like the Dominicans and Carmelites have long lived in religious communities that work for the care of the sick.[11]
Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation.[12] Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.[13]
Medieval hospitals in Europe followed a similar pattern to the Byzantine. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick.
When and where the first hospital was established is a matter of dispute. According to some authorities (e.g. Ratzinger, p. 141), St. Zoticus built one at Constantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenodochium in each city to be supported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Christians who cared for the pagans as well as for their own. A splendid instance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Cæsarea in Cappadocia (369). This "Basilias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, workshop and industrial schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Basilii"; Or. fun. "In Basil.", P.G., XXXVI, 578-579).
It's like that old joke about a group of PMs that have "invented the general AI". Now all that's left to do is for some researchers and engineers to create it.
Until the general public accepts the necessity of the age-related research, there won't be any effective mechanism for age reversion.
NIH yearly budget is 35B dollars. Half of that they spend on cancer research, the other half divides between the other diseases. Age research is a tiny fraction of this budget.
Until NIH spends at least 1/3 of their annual budget on fighting aging, there won't be any significant progress.
And uncontrolled regeneration can give you tumors [citation needed], so there is no easy path other than your own genetics or having a good lifestyle.
[1] https://en.wikipedia.org/wiki/Telomere
Even rivers and stars have an end...
I doubt they are the primary cause of ageing.
I prefer the theory explaining ageing as an epigenome misregulation that David Sinclair describes.
Maybe I'm overthinking it, but I feel like that is the classic hubris of mankind to aspire to become gods. We want to control nature and life, yet our limited knowledge prevents us from understanding the ramifications of our actions until it is too late. (Under a White Sky is an interesting read on the subject)
Gods were invented by people who refused to admit their ignorance of things they couldn't understand or explain.
Every year the list of unexplainable things gets shorter and shorter. Maybe we'll never be able to explain everything, but I do believe it's within reach to understand the aging process to the point of being able to reverse or even halt it. It may not happen in our lifetimes, and the society that figures it out may not be able to deal with the ramifications properly, but they will learn over time. Just as we've done with scientific and technological advancements in the past. Sometimes you can't figure out how to deal with something until you have to deal with it.
But we are becoming gods. The problem isn't with the aspiration, the problem is that we currently suck at being gods and need to get better at it.
Aging is not natural? I certainly understand why someone would not consider it a disorder.
> I want a few million years of a healthy young life.
I would avoid literal genies if I were you.
We should treat aging the same way. Some people's bodies fail them at 80, but others live to be 100+. If we develop good treatments there's no reason that everyone can't live to be 100 in relatively good health.
With all the talk about 'controlling our bodies' in terms of abortion, and I can see both sides of that one, your own life is the one thing you really own. To have that control taken away is the worst kind of insult by the state.
Plus, the people that need this are (quite obviously) unable to make this happen on their own. So this comes with the additional moral qualms of whether this is really what the wanted and if their mental state clear enough to make a decision like this.
Lastly, not killing these people is the "safe choice" - you're not getting sued for not killing a person. In the end, it probably boils down to this.
How so? We don't have to create a system in which it is legal to shoot someone in the head and then claim they asked you to do it. Have it be a medical procedure that must be done in a hospital by government certified doctors. You can even require a psych evaluation before it becomes an option.
I can understand there being some gray area in which it isn't clear that the person has all their faculties to the point they can request it, but that shouldn't stop us from creating a system that works for all the obvious cases.
Many terminally ill people receive substandard palliative care, and want assisted suicide – it seems likely that at least some wouldn't want it any more (or might never have sought it in the first place) if their palliative care was better.
What are the ethics of saying to people "we aren't going to do anything to fix the substandard palliative care you are receiving, but we are happy to help you kill yourself"?
Once you open the flood gates, you will have plenty who kill themselves who otherwise wouldn't with just a little bit of extra support.
It's one of those things that I might support in idealistic principle but where I develop serious reservations when I factor in how ugly people can be in real life.
Sir T Pratchett wrote extensively about being on the wrong end of dementia. He didn't have much to say about abortion when he was dealing with cognitive decline.
It is that doctor's are familiar with death.
Ordinary people aren't as familiar with death, and don't have a wide range of responses to it because society hides it and pretends it doesn't exist.
The main place regular people encounter death is on the news as a statistic of war and crime. Then when it visits their family and friends, they are unprepared, except for what they know of death, which is a calamity.
Sitcoms don't include death because they exist to take your mind off work, and provide a platform for advertising consumer goods.
Friends and acquaintances don't often talk about death in expansive terms. They only offer a cliche one liner - sorry for your loss - because that's the only response they've learnt. It's a well intentioned sentiment, and also one that's constrained by a fear of death that is unwarranted.
That's a shame because death is an expansive part of life. It's the point at which a life becomes whole, and we can see someone in their entirety. Death, along with birth, is the context for life.
It's going to happen to all of us, no matter how we try to deny it or hide it. Doctors know this and so they let it in. They do this before life descends into the shadows.
I relate to this so much. I had a period of staring my potential death in the face and there is nothing in modern society that prepares you for that. I was completely rudderless for a while because I had literally no social context in which death could be faced without making people intensely uncomfortable.
There's many things I think our society is pretty crap at, but the subject of death in general has to be one of the worst offenders by far. We shouldn't be sweeping death under the carpet as a taboo subject and pretending it doesn't exist, it should be something people talk about. Death is the one thing that unites us all, it would be a far less unpleasant thing to face if people could have a sensible conversation about it without fear or grimaces.
If you want to know about how hard life can get after the death of someone, I cannot recommend Blue by Kieslowsky enough.
Remembering that you'll die someday, and not just some distant day far away but literally any day or moment gives a good perspective to everything in your life and makes you focus on things that truly matters.
But I'm an atheist, and firmly believe that this is all we get, and death really is the end of everything for us. I'm not sure I'd be so accepting if I was facing some kind of afterlife. Even ignoring the possibility of an eternity being tortured in heck, I'm much happier with the thought of everything just stopping than with the thought of it somehow continuing on another level.
It's interesting, how our fear of death drives us. Yet (as gp says) we never talk about it.
I think about my own death, or some disability, at about the same frequency.
What would I do if I lost my hearing, or my sight.
It is one of the reasons I try to live this life, instead of waiting for some future rewards in an uncertain afterlife.
Yes, I am not religious, and I think being religious has little to do with thinking about death. Death is the great equalizer.
And the phrase "if we're alive", is used for longer time periods like next year or more.
Ricky Gervais isn't afraid of it...Have you seen After Life?
UK sitcoms beg to differ - just look at Coronation Street or Eastenders - they cover pretty much every category of death you can think of (except, I suppose, by wildlife.)
Odds of her outcome were something like 5%. She's well aware of how lucky she is.
"Being Mortal" by Atul Gawande talks about this. He mentions Stephen Gould's essay, "The Median Isn't The Message," in which Gould says:
> For most situations, however, I prefer the more martial view that death is the ultimate enemy—and I find nothing reproachable in those who rage mightily against the dying of the light.
Which is an idea I think meshes very well with the strategy of chasing low probability , high reward outcomes. Gawande's response makes a lot of sense to me personally:
> There is almost always a long tail of possibility, however thin. What's wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that's vastly more probable. The problem is that we have built our medical system and culture around the long tail. We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets—and have only the rudiments of a system to prepare patients for the near certainly that those tickets will not win. Hope is not a plan, but hope is our plan.
He also talks about several patients he treated through the years who suffered through futile treatments while trying to become one of the lucky ones and lost what quality of life they might have had in their dwindling time.
I'm glad your sister was one of the lucky ones who had a good outcome as opposed to going through the major surgery and chemo and being one of the 95%. It also seems to me that a different mindset in these sort of situations that educate patients on palliative options and try to make their remaining time as good as it can be would reduce much unnecessary suffering.
edit: for the remarkably special downvoters (stay classy HN) - that's the type of lung cancer my mother died from, in about 20 months time. You generally can't surgically remove small cell lung cancer. It was particularly brutal, with endless treatment attempts that were physically grueling and minimally effective. It's a highly aggressive cancer with a very low survival rate and few good treatment options. Accordingly, having watched her go through that, I can very much relate to what the parent said.
In the end, she went into the bathroom, threw up a lot of blood, and never woke up. They didn’t do an autopsy, but the assumption was that the cancer had just gotten too widely distributed throughout her system.
But, since she had spent much of her adult life helping my dad with one or the other of his medical problems, and she had been an HR director at Norman Regional Hospital for many years, she did focus on trying to keep the best quality of life that she could, right up to the end.
The irony was that she had quit smoking thirty years earlier. It was her sister that did her in. Since the sister was in stage 4 of stomach cancer, they let her smoke in her hospital room. And my mom was the primary caregiver who slept in that room and was there pretty much 24x7. So, her second-hand smoke is what got my mom.
Definitely focus on quality of life. Whatever you’ve got left, you should try to make those your best days, weeks, months, or years yet.
Look at any cancer drug trial and there is a massive spread in outcomes. Some people take a drug and die with horrible side effects in 2 months, others live 10 years with mild side effects.
Why did she recover after she was switched to hospice care? The best explanation I have is that in the hospital, her access to opioids had been limited. Letting a patient have too much can be risky. But in the hospice, where death is regarded as impending, those risks don't matter and she could have as much as she needed to actually be comfortable. And not suffering, not being in pain was maybe what allowed her to begin to heal.
I don't think exactly that her doctors were wrong in believing that her death was imminent and that a hospice was the right place for her. But what if we created a healthcare system where clinging to life is so exhausting for the patient that embracing the inevitability of death is the most healing option?
I think that is somewhat well known? I don't have good references about humans, but veterinarian James Alfred Wight (wrote books as James Herriot) has written about it, how lost cause lamb "miraculously" recovered after big dose pain killer (sorry, don't remember details, only his thoughs, how getting rest from pain helps).
this probably have to do with movement (which applies to other animals and humans) if they feel pain they don't move, that slows down the blood circulation and the healing process.
I was in the hospital 5 weeks at the end of 2020, and I was very aware of all the extra challenges that it brought to healing. Poor sleep due to lights/noise/interruptions, sleeping with a strange roommate who had their own sleep disruptions. Low quality food with few options, and very little fresh fruits and vegetables. On top of constant pain, boredom fear and isolation (despite all the people around).
I understand the hospitals are resource constrained, and have reasons for many of the things they do, but at the same time I feel like rest, nutrition and psychological elements are largely ignored when designing today’s hospital experiences.
For what it’s worth this was in Canada, so at least I didn’t have financial stresses in addition, but perhaps there are other countries more human in their approach to care.
Whatever else a hospital is, it is typically not a place that is designed for rest and recuperation and overall patient wellness. They want to push their curatives on you as quickly as possible and without a lot of regard for your mental well being, so that they can get you out quickly and move on to the next patient. Think of it more like a MASH unit, where you’re only supposed to be there for a short period of time before they stabilize you and ship you out somewhere else.
I grew up spending a great deal of my life in hospitals, because of my dad and his medical problems. And then my mom and her medical problems. But until recently, I never really understood things from their perspective. I hope I don’t develop hospital psychosis like my dad did, but I am definitely very wary of checking into a hospital unless there is no choice.
This is the crux of it. It's hard to predict exactly when people will die. Spend enough time with palliative care physicians and the phrase "if I had a crystal ball" is burned into your memory
Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
I am guessing that he had testing which determined it had spread and was terminal. It seems implausible that an otherwise healthy person would just pass up on a 15% chance of survival.
My dad went through some of that post-stroke. No way.
My mother (who worked in medicine and was very healthy) was diagnosed with a GBM and had a brief course of radiation to try to shrink it without a ton of luck.
She stopped working and went home and had an OK year then an awful 4 months and then fell out of bed and broke her hip and never woke up.
She could’ve maybe had 2 or 3 pretty bad years if she’d “fought” and was “lucky.”
But the family members making that choice weren't footing the bill and they didn't have to lay in bed all day, so why wouldn't they try? I also feel they had a gross misunderstanding of the capabilities of modern medicine.
In each case the doctor's asked, "do you want to give him/her a fighting chance?" Of course, no one wants to say 'no' to that question, because they don't really understand what's possible and don't understand what "winning" actually looks like.
What could be the other reason? Was she naieve? I do know she loved him, but it seemed he needed to do things for her love? She messed with his meds so she could more inheritance. Just American greed.
It's not like she even needed the money. She had two shoe stores in LA, and was a shoe designer.
She got all his cash. She had a lawyer on speed dial according to my brother. My mother got nothing. (We are not a litigious family for the most part.)
She spent part of the money on a Yurt in the backyard of her beautiful home, after a world trip staying in fancy hotels.
She wonders why her brothers, and mother, don't return calls.
One more thing. My father had a huge liver tumor. He had great insurance (Union Cadillac policy). Because modern doctors do not palpitate anymore, he went decade with the tumor. We all knew something didn't look right, but he was told by a doctor it was just scarring from a hernia operation. Not one doctor felt his abdomen, except interns at the hospital. (After the third different intern pushed on his stomach, I said enough. He's not a learning tool for you.)
He left the hospital with an incurable diagnosis. Many specialist looked at him.
This doctor affiliated with the hospital kept dragging my sick father in for appointments. He told him he would operate, after this sanctimonious speech about drinking.
My father was naturally elated.
The doctor called a couple of weeks later, and said he couldn't operrate.
It was all those unnessary office visits that irritated me, along with getting a guy's hope up.
(Sorry about the ramble. I once said, I didn't understand why Steve Jobs didn't use western medicine to cure his Pancreatic tumor. What I didn't know is how low the cure rate of that cancer was. I didn't know what kind of cancer (I hear their are basically two types, and one is somewhat kinda curable. The other is not.). I never should have said anything. When my day comes, I'm using that Right to Die option. I'm glad CA has that now. Oh boy, I am now depressed.)
Right, and people don't generally think to ask those questions because, at that point, they're not in an emotional state that is conducive to stopping and asking questions. That said, the phrase "fighting chance" is absolutely terrible here. It's far too loaded to convey what would actually be meant here.
That appears to be the crux of the problem: "footing the bill". It may sound counter intuitive but I have found that when cost is removed from the equation, then better decisions may arise or at least a few extra distortions are removed.
When money is directly involved then there are several potential, and in my view damaging, extra approaches that might arise. There's the: "we've spent so much and achieved [something] so let's go all in." Or "we've only spent this much so let's go for gold" Or: "We are paying for this anyway and so let's give it a go".
Health care systems that are funded by taxation ie pre-paid, in my view, escape those problems and encourage end of life scenarios that are more likely to be better (for a given value of better)
I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax". The NI rate is: https://www.gov.uk/national-insurance/how-much-you-pay - nominally 12% but is only levied on the first £x. It gets a bit complicated because employers also pay NI for their employees.
The thing about an organisation like the National Health Service is that if you have one and you get hurt, you get it fixed without thinking about it too much. We do pay quite a lot for it but it works and the cost is not so noticeable compared to Income Tax. My dad had a few heart related snags a few years ago that involved a three week stay in Exeter General, then a helicopter flight to London and a six month stay in the Royal Brompton, mostly in their intensive care unit (ICU) which would have been horrendously expensive. One of the docs described how he massaged my Dad's heart in his hands when the bloody thing decided to get a bit weary of being fiddled with too much.
The UK's NHS is not perfect or anywhere near perfect. It's a whopping great organisation with some good and some not so good staff and some horrendous bureaucracy. That said, I would prefer it to any other medical system. It works eventually and often works surprisingly well and often preemptively. Dad would be dead without it. Dad's GP practice missed a few clues. When his doc went on holiday, a Hospital Registrar (as it turns out) was drafted in to cover. Dad presented and his feet didn't touch the floor until he was in a hospital bed.
Again, I have to emphasise that the UK's NHS is not perfect but I don't worry about what to do if my arm fell off or something. I get to A&E and they fix me up.
I have also been at the far end of palliative care (Mum). Again the NHS did the business and did its best (cancer) but it had to accept defeat. That's when Hospice Care cuts in alongside the NHS. St Margarets were absolutely fantastic.
In the end it is taxation that pays for this thing but the fact that you can forget about money when dealing with health care issues is quite important, I think.
It remains a serious criminal offence in the UK to assist in suicide (suicide itself hasn't been a crime for decades).
> I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax".
That is utterly incorrect. National Insurance is not ring-fenced; the money goes into the government's revenue pool, same as Income Tax. It can then be spent on weapons, wars, or subsidies for fossil-fuel industries.
NI is just a wheeze to allow governments to increase taxes on income without appearing to raise the rate of Income Tax. There's a reason the rate of NI has never gone down.
[Edit] I appear to be wrong: NI income doesn't go into the "general pool", at least not directly (it seems to be complicated).
NI is an obnoxious tax. It is capped; earnings over about £900 pw are untaxed. Pensioners are untaxed. So the burden falls most-heavily on less-well-off working people (the less you earn, the greater proportion of your earnings goes in NI).
Many religious organisations want something similar and deliver approximately nothing in return.
I'm a bit warey of his assertion that all doctors think the same way as him though. He relies pretty heavily on his experience and a few anecdotes. I wonder if there is any actual data on how doctors view "futile" care and end of life.
“Most physicians would forgo aggressive treatment for themselves at the end of life, study finds” https://med.stanford.edu/news/all-news/2014/05/most-physicia...
My mom was an ER and ICU RN and NP. She’s to the point where I have a written protocol for when and how I am to call 911 in the event of an emergency for her.
Nobody wants to die, but few who understand want to live in the purgatory between life and death that futile care entails.
This is why palliative care is so important. All of our goals in life are vastly different all the time, even cycling every week.
I've seen what chemo does to people. No thank you. If I get cancer, I'll just self-medicate with whatever opioids I can get my hands on until either the cancer kills me or the pain gets bad enough that the opioids stop being able to do anything for it, at which point I'd just intentionally OD by a massive amount while alone in a remote location.
(and on top of all the debilitating, crippling effects of chemo, I am also, for multiple reasons, particularly attached to my hair... it's one of the only parts of my body I like, and I would literally rather die than lose my hair)
Unfortunately so much of this is decided at the last minute as people are terrified or just desperate for any lifeline no matter the consequences. Choices that, had they made them without those immediate pressures they may have made differently and had time to truly think through.
No. A death panel does not decide when someone is to die but when treatment is to be stopped due to mounting costs, regardless of the wishes of the patient.
This was the definition of the death panel:
> Palin's spokesperson pointed to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options.
To me, these weeds are to be uprooted: Christians willingly inflict suffering unto others, as they believe it is the natural state of human being and must be increased in servitude of their God, especially near death.
https://www.hoover.org/research/religious-faith-and-charitab...
> The differences in charity between secular and religious people are dramatic. Religious people are 25 percentage points more likely than secularists to donate money (91 percent to 66 percent) and 23 points more likely to volunteer time (67 percent to 44 percent).
https://www.philanthropyroundtable.org/philanthropy-magazine...
> In study after study, religious practice is the behavioral variable with the strongest and most consistent association with generous giving. And people with religious motivations don’t give just to faith-based causes—they are also much likelier to give to secular causes than the nonreligious.
https://givingusa.org/just-released-giving-usa-special-repor...
> People who are religiously affiliated are more likely to make a charitable donation of any kind, whether to a religious congregation or to another type of charitable organization.
> Religiously affiliated households give as much or more to other types of charities as non-religiously affiliated households do.
It is Jesus’ final message.
Sin does not exist, they made it up to make themselves and others suffer.
Have you considered that some people are so keen on giving away their fortunes because it makes them suffer more, and thus makes them think they are now cleaner in God’s eyes?
Following the First Council of Nicaea in 325 AD, Christianity became the official religion of the Roman Empire, leading to an expansion of the provision of care. Among the earliest were those built ca. 370 by St. Basil the Great, bishop of Caesarea Mazaca in Cappadocia in Asia Minor (modern-day Turkey), by Saint Fabiola in Rome ca. 390, and by the physician-priest Saint Sampson (d. 530) in Constantinople, Called the Basiliad, St. Basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients.[7] There was a separate section for lepers.[8] Eventually construction of a hospital in every cathedral town was begun.
Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church.[9] Ancient church leaders like St. Benedict of Nursia (480-547) emphasized medicine as an aid to the provision of hospitality.[10] 12th century Roman Catholic orders like the Dominicans and Carmelites have long lived in religious communities that work for the care of the sick.[11]
Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation.[12] Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.[13]
Medieval hospitals in Europe followed a similar pattern to the Byzantine. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick.
When and where the first hospital was established is a matter of dispute. According to some authorities (e.g. Ratzinger, p. 141), St. Zoticus built one at Constantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenodochium in each city to be supported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Christians who cared for the pagans as well as for their own. A splendid instance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Cæsarea in Cappadocia (369). This "Basilias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, workshop and industrial schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Basilii"; Or. fun. "In Basil.", P.G., XXXVI, 578-579).
https://news.ycombinator.com/item?id=3313570 (2011)
https://news.ycombinator.com/item?id=5104430 (2013)
http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die...
http://www.theguardian.com/society/2012/feb/08/how-doctors-c...
The bottom of the Cancerworld article says:
> This blogpost was first published in 2011 on Zócalo Public Square
The bottom of the Guardian article says:
> Taken from an article originally published at Zócalo Public Square.
> I (and the doctors in my family whom I’ve asked) am pretty much like the doctors in the article. If I get a terminal disease, I want to wring what I can out of the few months of life I have left and totally avoid any surgery, chemotherapy, amputations, ventilators, and the like. It would be a clean death. It would be okay.
> My big fear, though, is that I won’t get a terminal disease.
Yes, chemotherapy has very adverse side-effects. But it's also the best course of action we currently have for a lot of cancer patients. It varies depending on the type, grade and stage of the illness, as well as the patient's overall health [1]. It should not be rejected outright.
Now for my personal anecdata: My sister in law was in her 30s when they detected her breast cancer, and got chemo for some time. It was a very difficult time for her, but it worked - the cancer receded. She kept having to do get periodical checks to keep tabs on it.
Unfortunately her cancer came back, and this time it was more aggressive - it resisted all treatments and eventually metastasised. They took her off chemo, but her health deteriorated very quickly anyway. She died 1 and a half years ago, at home.
On average, chemotherapy gave her and my brother around 7 years of life, in exchange of some very shitty quality of life moths due to side effects. They definitively made the right choice in taking chemo the first time, and not taking it the second time. A lot of people's cancers never come back.
I am not saying that chemotherapy is worth it in all cases. I am painfully aware that it isn't. But it is worth in a lot of cases. Don't reject it outright.
PS: I should mention that we live on a country with a civilized health care system where her treatments were paid for by the state's Social Security. No one in this story had to deal with "can we afford this treatment" problems. If you are in that situation, I am sorry for you.
I wonder how often physicians die as a result of taking a drug such as Nembutal - the drug recommended by Exit International. Civilians can't buy this drug - not even illegally, e.g. on the Dark Web, as far as I can see. But physicians can.
I don't want to get caught. I don't want the kind of "palliative care" that amounts to death-by-dehydration. If I get throat cancer and can't swallow, no amount of pain-killers will make my death pleasant.
I want a stash of Nembutal, so that I can do myself in, if the prospect I'm facing is a nest of wires and tubes or untreatable pain. It's an ethical disgrace that it's illegal for me to manage the end of my own life.
Apparently any relative that accompanies me on the plane to Switzerland risks prosecution for assisting a suicide. So if I want to die quickly and peacefully, I'll have to do that on my own.
The amount of humbug that swirls around this subject makes my head swim.
