Cats and the Philosophy of Health Care

At our Socrates Cafe meeting on Saturday, we discussed the ethics of rationing health care.  How are decisions made about administering medical care?  Should health care be awarded to the wealthiest, the most fit, the least at-risk or the most at-risk?  Is health care a commodity that can be administered according to social and economic guidelines?  Is health care distinct from “illness care”?  And so on.  Our group is rather small and not especially representative of any particular demographic.  I don’t think we’re “solving” anything, we’re just enjoying discussion and engagement and some brain activity.  I’m exploring the results of allowing other people to comment on the products of my own bizarre thinking.  Which is kind of what blogging is about as well.

As I put in my own perspective on this issue, I realize that I speak from experiences that have centered mostly around my husband’s illness and death and from observances of non-human beings.  Jim used to chalk up a lot of his medical interventions as “better living through technology”.  He was the recipient of some very technical and somewhat heroic (although now pretty standard) procedures.  It was a complicated arena of insurance issues, multiple specializing doctors, drug interactions and availability, and the donor list system.  There were layers of decision-making involved and a fabric of responsibility that was pretty nebulous.  When his pulmonologist found out that he’d died, he asked me, “What are you doing about it?”  I wasn’t sure what he was talking about.  “I’m grieving!” I answered.  “I mean legally,” he explained.

Who is responsible for my health?

As for the observance of non-humans and their health, I look to the pets I have known.  Specifically cats.  I learned a lot from Pinkle, who somehow got injured up in the attic one day.  She simply stopped using her back legs until they had healed.  She slept.  She ate.  She tried out putting weight on them gradually, and eventually got back to doing all the things she had been doing.  She didn’t complain.  She didn’t seem miserable.  She didn’t worry or push herself or engage in any neurotic behavior that we could detect.  She took responsibility for herself, for the most part, and we provided food and shelter and quiet.  Phantom is another cat I have observed.  She is 16 years old now, and not living with me any more.  She had some urinary tract issues in the past when I did care for her.  I gave her antibiotics in pill and liquid form (which was an ordeal she did not welcome) and changed her food.  She had a bladder stone removed surgically as well.  That was maybe 10 years ago.  Her litter mate died of cancer a couple of years ago.  Cats don’t complain about pain much, and they don’t complain about death.  My kids tell me that Tabitha was purring as she died of the injection that ended her suffering.  Cats (and many other animals) have a tendency to seek out a quiet place to die.  They don’t make a big fuss.  We’re the ones who fuss.

Phantom del'Opera

Pinkle Purr (see poem by A.A. Milne)

What if we focused on healthy living and didn’t sweat so much about “illness care”?  What if we made it our social/economic/political responsibility to work hard to provide clean water, clean air, healthy food, shelter, education about health, and quiet (less stress) for as many of us as we can, and let illness play out as it would naturally?  What if we as a community took responsibility for supporting health but abstained from taking responsibility for preventing death?  It’s not like we’d be successful in that effort ultimately anyway, right?  We’d do our best to give you the basic needs, and the rest is up to you and nature.  That’s how human life went before technology kicked in, and plenty of people lived to reproduce (or we wouldn’t be here today).   Is there anything wrong with that model?

That’s my two cents for the health care debate.

3 thoughts on “Cats and the Philosophy of Health Care

  1. When my then husband, a young man and sole support of a family of four, was diagnosed with advanced kidney disease, his sister stepped in to offer her kidney and save his life. While he was suffering through hemodialysis, most of our community rallied to his support. Most, but not all. I was confronted in the grocery store by someone who went on to attack me verbally and personally for allowing surgeons to butcher two people and to harvest an organ from a healthy person. 14+ years later, they are both healthy, dynamic, productive members of society. I firmly believe his healthcare, paid for by private insurance and Medicare, showed a good investment in both medical technology and a compassionate society.

    Lives are fragile, and most Americans live one health emergency away from destitution. There are so many levels of fear & exploitation built into the private insurance system that, as a country, we spend more money on less healthcare than any other developed country. Just because the provider system is broken, it doesn’t mean that we should give up on the advances that can insure a better quality of life for entire families.

    I also believe it is every person’s right to decide what level of intervention he/she wants in managing illness. The right to die is as necessary as the right to live.

  2. I wonder about the investment in Jim’s healthcare. In some ways, I feel like all the intervention might have caused more stress than it was worth. It was obviously not sustainable, and it distracted from discussions about managing his death. Of course, this is in hindsight (and highly emotionally charged). I’m sure there’s a Middle Way…

  3. The first bypass was worth it, no question. Your children got to know their dad and you could stay home and be their mom. Jim made a million decisions along the way to the end about managing his illness that put the worth of further investment into question. The will to live is a powerful thing, but the wisdom to live well doesn’t seem as universally distributed. If medical schools showed some concern about the quality of life of those students, interns and residents who would eventually provide care & counsel to the sick, then maybe doctors would have a clue about what the value of living is and when it is being priced too dear.

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