Friday, May 4, 2012

Lawyers, Doctors and Life and Death

It is possible to get a law degree on line or by mail order.  There is no limitation to the size of a class for lawyers.  The only limit to the classroom size is sound system.  Lawyers could be trained in stadiums and shopping malls. There is further no direct correlations between the well being and health of a community and number of lawyers.  Law is an arts degree, albeit applied arts.  .  
There are distinct limits to the number of doctors a community can produce because the process of learning medicine is hands on. It's a science and an art. Students must have A grades in both arts and science.  The learning of medicine involves dissecting bodies, touching abscesses and talking to dying people with contagious disease while worrying if you are getting the disease the dying person already has.  It's distinctly smelly and nauseating to be a doctor.
Lawyers avoid disease.  Their contact with disease is less that a check out girl's.
Doctors are trained in scientific reality.  There is gravity in their discussion.  Lawyers are trained in argument and are notorious for the 'emperor has new clothes'.  A good lawyer can convince you a serial pedophic murderer is not a bad guy and just didn't get enough cuddling and breast milk.
There is a surplus of lawyers and laws.  There is a shortage of doctors. There is a direct correlation between the health of a community and presence or absence of doctors.  Less than one doctor per 500 people there's a greater burden of disease in the community.
There is no correlation between lawyers and health and there is even further no correlation between lawyers and crime or justice in a community.
I like lawyers. I think they take amazing risks financially and rarely personally.
Who best to decide whether a person is dead.  Hands down a doctor.
Add a lawyer to the equation and there will be delay, increased cost and increased argument. Lawyers make the best critics and are by far the most litigious, political and argumentative.  Lawyers are wonderful where there are no limits on the overall costs of health care.  Lawyers are happiest to make the most money in any context.  They are even better where  time isn't  a factor (I was just in a court where the judge was trying a matter that had occurred over a decade ago when dinosaurs by scientific time sense had ruled the world).
Note, doctors live in a real world of biology and chemistry where seconds and nano seconds in decision making affect life and death. They're like the soldiers in the front lines whereas lawyers are more like the historians who discuss battlefields on Monday morning.
Right now in Ontario there is a tribunal for resolving death.  They leave it to doctors in most cases but now doctors have the burden of everyone looking over their shoulders so when they want  to they step in and discuss death.  It's a doctor, lawyer, layperson committee. I'm always suspicious of the lay persons. Who are these people and what political favour got them in these truly cudo positions.
If a person is dead a doctor wants to stop taking care of them. If there was no limit to resources and infinite funding for medical resources a lawyer would gladly maintain a dead person as they are like 'dead files' in the legal sense.  "Cold cases' in the police sense.  But doctors are devoted to the living and if anything would rather the dead cases be transfered as quickly as possible to the pathologist or mortuarian.
Is a person alive?  A doctor knows betters hands down over a lawyer.  To a lawyer life and death is more like the Monty Python joke about the 'Dead Parrot."  "It's a pretty parrot. Are you sure it's dead." "Yes, it's dead, you sold me a dead parrot."  "N o, it's just sleeping."
In all aspects of my medical care i make decisions about life and death.  I've done amputations and discarded dead babies and pronounced dozens of people dead.
Today a lawyer wants me to discuss these decisons with him.  For that to occur there needs to be another room in the hospital with a bed and 24 hour 7 day week call schedule and lawyers will have to be on call in the hospital even though they'd like to do 'call' from their homes over the phone maybe with skype or television camera.  "Yes, doctor, he looks dead to me over this android iphone . "  The cost of a parallel lawyer on call system will ensure that thousands of babies next year will die because there will not be a surgical unit as theres now another law office in the hospital. There already are law offices in the hospital and administration offices. There's just no room for doctors or patients.
Decisions happen when there's a dead person and doctors have to move the dead person out of the room to let in the live person. It's called triage.
CBC had a freak show sexist person on the radio this morning saying the days are gone when doctors make 'paternalistic' decisions.  What is this 'paternalistic" decisions business anyway.  A leading doctor in the American Civil War was a woman who pronounced dead thousands of soldiers. In 1930 30% of medical school classes were female. Half my class were female.  My teachers were female doctors.  I was called before the College of Physicians and Surgeons over the politically incorrect though clinically correct life saving care of a female child and was judged by 6 women doctors, not a man among them.  They were all extremely parental but not a single maternalistic one among them was paternalistic.  The judges are historically paternalistic but it's still truly frightening when the national  media has this level of sexism front and centre in Canada a supposedly civilized modern or post modern society.  CBC Freak show.
Yet the law would call me offensive if I were to speak disparagingly of the worst evils of maternalistic medical care as it endeavours to deny the dead life saving measures
To the best of my knowledge everyone wants to cherry pick. Right now that's what is happening in the life and death debate.  Doctors are doing it and doing it extremely well and have for centuries. Now lawyers want in on the action, not pro bono, but for a remarkable fee, and doctors would gladly include them. All I ask is that doctors be assured that they get paid equal to lawyers and given the same amount of time in the decision making process about life and death because last I looked the law was principally about money.
Medicine is about life and death.
That said I really admire all my lawyer colleagues who do work pro bono. They exist and are a grand bunch of men and women. Many in their profession frown on them as much as doctors are frowned on who by others standards 'give it away for free'.
All manner of folk don't want to believe their loved one is dead.  All manner of folk want miracles.  Everyone feels good as the gift giver.  No one likes to give bad news.  I confess I'm a little miffed to think that others want the cream and get in on the high profile and cherry picked cases and 'special cases' where they get to say "lets keep your loved one, dead as they may be, a while longer on the life support equipment that someone else is paying for."  I want to be a patient 'advocate'. That's what a doctor by definition was but now the word 'advocate' is restricted to the lawyer.  And soon there will need to be two lawyers because being of two minds about all things they always travel in pairs.
My friends are great lawyers and I love their company so I really appreciated hearing that US doctors are now having lawyers accompany them 24/7 like bodyguards. The amount of money I miss billing for in the public health system because I 'm so distracted by trying to keep people alive would likely pay for a similiar service.  The last hospital I worked at I used to coffee clutch every other day with the hospital lawyer.  But the hard decisions were always in the wee hours of the night when you needed a lawyer at your side to tell you what to do and then for that same lawyer to go to jail with you when you made the wrong decision.  I want someone to have my back and if it's going to double or triple or quadruple the cost of health care, so be it.
Every dead person, not just the pretty or rich ones, should have the same benefit and given an MRI or a lawyer I'm sure dead people would want the lawyer. They certainly don't care for another MRI after they're dead but lawyers who have comforted me in trying times could well comfort the dead.
Now the decision about life and death is going to the Supreme Court of Canada. This is the same group that is pro abortion and said babies were dead and could be killed even better when they were in fact alive. There's one lovely lady who was aborted and chucked in the waste only to live and go on today to give talks about life and death.  Everyone who decides life and death decisions should know her.
The Supreme Court of Canada are all lawyers.  The question is whether dead people need lawyers when we cut away the chaff and just as I saw doctors need lawyers and as lawyers go in pairs and hence need lawyers, the judges will likely say the dead need lawyers.
I am indeed looking forward to being asked by the Supreme Court of Canada to teach the new law students about death. I'm looking forward to showing them where to touch dead people, how neck vessels aren't often as useful as groin vessels for getting pulses. Further it's a particular smell that one needs to become intimitately aware of .So I want to take the lawyers and those lay persons out to smell floaters first. Then I'm going to go round the morgues and get the nostrils of lawyers really geared up for the more pungent death smells.  Gangrene is particularly memorable. Dissecting dead eyes so I gained a real appreciation of the dead gaze and would think dissecting dead people's eye should be part of the curriculum for sure.  I really enjoyed that. Studying the urine and feces and any genital discharge from the body was alwasy helpful.  I haven't noted genital discharge  so it's not been part of my observation but it's said to occur.  I've not needed it for decision making but using a stethescope and listening to chests and also know how to know when EKG machines are unplugged or malfunctioning was important.    I've found that looking at the  feces and urine and smelling sweat helped my decision. There's a whole lot more to the decision making too and frankly I've never met a lawyer to date who is certified qualified or capable of reliably knowing death. I further expect that my training of lawyers will require them to do at least one more year of law school to accomplish what is the bare minimum of knowledge about life and death in a scientific world.  I could teach a farmer a whole faster that a city slicker lawyer but that's a whole other kettle of fish.
I've not made a mistake yet pronouncing people dead.   All my dead have stayed dead but a few of my colleagues, those who worked more with the dead,  who were way better than me at telling death, had their pateints miraculously come a live.
I'd think therefore a religious leader and a lawyer should be present and trained in the decision making about life or death.  I'd be glad to do a year of life and death scientific training for religious leaders and extend their educational requirements in terms of cost and time as well. So now I've got a lawyer, a religious leader, and a lay person and because of that sexist CBC attitude I'd like some representatives from various gender groups.  Transexuals, homosexuals and lesbians shouldn't be excluded.  As well, a random assortment of cultural groups or perhaps the whole United Nations could be present. .  Finally I knew when my grandmother was dead as a child. Most likely by luck. But I've known children who knew things were alive which old folk didn't. So I'd say we should have a child making rounds everyday with me.  It's a committee then and government loves a committee because then no one is accountable and everyone can pass the buck.  Of course the expansion of hospitals will cost billions so that my entourage will be able to go from room to room in the hospital. Probably twenty or thirty lanes will reduce likelihood of foot traffic jams between wards.
But I'm a private person and when I die the last thing I'd want is a committee about.  At most I'd like a doctor and a family member and if I don't have a family member I'd take a friend, a religious leader or a lawyer.  Hell, a cowboy or fireman would be good too but then I'm not fussy.
What I really think is that we should all accept that we need a living will and when we go for our driver's lesson we should have a box to check off.  When you're dead do you want to be dead and stay dead or do you want to come back to life.  Only some of the people I resuscitated thanked me. The others hated me till they died.  I'd prefer the lawyers take the ones who hated me for resuscitating them while I'll be glad to continue to care for the ones who are grateful that I saved their lives.


3 comments:

Anonymous said...

I WOULDN'T WANT TO COME FOR A COLD AND HAVE MY BODY PARTED OUT

Anonymous said...

I WOULDN'T WANT TO COME FOR A COLD AND HAVE MY BODY PARTED OUT

haykind said...

Since institutions now have lawyers probably patients going into institutions should have them too. I think working out a living will with a lawyer is a good idea all round.