Demented Adventists
How about B12, D3, Natural E, and what Jesus fixed for breakfast? And how long should we live in a world far from the Tree of Life? There are worse things than dying.
By Jack Hoehn (John B. Hoehn, M.D.)
He was a retired pastor and was once the president of an SDA Conference. His formerly active and intelligent wife of many years had progressive Alzheimer’s dementia. He cared for her kindly and faithfully in their own home. She lost more and more awareness of the present, although her past memories could be surprisingly accurate. So one day in the afternoon she said to her graying partner and caregiver, “You’ve been very kind to me, but you had better leave now, for my husband will be coming home soon.…”
One could laugh and cry at the same time. Obviously her memories of her husband were of a younger, vigorous man who had courted and wed her many years ago. Now there was this kindly older gentleman who had been with her all day, but she could not connect her present reality with her remaining older memories.
Alzheimer’s Dementia is a plague in many health reforming Adventist homes, as well as in our neighbors’ homes.
I’ve watched leading pastors and evangelists, brilliant men and women, administrators, executives, teachers become worse than shells of their former selves by dementia. Spiritual and moral leaders have become quite amoral and parodies of their former selves. At times I almost hear the demons’ dancing about their destruction and conquest of not only a mind, but a soul destroyed by multi-infarct dementia, Pick’s disease, Parkinson’s disease (Lewy body dementia), and Alzheimer’s disease.
Living Too Long
The causes of all this loss of cognition are not known but include several factors. As we live longer with the conquest of infectious diseases, cancers, and cardiovascular deaths by medical science, people are now commonly living to their 90’s. If we were all dying in our 70’s there would be far less dementia.
For this reason, as a physician, I do not share the common sentiment that says, “What a tragedy; she died so young!” or “Why did he have to die; he’d never been sick a day in his life!” The alternative of a long life without mental comprehension, the so called “living as a vegetable” is surely not desirable. Death and loss is a big problem for the survivors who are left alone and in grief, but death is a sure cure and sometimes a preventative for dementia, so personally I mourn for the survivors, not for the departed that I sometimes envy.
Dr. Ezekiel Emanuel wrote a controversial article for the Atlantic Monthly, October 2014 issue titled, “Why I Hope to Die at 75.” This physician with a 90-year-old father details why living longer is not always desirable. Although you may not like his personal plan for stopping all preventative care and most curative care after that age, he does have reasons for his decision that have some morality and unselfishness behind them, and are worth considering even by Adventists striving to outlive the rest of the population with our Health Reform message.[1] Dr. Emanuel has a very clear list of what he would and would not do after age 75. (See footnote for more specifics.)[2]
At what cost to our family, our society, the children of the world, do we invest expensive resources in keeping alive elderly people with limited quality of life and no prognosis for regaining productive independent living? At what age should we stop doing high tech bypasses, angioplasties, valvuloplasties, intensive care, cancer chemotherapy that is palliative and not curative? When is comfort care and hospice the moral choice for Christians of age when facing an illness? If we do not fear death, why should we behave as if we do, with life preservation and prolongation at all cost and at all ages?
Three Wills
There is a very practical issue here that some of us neglect. And that is to have a clear statement of our intentions on life-prolonging procedures legally left for our family members and available to our health care providers. Adventist have had advice from Ellen White on this for many years:
“Wills should be made in a manner to stand the test of law… Death will not come one day sooner, brethren, because you have made your will.”[3]
Wills regarding our property disposition at death are still important, but there are two additional “wills” and another document that need to be added.
“Living Will (Attorney for Health Care)/POLST
The second Will you need is a document stating that you do NOT wish your life to be artificially prolonged, in case of death or near death. This is sometimes called a “Living Will,” and you need to make a document (Attorney for Health Care) to give legal authority to a younger sibling, a child your trust, or other relative or friend who will outlive you and who can act on your behalf if you are unconscious or otherwise impaired. This legal document can be made with your lawyer or by using legal software you can buy for your computer.
These documents are only valid if you are unconscious or incapable of expressing your will; at any time you can say, if you are aware and able to speak or write, “Take me to the hospital, I want to be treated.…” But if you are found on the floor, unconscious, half alive, or alive and unable to speak, you need to leave instructions on what you want done or on what you do not want done.
I value quality of life, more than quantity of life, so here are my personal instructions after age 60:
- If I have no heart beat or respirations, say a prayer for me; don’t try to bring me back. No cardiopulmonary resuscitation, no CPR. No code, no shocks. No intubation or ventilation.
- If I am half alive, keep me comfortable, but don’t slow down my natural death. Comfort care only. No intubation. No ventilator. Don’t take me to the hospital unless you can’t keep me comfortable at home. No ICU care, no lab tests, no surgery. No antibiotics.
- If I am alive but unconscious and not able to chew and swallow, No tube feeding, no artificial nutrition. Comfort care only.
- Hospice care is welcome anytime during my incapacity. Sing to me; talk to me. I don’t want to be alone during my last hours. But I am happy to be at rest in death with Jesus.
(You may also need to indicate if you wish your body parts to be recycled after your death as an organ donor. This is more important for young people, as the older we get the less value our organs have, but you may wish to have your body used for medical education as well.)
In my state there is a shorter form for this information that your doctor can fill out for you at your next office visit. This POLST (Physician Order Life-Saving Treatment) is a standardized form your doctor fills out and you then post on your fridge at home in case an ambulance has been called to your house and finds you unable to tell them what to do and your Attorney for Health care is not there to tell them what not to do. The POLST is a summary of the above information and directs first responders to know what or what not to do to your dying body.
Attorney-in-fact (POA)
The third extra “Will” you need is to give full authority to a younger sibling, a child you trust, or other relative or best friend you have complete trust in to manage your financial affairs before you die. This is called giving them “Power of Attorney” (POA), and lets them control your finances if you are incapable of this. This gives that person the right to made decisions on your behalf, even if you disagree with them, so only give this to someone you trust. You can make the document now and put it someplace to be used only when you become incompetent, but please do it now before it is needed, so it is there “in case.” This legal document also can be made with your lawyer or by using legal software.
This POA does not give them the legal right to tell the doctors or hospitals what to do for you, so you need to have all three separate Wills (Last Will and Testament/Attorney for Health Care/Attorney in Fact), and a POLST form filled out, to meet the needs if you become demented or otherwise incapable of managing your own care.
Good Genes?
For some reason, dying young is not the most welcome advice doctors can give their patients, so most of us wish to know how to prevent or treat dementia. The first way to prevent dementia is to choose good parents. There are some genetic mutations (APOE, APP, PSEN1, or PSEN2) that are known to cause dementia. If your parents have these genes your chances of becoming demented early or in your old age are much greater than if you don’t have the gene. However, sadly, to date there are no interventions specific for these genetic mutations. Testing for this gene tells you if you have it, but doesn’t offer any way to escape your destiny, so testing is not advised at this time.
Medication for Dementia?
Medications for Alzheimer’s dementia can slow the progression of the disease, but Aricept, Namenda, Rivastigmine (Exelon) patches, are not a cure for dementia. In some countries they are not even paid for by insurance because they are thought to be nearly useless. But some people do improve with them and need institutional memory care later than if they don’t use them. They are worth a try.
Feeding Your Brain
Most of us want prevention, not cure. And according to the latest information, such as Dr. Gary Small’s book The Alzheimer’s Prevention Program,[4] it all boils down to– eat nutritious foods, exercise more, and reduce stress. Does that not sound like our classic Adventist health/spirituality message? Just practice your Adventism.
But if that is true, why do so many Adventists, even vegans and marathon runners, and very spiritual people still suffer the different dementias?
Here are a few specific hints:
Vitamin B12
All vegans and even many omnivores should have their vitamin B12 level checked. Most all vitamins just flow into your body with food; if you eat them, you get them. But not B12. Some people take in enough B12 but their bodies do not absorb it. This is especially true for people with stomach problems, people who have surgeries, or people who need to take acid blocking medicines, etc. True vegans do not have any easy plant source of B12, and attempts to pretend it is OK to have low B12 levels are misguided. So just have a blood test, and if you are low, take a supplement by mouth (those you dissolve before you swallow are the best). And then recheck, if you still are low even with a supplement (500 to 2500 mcg a day), you will need to take vitamin B12 shots on a monthly basis for the rest of your life. Low B12 can cause dementia.
Vitamin D
Those living in the southern states of the USA have less problem with this, but Canadians and most people living in the northern states need to take supplemental Vitamin D. This is important for bone health, but you may not know that low Vitamin D levels can also cause depression, and there is a higher incidence of multiple sclerosis (MS) in people with low Vitamin D levels. Again, have your blood tested, and in this case, a low “Normal” level of 30 is not safe. You need to have an optimal level of 60-100 on your test. Babies can take 400 units a day, but Adults often need 10,000 units a day to get up to optimal levels. Vitamin D3 is the safest and most active form, it comes from the lanolin of sheep’s wool, so nothing has to die to get Vitamin D3 if you have a tender vegetarian heart. Once you get optimum levels, you can keep it there with 2,000 to 5,000 units a day, depending on your body size, in most cases. The recommended allowances are much lower than the optimal levels for brain and bone health.
Vitamin E, Only Natural
Many years ago Vitamin E was advised for preventing or treating dementia, and some studies suggested it helped. Then later studies suggested it was just a placebo or even harmful. Recently, new studies have shown some benefit. Until recently I advised people to get vitamin E only from foods like wheat germ. But the more nuanced advice is now this: Vitamin E, 400 units a day, may help prevent or treat dementia, but DO NOT use synthetic Vitamin E (dl-alpha tocopherol—a petroleum by product); use only natural source Vitamin E (d-alpha-tocopherol—sold as “natural” or “mixed” tocopherols). There is a difference in how the body uses it.
Omega-3 Fatty Acids
I’m not talking about heart disease here; I’m talking about brain. As scientists of the brain will tell you, your human brain is rich in Omega-3 fatty acids, especially the EPA and DHA types. Plants have lots of Omega-6 and also Omega-3 fatty acids of the ALA type (flax seed, canola, soybean oils, walnuts, Brussels sprouts, kale, spinach, salad greens), so if you are eating your seven plants a day you can get your ALA. Your body can convert some ALA to EPA and DHA, but not very efficiently.
I recommend that babies, who grow a lot of brain from birth to 8 years, take an EPA, DHA supplement if they are not fed fish. I recommend that adults trying to keep healthy brains take an EPA/DHA supplement if they don’t eat fish. 1 gram capsules of purified fish oil a day will do the trick for most adults. If you are wealthy and want to remain pure vegan you can get algal source EPA/DHA supplements. Others will take what Jesus fixed for breakfast[5] and eat some fish (salmon, mackerel, sardines, herring, trout, or swordfish), or take an inexpensive fish oil capsule.
Turmeric – Curry to the Rescue?
There is a yellow flower that grows in the southern parts of India, whose root was boiled and then dried and powdered and was used first as a yellow dye and then as a spice. It has been used for almost everything in traditional medicine in India, but has proven to be a possible preventative of Alzheimer’s dementia. This yellow powder is called turmeric and this contains an active ingredient known as curcumin. Turmeric is used as a major ingredient in the spices used to make the curries characteristic of Indian and other nearby Asian traditional diets. Observation has shown that Alzheimer’s dementia is less frequent among curry eaters. One study in Indian showed that adults over 60 who had curry occasionally or often (more than once a month) had less dementia than those who never or rarely had curry. So a visit to the Taj Mahal or Thai Palace in your community for a yellow curry dish made with turmeric twice a month might be brain medicine. You can’t just eat powdered turmeric; it has to be in oil to release the curcumin, and black pepper needs to be mixed with it to increase the absorption. Sorry, Adventist health reformers, some spices, including curry powder with turmeric and pepper, need to be back on your table at least twice a month.[6]
Caffeine?
Another reversal for Adventists is that Postum, decaf, herbal tea, Rooibos, and Peppermint won’t do it. But for “people who already had an increased risk of cognitive decline because of cardiovascular risk factors, consuming about 500 milligrams of caffeine a day was strongly associated with memory preservation,” says Harvard’s Jae Hee Kang.” [7] That is a lot of coffee–4 or 5 cups of brewed coffee. Starbucks straight brewed Pikes Place coffee (not their Lattes or Mochas!) is pretty strong and has 260 mg caffeine in a 12 oz. “tall.” Two cups a day could slap your memory back in place!
Espresso based drinks actually have less caffeine than brewed coffee; a “double shot” at Starbucks has 150 mg, a single shot half that amount. So you would need to drink seven “tall” single shot Americanos, Lattes, Cappuccinos, Mochas or three and a half double shot “grande” versions of the same to get the memory boosting dose every day.
Obviously taking that much caffeine can cause nervousness, rapid or irregular heartbeat, nausea, anxiety, difficulty sleeping, sweating, dizziness, vomiting, so take this drug with care if trying to improve your or grandma’s memory. Memory loss is so corrosive to the quality of life that finding out if you would only have a little difficulty sleeping might be worth the risk of taking caffeinated beverages. (I realize that for an Adventist to admit that coffee can be a good drug for some people involves swallowing not only coffee, but also some pride.)
Obesity
Overweight people have twice the risk of Alzheimer’s dementia as normal weight people. Obese people have four times the risk of Alzheimer’s dementia. So get that BMI down below 30 at least. And believe me, I understand how difficult this can be for many of us, but we need to know the facts. Yet I have seen many slender vegans with dementia.
Stroke Prevention
The sudden and massive loss of brain function of a stroke (a brain “heart attack”) is well known to all of us. What is not as well known is that tiny strokes happen to our brains much more often than large strokes, and the cumulative effect of many small cerebrovascular accidents (little strokes, even those without symptoms or silent strokes) can lead to a progressive form of memory loss called “Multi-infarct Dementia.” This is common enough that on MRI’s of the brain most people show these so called “lacunar infarcts” and “white matter changes,” so radiologists call them “age-related” white matter changes. And in almost all of us as we age the brain itself shrinks in size and the fluid about the brain increases.
We know that avoiding high blood sugar, high cholesterol, high blood pressure, smoking, alcohol use and atrial fibrillation is important. Some doctors think taking aspirin can help prevent some of these mini-strokes from happening. Again the slim vegan who takes fish oil, B12, Vitamin D, and natural Vitamin E supplements will have some advantage here, but may also need to take a baby aspirin.
Avoiding Dementia?
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Follow the traditional SDA lifestyle of plant-based diet; exercise; avoid alcohol; avoid tobacco; don’t get fat; trust in God; and have frequent socialization with family and friends.
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But have your doctor check your B12 level (aim for 400-900 range) and your Vitamin D levels (aim for 60-100 range) as well as your blood sugar and cholesterol, and take supplements or medicines if needed.
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If you eat fish, have fatty fish once a week or more. If you don’t want to eat anything fishy, take a fish oil capsule once a day or its algal equivalent. (Be sure your babies have a DHE/EPA chewy once a day till they are eight.)
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Consider a Turmeric curry meal at least once or twice a month.
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Consider Natural Vitamin E, 400 units a day, not synthetic.
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Consider a baby aspirin, 81 mg a day, for men and women over 55 if you have risk factors for heart attacks, strokes or mini-strokes.
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At some age, the moral choice is to stop doing preventative and curative care, and let God’s will that all die the first death take place. There is a time to be born, and there is a time to die. We would like that time to die to be before our brains have died. Living too long can be worse than death.
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And at whatever age you must die, be sure to die young, hanging on to Jesus with full hope of the resurrection of a new body, not desperately hanging on to a poor quality semi-life with this old worn out one!
FOOTNOTES:
[1] https://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/
[2] See article above for full context of Dr. Emanuel’s suggestions, but here is a summary:
“Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either. This means colonoscopies and other cancer-screening tests are out—and before 75. If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor. But 65 will be my last colonoscopy. No screening for prostate cancer at any age… After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off.
“What about simple stuff? Flu shots are out… A big challenge is antibiotics for pneumonia or skin and urinary infections.…. It is really hard for us to say no…But, as Osler reminds us, unlike the decays associated with chronic conditions, death from these infections is quick and relatively painless. So, no to antibiotics.
“Obviously, a do-not-resuscitate order and a complete advance directive indicating no ventilators, dialysis, surgery, antibiotics, or any other medication—nothing except palliative care even if I am conscious but not mentally competent—have been written and recorded. In short, no life-sustaining interventions. I will die when whatever comes first takes me.”
[3] Ellen White, 4T, page 482.
[4] https://www.drgarysmall.com/books/the-alzheimers-prevention-program
[5] John chapter 21.
[6] See this review article from Indian Academy of Neurology for more details on Turmeric and Alzheimer’s disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781139/
[7] Nutrition Action Health Newsletter, January/February 2014, page 5.
COMMENTS: on the ideas in this article are welcome and will all be read, but may be shortened, deleted, or edited by the author to keep them on topic for the Adventist Today audience.
I’d forego the caffeine. Not every scientific study is well-designed and I’d hesitate to recommend something that the prophet decries. One day we will understand more of the dangers of caffeine. Until then, I see many studies regarding caffeine, chocolate, alcohol etc as seeking to justify entrenched behaviors.
The evidentiary support for the purported health benefits of caffeine is overwhelming. I’m not sure why Adventists continue to shy away from it, but in moderation, study after study after study after study after study after study demonstrates very, very clearly that caffeine intake is associated with lower mortality / a longer lifespan / fewer cardiac events.
But… you know, since caffeine is a “drug” by all means, continue to cite a 2,000 year old book as your reason for abstention.
The question I have is: If I treat caffeine and alcohol as drugs, which they are, and if I drink coffee during the day to keep my brain alert, and then I must drink wine or take another drug to go to sleep at night, am I any better off than if I did neither?
You don’t need the wine or drug at night – just quit drinking coffee earlier in the day.
My mother was a nurse and one of her career stories was about the retired Church of Christ minister who suffered from insomnia. The neurologist suggested that he drink a glass of wine before bedtime and see if that helped him sleep. He would not do it unless the doctor wrote him a prescription. So the doctor wrote him one. At his next office visit the minister reported that he was sleeping much better. The dose of alcohol helped him to relax enough to sleep and his health improved as a result.
Some years later my mother developed a tremor in her hands that was a long-term side-effect from a cardiac medication. The same neurologist gave her the same recommendation in the hope it might moderate the tremors. Going through the grocery store with her on the way home and picking-out what wine she would try was one of the funniest times I ever had with her as we joked about meeting the pastor or one of the church elders around the next turn! Then as we drove out of the parking lot we passed the pastors wife! That just made it all the funnier for us. Only the wine didn’t help her.
Excellent up-to-date advice. Thank you Dr. Hoehn, for reminding us of how we can live longer and healthy.
I have all my directives written and signed and it gives a peace of mind knowing that my daughter, a nurse practitioner and my executor assures me that DNR will be followed appropriately when the time comes.
One thing unmentioned to keep young is not only to be active physically, but mentally: read lots, work crossword puzzles or Scrabble (my favorite computer game) and keep up with news both medical and political and international. Even when our bodies slow down if our minds are active there is joy in life. (from a 90-yr. old who plans to reach 100).
If you are so blessed that you live to 100, my wish for you is that you be like Moses, whose mind was sharp and his vision undimmed until the day he died.
Jack,
I want to echo and endorse your recommendations for all three types of wills. After spending more than 20 years caring for my parents and in-laws in their declining years I have many times seen life snatched from the jaws of death where the results was a continuation of suffering that each time became worse. We each should make our own quality-of-life decisions ahead of time instead of taking the chance someone will make the same decision for us, because medical ethics may not allow that to happen. Make sure your heirs and the person to whom you have given power-of-attorney has copies of your latest versions and that you trust them to carry-out your wishes. Being in the role of carrying-out a dying parent’s wishes is not easy. I remember in my father’s final days when he was suffering a cascade of strokes and a weekend-duty physician ordered actions contrary to my father’s Living Will and Advance Medical Directive (LWAMD). His demands that we follow his orders escalated into shouting at us as we refused to allow them. Our hearts wanted us to cooperate, but we had agreed to carry-out my father’s wishes and we ended the argument with threat of a medical malpractice lawsuit being filed first thing on Monday morning if the doctor violated the terms of the LWAMD. That drove our decision to get hospice care and bring him home where he died three days later. It was a horribly painful time for all of us that I believe was made much simpler and less traumatic by having a plan and sticking to it.
If only this were published in the Review! The physicians presently writing dare not disagree with SdA thinking and EGW’s out-dated advice.
What about wine in moderation that has been shown to aid seniors? We have to be ready to listen to the best medical advice when it disagrees with older positions.
http://www.atodayarchive.org/article/2147/opinion/hoehn-jack/2013/the-slippery-wine-skin
Jack, you write that “talking to someone who has imbibed a glass of wine is often a distinct pain for those who haven’t had a drink.”
As a lifelong tee-totaller, I disagree. Many in my extended family enjoy wine with a meal and I have never been in “pain.” In Jewish and Italian and many other families of European extract, it is a pleasant part of meal. Yes, drunkeness does happen, but one glass, sipped slowly does not cause drunkeness.
Caffeine can similarly be overused. I have known folks who regularly drank 10-12 cups, straight, a day. Personally, I drink iced chocolate with a little coffee and milk in summer. Studies have shown that coffee also helps elderly who have not been under hospice care. Do you disregard the studies on both wine and coffee based on your personal opinions, or have you been around many who have become inebriated with one glass of wine?
Alcohol sipped slowly or quickly has a drug effect. If it didn’t people would stop using it. It is obvious to both careful observers and is scientifically testable in laboratory situations. The louder voices in our local French cafe (which has very good food) come from the tables who have enjoyed a glass of wine or two (I wasn’t counting) with their meal. And in family situations with wine drinkers and none wine drinkers the disinhibition from 1 glass of wine is obvious to everyone except the indulgers.
I am not talking about drunkeness. Although 1 out of 10 alcohol drinkers will become alcoholics and 3 out of 10 who drink 3 glasses or more a day will have health consequences. More than that will have social consequences which are harder to measure, but very real. Little drug, smaller effects. More drug, more obvious effects of course.
You have personally observed this behavior in family situations? It has not been my experience over many years, nor has it been demonstrated repeatedly in studies. Why accept studies about caffeine and reject those of wine?
Jack,
Back in the late 1980s I helped establish a community anti-drug coalition that was recognized by the Office of National Drug Control Policy as a model for effectiveness in delivering substance abuse prevention education. (For this formerly hard-line temperance campaigner it was an eye-opening experience!) Something that participation did was get me on the mailing list for research reports from the National Institutes of Mental Health on addiction-related topics even though I’ve been away from it for more than two decades. I still read them. From what I’ve been reading, the research doesn’t support the statistics you cited about alcohol consumption. Those numbers have been repeated so often that they are commonly accepted as factual. The newer numbers are showing considerably lower alcohol addiction rates but higher abuse rates, the difference being from a more precise definition and measurement of chemical addiction as contrasted with abuse behaviors. Another significant and often overlooked variable in alcohol consumption is the role of ethnic traditions and social prejudices. For example, there are historic cultures where having one or two drinks each evening is routine but alcoholism rates are much lower than in countries without such social traditions. At the same time, a person who has a strong religion-based attitude against alcohol consumption is virtually guaranteed to be offended by a dinner companion having a drink, but where everyone at the table has a drink they are very likely to find sharing the meal a more pleasant experience.
The problem is too comprehensive and complicated to make any consistent advice on an over all basis. What ever decision is made, will no doubt be part right and part wrong concerning each individual situation. None the less, thanks for the information as each of us should consider all the options before making any decision.
In 1984 the then Governor of Colorado, Richard Lamb, ignited a firestorm when he pronounced that the old, if very ill, have duty to die and get out of the way! It contained some logic, was vague on process, and was written off by many of the very old as another evidence of the notorious foot in mouth disease to which he seemed addicted. There is a sense in which he was on to something, ahead of his time, but the process thing was, and, is still the sticky point. Who decides what and when and how? I believe government forces are moving in that direction. Better if we decided for ourselves.
It is an economic issue, but that is not all. It is a relationship issue, of equal importance, for family members who must “stand by” the aging in the failing, declining moments.
Jack’s advice is sound. Governor Lamb might have made more headway to advise that every person has the obligation to determine in advance what should be done for oneself in those later years and leave it on deposit as instructions for caregivers. My dad at age 85 had a heart attack during a visit to the doctor at his office who “cored” him (from the hospital code “core zero,” resuscitation attempt) several times because he had provided no contrary instructions for that circumstance. He lived two more years, most spent in a nursing home with a diminished quality of life, amassing large expenditures for his care. He faded away into death eventually. A heart attack at 85 was a blessing interrupted by a good doctor and lack of instructions by his patient.
Quality and quantity of life are not easy values to anticipate or to premeasure because they aren’t always mutually exclusive. But, the “if this then” approach is written, with forms as a guide for assistance to caregivers, what Jack is suggesting would be achieved on a large scale.
As an aside, my grandmother, my dad’s mother, lived a relatively healthy life to age 99. She lived the life of a Kansas farm wife. Milk, cream, bacon, lard, beef, pork, coffee made up the core of her life time diet. It appears to me that if you have to choose between proper diet or good genes, take the later! In my case, I’m choosing both (so far I’m happy with the gene gift), with a thank you to the diet wisdom, outlined here by Jack, and gleaned from my SDA upbringing! Some adjustments. No wine, but do enjoy the daily health benefits of black coffee!
Having lived with an alcoholic for many years and going to more AA meetings than I care to remember, I have never met an alcoholic that did not regret taking that first drink. As to the myth of the typical French harmless alcohol drinking culture, according to the report published by the European Journal of Public Health, alcohol consumption was responsible for the deaths of 49,000 people in France every year. Taking that first drink is like playing Russian roulette. No one taking that first drink is planning on being an alcoholic.
Finally someone with some facts! Any answer to this one?
Some grape juices have the same benefits as fermented wine but, in moderation, because of the sugar.
It is necessary to consider any statistic in context. What is that number as a percentage of the French population? How does that compare to other countries and cultural groups?
This next thing I’m going to share is some of what I learned in the late 1980s and early 90s as co-founder and a director of a nationally-recognized community anti-drug coalition that was honored by the President’s Office of Drug Control Policy for creating one of the most effective public school-based drug prevention programs in America. I don’t want to sound harsh, but saying “Taking that first drink is like Russian roulette” is utter, fact-less nonsense. It only sounds credible because it seems to explain what is difficult to understand while simplifying and dismissing the complexities of substance abuse and addiction. The concept that addiction only requires the first drink to put a person on the path to death, or the first dose of some illegal drug will kill them is an illusion that has promoted for many decades to create public support for the enactment and enforcement of tougher anti-drug laws that have been utterly ineffective. They got a huge boost in the 1980s when crack cocaine became popular and the proponents of new laws promoted the claim that cocaine in crystalline form was somehow more addictive than in powder form. Well, it wasn’t and the difference was that someone using the crystalline form usually got a larger dose, which made them more likely to overdose. But the claim caused widespread public alarm and tougher laws were passed. Another falsehood that has been repeated for so long that it is accepted as truth is that once a person is an addict they are always an addict.
Actual rates of chemical addiction are far lower than believed because addiction is a complex thing that is not so much substance-based as it is personality- and behavior-based. This is where phrases such as your reference to a first drink and Russian roulette come into play because they promote ignorance about the complexities of addiction and denial among parents. That denial is blinding and children take easy advantage of it to the point where they are often able to hide high levels of substance abuse right under the noses of their parents. I have seen at-least three cases in the church where the teen-aged children died from overdoses of drugs their parents absolutely would not believe their children were taking!
Lest we think alcohol is as dangerous as some say, let us remember that the redeeming and transforming power of God is stronger. While I have seen teens die while their parents were in denial about their drug use, I have also seen severe drug abusers redeemed and learn to live without drink or drugs. You do not need to fear the danger if you are more familiar with and confident of God’s power to cure!
If someone is afraid to take the first drink, he shouldn’t! Some folks have addictive personalities to fat foods, heavily sweetened foods, and overeating, to name a few. How many people yearly die from diseases caused by unrestrained appetites? Diabetes, heart and liver problems are just a few. There are more obese children today than ever in this nation’s history; all headed for diabetes and now physicians are finding obese children with cirrhosis of the liver! A disease that most often was found in alcoholics, and not in children.
Bugs, don’t be so quick to presume that Grandmother lived on a second rate diet. You may not be aware, but all of the foods you mention are back on the health-promoting list. The ‘cholesterol hypothesis’ as a cause of heart and cerebrovascular disease is dead. Ancel Keyes’ data was flawed and fraudulent. Yudkins ‘Sugar hypothesis’ which was rejected in favour of Keyes is now being shown to be nearer an adequate explanation for the diseases of modernity. And sugar is not only the white stuff you put in coffee and cakes. It is the largest portion of all starch foods, ie, carbohydrates, bread/grains, starchy veg, eg potatoes etc. Why is it so bad? It stacks on the fat, triglycerides and then cholesterol. But above all, it is highly inflammatory. Inflammation is the new causal idea for heart disease. Another great inflamer of so many biochemical pathways are Omega 6 fats. These are most commonly found in processed fats of vegetable origin. Margarine. It is toxic. Grandma’s lard is a far healthier fat. At least, butter, from grass-fed cows, is to be preferred. And tastes far better too.
The starches also contribute to the epidemic of cognitive decline of ageing. It need not be inevitable. Sugar/starch is now considered the commonest cause of dementia, so much so that it is being labelled Type III diabetes. See David Perlmutter MD and nutritionist’s book Grain Brain. ALso William Davis Md, cardiologist, Wheat Belly. The ideal diet is now High quality protein (grass-fed animals, wild caught fish) plus above-ground vegetables. Nuts and seeds, in their natural unroasted state provide extra of the ‘good oils.’ Avocado is one of the few that qualify for superfood status. Ellen and Kellog’s advice re a diet of grains is bad medicine.
Jesus’ and Paul’s advice re wine is important. ‘Drink ye all of it’ should not be limited to communion service. All benefit. ‘Take a little wine for your stomach’s sake’ is now being shown as good advice for enhancing the health one’s gut bacteria/biome. Red wine is thus a ‘prebiotic.’ Of course the resveratrol and other nutriceuticals add to its benefits, when taken in small doses. 2-3 glasses five days a week seems optimal. (I will have to work on it) Other than that, it is simply the best accompaniment to a good meal known to humankind. When God created fermentation He knew exactly what he was doing.
Speaking of fermentation. Jack’s advice re Vit D3 is excellent. Get tested and then boost your D level to the max. But Jack forgot to mention that you also need a lot of Vitamin K2. Vit D will enhance absorption of calcium from the gut, but left to its own devices, will deposit in a lot of places you don’t want it, such as artery walls and wrinkles. K2 will activate the enzymes which actively transport Calcium to your teeth and bones. K2 was discovered by dentist Weston Price about 80 years ago. He called it Activator X, and he got it from grass-fed butter oil…
Serge and Elaine,
I have just been reading that grains are back on the to do list again. A lot of the non-gluten fad hasn’t been based on fact, according to some top-rated nutrition schools. I think we have to pick and choose the best advice from differing sources that make sense to us and we can live with.
Alcohol has caused more suffering, disease, and death than any drug in history. Maybe sacrificing it ourselves can save those we influence. I think using wine is a selfish act setting oneself as above those who would be hurt by it. If it’s bad for 5%, it’s bad for all of us!
Caffiene is a drug that some people need for a healthier brain. It’s safer for an ADD sufferer to use coffee as a stimulant than the toxic drugs phyicians prescribe. I agree with Dr. H on these two drugs.
EM, the major issue with grains is not only gluten. Glycaemic load is of far greater consequence. Where does our modern epidemic of obesity come from? Overeating of grains of any variety, gluten-containing or not, is a likely culprit.
Now you say that if alcohol is bad for 5% then we should all leave it off. Well, obesity is bad for all too, as bad as inability to control one’s drinking. So if grains provide the ‘base load’ of excess calories which people consume, then best we all leave them off.
And there are a lot more obese people in America than those who abuse alcohol!
My doc recommended the “Wheat Belly” diet. Good suggestion to limit bread intake, but whole grains should be part of a diet, in moderation. In fact, everything in moderation: coffeee, wine, food.
Serge:
You say, “Ellen and Kellog’s advice re a diet of grains is bad medicine”. Does that include oats? 20 years ago, with skyrocketing cholesterol and a family history of strokes and heart attacks, a cardiologist prescribed that I take Lipitor. Instead I have eaten oatmeal 4-5 days per week, on average and my cholesterol was controlled. Are you saying that I would have been better off, overall, by taking Lipitor every day instead for 20 years?
Richard, Lipitor, and all statins, are nasty drugs. They do lower cholesterol, but at great expense. Memory problems, loss of energy and muscle pain are but a few of the side effects. It is possible to lower cholesterol too much, hence the loss of myelin required for brain function. Brains are 1/3 cholesterol. Cardiac failure has occurred for some, and this is related to the loss of energy felt by many who take statins, because while these drugs block production of cholesterol, they also block production of CoQ10 which is a vital part of the energy cycle in the cell.
Its the fibre in oats which helps keep cholesterol down. So just take the oat bran. Better than statins for lowering cholesterol is simply cut out all grains. Works brilliantly. Protein, fats and above-ground vegetables will supply all the nutrients you actually need, provided they (the fats) are not made in a factory. You will then find that your triglycerides will be lower, and your good HDL cholesterol will be higher. Ratios of all these are more significant than total numbers. As the ‘cholesterol hypothesis’ fades into the scientific background, statins will come to be prescribed less and less.
Serge and Jack:
I assume for protein, you are not referring only to the beans on my haystack, but I have been telling people for years that all flesh foods are contaminated with chemicals. Even fish from oceans and rivers contain mercury and DDT, and all commercial meats contain antibiotics and growth hormones. For fats, I assume that I can safely consume all of the avocados and grapeseed oil that I can afford. But then you say “above-ground vegetables” so I must eliminate potatoes (including sweet potatoes), carrots, beets, turnips, radishes, and onions. This would/will be difficult. I am 66 quite healthy with a slightly raised BMI (27) on my current SDA diet and a little meat (turkey at Thanksgiving, etc.). And I still may get Alzheimer’s like my father in 10-15 years, so maybe I should just drink myself to death and get it over with.
he said facetiously.
I’ll attest to the muscle pains. Statins lowered my tolerance for short-term dehydration to the point where I ended-up in the hospital emergency room three different times with cramps so severe that once they thought I’d developed a blood clot in a leg muscle. The solutions were paying more attention to staying hydrated and stopping the medication.
Thanks, Serge. My grandmother, for better or for worse, never touched alcohol in all her life, as far as i know. She was a lifelong, staunch, Assembly of God believer, and as with Adventism, drinking was not allowed in their discipline. I visited her last when she was 95 and her mind seemed as clear as ever I remembered her. Dementia didn’t appear to affect her.
In my lifetime, now 74, I have seen all the food fads zoom in, bounce, ricochet out, with such mind bending contradictions that my wife and I long ago decided to ignore the dissonance and just eat what we wanted, always, and this is the key, in moderation. She weighs 124 (she weighed 184 ten years ago, modified the Adkins diet and has maintained by controlling calorie intake) , I’m 158, both average height. We’re considered skinny in our 55+ community! She drinks daily wine. I can’t drink alcohol anymore because the only medication I take, a symptom treatment for lifelong migraines, Topiramate, isn’t compatible with it. So I drink sparkling water and coffee. We’re not vegetarians. But we don’t ignore good nutrition advice, such as offered here by Jack, either. I have a brother who is an alcoholic so I know the travails of that.
I have no desire to die at 75, nor an interest in reading Dr. Ezekiel Emanuel’s book, even though his thesis might even parallel my thinking. Don’t have time for that. I’m five months away from that point of age!
All the options in life are loaded with risks of varying degrees. Driving cars, riding in airplanes, hiking in snake habitats, eating mushrooms, drinking alcohol, vacationing in Iran, eating excessive calories, etc. Advisers advise. We make our choices. We live our lives without the possibility of having done differently than what we have done. And then we die. That is not fatalism. It is the function of being human.
In Japan, the women who eat ‘Natto’ (fermented soya beans) which is very high in K2 do not get hip fractures at anything like the rate of those who do not eat it. Other foods high in K2 are very mature cheeses (Brie, Camambert, Gouda etc) and fermented vegetables. Sauerkraut the obvious one. Must be homemade though, as the store bought kind is pasteurised and so the benefits of the probiotic bacteria is lost. Or you can add K2 (MK7 preferred to MK4 variety) to your list of useful/essential supplements, again, particularly if you are vegetarian. (100 mcg K2 for every 10,000 units of D3 is currently advised). Visit Weston-Price foundation site and search K2. Similarly, Mercola.com has a couple of good summary articles.
Higher cholesterol means not nearly so much as the HDL LDL ratio. I have always had over 200 but with no problems; BMI low, and vegetarian with occasional chicken in small amounts. Three major joint replacement that so far has not been shown to be caused by diet or ? Still biking daily on stationary bike and walking without cane or walker at 90, no sign of dementia (my children wouldn’t tell me 🙂 Play a mean game of Scrabble and read voraciously several major news journal, newspaper daily, lots of books. That’s one senior’s method for longevity (so far!).
All things considered I would rather live with someone addicted to caffine than alcohol.
The problem is with the advice on all of these is many think a little is good more is better. At that point the supposed benefits are outweighed by the negative.
Personally for me any caffine has negative effects and having seen the devastation of alcohol on family members I don’t seeing light in starting that even in moderation
Isn’t it amazing how many dangers we face! A little bit of this or that is good for us, but too much is dangerous. I remember my grandparents getting on a kick about drinking vegetable juice. For a four year-old it was great fun helping them feed those big bags of carrots into the juicer and watching the juice flowing-out into Grandma’s canning jars. I drank some with them. But they drank so much their skin started turning orange! He lived to be 96 and was in good health until the last few years. She lived to be 87 but suffered from Alzheimer’s the last six or seven years.
Alas, there are no perfect foods here! I’m looking forward to eating from the Tree of Life that is promised “for the healing of the nations.” Hmmm… I wonder what’s in that fruit that’s absent from our foods today… 🙂
Having had some of the same experiences with dementia in the family, I agree with much Dr. Hoehn has said. But I do question the age brackets for discontinuing screening and treatment for some diseases. There is a difference between dying from an acute sudden heart attack and dying from undetected and untreated prostate cancer or colon cancer. My brother never had a colonoscopy before being diagnosed with stage 4 colon cancer at age 65. He lived one more “hellatious” year which was not worth living. I, on the other hand, have had two colonoscopies with each one detecting and removing pre-cancerous polyps. I would rather do these tests every 5 years and die of a something else. Moreover I can’t imagine anyone wanting to die from prostate cancer that has metastasized into the bones rather than have screening and treatment, such as proton, if necessary. Many of the studies that are done regarding lifespan screening for diseases are sponsored by insurance companies who are terrified of an aging population that will need more expensive treatments to prolong life. The studies on mammography for breast cancer and PSA testing for prostate cancer are clear examples of insurance companies and government comparing quantity of life and ignoring quality of life.
As for the SDA diet, the basic guidelines from EGW are sensible and proven. But SDAs only follow what they want to follow. Go to any potluck and count the dishes with massive amounts of cheese, margarine, oil, and sugar. EGW said it was better to eat pork than cheese!
Correction: I cannot find the statement comparing pork to cheese–only that cheese is unfit for food.
Agree re the potluck. But it is based on the view that if the food originates from a plant it must be good, however badly it has been processed. EGW was wrong on the cheese. Traditional, mature/aged cheeses are one of the few food sources of Vit K2 and should be eaten. Google ‘the French paradox.’ They eat lots of fatty cheeses, plus red wine, yet their heart disease rates are much lower than USA. Seems its a case of slow food vs fast food.
EGW died, it appears, of the consequences of a hip fracture. This suggests she had some degree of osteoporosis. She would have done better to have taken in a lot more Vit D, by sun exposure or diet and taken the cheese for its K2. A lot of eggs would have helped in that regards also. Her bones would have been a lot healthier.
Re your notes on cancer. The bowel, breast and prostate cancer rates you speak of are a lot less in people with high Vit D levels. Staying out of the sun to avoid a melanoma is advice which has resulted, it is estimated, in five of those commoner cancers, for every melanoma avoided. Not good odds, eh? Vit D has receptors in every tissue of the body. Its multiple and critical roles are only beginning to be understood. Preventing rickets is almost its most minor role. The RDI’s for Vit D will likely increase over time. And along with it, K2.
BTW, what’s wrong with pork? Billions of people thrive on it.
Serge:
Thank you for the detailed explanation. Re Pork…
Lev 11:4 But you must not eat animals such as camels, rock badgers, and rabbits that chew the cud but don’t have divided hoofs. And you must not eat pigs–they have divided hoofs, but don’t chew the cud. All of these animals are unclean, and you are forbidden even to touch their dead bodies.
Pork is advertised as “the other white meat.” Today, it now more nor less healthful than the other meats. Beef consumption is down while poultry is up. People are finally beginning to realize that beef production is so costly and harmful to our environment and are eating more plant foods, especially green leafy veggies.
Or, just watch how much food people pile onto their plates.
Insurance companies and Medicare is paying too much for annual screening such as mammograms and PSA. Mammography is not recommended past 65 if there has been two negative results. Slightly elevated PSA has also caused unnecesary surgery and treatment as has breast ca diagnoses.
While screening exams are recommended for everyone, treatment should not be the first suggestion.
In further response to the statements about screening for cancer, PSA tests are very inexpensive. A man can obtain one for about $50 online from lifextension.com even without insurance. Although the result from an individual PSA test may be unreliable, comparing the results from multiple tests over a period of years will show a trend and will identify a significant change in health. Last year, my PSA was well within the normal range but had increased by about 500% from the prior test. One doctor assured me there was no problem. A second opinion resulted in a biopsy that was positive for prostate cancer. Although my 45 proton treatments at LLUMC were not enjoyable, I am happy that it is now resolved. Without the PSA test, or unless it was detected accidentally some other way, I may have had an excruciating death from it in a few years. If my brother had had a colonoscopy at or before age 60, he would be alive today. I still believe that recommendations against screening are based on monetary considerations, not quality of life issues. I read yesterday where diagnostic dogs in Great Britain are able to detect prostate and bladder cancer accurately 98-99% of the time by smelling urine. Maybe we will be able to detect cancers for the price of a bag of Alpo in the future.
Had doubts before I had the prostate biopsy today. Had a couple a few years ago when PSA peak at 12, both negative, no current new symptoms. No family history of it. Fifteen year PSA average about 8. New doc said to do it since my average was “high.” Jack, wish I had read your edit here before I went in this morning. Thought of canceling, would have on your word and that of others that echo your statement. Of course, in a couple of weeks I will know the biopsy results. If positive, you are saying it doesn’t matter since treatment is more harmful, probably, than letting it be. The doc said today he didn’t notice any anomalies on needle insertions.
Not aware of long term of biopsy damage (had none before), though there are plenty of risks, I’m, sure. My suspicion has to do with the money trail. As a chaplain, I had reason to believe the number of surgeries performed by some doctors was directly proportional to their purchases, cars, boats, homes, vacations, investments, etc. Not provable, of course. I recently read the amount charged for each colonoscopy and quickly understood why doctors are willing to specialize in that apparently unpleasant procedure.
These may be fools words, but I have had my last prostate biopsy and PSA.
My enlarged prostate. Options for this are not attractive. What to do. (Rhetorical)
I’m 74. That is a germane point I omitted.
In reply to William Noels question: Statistics from World Health Organization in comparing alcohol related deaths of l92 countries, France ranked 17th with a death rate of 4.0 per 100,000 and the US rate was 1.6 ranking them 49th. These are just death rates – there is no measuring the destruction and misery left in the path of alcoholism. You may think my remark comparing taking the first drink to playing Russian roulette as nonsense if you like. I stand by that remark and make no apologies for it. Who knows when they take that first drink that they will be an alcoholic? Do you think my SDA nephew who died of alcoholism knew that? How many alcoholics have you talked to that did not regret taking that first drink? Consider me uneducated and ignorant if you wish, but I repeat: TAKING THAT FIRST DRINK IS LIKE PLAYING RUSSIAN ROULETTE. You can teach your children and grandchildren to have their first beer or glass of wine if you like. Not me.
I totally agree with you that alcohol and other drugs are destructive. No, I didn’t teach my children it was OK to drink. I taught them to consider alternatives, measure risks, understand consequences and make positive life decisions. When they became adults they were able to make responsible decisions for themselves. It has been effective. My son left the church and is in an Army unit where it is common for members of his team to drink after hours, sometimes heavily. His personal max is one or two beers because he doesn’t want the risk of being drunk. Usually he is the designated driver taking the others home. He has the emotional and social structures and strengths to not desire it.
Not everyone has those risk-evaluation and decision-making skills. In fact, the legalism so prevalent in Adventism is a major contributor to substance abuse because it fails to allow a person to collect information, measure and test risks, make informed decisions and be responsible for the results. Legalism draws absolutes and just plain condemns. So the logic develops that, if I’m going to be condemned I might as well have some fun enjoying what is forbidden on the way. This is why substance abuse rates on Adventist academy and college campuses are close to average for public campuses. It is also why those Adventist students who do become involved in it are 2-3 times more likely to become serious abusers. Only warning our children about the dangers doesn’t work because it dangles in front of them the temptation to test limits and see if the danger really is there. Comparing that first drink to Russian Roulette just makes the temptation more enticing. The more they drink without dying or suffering serious physical damage just paints the falsehood in brighter shades of neon. It gives them new freedom to continue drinking and expand into using other drugs because they’ve learned Dad and Mom don’t know what they’re talking about and won’t recognize what they’re seeing right under their noses. Because they’ve been taught legalism where God’s love and forgiveness are a minor and distant footnotes to keeping the Law of God and they have no mechanism to deal with guilt, which drives them into another spiral of consumption to numb their guilt feelings.
The greatest danger isn’t the alcohol or other drugs, it is the combination of spiritual, personal and social structures that permit and facilitate their use and abuse. I know it isn’t easy to accept, but I’ve seen it countless times in the church. I remember vividly the church elder who came to me angrily after a presentation on the topic to claim I was lying when his eldest daughter was a known abuser on an Adventist college campus! (His eyes were opened when she went into rehab.) Be like that elder if you wish. Illusions just let the problem grow right under your nose.
They seldom, if ever ask parental permission. You can almost guarantee that young people today will try both cigarettes, often marijuana, and liquor. If they don’t know the dangers, they aren’t living in the real world. How many teens know that drinking and driving is a no-no? Same for texting, so they never do it, right? If a good friend is killed because of this, it is a terrible reminder.
Wine is to alcoholism as food is to obesity.
Dr. Hoehn;
Thanks for a thoughtful article on the subject of dying. Your suggestions regarding ‘legalizing’ one’s desires are particularly helpful.
I would add only the following with respect to that issue. Check with each of the following organizations/individuals to see what they will accept as a legally valid statement of one’s desires on this issue.
1) Emergency Medical Response (the ambulance service in your area)
2) Your doctor
3) Your desired hospital
4) State law
One may find that having an Advanced Directive ‘signed and sealed’ means nothing to some health care providers. One’s desires might have to be conveyed via a POLST form to be legally accepted by any of these entities.
Having an Advanced Directive, many may think that they have addressed this issue properly only to find that their documents will not be accepted by the only people that really matter – the ambulance services, the hospital, and/or the treating physicians.
Once the proper form(s) are completed display them in an easily identifiable place just inside the door to one’s residence – so that EMS personnel can find them immediately in an ‘emergency’ situation. (One might also keep a copy of the form on their person for hospital personnel).
It is likely that one may find that they do not need to spend any money on an Advanced Directive. Depending on where they live they may be able to state their desires on a free (notarized) POLST form.
All of the above of course deals only with the narrow issue of one’s desires with respect to level(s) of care and dying. Legal counsel very well may be appropriate – and recommended – for other issues unrelated (directly) to the issues of health care and dying (such as a Living Will, establishment of a Trust, or Estate planning).
On another point – I must also take exception to Dr. Emanuel’s rationale. He is, essentially, assuming the ‘right’ to act in God’s place. Many individuals live a wonderful life well past 75 years! He is perfectly within his right do decide how he wants to live – or die.
But for he, or anyone else, to ASSUME the ‘right’ to dictate to anyone else how they choose to spend (or end) their lives is arrogant, evil, and simply wrong.
It is sobering that this man was one of the principle ‘architects’ of the so-called ‘Affordable’ Care Act. Sadly, his twisted, evil philosophy will likely become central in the decisions that will be made for many of us by a government that has now chosen to, rather than treasure life, assume the ‘right’ to act in God’s place!
Don,
Excellent points! Your best chances of having medical personnel comply with the elements of your legal directive is if you are admitted on a non-emergency basis. Unfortunately, until someone gets in-front of a care provider and forces them to look at the documents they will be ignored. EMS personnel pay attention to them? No way! They’re too focused on saving/sustaining life. The staff of the Emergency Room will continue until either the patient is moved out of their area or it is obvious that life-saving efforts are not producing results. Why? Legal liability. I got a firsthand experience with this when my mother and I were involved in a head-on collision. Several years before she’d had a heart valve and the aortic arch replaced. Apparently the force of the collision ruptured the graft and she was dead instantly. Though I was injured, I told the paramedics that she did not want CPR, that she’d had a pacemaker and an aortic graft and chest compressions would likely cause more damage. They still gave her the full treatment, which produced no positive results. I was in the next bed in the trauma bay when the doctor called a halt to the CPR. My wife and I have known the local EMS chief since grade school so I called him to ask why they had done what they did. His answer: the law required it until they were directed otherwise by a physician. He had even heard of people having “NO CPR!” tattooed across their chest but even that would not release them from the law.
Don and Bill:
Thank you for that advice. I would not have thought that a person’s choices would be ignored. Too much litigiousness — my apologies to the lawyers! EGW once wrote to Dr. Kellogg that if she were ill she would rather see a lawyer than a doctor–how times change!
Some have taken issue with my characterization of Dr. Emanuel’s stated positions regarding his personal choices for health care as ‘twisted’ and ‘evil’.
To be clear (as was stated in the original post) Dr. Emanuel has a perfect right to decide his OWN fate and appropriate medical care. But that is where his right ends.
Referring to Dr. Emanuel’s positions as having ‘morality’ and ‘unselfishness’ behind them is a real stretch.
Dr. Emanuel went on to prove that he clearly was not satisfied with simply stating his personal preference(s). His vision was to – through public policy – FORCE his scheme on an entire nation! And that is precisely what he went on to do. THAT is what makes this man’s actions evil.
This should remind is of what happened just a generation ago when hundreds of thousands of people (including children) were killed simply because some (‘morally superior’ person) decided that they served no useful purpose and that is was a waste of good food to feed them. We call that period of history the ‘holocaust’.
Very soon someone who never knew you (and, quite frankly, won’t care to know you) may be required to make decisions about your health care. Decisions that will determine if you are allowed to live or die – REGARDLESS of you or your loved one’s personal desires.
This is simply wrong, and I will not back down from calling it what it is – pure evil.
Now that Dr. Emanuel’s scheme is codified into law (the ACA) the true intent of those who subscribe to this ideology is becoming even more clear. Read on………….
http://www.wnd.com/2015/04/princeton-prof-kill-severely-disabled-infants-under-obamacare/
Where will this madness stop?!
Kudos and congratulations, Dr Hoehn, for a most splendid article, one that should have much more widespread circulation than ADVENTIST TODAY
affords. My vegan aunt died of profound Alzheimers, I strongly believe she had no nutrient sources of B 12 from her diet.
I like LIFE EXTENSION FOUNDATION for their VITAMIN/SUPPLEMENT products, but also for their blood testing. You do not need a doctor’s order
or prescription to get your Vitamin D level, or blood lipid level etc. or other tests —and currently, April, I believe they have a sale price for these tests.
Our vegan/vegetarian readers should all be advised as to reduced Vitamin B 12 levels. Even the meat eaters amongst us may not absorb the Vitamin B 12
with oral consumption, requiring injections or sub-lingual forms of B 12.
My Vitamin D level was extremely low even after being in the sun for three whole months in Maui, and occasional visits to their infamous nude beach!
My internist explained that as we age, our skin cells may not transform the sunlight into Vitamon D, so obtaining a serum level is important, for older,people even those living in sunny climates, but definitely those in the cloudy Pacific Northwest, or London England! AND 5000 units / day of VIT D3 not too big a dose! Your serum Vitamin D level,should be on the HIGH side of the normal range.
Thanks for sharing this helpful information, Jack, along with that of your commentators & your responses. I agree that what is most concerning is having my body outlive my brain, & that healthful living by current scientific information is the best strategy, but I’m not ready to forgo screening for early diagnosis of debilitating or painful diseases that could be cured or ameliorated in by treatment.
Would you comment on the suggestions re: avoiding root vegetables & grains (aside from GMO & gluten concerns)?