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Author Topic: When should life support be pulled from a patient?  (Read 17585 times)

Offline Karen W.

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How does the medical community determine the time to remove someone from Life support.

What medical knowledge should a lay person possess when trying to determine the whens of removing life support and giving up on life, when living on a machine? What should be the scientific evidence that there is no further hope and all attempts of survival are gone..once hooked to a machine..

What medical components help to determine the end..

Would that be brain activity or rather the lack of it?


 

Offline RD

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When should life support be pulled from a patient?
« Reply #1 on: 17/07/2008 15:20:18 »
UK public health system (NHS)

Quote
If a patient is declared clinically brain dead, the decision may be taken to turn off their life support machine. This will be discussed with the patient's family, but the ultimate decision rests with the consultant. Strict criteria must be met when declaring a patient clinically brain dead
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=576&sectionId=8#

If a patent had made an advance medical directive, a.k.a "living will", stating that they would not wish to live if severely brain-damaged, then doctors could pull-the-plug even though the patient was not brain dead, but in a "vegetative state". 
« Last Edit: 17/07/2008 15:30:52 by RD »
 

Offline Karen W.

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When should life support be pulled from a patient?
« Reply #2 on: 17/07/2008 15:55:31 »
Can you explain an advance directive......
should a patient choose to stay on life
support.  How  seriously would the patients
rights be followd and can someone else besides family be given this decision if the patient knows that the family would disconnect...when they prefer to stay on?
 

Offline RD

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When should life support be pulled from a patient?
« Reply #3 on: 17/07/2008 16:08:37 »
"Life support" can mean "given food & water via a tube"...

Quote
June 14, 2005
Suing to Stay on Life Support
From an editorial in the Christian Science Monitor:

A man named Leslie Burke, who's a patient in England, has thrown a legal challenge to Britain's universal tax-supported healthcare system. The outcome could serve as a lesson for any nation with a strong or growing government role in personal healthcare.

Mr. Burke is mentally competent, but because his doctors say a debilitating condition might result in him needing food and water through a tube, he sued the National Health Service (NHS) to guarantee that it not withhold such care should he need it. He did not want to be dehydrated against his wishes. He won the first round. . . .


The Burke case has the potential to alter the relationship between patient and doctor not only in Britain, but in the US as well, since a number of federal courts have cited international or foreign precedents when justifying decisions. And given the onset of baby-boomer retirement, Medicare may soon be forced to ration healthcare in cases that doctors decide are "hopeless." Medicare already has strict rules on what it will pay for.

The Schiavo case challenged people to consider the meaning, purpose, and source of life. But, as the Burke case might do, it also reaffirmed the right of individuals, or their legal proxies, to decide the treatment that might or might not be applied in a case of severe disability.

British patients, if they can afford it, may always resort to private care. But if they can't, Britain, and perhaps many other nations, must face the question of whether to keep paying for any life-saving treatment, or simply ration such care.

http://lawprofessors.typepad.com/elder_law/advance_directivesendoflife/index.html


« Last Edit: 17/07/2008 16:14:52 by RD »
 

Offline RD

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When should life support be pulled from a patient?
« Reply #4 on: 17/07/2008 16:19:23 »
can someone else besides family be given this decision

"someone else" would be a proxy...

Quote
Health Care Proxy: This is a legal document in which an individual designates another person to make health care decisions if he or she is rendered incapable of making their wishes known. The health care proxy has, in essence, the same rights to request or refuse treatment that the individual would have if capable of making and communicating decisions.
http://www.medicinenet.com/advance_medical_directives/article.htm
 

Offline Karen W.

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When should life support be pulled from a patient?
« Reply #5 on: 17/07/2008 16:40:23 »
Thanks Rd..
 

Offline chris

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When should life support be pulled from a patient?
« Reply #6 on: 19/07/2008 23:44:37 »
I think
How does the medical community determine the time to remove someone from Life support.

Hi Karen - I think you can relax for now - we know you're alive!

C
 

Offline Karen W.

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When should life support be pulled from a patient?
« Reply #7 on: 20/07/2008 04:27:23 »
LOL...Yes I am...and I wish to stay that way, but I have to make some decisions right away and I need to be able to make them with clear definitions of what they could mean..


Is a patient considered brain dead, beyond help with life support? Not food and water but a machine to keep them breathing?

Can you have brain activity and still recover over time on life support machine....?

Example.. someone undergoes a very high risk surgery and something happens , perhaps they lapse into coma or their heart stops but is restarted and for whatever reason this person cannot seem to maintain breathing on their own.. so are hooked up to a machine... with me so far..? Now say this person wants to remain alive as long as possible...... at what point should that person allow a proxy to pull their plug.. what point is the point of NO RETURN? I really need to understand this better in order to decide what I want... what are the pros and cons... when is the machine just not going to fix things?


Have there been cases where the person has remained on a machine for an incredible amount of time and actually improved after a few years or months... when does one say uncle and let go?

I want medical facts so I can decide whats best for me what I want and don't want..

I would appreciate some straight answers too!*smiles* I want No religious views here on this question... I want facts.. and realities ok...
 

Offline RD

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When should life support be pulled from a patient?
« Reply #8 on: 20/07/2008 05:52:30 »
The case of Eddie Kidd, the UK version of Evil Kineval, gives an example of the time-scales involved in recovery from brain injuries...

Quote
Kidd suffered serious head and pelvic injuries in a stunt bike crash at the Bulldog Bash, held at Long Marston Airfield near Stratford-upon-Avon on 6 August 1996, when a landing went wrong. Doctors later told his parents that he could be in a coma for up to 10 years, but he regained consciousness within six weeks of the accident. Kidd was wheelchair-bound for several years afterwards, with limited co-ordination and speech, but he has since vowed to return to the world of stunts.

Kidd appeared in an episode of Russell Brand's 2002 TV documentary series RE:Brand on the digital satellite channel Play UK to talk about his life after the accident.

Kidd took control of a motorcycle again when he formally opened the Beyond Boundaries Live 2007 Exhibition at Sandown Park, Esher on 29 June 2007 whilst riding a Conquest 1200 trike, manufactured by Martin Conquest Limited.
http://en.wikipedia.org/wiki/Eddie_Kidd
« Last Edit: 20/07/2008 06:03:16 by RD »
 

Offline RD

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When should life support be pulled from a patient?
« Reply #9 on: 20/07/2008 06:26:49 »
Now say this person wants to remain alive as long as possible...... at what point should that person allow a proxy to pull their plug..

If the person wants to live as long as possible, even if in an apparently permanent coma, or severely brain-damaged, then they could tell their proxy exactly that, i.e. "do everything possible keep me alive". There would be serious financial implications; intensive care costs thousands of pounds/dollars a day.

The patient's health insurance company or bank balance may determine when expensive medical treatment stops.
« Last Edit: 20/07/2008 06:58:30 by RD »
 

Offline Karen W.

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When should life support be pulled from a patient?
« Reply #10 on: 20/07/2008 11:11:34 »
The case of Eddie Kidd, the UK version of Evil Kineval, gives an example of the time-scales involved in recovery from brain injuries...

Quote
Kidd suffered serious head and pelvic injuries in a stunt bike crash at the Bulldog Bash, held at Long Marston Airfield near Stratford-upon-Avon on 6 August 1996, when a landing went wrong. Doctors later told his parents that he could be in a coma for up to 10 years, but he regained consciousness within six weeks of the accident. Kidd was wheelchair-bound for several years afterwards, with limited co-ordination and speech, but he has since vowed to return to the world of stunts.

Kidd appeared in an episode of Russell Brand's 2002 TV documentary series RE:Brand on the digital satellite channel Play UK to talk about his life after the accident.

Kidd took control of a motorcycle again when he formally opened the Beyond Boundaries Live 2007 Exhibition at Sandown Park, Esher on 29 June 2007 whilst riding a Conquest 1200 trike, manufactured by Martin Conquest Limited.
http://en.wikipedia.org/wiki/Eddie_Kidd


Thanks Rd.. That is the kind of things that help some...

When does a doctor say no chance of survival off a machine.. how is that determined? What factors are involved in that decision...? Do you know.. what kind of things aside from financial are involved.. I see Hubby will have to make sure he pays the insurance in a timely manner eh?? LOL.... Boy I best not have him in charge!! LOL...

if the premiums are paid is it legal for an insurance company to step in? and say pull the plug if a patient has made arrangements to the contrary?

 

Offline RD

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When should life support be pulled from a patient?
« Reply #11 on: 20/07/2008 13:20:50 »
When does a doctor say no chance of survival off a machine.. how is that determined? What factors are involved in that decision...? Do you know.. what kind of things aside from financial are involved..

Note there are circumstances where a person requires a ventilator but does not have brain damage.
I believe the Superman actor Christopher Reeve was on a ventilator for about a decade after he broke his neck.

if the premiums are paid is it legal for an insurance company to step in? and say pull the plug if a patient has made arrangements to the contrary?

You should read the small print in your insurance policy to find out if they will pick up the tab in this unlikely event.
The two examples I have listed, Kidd and Reeve, were very wealthy individuals who could afford unlimited medical bills.

The odds of survival and extent of recovery from a vegetative state are listed at the bottom of this webpage
http://www.braininjury.com/coma.html
 

Offline Karen W.

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When should life support be pulled from a patient?
« Reply #12 on: 20/07/2008 14:20:17 »
Thanks RD!
 

Offline Karen W.

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When should life support be pulled from a patient?
« Reply #13 on: 20/07/2008 14:26:31 »
That really had some good information.. Thank you very much RD! I am still not sure where to head on this one... Its kind of a big deal... Its not just me I have to think about...

very good information...
 

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When should life support be pulled from a patient?
« Reply #13 on: 20/07/2008 14:26:31 »

 

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