Allowing Patients to Die: Louise Aronson and Bill Andereck
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
49 min
2 speakers
8 chapters
transcribed 9 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the opening story and why is it relevant to the ethics of allowing patients to die?
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Welcome to the JerryPal podcast. This is Eric Widera. This is Alex Smith. And Alex, who do we have with us today?
We're delighted to welcome back Louise Aaronson, who's a geriatrician and author in the UCSF division of geriatrics. Her most recent book is Elderhood. Louise, welcome back to Jerry Pal.
Thanks for having me.
And we're delighted to welcome for the first time guest Bill Anderek, who's a primary care internist and senior scholar in Sutter Health's program and medicine and human values, a program that he co-founded with former UCSF faculty member Al Johnson. And he's also chaired the California Pacific Medical Center's Ethics Committee since nineteen eighty five. Bill, welcome to the Jerry Pell podcast.
Thank you, Alex. So we have a really interesting and a potentially challenging uh podcast today. We're gonna be talking about the title is Allowing Patients to Die. I think the theme is more Saving someone's life and the regret that follows. And for this podcast in particular, both Bill and Luis wrote articles that we're going to be discussing, particular patient cases. So while you don't have to, we're going to summarize these articles. If you have a chance to read those articles before you listen to this podcast, I highly recommend that you do. We were going to have them on the show notes to this podcast. podcast. Let's just go to Jerry Powell for this podcast. And we'll have links to those articles. But again, I think i you may get a lot more out of this if you read those articles first, but you don't have to, because we will summarize them too.
But but before we go into all of that. I think Bill, you have a song request for Alex?
I do. Uh Alex asked me for a song that was resonating in my head at the time and it would be Guy Clark's Song The Cape.
Why Guy Clark's the Cape?
Oh, it's a long story I'll make short. I grew up in Tennessee, went to school with Vanderbilt. Before I came to uh San Francisco, I spent a little time in Austin, Texas. This is in the early seventies. Um at the beginning of the music movement with Jerry Jeff, uh Guy Clark, um, and and all all the crew, most of them who were rejects or or transfers from Nashville. Um but that song has stayed with me and I finally the lyrics, I can't help it, it gives a nod to Kierkegaard.
All right,
Alex.
That's awesome.
That's gotta be a first.
Yeah, great choice. Here we go. Eight years old with a flower sack cape tied all around his neck. He climbed up on the garage, he's figuring what the heck He screwed his courage up so tight, the whole thing came unwound. He gotta run and start, and bless his heart, he headed for the ground. He's one of those who knows that life is just a leap of faith. Spread your arms and hold your breath, and always trust your cape. Thank
you. Fabulous. Okay, we got a lot to talk about. We got two articles, but I'm gonna throw in a third actually. It's not really an article. It's something me and Alex were talking about. Uh uh the patient case Dax.
Yeah, th this was a famous case. It's uh much discussed in bioethics courses in Beecham and Childress's Principles of Biomedical Ethics. Um, this is the case of Dax Cowart, who in nineteen seventy-three was in a horrible burn accident. He was a twenty-five-year-old guy, former captain of the football team, former Air Force pilot. Um his father had inadvertently parked his car on top of Of a like a propane pipeline that was leaking and the car exploded. His father was killed. He was horribly burned over most of his bodies, lost many of his fingers. Uh farmer nearby came to to to rescue him and he said, Can't you see I'm dying or I'm dead? I'm gonna die. Um just get me a gun. He had a 14-month recovery in hospital and rehab and continually asked.
To have life sustaining treatment suspended so that he could be allowed to die. Uh they did not doctors did not listen to him. And afterward he said he was glad to be alive and not but but and that doctors should have listened to him and he should have been allowed to die.
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Chapters
8 chapters
1
What is the opening story and why is it relevant to the ethics of allowing patients to die?
0:00–6:19
2
How does the song “The Cape” set the tone for the episode’s themes?
6:19–12:04
3
What does the Dax Cowart case illustrate about patient autonomy and the duty to rescue?
12:04–18:26
4
How did Louise Aronson’s mother’s experience highlight modern challenges with advance directives?
18:26–24:57
5
What ethical dilemmas did Bill Andereck face in the Sam story and how did he resolve them?
24:57–30:40
6
Why do clinicians feel regret after saving lives, and how does the “lifeguard” mentality affect decision‑making?
30:40–36:06
7
How do ageism, age realism, and future‑self bias influence end‑of‑life choices?
36:06–42:21
8
If you could wave a magic wand, what changes would improve medical training and advance‑directive use?
42:21–49:01
Speakers
2 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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