Euthanasia

The current buzz in the medico sphere has been about mercy-killing, euthanasia. There were several reports and articles in the papers recently about this controversial topic.

To me, being able to legalize euthanasia would mean reaching a pinnacle in human civilization. Most doctors are against legalizing it, especially those specializing in end-of-life care like palliative medicine and rehab medicine. The avenue for abuse is also present.

I am NOT an advocate for euthanasia but the notion seems too good to not implement it.

To me, it's all about the quality of life of a patient and not about the length. However, the choice to live or die definitely has to be made by the patient and should not be by the medical carer/relatives. Caveats such as a comatose patient would have to be explored carefully by all parties involved. The concept of "quality of life" would also have to be in the patient's perspective too. Being a young quadriplegic might be acceptable to some but not to athletes. Having a terminal illness could be alright for some and not to others.

Empowering patients with choices for euthanasia and the chance to make informed decisions will become necessary in the near future in my opinion. It sometimes seem ridiculous how the medical staff want to involve patients in treatment decisions and management choices yet not allow them to choose if they would want to end their life. Lots of policies, rules and laws have to be set before we rush into legalizing euthanasia, but i know that it would be the next step we all have to take.

That said, most of the time i feel we should try to live life to the fullest. Being able to see your loved ones, being able to experience the next sunrise even if you have a terminal illness are little joys we all should not give up. But this is from the perspective of a person who is still fit for now........

Cord blood banking

There was an interesting review article on Straits Times Saturday Octorber 25 2008 discussing about cord blood banking by Andy Ho.

The debate was whether public or private cord blood banking was "better". It also discussed briefly the feasibility of usage of cord blood in the future.

The basic of cord blood is for its hematopiotic stem cells which are can subsequently form other types of blood cells eg. red,white and platelets. It can be used to treat genetic diseases and cancers.
There is a big market in private cord banking and it's definitely lucrative. There are both private and public cord banking centres avaliable in Singapore.

Studies have shown that there is no good evidence that storing cord blood is useful in low-risk families with no history of genetic disorders. As also stated in the article, using one's own cord blood is probably ineffective to treat cancers like leukaemias as their own cord blood would also likely have that genetic defect. There is also a lag time to diagnosis of these diseases and the cord blood could already be defective. The chance of success would be higher if another's cord blood is used.

Thus said, wouldn't it be simple common sense to have only a public cord bank in Singapore? It could benefit the greater good. Private cord banks are banned in most European countries and is generally discouraged in America. Some private cord banks are also listed and traded on stock exchanges. This can only be for profit and does not benefit patients in any way.

I might not be willing to explore the issue more but i feel that Singapore should just ban private cord banking. It's just common sense to me though it might be just a bias view.

Round 1: TCM vs Western Medicine

There has always been an ongoing debate about the effectiveness of traditional chinese medicine TCM or other forms of traditional medicine and western medicine.

In Singapore, TCM is ingrained into our culture and each race has their own traditional cures and potions. Many might frown on them as most have no scientific basis, however, you cannot deny the fact that some do achieve what they claim to be able to do. The truth is most of the herbs probably contain contents which western medicine use in pills, just that it has not been analyzed yet.

I'm a fence-sitter when it comes to this topic. People (mostly aunties...hahaha) often pop the question on whether this-and-that is effective to me. My reply would always be the same: I am unsure of their effacacy but i think there is no harm trying. Of course, this is excluding power-walnut and all the other obviously bogus-money-making-scheme medicines.

Certain events in the past few years have made me ponder about my still-current stand. I had a colleague/friend who was diagnosed with a terrible disease almost 7 months back. It was a "textbook" case condition which would most likely be curable with definitive but extremely disfiguring surgery. He consulted myself and Dr Y (another colleague) countless times about possible options and our advice was always to seek specialist help for surgery. Second opinions upon second opinions were sought, scans upon scans were done and finally he decided on TCM.
Unfortunately he passed away recently.

Myself and Y thought he had undergone surgery and was wondering why there was no news of his hospitalisation. The shock came when we were both informed of his demise. Dr Y was extremely livid, saying TCM caused his death. I had to agree, since i believe the TCM dude told him it would be better after the meds. I think it was quite irresponsible treatment in that sense.

On the flipside, surgery might not have saved him. Moreover, if it did, could he live with the severe disfigurment? How would his quality of life be? Would he be in bed for 6 months and then need regular followup? His ADLs (activities of daily living) would also be affected.

Could TCM have been the best treatment for him in the end? Giving him the sliver of hope and comfort. Giving him analgesia till his last days. Giving him time to spend with his family and friends before time expired.

A Silly Question

There are many subscribers to the view that there isn't such a thing as a silly question. Inquisition is encouraged and from curiosity many a new discoveries are made.

However, i just asked a silly question the other day.

An extremely concerned mother brought in her little girl the other day. I could heard her wailing outside before she came in. Her nose was bloodied and she had a small abrasion on her forehead. It was obvious that she probably fell face first while playing at some random playground and was OBVIOUSLY in pain.

So the first thing i said to her in my cutesy voice was.... "Hello. I'm Beardoc. Is it very painful???"

The mom was rather kind and said: "I think she is in pain...look...she's crying.."

I could imagine the mom rolling her eyes and giving me the "are you a retard?" look in her mind's eye.

Yeah...now that's a silly question.

=.=

It's been a rather long time since i blogged and people have been bugging me to start something again.
However, i have forgotten the password!

So...anyway nothing much has happened recently. Just came back from a New Zealand trip with my unit. Twas extremely enjoyable and i'm glad i got to know my unit guys better now.

The main thing that's kinda bothering me now is what to do about the future, medical-wise. Friends and colleagues around me have more or less decided on what specialty to do. I on the other hand still have no clue. Just wasting away in army. Taking up the GDFM course seems more like a time-filler than anything else.

What determines the path one chooses? Interest, future prospects or pure financial gains??
Sighh...