Withdrawing life support

[Confused]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

[Goat]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

I would merely point out that for the person, things are different now than they were 20 years ago, and that what ever is decided, has to be decided with compassion, and with the best interests of the patient. I would stress that it isn't about them, it is about the person who is sick. I would tell them they should put aside their personal feelings and fears, and look at what is right for the person. I would say that the person who is sick probably would not want people to be angry at each other over this choice, and that while disagreement is common in situations like that, it should not be the cause of a family feud.

I would try to redirect them to consider the patient, and not their own desires and fears.

[Confused]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

I would merely point out that for the person, things are different now than they were 20 years ago, and that what ever is decided, has to be decided with compassion, and with the best interests of the patient. I would stress that it isn't about them, it is about the person who is sick. I would tell them they should put aside their personal feelings and fears, and look at what is right for the person. I would say that the person who is sick probably would not want people to be angry at each other over this choice, and that while disagreement is common in situations like that, it should not be the cause of a family feud.

I would try to redirect them to consider the patient, and not their own desires and fears.

I have been in this position too many times and to be honest, the decision is never cut and dry. It isn't possible to determine what the patient wants at that exact moment. IF we have him on a morphine and ativan drip, they could be out of pain and calm. Would their decision at that moment reflect withdrawing of life support? The hearing is theorized to be the final sense to go. Would that patient scream to give them longer if they could? Or would they thank them.

My position is difficult. I have to separate my own beliefs and try to stand for the patients rights. This is hard to do when from day one, the patient has been on a breathing machine and sedated. I don't know them enough. I can only encourage the family to think of what he would want. But the response is always the same, "What do you think". I can't answer that for them. I can only say medicine has done all it can. Withdraw life support and he will sink or swim. Leave that up to God. Despite the comfort this may provide them, it kills me because my current belief doesn't support life after death. Even when I am shady in my belief, for all I know, my advice may be condemning that soul hell.

Is there any answer that one can live with here?

[Goat]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

I would merely point out that for the person, things are different now than they were 20 years ago, and that what ever is decided, has to be decided with compassion, and with the best interests of the patient. I would stress that it isn't about them, it is about the person who is sick. I would tell them they should put aside their personal feelings and fears, and look at what is right for the person. I would say that the person who is sick probably would not want people to be angry at each other over this choice, and that while disagreement is common in situations like that, it should not be the cause of a family feud.

I would try to redirect them to consider the patient, and not their own desires and fears.

I have been in this position too many times and to be honest, the decision is never cut and dry. It isn't possible to determine what the patient wants at that exact moment. IF we have him on a morphine and ativan drip, they could be out of pain and calm. Would their decision at that moment reflect withdrawing of life support? The hearing is theorized to be the final sense to go. Would that patient scream to give them longer if they could? Or would they thank them.

My position is difficult. I have to separate my own beliefs and try to stand for the patients rights. This is hard to do when from day one, the patient has been on a breathing machine and sedated. I don't know them enough. I can only encourage the family to think of what he would want. But the response is always the same, "What do you think". I can't answer that for them. I can only say medicine has done all it can. Withdraw life support and he will sink or swim. Leave that up to God. Despite the comfort this may provide them, it kills me because my current belief doesn't support life after death. Even when I am shady in my belief, for all I know, my advice may be condemning that soul hell.

Is there any answer that one can live with here?

That is the best answer. As for if there is an afterlife, and what the faith of that soul, well, that would be out of your hands anyway.

[WafflesFTW]

It really depends on the level of severity. Mental specifically. If the brain is mush let him/her go but if full mental recovery is possible hang on. When the time is right let that person decide for himself. If mental recovery cannot occur then the person is as good as dead anyway.

[Confused]

It really depends on the level of severity. Mental specifically. If the brain is mush let him/her go but if full mental recovery is possible hang on. When the time is right let that person decide for himself. If mental recovery cannot occur then the person is as good as dead anyway.

Ok, Go back and read the OP and then see if you can figure out why this makes no sense to me.

[WafflesFTW]

Ah I thought the OP meant physically meaningful recovery. In this case, just let the guy go. Whatever that counts in his body is dead anyway.

[realthinker]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

I would merely point out that for the person, things are different now than they were 20 years ago, and that what ever is decided, has to be decided with compassion, and with the best interests of the patient. I would stress that it isn't about them, it is about the person who is sick. I would tell them they should put aside their personal feelings and fears, and look at what is right for the person. I would say that the person who is sick probably would not want people to be angry at each other over this choice, and that while disagreement is common in situations like that, it should not be the cause of a family feud.

I would try to redirect them to consider the patient, and not their own desires and fears.

It's not only about the patient. It's about whomever will be responsible for all of the possible consequences of the decision. Does the patient have the financial resources to pay for a prolonged vegetative state? If not, upon whom will that fall? Who will be the caretaker if the patient should recover to the point that hospitalization is not required but independent living is not possible? Either of those issues can destroy a family, generations of a family.

[Confused]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

I would merely point out that for the person, things are different now than they were 20 years ago, and that what ever is decided, has to be decided with compassion, and with the best interests of the patient. I would stress that it isn't about them, it is about the person who is sick. I would tell them they should put aside their personal feelings and fears, and look at what is right for the person. I would say that the person who is sick probably would not want people to be angry at each other over this choice, and that while disagreement is common in situations like that, it should not be the cause of a family feud.

I would try to redirect them to consider the patient, and not their own desires and fears.

It's not only about the patient. It's about whomever will be responsible for all of the possible consequences of the decision. Does the patient have the financial resources to pay for a prolonged vegetative state? If not, upon whom will that fall? Who will be the caretaker if the patient should recover to the point that hospitalization is not required but independent living is not possible? Either of those issues can destroy a family, generations of a family.

My dilemma isn't one that I feel finances should even be relevant to. You miss the point here. The consequences of the choice that must be made here shouldn't include the financial burden. What is the price of life. How much is it worth if you are to think about the financial burden? Is that really the bottom line?

I am sorry but cost shouldn't even be a consideration here IMHO. The burden here is living with a decision to value quality or quantity of life. Not the cost of life itself. No. If this was your mother you had to make a decision about, would the cost of caring for her in a vegetative state for then next 20 years until she finally passed away be a factor? If it was, then perhaps we should consider the same factors for our children. Should we carry the financial burden of caring for them? Do we owe our parents any less than what they sacrificed for us? Sorry, but I have to say that financial burdens shouldn't factor into this most difficult ethical decision we would ever have to make for a loved one.

I am sorry, but the only thought here should be about the patient. Anything else would diminish the value of your family by considering it in terms of "cost".

[realthinker]

I am often in situations where families look to me for advice on what they should do when a loved one is on life support with almost no hope of any meaningful recovery. By meaningful, I mean they will never be off the ventilator, they will be fed through a tube in their stomach, they will never be able to show any signs of being conscious of their surroundings.

Looking at that persons living will, they request every effort be made to continue their life. Their living will is 20 years old and is no longer even valid. But the division between family members has created an ethical dilemma that forgets about what is in the patients best interests.

In such circumstances, what advice would you give the family as a whole? Recall, like it or not, you WILL influence this families decision.

Why would you give the advice you chose?

I would merely point out that for the person, things are different now than they were 20 years ago, and that what ever is decided, has to be decided with compassion, and with the best interests of the patient. I would stress that it isn't about them, it is about the person who is sick. I would tell them they should put aside their personal feelings and fears, and look at what is right for the person. I would say that the person who is sick probably would not want people to be angry at each other over this choice, and that while disagreement is common in situations like that, it should not be the cause of a family feud.

I would try to redirect them to consider the patient, and not their own desires and fears.

It's not only about the patient. It's about whomever will be responsible for all of the possible consequences of the decision. Does the patient have the financial resources to pay for a prolonged vegetative state? If not, upon whom will that fall? Who will be the caretaker if the patient should recover to the point that hospitalization is not required but independent living is not possible? Either of those issues can destroy a family, generations of a family.

My dilemma isn't one that I feel finances should even be relevant to. You miss the point here. The consequences of the choice that must be made here shouldn't include the financial burden. What is the price of life. How much is it worth if you are to think about the financial burden? Is that really the bottom line?

I am sorry but cost shouldn't even be a consideration here IMHO. The burden here is living with a decision to value quality or quantity of life. Not the cost of life itself. No. If this was your mother you had to make a decision about, would the cost of caring for her in a vegetative state for then next 20 years until she finally passed away be a factor? If it was, then perhaps we should consider the same factors for our children. Should we carry the financial burden of caring for them? Do we owe our parents any less than what they sacrificed for us? Sorry, but I have to say that financial burdens shouldn't factor into this most difficult ethical decision we would ever have to make for a loved one.

I am sorry, but the only thought here should be about the patient. Anything else would diminish the value of your family by considering it in terms of "cost".

If you think that the financial realities of long term invalid care are irrelevant you are remarkably naive. That financial cost spills over into the viability of the family. Should a family sacrifice their livelihood and the livelihood of the next generation for a single member who will never even appreciate what is being done for them? Is it responsible to introduce the kind of resentment that causes into a family? I don't care how much the patient is loved, when the money's gone and the kids don't get what they need and the college savings is spent keeping that person alive, there will be issues. What does it do to a marriage when the money is going to the nursing home instead of retirement? Second mortgages and second jobs don't help families, and the impact can last for generations.

I'm not putting a dollar figure on life. I'm talking about choices regarding who in the family gets to thrive and who does not, and at whose expense. The choice is about whether a few more months or years of unappreciated breathing is a fair trade off for possibly a lifetime's worth of education and stability for a family of children. Does one sacrifice one's self and the children to prolong the death of the parent?