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Well, I can’t speak for all physicians, but I think it is generally refused when the sole purpose of those treatments is to prolong life, in a futile situation.Many, many times, it is obvious that a person is near death. Their quality of life is awful. They are exhausted. Their body has long ago, ceased to bring them joy.Their family, however, is demanding that we “do everything.”Not wanting to “upset the kids.” They allow treatment that is not only NOT lifesaving but makes them miserable and leads to a whole host of other discomforts and indignities.They are quite literally treated to death.As physicians, we see this happen on a daily basis.It’s terribly inhumane.I will not allow chemo or dialysis or a ventilator, in myself, if there is no hope for recovery.My family knows this.I have documents in place that outline what my wishes are concerning futile treatment.Let me illustrate.I had a colleague. He was a pretty young guy, in his 40’s, with school aged kids.He was diagnosed with a GBM, the most deadly form of brain tumor. He was given 4 month without treatment maybe a little longer with.When asked what treatment he was considering, he thought for a minute, then whispered, “the beach.”He took his family on a trip to Europe. He played with his kids, on the beach. They wandered through fun and interesting places.He had wonderful, intimate meals in little cafes, with his wife. They sampled many fine wines and a lot of delicious food.They soaked up as much joy and good memories as their hearts could hold.When seizures became an uncontrollable problem, he returned to the U.S and entered hospice.He died at home, surrounded by his family, a few short weeks later.I thought he was very wise man.He had seen, just as I had, all the people getting therapies that would prolong their lives, only briefly but would devastate their families both emotionally and financially.Their last months on this earth were spent recovering from the treatment or getting over the surgery. They missed their opportunity for a lovely, peaceful interlude with their loved ones, in favor of the next round of chemo, or surgery or dialysis, etc.I would never, ever, allow that for myself.When it is my time, I’m going.Peace.

I’ve been pretty lucky, made it to my 60’s without having to take a pain pill. Then the unthinkable happened during a routine dental procedure, the nerves were damaged. I stuck it out for 6 months in agony, not wanting to take an opioid. My primary Dr. and my Dr. of Oriental medicine said I was putting too much stress on my body by not using them to get relief. I went ahead and started taking them, knowing I was going to have multiple surgeries, 30+ none of them helped the pain until I found a Doctor in Baltimore that specialized in peripheral nerve damage. It was a tough surgery but stopped the nerve pain. I was on a small dose of oxycodone and weaned off with no problems. I had several doctors ask me how I didn't get addicted, for me, it was a choice. I don’t believe we have a clue to what they call an opioid crisis. When I went to a pain clinic during all of this, I was there to see if they had another way to help, a nerve block. I sat in the waiting room with people who were in horrible pain, most of them elderly. When my name was called, I was asked to provide a urine sample, which I refused. When the doctor came in he went on a rant about how patients abuse drugs and he has to test me. I believe the ones who are being hurt the most are chronic pain patients. They treat you like a drug addict. I never went back. Had the same experience with my elderly father who had prostate cancer and a knee that had been replaced twice and still caused him a great deal of pain. He was 87 at the time and he too got the lecture on abusing drugs. He was dying. I finally had to utilize hospice to make sure he was comfortable. The whole experience opened my eyes to the ugly underbelly of our system that doesn’t do what they can to help those that need them to function. Chronic pain is horrible, these people need comfort, support, and a Dr that understands what it's like to wake up every day wondering how to make it through the day. We first need to be able to distinguish those that are in pain and treat them with compassion. Opiate abusers, like my son was. will always find a way to get hold of the drugs. There needs to be a distinction between abusing drugs and needing them, like diabetics that need insulin.

The vast number of people, living successfully, daily, with HIV. HIV isn't the picture in your imagination that flashes back to the 80″s, with people dying quickly, emaciated, and with no immune system. There are protease inhibitors & antiretroviral drugs, that, taken daily, not only allow the patientto start regaining white blood cells, but can live, successfully, undetectable. Meaning? When blood samples are screened, they can't find a trace of the viral cells. People are thriving today instead of dying.After having buried many of my friends & family, and performing and hosting benefits, ( my show, Variety Showcase, 2003-2007, raised iver $37,000 for north texas AIDS charities/hospices), I've found it necessary to learn about this. Education eliminates fear and silence = death. I'm sure , as i write this, you know someone who is HIV positive.According to the CDC, if one person is POS & their partner is NEG and they're both taking prexisting prophylaxis drugs, they can remain safe from transmission,(to each other and others).