Taking a child off life support - page 5
by vaughanmk 8,255 Views | 71 Comments
What do you think? This 14 year old boy accidently shot himself in the neck. The local news is reporting that the hospital is trying to take the patient off life support without parents approval. The mom wants to transfer the... Read More
- 0May 19, '06 by MultipurposeRNIf this poor kid is truly brain dead then nature will take it's course. Maybe there is no legal or ethical obligation to provide futile care, but the mom just may need more time to come to grips. Better for everyone if she can finally accept that he's died or he finally goes on his own than for the hospital to force the issue if they don't have to right now, otherwise she may never get past the grief. I think sometimes we forget that not everyone can accept tragedy in the time frame we think they should..and sometimes, tragedy is never accepted. The Mom may not ever accept this, but at least if he goes on his own she won't feel that he's been murdered. Of course he wouldn't be, but her perception is that he would be, and that's a hard thing to inflict on this lady who's already going through hell.
- 0May 19, '06 by MrsWampthangi have been reading this thread off and on, and it's interesting to me that the suggestion is made to send the child to ltac. i work in such a facility and see cases like this a lot. believe me when i say that futile cases such as this are draining on the staff. seeing the families keeping their families on life support for their own sake is truly heartbreaking......for the patient. we take excellent care of all of our patients, but to see a patient lay in the bed day after day and do nothing but exist for the family, who often times don't even come to see them, it's just cruel. i know it is probably harder to make that decision if the patient is a child though. i had to help my dad make the decision to let my mother go. it was hard and she died a week after we took her off life support. i still question myself about whether she wanted to die or not. she would never have been able to go home, she was in ill health before she went into the hospital with a ruptured stomach ulcer, so she would have had to go to a nursing home at further physical stress to my dad. was it the right decision? i feel in my heart that it was; and i know my dad agrees. but if it had been one of my children, i would hope that my nurse's wisdom would overrule my mother's heart, especially if it meant that someone would live on with my child's organs. as for the argument about a waste of resources, yeah, i guess it is at that. i have seen a lot of waste of resources during my time of being a medic, an er nurse and now an ltac nurse. i just don't know what the answer is except to hope that that mother has someone who will be brutally honest but compassionate with that mom and will eventually make her see the truth and she will let her son go. god bless her.
- 0May 19, '06 by MaxineHMultipurposeRN, I totally agree with you, well said. Everyone mourn and grieve differently. Not until something tragic happen to you or someone you love dearly, then you'll understand and know what that mother is going through; and trust me, I'm speaking from experience. We sometimes forget that we are only human. She needs time to accept, why should she be deprive of it?
I will not go too much into my experience because my eyes are teary right now, but my first daughter when she was 4 years old went into a coma for 3 1/2 weeks, the doctors wrote her off as dead, they were just waiting to pull the plugs, and I argued with those doctors everyday. I stayed there with her in one suite of clothes, and the only thing that could go down my throat was water. I lost faith, and started cursing GOD for taking my only child from me. She's now in Canada at MED. School.
- 0May 19, '06 by fergus51I sometimes think it would be kinder for the parents if there was a certain time limit after brain death had been determined where the person HAD to be taken off support. The reason I say this is because brain death is permanent. Unfortunately this mother isn't going to be lucky like Maxine. Her child is dead but she may just not want to be the one who makes the decision to take him off the vent. I've seen that with families before. When the doctor finally goes in and says "We have to take him off the vent. Bring your family in tomorrow, you can sign the papers and say your goodbyes before we let him go peacefully" it seems like a relief to some of them. The doctor isn't making the decision for them and still has to get their consent, but he makes it more definite.
- 0May 19, '06 by elkparkQuote from MultipurposeRNBut nature HAS taken its course, and he HAS "gone on his own" -- he's already dead. The ventilator, fluids, etc., in the ICU are just maintaining the cadaver.If this poor kid is truly brain dead then nature will take it's course .. at least if he goes on his own she won't feel that he's been murdered. Of course he wouldn't be, but her perception is that he would be, and that's a hard thing to inflict on this lady who's already going through hell.
I don't doubt that the mother is irrational with grief; any one of us would be -- but that's exactly why she should not be making important decisions at this time.
- 0May 19, '06 by ortess1971"Futile Care" can be a very subjective thing. Brain death is one thing, not much subjective about that, but sometimes medical professionals(doctors especially) write people off much too quickly. My sister had meningitis(bacterial)as an infant. My mom stayed there every day and there were some doctors that thought she was deluding herself as well. My sister is now a beautiful, healthy and happy 27 year old. My problem is when people think just because someone is handicapped, old(but mentally "with it") or sick that their life isn't worth living anymore. As a nurse, I figure my job is to advocate for that patient and family in a compassionate manner. I'm not an accountant and I'm not a hospital adminstrator either. I refuse to let $$$$ factors dictate my nursing practice. Now, this particular case, I think this child will not recover and I think the mom is in denial but compassion is the way to approach this woman, not disdain or contempt or thinking she wants to "torture" her child. It's easy to say what she should do because most of us aren't living her reality. These things take time. Just my 2 cents....
- 1May 19, '06 by GompersQuote from fergus51I agree 100%. In our NICU, we rarely see complete brain death, but rather we'll see massive, irreversable damage. I don't just mean a brain bleed, I mean where hydrocephalus has taken over the brain to the point where the good tissue has just completely atrophied into nothing. Times like this, instead of TELLING the families that they will remove life support, the docs will ASK the families if they wish to do that.I sometimes think it would be kinder for the parents if there was a certain time limit after brain death had been determined where the person HAD to be taken off support. The reason I say this is because brain death is permanent. Unfortunately this mother isn't going to be lucky like Maxine. Her child is dead but she may just not want to be the one who makes the decision to take him off the vent. I've seen that with families before. When the doctor finally goes in and says "We have to take him off the vent. Bring your family in tomorrow, you can sign the papers and say your goodbyes before we let him go peacefully" it seems like a relief to some of them. The doctor isn't making the decision for them and still has to get their consent, but he makes it more definite.
Now, what parent is going to say, "YES! I thought you'd never ask!"
But when the docs say, "There is nothing else we can do. The damage is irreversable. There will be no quality of life. Bring in your family so we can take the baby off life support and let him/her die peacefully and with dignity," then 95% of the time, the families agree. They seem to be relieved of the burden of having to be the one who decides.
In other countries, I've heard that the docs have more of a say in what happens in these situations. But in the USA, the customer is always right, and we will do whatever these familes say, no matter how futile the situation might be.
This is by far the hardest part of pediatric nursing.
- 0May 19, '06 by Darth NightingaleQuote from vaughanmkwhat is life and what is death are legal and politically answered... sad but true. as health care professionals (or future health care professionals) we do have to come to grips with this fact... and react politically, most importantly by how we vote.... <snip> either way isn't it ultimately up to the family and not the hospital to withdrawl life support. i mean as soon as the patient stabilizes enough, he should be able to go to a long term facility on the vent, if mom wants to keep the poor kid alive.
i think we are going to face more and more situations like this as technology increases and the population age increases too. i see this being much more of a political issue in the next ten years. hopefully then it will be settled.
the cost issue is a valid issue. resources are limit a money and time spent on one pt.. is less money and time spent on another... another sad but true.
with that said... i'm sure it's infinitely easier to write a post about this drama than to actually be one of the players in it... so i'm definitely not judging anyone.
- 0May 20, '06 by mom23RNQuote from L&DsomedayI'm so glad that seh finally came to an "understanding" if there is such a thing. She did what was right for her son. As I said in my earlier post, as parents we would take them anyway we could have them, but it's usually not fair to the child.This boy was just taken off of life support in the past hour. A doctor from outside of KUMed agreed with the hospital and the mother agreed to take him off of life support.
I am so saddened for her loss.