doctors refusing to continue

  1. this is about an elderly man and his doctor who has refused to continue:

    because he said that to continue would be "grotesque"

    Isn't it just as grotesque to abandon the patient?
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    About GingerSue

    Joined: Oct '04; Posts: 1,975; Likes: 254
    from CA
    Specialty: 20 year(s) of experience


  3. by   NotReady4PrimeTime
    Have you ever nursed a patient who doesn't move, doesn't breathe, doesn't even know he's still here? Someone whose heart is only beating because a ventilator is blowing air into his lungs? Someone whose skin is riddled with bone-deep ulcers because even though he's been turned religiously every two hours for eight months, and his tube feeds have been administered on schedule, there just isn't any way to stop the breakdown? Someone who is a sitting duck for every single bug in the unit because his immune system recognizes what his family refuses to see? If you have, then you wouldn't need to ask this question.
  4. by   traumaRUs
    I work in dialysis: one of our patients comes to us via ambulance, has no sitting balance, decubitus ulcers to the bone, has a G-tube, isn't aware of pain and oh yes, did I mention he has lost 12 kgs of body weight in the last 90 days!!! This is unethical! Abandoning this pt is the kindest thing this doctor did!
  5. by   RN1982
    In other countries this wouldn't happen, so why are we doing this to the people here. It's disgusting. I think doctors should be able to make the determination when it's time to withdraw care and even override a family's decision in situations that would be otherwise futile. It's just awful that people do this to their family members. I had a patient who was 100 years old, on a vent, peg tube, decubs to the bone and the daughter (who can't even take care of herself by the way) is yelling in his ear,"five more years dad". Sometimes I just want to throw down my charts and scream "this is torture not healthcare"

    And I'm gonna say this and its gonna **** some people off and I don't care. But these patients, the ones who are vented for life with no chance of a quality of life, need to be let go. Do you realize how much medicare/medicaid is being used to pay for the care of these patients. It burns me to think that a patient with no quality of life is being kept alive with my tax dollars.
    Last edit by RN1982 on Jun 18, '08
  6. by   CHATSDALE
    if you kept a dog in that condition the police would come and arrest you for animal cruelity, no compassion for humans
  7. by   ukstudent
    GingerSue as one of my co-workers said the other day. "We ICU nurses could teach the interrogators in Guantanamo a thing or two about torture."

    What's grotesque is what happens to pt's when God is clearly trying to call them back and families and sometimes Doctors just wont let go. This is one of the leading causes of burn out in ICU nursing.
  8. by   Turd.Ferguson
    Sometimes death is better.
  9. by   nuangel1
    i used work icu saw soo many cases like that .its sad and unethical to cont this care .it is torture .i never could understand the difference b/w what we see thru our nurses eye vs what the family see's .or in this case won't or can't.this man has a right to die peacefully and with dignity.they need to cont court case and get an indepent person to become this pts gaurdian.
  10. by   NotReady4PrimeTime
    There are three physicians who have resigned from the ICU at the Winnipeg Grace Hospital over this man. So now the ICU is running with only 50% of its udsual complement of physicians and many other lives could be affected. Lives that still retain some meaning. The family believes that artificial "life" support is somehow natural and necessary. It has me wondering how any otrhodox Jew ever actually dies. Not to start a firestorm, but maybe if it's really not his time to die, as they've professed, he should be extubated. If he breathes, then the family is correct, it's not his time to die. The clinical ethicist quoted in the story is, I'm pretty sure, Jewish himself, although not orthodox. He supports the doctors' decisions to remove themselves from this case. Mr Golubchuk will now continue to be flogged until his heart finally arrests and is not responsive to ACLS, then it will well and truly be over.

    Another thought just occurred to me. I wonder how many hours a day his family members are spending at his bedside, and how much of his care they are helping with. My guess is almost none.
  11. by   Diary/Dairy
    Quote from ukstudent
    GingerSue as one of my co-workers said the other day. "We ICU nurses could teach the interrogators in Guantanamo a thing or two about torture."

    What's grotesque is what happens to pt's when God is clearly trying to call them back and families and sometimes Doctors just wont let go. This is one of the leading causes of burn out in ICU nursing.
    Your friend is really wise - we could teach them about torture. I feel so sorry for some of those little old people I took care of.....
  12. by   Mulan
    the article says he has no brain function

    in my opinion, he's already dead
  13. by   careerchoices
    I remember one of my early patients. Her name was wither Ida or Violet, and it was 1990. I don't even remember her admitting diagnosis...was it an aneurysm? Probably. She was in her 90's.

    In any case, they had removed a large part of her parietal, and there were various problems after surgery with a CVA and infection. In the end, this poor woman was still missing a large chunk of her skull, but the skin and dura matter had grown back. And she just lay there in the rehab unit, the hole in her skull moving with her pulse and even her breathing. Nobody wanted to open her back up and try to close the hole with any prosthetic, there was no way she would survive it. And as an elderly female with zero activity, she did not grow bone well at all.

    Her frontal lobes were a train wreck. She was not aware of anything. Not on a vent, but on a J-tube. She just lay there, waiting to die. We had excellent care at that time, and thankfully when I last saw her she had no bedsores, but she did not have anything else, either.

    I used to worry that perhaps Ida was trapped down in that brain, somehow able to think deep inside, so I always talked to her and explained everything to the level I would want it explained to me. As I recall, they did some sort of scan in nuc med and could not see any sort of higher brain function at all, but it always worried me.

    Imagine being trapped, staring at a drab wall for months or years while you wait to die.

    In Ida's case, pulling the vent was not an option. I thought that rather sad. She's still one of the cases I think of when I question if we're doing the right thing for our population.
  14. by   XB9S
    I couldn't see this happening in the UK, the medics make the decisions about futility of treatment and obviously discuss with the family and try to respect their wishes but if it is considered to be futile then treatment would be discontinued with support for the family to help them begin to grieve. If there was any legal dispute raised it would be dealt with quickly

    I don't understand in a case such as this why the legal system can not be expidited, surely it would be in the best interests of the patient and his family to have an informed decision as quickly as possible rather than wait 3 months till september for a case to be heard.

    It sounds like a very sad case for both the patient to endure the trauma of ICU and the family who cannot begin to grieve until the inevitable happens. Also I feel for the staff who must feel like piggy in the middle of this horrible situation

    My heart goes out to all involved