Sunday, November 30, 2008

How do we cope...

How do we cope with turning off life support for a loved one? There is no easy answer. Some turn to other family members for support, through talking, crying and sharing emotions we can learn to cope with our loss. I believe most find comfort in God. Prayer is huge healing tool.

Though I have been lucky enough to have not experienced this at all, I believe prayer and the comfort of loved ones surrounding me would make all the difference in my healing process. Time of course is the ultimate healer, but with God, Family and friends, how can you go wrong?

I am by no means any sort of doctor, but if you are dealing with life support issues of a loved one, then pray to God for help to carry you through these hard times and surround yourself with family and friends. Do not elect to be by yourself and think that you can handle this alone. It's a huge burden, which should be shared with all your relatives. Being alone, will only make you think of the pain 24 hours a day. You need a relief valve to vent your grief and by talking about it with relatives and God, you can relieve this burden which will consume you otherwise.

Monday, November 24, 2008

Persistent Vegatative State (PVS)

People experiencing PVS have a severely damaged cerebral cortex. This is the upper brain responsible for cognition, perception, language and purposeful movement. If there is a cut off of oxygen from the brain, it will lay waste to the cerebral hemispheres well before it damages the lower brain, or brain stem, which controls respiration, blood pressure, and the sleep-wake cycle, as well as voluntary reflexes.

The brain stem remains largely intact in PVS patients. Thus they will occasionally yawn, chew, swallow, sigh, grimace, laugh and cry. They open their eyes and seem to glance about: on closer inspection, however, their eyeballs are seen to be moving uncoordinated, random directions with no visual input to the brain. (Death & Dying).

PVS patients test our institutions about the boundary between life and death. What precisely does "death" mean? Is it primarily a biological, philosophical or religious concept? What marks the moment when somebody dies? Whatever "death" is, it ought to be permanent and irreversible.

Thursday, November 20, 2008

The need for a living will

Have a living will in place and make it specific as to what your wishes are, in case you're involved in an accident leaving you dependent on life support. If you don't, you leave open the possibility of physical and financial stress on loved ones by putting family against family when they disagree on treatments, etc.

This conflict, is becoming increasingly common as science extends its ability to prolong life.

"Increasingly so -- over the past few years as technology allows us to keep people alive with more complex medical situations for longer -- I think we're seeing more really difficult end-of-life type cases," said Dr. Jeff Blackmer, executive director, office of ethics, for the Canadian Medical Association, which represents 65,000 doctors.

"Our viewpoint is that we want to make sure that clinical decisions are left to physicians and not judges," he added. "These decisions are not made lightly and they're not made in haste, and they're not made with anything except the best interest of that individual patient at heart."

"The family sees it as when there is life there is hope. He is breathing, his brain functions, he holds their hands," Neil Kravetsky, the family's lawyer, told the Canadian Broadcast Corporation.

To avoid conflicts, court cases, added stress and financial hardship that are common with these kinds of conflicts, it is imperative that we have a living will stating our requests in such situations.

Tuesday, November 18, 2008

Uniform Determination of Death Act

This law was proposed in 1981 by a Federal commision. Moving beyond the traditional no-pulse, no-breath standard, this law defines death as the "irreversible cessation of all functions of the entire brain, including the brain stem." (Death & Dying). This law appears to shift focus from the chest to the cranial cavity and does not discriminate among neurological functions.

It appears the court system is making strives to define death in a legal format. More and more cases are being brought into the court system simply because the families cannot decide what to do amongst themselves. It is critically important in todays society that we as human beings have a plan for our loved ones as to what to do with ourselves if we end up in a permanent vegatative state.

Saturday, November 15, 2008

Texas Life Support Case

Mr. Spiro Nikolouzos, a retired electrical engineer was admitted to St. Luke's Episcopal Hospital emergency room in Houston, Texas, 10 February 2005. His wife Jannette Nikolouzos was informed by a mere letter "that it would withdraw life-sustaining care of her husband of 34 years in 10 days" unless she found another facility to care for him. He would have been a patient at the hospital for one month's time.

The hospital director or doctor of Spiro didn't even have the common courtesy of calling his wife and informing her of this! I know the letter was for legalities, but somebody should've also called his wife. She was able to have her husband transferred to San Antonio prior to his "expiration" date.

Texas became the first state in 1999 to pass a law establishing an ethics board review of when to disable life support. The bill "gives hospitals the authority to remove patients from life support, but requires they give the family 10 days notice to find another facility." According to Dr. David Pate, St. Luke's chief medical officer, Spiro was unaware of his surroundings, he couldn't eat, he couldn't speak, he couldn't move any of his extremities.

Although I agree with having some sort of time table, I think 30 days is just not enough time. I believe 6 months should be the minimum standard.

Monday, November 10, 2008

Religion Weighs in...

When religion is involved, it can be an even harder event to withstand. A court in London on Saturday, August 27, 2005 upheld the right of the National Health Service to withdraw life support systems from a critically ill 86-year-old man who is considered by doctors to have no chance of getting better.

His Muslim family appealed to the court to block the decision on the grounds that their religious beliefs required doctors to do everything in their power to keep their father alive. Only God had the power to bestow death, they said.

But Mr Justice Kirkwood said the family's evidence and beliefs were outweighed by an overwhelming consensus of doctors who had looked at the man's medical condition.

One of the man's sons had told the judge earlier in the hearing that according to the Islamic faith it was imperative for doctors to protect life.
"If the available medicine can protect life then it must. Death is in the hands of God. Any withdrawal of life support would be tantamount to murder," he said.

"It is in his best interests that he be allowed a peaceful and dignified death. "Everything should be done to support him in that, including hydration and nutrition, but it's not in his best interests that he should continue to be subjected to painful and undignified medical processes which do nothing to improve his terminal condition."

When there is no chance of recovery... you must learn to let go and let the person die with dognity.

Sunday, November 9, 2008

A Whole New Light...

Another perspective view to look at is what happens when a person is kept on life support when they have no chance at recovery.

For every hour that someone spends in a hospital bed, is an hour that bed must be denied to another patient. Every minute on a ventilator or with a machine pumping their blood is a minute those machines cannot be helping someone else out there who needs them. Every second during which a nurse or doctor must administer 'care' to the child is a second they cannot help another person. Even the food and water that they send down the persons throat or in through a feeding gastric tube cannot be used to feed or hydrate someone else.

Doctors Judgement?

What do you do in a case where the doctors make the "judgement call" and turn off life support without family consent? Apparently that's what happened in Darwin, Australia last month (October). 29 year old Paulo Melo, sustained brain and spinal injuries from a car crash in Kakadu National park and died after his artificial respirator was turned off by the hospital. Paulo Melo's family have contested Royal Darwin Hospital's decision and are awaiting court judgement. Wow... I know in America, these doctors would probably have a fat lawsuit on their hands! What would you do if you were in this family's place? Please see link to this case under the "links" for full story.

Friday, November 7, 2008

Life Support... or Life Long Support?

I believe in life support... it is a great thing! It has helped thousands of people survive life threatening injuries. BUT... (There's that perverbial "But" word we all love at the end of a sentence!) When does life support become a burden? We all hope our loved ones have a quick recovery, but what happens when it's not? What if the person is in a "vegatative" state with doctors saying there's no hope of recovery... no brain waves, no movement? What do we do then? Do we keep our hopes alive and pray the doctors are wrong? I'm sure most do... for a little while anyway. After sometime, we have to ask ourselves... "How long do we wait? How much financial support can we afford?" As painful as it is, we have to put into perspective the quality of life issue for the injured person and look at our own financial means of support as well. It's a powder keg issue that sometimes tears families apart.

Wednesday, October 29, 2008

Rainbows In The Dark

This blog is going to be on a very controversial and touchy subject; when, if ever is it OK to turn off life support on a human being? When I refer to life support, I'm including such neccessities as a feeding tube, mechanical respiration, intravenous drips, heart or lung bypass or total parenteral nutritcian. This is one of those issues that will forever be OK with some, and absolutely not OK for others. Some view this as a sin, or murder if you will, while others view it as having mercy on a person.

How many times have we heard about or seen in our media of a court case involving the right to remove somebody from life support? The most recent story that I can think of is of 41 year old Terri Schiavo of Florida. Here's a little background on Terri's case.

"Theresa Marie Schindler "Terri" Schiavo; (December 3, 1963 – March 31, 2005) was American woman who suffered brain damage and became dependent on a feeding tube. She collapsed in her home on February 25, 1990, and experienced respiratory and cardiac arrest, resulting in extensive brain damage, a diagnosis of persistent vegetative state (PVS) and 15 years of institutionalization. In 1998, Michael Schiavo, her husband and guardian, petitioned the Pinellas County Circuit Court to remove her feeding tube. Robert and Mary Schindler, her parents, opposed this, arguing she was still conscious of things and people surrounding her. The court determined that Schiavo would not wish to continue life-prolonging measures. This controversy lasted seven years and included involvement by politicians and numerous advocacy groups, particularly those involved in pro-life or disability rights causes.

Before the local court's decision was carried out, on March 18, 2005, the Floridian Government and the U.S. had passed laws that sought, unsuccessfully, to prevent removal of Schiavo's feeding tube. These events resulted in extensive national and international media coverage. By March 2005, the legal history around the Schiavo case included fourteen appeals and numerous motions, petitions, and hearings in the Florida courts; five suits in the Federal District Court; Florida legislation struck down by the Supreme Court of Florida; a subpoena by a congressional committee to qualify Schiavo for witness protection; Federal Legislation; and four denials of certiorari from the Supreme Court of The United States.

She died at a Pinellas Park Hospice on March 31, 2005, at the age of 41, after almost 14 days without food and water. Some have since maintained that her death constituted judicial murder. Terri's parents alleged that her husband was abusive and that this had led indirectly to her condition. The Florida Department of Children and Families rejected these allegations."

How many of you agreed or disagreed with the courts ruling and why?