Our Death-Denying Society (Revisited) - page 4

by TheCommuter Senior Moderator | 7,526 Views | 42 Comments

Several high-profile instances of brain death have entered the public's awareness in recent weeks, including the painstakingly tragic demise of 13-year-old student Jahi McMath. Hence, now is the time to provide some basic... Read More


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    Recently we admitted an 88 yr old pt. It was his 4th admit in the past couple of months. When the Pts wife was asked about DNR status by the MD she asked him to do everything as long as it wouldn't hurt him. She asked if CPR hurt. The MD, with the admitting Rn in the room, said "not if it's done right"! The Rn just about fell over. When I picked up the Pt I initiated as gently as I could a conversation about CPR and it's effects on 88 yr old ribs. She thought for a moment and said I guess I'll have to talk with the doctor again. I don't know if she had that conversation but I hope she did. If she still wants CPR and full code status that's fine with me (not something I would do for myself or someone I loved) only as long as she's fully and correctly informed about the consequences.

    I think most of us are in denial of death. When someone is brain dead and on vents, meds etc. we're not prolonging their life. They are already dead. I don't know what to call it. Keeping the organs functioning or something like that but it's not life. They are not going to wake up later because their brain function is gone and will not recover like a liver or kidney may recover after it takes a hit.
  2. 4
    Human beings are not animals.
    Yes, we are animals. Just because we have dolled up our culture and drastically changed the face of the planet does not change the fact that we are, in fact, animals. We are mammals, just like dogs, monkeys, whales, etc.
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    Quote from Semolina
    I'm not a nurse, so obviously my knowledge is very limited. But the determination to preserve life no matter what is not something I've ever seen or heard about from my friends or family. I'm at the age where parents, aunts and uncles are inevitably dying, and I've had many, many conversations with friends and relatives about end-of-life issues. I've never had the feeling that death should not be acknowledged or openly discussed.

    Is it really true that this attitude is in all of society? I assume this article was written in response to a recent, highly-publicized case, and I'm sure that case and others like it are very distressing to health care professionals. I also assume there is a big difference in issues involving younger people -- my experiences as described above involved people in their 70s and 80s.

    Again, I have no doubt that there are individual cases where people insist on preserving life inappropriately -- my question is about how widespread this attitude is. I also question whether it's true that most people don't know what "brain dead" means -- when someone I know died recently, everyone I discussed it with knew that "brain dead" meant no hope, and as far as I know the family stopped life support in a timely fashion.
    As a nurse, I can vouch for what others are saying...it is becoming more and more predominant where families are turning down hospice and fighting till the very last breath to keep that life going, despite the misery and pain of the loved one...I have had them turn down hospice because the family or "the patient" is not ready to die yet (seriously? Hospice does not kill, it alleviates pain and provides support. Some patients even get better and leave Hospice. For those that don't, at least they have the services they need, as do their families).
    I have had them tell me not to medicate their loved one (in spite the agony the person was enduring) because "it will make them sleepy." Or "they might get addicted." Or, "the pain isn't really that bad, they are just so used to the pain meds now." I beg to differ...I can see the pain in my patient's face, in the way they hold themselves, in the way they breathe...I see the misery in his/her face. I usually try to explain to the families that, if it were them in that bed I am sure they would want to be made as comfortable as we could make it and still be safe, but to let the person suffer needlessly is inhumane. Thank God so far they have all agreed that torture is not the way to go, but I fear the day I will encounter that one family member who thinks keeping the person awake to interact with the myriad people there visiting is more important than their final comfort...do we really want our final memories to be of excruciating agony as it can be with cancer? I know I do not.
    I have had to watch my patients leak the fluids out of their skin because they are no longer able to process all the stuff being pumped into them. Their kidneys have failed, their heart is failing, their lungs are weakening...meds can only go so far and if resources of the body are exhausted, then meds can do nothing more...yet, they keep them going...God help me, if I am ever in that condition, please, please make me comfortable, keep me dry. Don't let me hurt. I love my life, but, when my time comes, let me make the transition with dignity and peace. Do not expect me to make small talk and chitchat if I am in pain. It breaks the heart some days to submit our poor patients to some of the procedures and treatments their families demand, even though we know that there is nothing more that can be done and we are just prolonging the pain. God help us all.
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    Quote from smartnurse1982
    Yes,that's exactly what I'm saying(this is based on my religious beliefs,however).
    Death isn't natural and wasn't meant to be apart of the human condition.
    Until Adam and Eve ate the fruit,then of course death became what it is
    So, under that premise, the body of this child Jahi should continue to be sustained, letting the heart beat, the nutrition be put into her, in spite of possible continuing decay, of fluids seeping through the skin because the body can no longer process them appropriately? Until and beyond the point where the brain begins to decay (liquefy is what some research suggests) because the blood flow in that area is substandard, if at all flowing)? (I think the studies said there was no blood flow).
    I do not understand this thought process.
    I worry about what the children of that particular family may be exposed to as they see their "alive" sister continue to decay. What will they think? What will they feel? What will they suffer through? This whole scenario just horrifies me. Sorry; I respect your religiosity, but for my own loved ones I hope I choose what is best for them, regardless of my own personal feelings, if the time ever comes and pray harder that I go before them so it never does.
    ProfRN4 likes this.
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    I wish I were tech savvy enough to insert a link here (via the app), but I'm not

    Google the name Avonte Oquendo. A story that is local to me. An autistic boy (non-verbal, low functioning) who has been missing for 3 months. Some remains have been found, including clothing that he was reportedly wearing the day he went missing. And the parents are not believing it is him- until DNA results are officially back. I PRAY that once they are back, that they do accept it.

    Again, I get that people don't want to believe that their loved ones are gone. It's devastating. Personally, I experienced a tragic loss at a fairly young age. It was more devastating for my parents (it was their child, my brother). While the phrase "I can't believe he's gone" was often uttered, never did I hear "I don't believe he's dead" by anyone close to us.

    Maybe, because if what I do for a living, and because of my early experience with death, I just don't see it the way others do. Also, I worked in pediatric on lilacs, where it goes without saying that not everyone's journey ends happily.
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    Quote from ProfRN4
    Google the name Avonte Oquendo. A story that is local to me. An autistic boy (non-verbal, low functioning) who has been missing for 3 months. Some remains have been found, including clothing that he was reportedly wearing the day he went missing. And the parents are not believing it is him- until DNA results are officially back. I PRAY that once they are back, that they do accept it..
    That is a tragic case -- but honestly, all we know is what their lawyer said to the press. We don't know what Avonte Oquendo's family really thinks.

    In a highly-publicized case like this one I would probably make a statement similar to theirs -- give the tabloids an easy cliche to quote. And their lawyer did say "it’s not looking great."

    Plus -- since you're local you will understand this -- think of how many bodies are pulled out of the East and Hudson Rivers. It's a common thing to see in a densely populated area. Always sad, but not shocking if you've lived here a while. It's VERY, VERY, VERY unlikely that someone else had similar clothing, but not impossible.

    I would not criticize any family member for wanting DNA evidence in a situation like this -- I don't know if DNA testing is always done, but I have heard of it in similar cases. I can't imagine expecting a family to accept ID based exclusively on clothing. It's not explicitly stated, but the NYT story suggests that DNA testing was at the behest of the police -- not something the family insisted on.

    Here's the Daily News story:

    Avonte Oquendo’s family cling to hope, await DNA tests as cops find second arm in Queens - NY Daily News

    And from the NYT:

    http://www.nytimes.com/2014/01/18/ny...-boy.html?_r=0
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    Quote from Semolina
    Is it really true that this attitude is in all of society? I assume this article was written in response to a recent, highly-publicized case, and I'm sure that case and others like it are very distressing to health care professionals. I also assume there is a big difference in issues involving younger people -- my experiences as described above involved people in their 70s and 80s.
    I wrote the first installment of Our Death-Defying, Death Denying Society in 2012, more than a year before Jahi McMath met her unfortunate demise. Our cultural attitude of death avoidance has been prevalent for a long time.

    http://allnurses.com/nursing-activis...ng-773839.html
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    Quote from SubSippi
    Physician assisted suicide is, in my opinion, 100% "right."
    This has even been part of discussion with my husband as we're planning our advanced directives and MOLSTs at 26 and 29 respectively. Now of course, I have bipolar disorder, but that's even more the reason that I want things like this to be talked about now, when I'm in mentally stable place. I know it's likely that we won't have to deal with these things until much later in our lives, but I want things to be in place if I'm in a traumatic car accident tomorrow! Anything can happen and I want as much say into what happens to me when I can't speak for myself when the time comes.
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    Quote from blackvans1234
    I have done CPR twice in my short career in medicine, both patients made it.

    However seeing the suffering and agony of living after a severe stroke is a fate worse than death if you ask me.

    I'm a NODA volunteer.
    What is NODA?
  10. 0
    In Maryland, we have a MOLST that does carry over to the hospital upon transfer. It's a bit more extensive than a DNR - including things like artificial fluids and blood products.


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