Turning off Life Support without Family Permission???

baseline · Feb 24, 2003

There is just so much missing information here. This whole thing is such a mess! And the press is so unreliable. The "spokesperson" is highly susupicious to me and slants alot of information given to the press IMHO. But no, I am having trouble with the concept that Duke would just pull the plug against family wishes. There has to be more to the story that we aren't being told.

cindyln · Feb 24, 2003

I would think that especially in this case the hospital should have responded to the families wishes. I saw the interview also. He also enlightened us as to why no donation of her usable organs.

emily_mom · Feb 24, 2003

I missed that part Cindy. What did he say?

I think this guy is a jerk and is using the family for selfish reasons. Advocate my orifice.

KM

sjoe · Feb 24, 2003

Of course a doc has the authority to declare someone dead and DC life support.

"Smoothing it over" with the family or DPOAHC beforehand is a courtesy, however, that one would think would have been exercised in this case, for PR reasons, if nothing else.

MissdonditaBsn · Feb 24, 2003

I think that there are so many layers to this story that we are never going to know the whole truth. It seems that the press coverage on this story is completely one sided. I too am very suspicious of this "spokesperson". Don't get me wrong, I believe that he did care for that little girl, but I also think he has alterior motives (putting on flame resistant suit).

I am having a very difficult time believing that the hospital would have turned off life support without the families permission. I don't see at all how that could be considered legal. I believe that this is purely a case of miscommunication between the family and the hospital, or downright misunderstanding on the part of the family.

Who knows, as I have said before in other threads, the only people who know the real story are those involved in the case, and for obvious reasons I believe that Duke is going to keep themselves out of the press as much as possible. They are already in a whole heap of trouble. Even though Duke thus far has taken full responsiblity, If they spout off to the press right now they are going to be seen as uncaring, trying to deny or belittle the tragedy, and as even bigger ogres in the eyes of the general public. what I am trying to say is that the only side of the story that we are hearing right now is that of the "spokesperson", I think it will be a lonnggg time before we hear Dukes.

cindyln · Feb 24, 2003

Originally posted by emily_mom
I missed that part Cindy. What did he say?

KM

He said that an autopsy was going to be done and they needed all organs for that. Not being into forensics I believe him in that aspect.

baseline · Feb 24, 2003

Another reason for Duke to stay quiet is the inevitable impending law suit. I imagine their legal beagals have advised careful speech.

caroladybelle, BSN, RN · Feb 24, 2003

My understanding is that if brain death has been established - the patient is "dead" for all intents -there is no family permission required to stop the artificial support. Dead is dead.

This was in the courts a few years ago. A 12 year old diabetic girl lapsed into an irreversible coma, a few hours after coming into a Sarasota, FL hospital ER. She had been sick and not eating for several days. The parents, sued the hospital for negligence, and also sued to keep her on the vent, despite several diagnoses with documentation regarding brain death. The court ruled that they were not obligated to keep her "alive" as death for all intents and practices had occurred.

They did as a matter of goodwill (PR, PR, PR!) send her home on the vent and provided home care. She did die with a short period of time.

Technically, many courts have ruled in many cases that if a pt would have "No meaning chance for significant recovery", the MD can refuse to code a pt. Of course most will still include family and pt in decision, as even a threatened lawsuit costs as well as for goodwill sake.

RNbeach, ASN, RN · Feb 24, 2003

I was listeing to CNN last night and I believe I heard them say that in the state of Maryland, the families permission is not needed in order to stop life support.. once it has been determined that there is no brain activity..

I know that what you are saying Caroladybelle!

I think it differs from state to state!

bestblondRN · Feb 24, 2003

Well said caroladybelle! Dead is dead, and there was a period of about 4 hours following the media announcement of Jesica's brain death until her heart stopped. My understanding from a previous news story was that her heart stopped at 5 p.m. or so, and the vent was turned off at 5:07. This gave the family at least 4 hours or so during which to say their goodbyes, but it sounded as though her heart stopped on its own--not that the vent was pulled first.

There's a lot of information we don't have, so I think it's difficult to say anything for sure. Bottom line--I don't think this Mahoney character has the family's or Jesica's best interest at heart here, and I think he's into this for the publicity and whatever monies he will get for his role as POA from the lawsuit that will ensue. JMHO, but I don't trust him or his motives. He's attempting to garner sympathy by making very inflammatory statements, and of course, this will slant the public's and media's views of things.

dawngloves, BSN, RN · Feb 24, 2003

Originally posted by B_Matt

I think it differs from state to state!

That is also the case in North Caroline. That MD did not need family consent.