paramedicmike Posted August 31, 2008 Share Posted August 31, 2008 How in the world do they justify withdrawing care from this woman? Vent status aside, if she's awake and able to communicate how does any medical professional justify the withdrawal of care? Please discuss. -be safe [web:bbf8271fa5]http://news.yahoo.com/s/ap/20080829/ap_on_re_us/obit_warren[/web:bbf8271fa5] Link to comment Share on other sites More sharing options...
mshow00 Posted August 31, 2008 Share Posted August 31, 2008 Just my opinion here, but who are we to say "No, you are 'alive' and will have to suffer as a vegetable for the rest of your natural days be it 1 or 1,826" (5 years plus 1 for leap) . I know regardless of my mental status I do not want to live like that, nor does my wife. We have both talked about this to great lengths and all of our families know our wishes. The loss of life at any stage is sad, but I believe it would be a greater injustice to make her "live" (use that term loosely here) out the rest of her life in that state. Call is suicide, assisted suicide, murder, or mercy in the end she had to suffer a whole lot less this way. You have the right to refuse any treatment at any time as long as you understand the risk, why should this be any different? Link to comment Share on other sites More sharing options...
spenac Posted August 31, 2008 Share Posted August 31, 2008 This is why I have a living will stating exactly what measures I will accept to save my life. If I will have no quality I want the machines stopped. If God wanted me to live on a machine I would have been born with them. So my choice is let me go. I made my decision when fully competent. If you have wishes you better fill out proper forms so you don't get stuck on a machine costing your family everything that they have. Link to comment Share on other sites More sharing options...
p3medic Posted August 31, 2008 Share Posted August 31, 2008 Agreed....let her go. Link to comment Share on other sites More sharing options...
rock_shoes Posted August 31, 2008 Share Posted August 31, 2008 Patients have the right to refuse care up to and including refusal that results in death. To be perfectly honest I would make the same decision given the circumstances. Link to comment Share on other sites More sharing options...
firedoc5 Posted August 31, 2008 Share Posted August 31, 2008 I always said that if I was in that state or dying of some kind of untreatable/incurable terminal disease to just keep me pain free and let me go. My grandfather laid in a vegetative state for seventeen years after open heart surgery. At the time, in post op he coded. They were able to revive him but not until there was irreversible brain damage. He was on a vent for three days and the family said to take him off and let him go. But he kept breathing. He was bedridden, blind, mute, and unable to move. His arms were permanately in a decorticate posture position. He couldn't even swallow efficiently. He had to be fed with a tube. He couldn't even drink. But my grandmother eventually took him home. He was in a hospital bed and would be sat up in a recliner every day when possible. He was turned every four hours without fail. My grandmother did this for fifteen years and not once did that man have a bed sore. He finally passed away in '91 from renal failure. Now my grandmother is in a nursing home in LA. After many CVA's she's not much better off than my grandfather was. But she can speak a little. Actually her mind is as sharp as ever, but there's no connection between her brain and being able to act or communicate. It's one of those things where she could go tomorrow, or it could be fifteen years from now. You just never know. Link to comment Share on other sites More sharing options...
itku2er Posted September 1, 2008 Share Posted September 1, 2008 How in the world do they justify withdrawing care from this woman? Vent status aside, if she's awake and able to communicate how does any medical professional justify the withdrawal of care? Please discuss. -be safe Mike may I ask a question: Do you think it was wrong to withhold the treatment and unplug the vent because she was a world class athelete? That is the way I took it if I am wrong please let me know (I am usually always wrong when it comes to you ) Well it is a good discussion point, My thoughts on it are if she wanted to die then by all rights she has that choice to with drawl the treatment. She was a vital woman very active and for her family and freinds to keep her alive just with a machine would have been a dishonor to her. No one wants to let their loved ones go but some times we just have to do what is right for them not us. I do wonder though why her twin was the spokesperson and made that decision and not her husband or children. Even on the vent and responding with eye movement we do not know what kind of personal hell she might have been going through mentally. If she was aware of what happened to her and how she would live out the rest of her life dying might have been the only choice she could make. We will never know what her thoughts were and how she might have precieved her future. We can sit back and judge the decision till the cows come home on if it was right or wrong but it all boils down to this...she has a right to die if she wishes and it seems that was her wish. Link to comment Share on other sites More sharing options...
paramedicmike Posted September 1, 2008 Author Share Posted September 1, 2008 Ok...based on the replies so far I'm inclined to think none of you read the article. Or, if you did, you missed the point. That may be my fault, though, in how I presented this. This has nothing to do with the fact that she is a world class athlete (Sorry, Terri. Wrong again!). I'd still broach this topic if the patient in question was my neighbor or an homeless guy out on the street. This has everything to do with the reports by the family that she was awake and able to communicate with people around her. I understand people have the right to refuse treatment even if it means they'll die. But at what point, in a case like this, does it become murder? She was, in effect, asking to be killed. We have the right to refuse treatment. We do not have the right to be killed. Nor do we have the right to ask people to kill us. Last I checked, right, wrong or indifferent, suicide and murder are both illegal (except under very limited circumstances in Oregon). Let me frame the discussion a little better as I don't care what your personal beliefs are (nor will I share mine as I know you don't care either. ). How about this: Do you think removing this conscious, coherent (based on incomplete reports I know) from her vent constitutes murder? Suicide? Does she have a right to ask people to, in effect, kill her? Do we as family members (hypothetically, of course) have a responsibility to pull the plug if our loved ones are awake and able to communicate? (Brain dead or in a vegetative state is different so please don't confuse the two.) Do we as health care providers have a responsibility to honor this woman's wishes? Would it constitute murder on our part? Does this violate primum non nocere? After all, we would actively act to take this woman's life. How's that for a start? My apologies for a confusing introduction. -be safe Link to comment Share on other sites More sharing options...
p3medic Posted September 1, 2008 Share Posted September 1, 2008 She is vent dependant, without it she can not survive. She is awake and alert on the vent, and made a sound decision with a sound mind. Personally, I wouldn't want to be kept alive on a vent, so I think it is her choice to make. I wouldn't consider it murder, murder would be giving her a potassium bolus, in this case they turned off a machine, one she was never meant to need to survive. At least thats how I see it. Link to comment Share on other sites More sharing options...
Ridryder 911 Posted September 1, 2008 Share Posted September 1, 2008 They should be prosecuted for murder!Sorry, just because someone had an active life and now a tragic event occurred, one can dismiss life immediately. Was this a terminal case, was there no brain function, or more an inconvenience? Sure, spinal cord injuries are horrible and tragic in which none of us want to ever be directly involved in. Yet, there are those that have overcome to have a life and even a productive life (albeit limited role than the normal). Just because she was a athlete should have no influence. Would we pull the plug on a patient that had became a cardiac crippled, that was a former tennis pro or runner? How does one really know that this was not a maladaption process? That nearly everyone that is struck with this type of injury goes through the grieving process of wanting to die and end life. I have a friend that received a spinal cord injury. He was your normal average Joe, very athletic, macho male.. He was dirt bike riding and flipped his bike receiving a C-5,6,7 fxr. Did he hate his life afterwards, you bet. He was engaged and broke it off, he was in a junior college (for 4 years) and dropped out. As is in his words, life sucked! Yet, with time and rehabilitation, things changed. Ironically, today he describes it as positive thing. Yes, he wished it would had never occurred yet ... he did go back to school and not only received his A.D. but his PhD. He now works as a University professor with other handicapped survivors. If you would had asked him the same question, he would had immediately answered the same thing. I was a burn nurse for a few years. Was there horrible tragedies that one could had gave up on if allowed ... you bet! Some that I would had personally pulled the plug if allowed, yet I know of one that is now a very productive engineer and great husband and father. Yes, such extent of no pinna (ears) and nose, lost the right hand and only has two fingers on the other. Yet, successful in all rights as a human being. Is there cases where we should allow patients to die. Yes. Those are well defined as terminal, no cognitive brain function(s), end stage diseases that have no chance of reversal or age dependent/ physically never heal or respond to therapy. Just asking a patient afterwards should not be considered that they have all the information needed to make a logical and informed consent. Inconvenience is NOT one of the criteria. R/r 911 Link to comment Share on other sites More sharing options...
Recommended Posts