Question RE: End of Life

claykenny

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Let’s say your significant other suffered a catastrophic accident. They are in the ICU on a ventilator and tests show no brain activity, besides some primitive brain stem function. You’ve had multiple opinions from different doctors and the consensus is they will be reliant on a ventilator and feeding tube until something (pneumonia or another cause of sepsis, probably) kills them with no hope of meaningful recovery. That may take weeks, months, or even years for natural causes to stop their heart and result in true death. They are young and don’t have a living will and never explicitly told you their wishes for a situation like this.

Despite insurance, it’s going to cost hundreds of thousands of dollars to keep them going. Maybe even millions. Your entire life is going to change keeping them on that ventilator. Financially, emotionally, psychologically.

Should we, as a society, allow people to withdraw care? They still have a heart beat and are alive. Isn’t it murder to take the patient off the ventilator? Shouldn’t we not force the patient to remain alive as long as possible? Obviously we aren’t paying for it financially as a society. Or are there situations where “pulling the plug” is ok?
 
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RNHawk

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Let’s say your significant other suffered a catastrophic accident. They are in the ICU on a ventilator and tests show no brain activity, besides some primitive brain stem function. You’ve had multiple opinions from different doctors and the consensus is they will be reliant on a ventilator and feeding tube until something (pneumonia or another cause of sepsis, probably) kills them with no hope of meaningful recovery. That may take weeks, months, or even years for natural causes to stop their heart and result in true death. They are young and don’t have a living will and never explicitly told you their wishes for a situation like this.

Despite insurance, it’s going to cost hundreds of thousands of dollars to keep them going. Maybe even millions. Your entire life is going to change keeping them on that ventilator. Financially, emotionally, psychologically.

Should we, as a society, allow people to withdraw care? They still have a heart beat and are alive. Isn’t it murder to take the patient off the ventilator? Shouldn’t we not only force the patient to remain alive as long as possible? Obviously we aren’t paying for it financially as a society. Or are there situations where “pulling the plug” is ok?
What are the patient's wishes? If they didn't want this then I 100% support removing the vent, (I have had to do it a few times in my career)
 

claykenny

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What are the patient's wishes? If they didn't want this then I 100% support removing the vent, (I have had to do it a few times in my career)

Read the post. No living will. Never conveyed wishes to family. Next of kin is calling shots.
 
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RNHawk

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Brain death: Irreversible cessation of all functions of the entire brain, including the brain stem. A person who is brain dead is dead, with no chance of revival.
 
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claykenny

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Brain death: Irreversible cessation of all functions of the entire brain, including the brain stem. A person who is brain dead is dead, with no chance of revival.

Thanks for the definition, nurse. They still have a heart beat. Isn’t it worth keeping them alive as long as possible? What if a cure for brain dead is just years away?
 
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claykenny

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"besides some primitive brain stem function". He probably needs to clarify if this person is brain dead like I said it is a mute question

You used the term “brain dead”. I did not. No significant cortical function but still brain stem activity and reflexes. Not enough to be declared “brain dead” by exam or definition, but effectively a non-recoverable neurological injury with no hope for meaningful future function and lifetime trach/PEG/LTAC.
 
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ConvenientParking

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What happens if you give them an intramuscular injection of LSD a la Aldous Huxley on his death bed? Still nothing on the brain scans? If not, probably try to score some recreational painkillers for the memorial service and pull the plug.
 
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FAUlty Gator

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It’s Iowa, so either old and fat but incompetent enough they couldn’t rise to a worthless administrator position or young and fat but also lacking any real world nursing experience.
So you’re saying I have a chance. Hmmmmmm…

Pull the plug. And I start my new life with fat Nurse Ratched.
 

bdcolt45er

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All life is sacred. Taking a life is a sin
It's not taking a life. The "life" isn't capable of living. A person in this condition can't breathe on their own, they can't maintain their nutrition, they can't protect their airway, they likey can't regulate their body temperature. It is perfectly appropriate and ethical to withdrawal care in this situation
 

gohawks50

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It's not taking a life. The "life" isn't capable of living. A person in this condition can't breathe on their own, they can't maintain their nutrition, they can't protect their airway, they likey can't regulate their body temperature. It is perfectly appropriate and ethical to withdrawal care in this situation
Pretty sure, Devil was being sarcastic.
 

Hoosierhawkeye

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Let’s say your significant other suffered a catastrophic accident. They are in the ICU on a ventilator and tests show no brain activity, besides some primitive brain stem function. You’ve had multiple opinions from different doctors and the consensus is they will be reliant on a ventilator and feeding tube until something (pneumonia or another cause of sepsis, probably) kills them with no hope of meaningful recovery. That may take weeks, months, or even years for natural causes to stop their heart and result in true death. They are young and don’t have a living will and never explicitly told you their wishes for a situation like this.

Despite insurance, it’s going to cost hundreds of thousands of dollars to keep them going. Maybe even millions. Your entire life is going to change keeping them on that ventilator. Financially, emotionally, psychologically.

Should we, as a society, allow people to withdraw care? They still have a heart beat and are alive. Isn’t it murder to take the patient off the ventilator? Shouldn’t we not force the patient to remain alive as long as possible? Obviously we aren’t paying for it financially as a society. Or are there situations where “pulling the plug” is ok?

If there is no known medical possibility for future life outside of being hooked up to large machines in a hospital setting then it's acceptable to terminate life support.

This isn't even remotely controversial.

The key part of this is what the future holds based on medical expertise.
 
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St. Louis Hawk

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But what if your doctor is pro-life and has decided that because of their personal religious beliefs, they know better than you — and thus they have decided to keep you alive, contrary to your and your family’s wishes?
 
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St. Louis Hawk

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Pull the plug, but only after a trial of crystals, essential oils, copper bracelets, and chiropractic care.

And all the thoughts and prayers one can muster.

Your practice consists of treating M1ers? Nice sub-specialty. I like it.
 

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