Let's call it "organ support," not life support

[nurseprnRN]

This is an idea that originated in a legal nursing group discussion about the brain-dead teen at Children's in Oakland. While I completely understand the family's pain and that a lot of it is due to misunderstandings (e.g., the mother is reported to have said, "She's not dead, her heart is still beating and she breathes,"), I think the language we use in these situations contributes to this, and would like to spread the idea that better language would be more descriptive.

What would it be like if the health care people involved in this didn't say that a brain-dead person was on "life support," but instead called it "organ support"? In these cases, the life is over.

[MunoRN, RN]

Confusion would set in.I do have a question.Why are brain dead pts given Anesthesia before organ donation if they are dead and can't feel anything?Please,don't slam me. Its a genuine question.

Much of what anesthesiologists do is still required for at least the first part of "beating heart" organ donation. Patients are often on vasopressors and inotropes to maintain perfusion, gas exchange, and cardiac function. There is also a localized response to surgery that may require muscle relaxers.

[morte, LPN, LVN]

But, they are no longer human.

I would like likely sucker punch anyone calling a loved one of mine as 'maintaining a cadaver'.

That is so dehumanizing.

[LadyFree28, BSN, LPN, RN]

Another one I'd like to see change is Do Not Resuscitate to Allow Natural Death -- much more realistic terms.

This is already in the charts on the Advance directives who choose this option, at least in the long term care setting for the company I work with...so I am sure this is happening...

[edmia, BSN, RN]

This is already in the charts on the Advance directives who choose this option at least in the long term care setting for the company I work with...so I am sure this is happening...[/quote']

Yes! I know some states are being more proactive with this. Thanks, it's good to hear that the change is materializing.

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[Ruas61, BSN, RN]

But, they are no longer human.

It is still a human body.

There should be respect for that in both life and death.

Are you trying to be provocative?

[edmia, BSN, RN]

It is still a human body. There should be respect for that in both life and death. Are you trying to be provocative?

I agree with you on this one - the body is still human. Even remains unearthed are called "human remains".

Does not change the fact that it is a dead body. But I also would not feel right calling her a cadaver... Just out of respect.

But she is not on Life support, she's not alive.

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[Esme12, ASN, BSN, RN]

Confusion would set in.I do have a question.Why are brain dead pts given Anesthesia before organ donation if they are dead and can't feel anything?Please,don't slam me. Its a genuine question.

Muno is right...

Much of what anesthesiologists do is still required for at least the first part of "beating heart" organ donation. Patients are often on vasopressors and inotropes to maintain perfusion, gas exchange, and cardiac function. There is also a localized response to surgery that may require muscle relaxers.

A MD blog I follow had an anesthesiologist says it best Why an anesthesiologist would be needed for organ donation

Anyone who wonders why an anesthesiologist would be needed for organ donation by a brain-dead person clearly has no grasp of what an anesthesiologist’s job is. An anesthesiologist’s job is to keep a patient’s organs well-perfused and well-oxygenated. Usually this is synonymous with keeping a patient alive under anesthesia. In this special case, it means keeping the patient’s heart and lung functions stable so that the donated organs can continue to give life in another or several others. I won’t lie and say this type of case feels just like any other, even like just another cardiac case. It doesn’t. It’s strange. The patient is dead in the ways that matter most to his or her loved ones but alive in ways that will matter to others. Dead but not completely dead. I am taking care of a living shell of someone. A body that is dying and that eventually will come to a full stop

I try very hard to not use the term life support. I use maximum mechanical support for the vital organs as much as possible it has actually become a habit. I shy away from terms like "help the breathe" while terms like this can be used in many circumstances there at times that the severity of the situation requires tactful truthful information that informs the family of the gravity of the situation and the potential for bad out come. I never give my opinion that someone will get better o that it is ok for them to go home because a patient is "fine".

I think it is terrible to call a patient a corpse and that they are not human. Of course they are human and the patient in the body bag is human remains. There are ways to be truthful without being hurtful. In Jahi's case, I think the MD's frustration at this families instance to the contrary has forced them to be brutally honest with them instead of using the usual euphemisms used to comfort and inform the family.

I agree with changing the terminology for certain circumstances. I have had families be told by MD's they will place to tube to help the patient breathe and then respiratory/nursing uses the term life support and the family flips out and states "they never wanted life support the Doctor lied!" Like everything else in medicine there are very few black and white circumstances and we need to be careful in what we say to families and HOW we say it.

[TopazLover, BSN, RN]

As a family member who has gone through this scenario not once, but twice, I like the idea of mechanical support. In both cases of family, they were maintained on vents up to 24 hr. after the possibility of life was gone. Both were organ donors, neither was able to have organs harvested due to infection. It was cruel enough when they would not even harvest for research. To compound that horrible time by claiming it is to support organs is not helpful to family members. One of the purposes of that 24 hr. rule is not just hospital policy. It allows the family to say goodbye in different ways. To lose loved ones on vents is very different than losing them with what I would call a natural death. Even though I knew neither I, nor anyone else, was "pulling the plug" there still was that wishful thinking.

It really is life support, even though the brain is dead. Some cells are still living and to deny that by calling it anything but life cheapens that life even more.

In general, people are not on "life support" measures because they want to be. In both of the family cases it was the exact opposite of what they wanted. Unfortunately, when ventilation is begun for a person who is expected to survive, it is tough to just stop. I wanted to honor their wishes. These wishes were over ruled when the legalities became involved.

[Esme12, ASN, BSN, RN]

As a family member who has gone through this scenario not once, but twice, I like the idea of mechanical support. In both cases of family, they were maintained on vents up to 24 hr. after the possibility of life was gone. Both were organ donors, neither was able to have organs harvested due to infection. It was cruel enough when they would not even harvest for research. To compound that horrible time by claiming it is to support organs is not helpful to family members. One of the purposes of that 24 hr. rule is not just hospital policy. It allows the family to say goodbye in different ways. To lose loved ones on vents is very different than losing them with what I would call a natural death. Even though I knew neither I, nor anyone else, was "pulling the plug" there still was that wishful thinking.

It really is life support, even though the brain is dead. Some cells are still living and to deny that by calling it anything but life cheapens that life even more.

In general, people are not on "life support" measures because they want to be. In both of the family cases it was the exact opposite of what they wanted. Unfortunately, when ventilation is begun for a person who is expected to survive, it is tough to just stop. I wanted to honor their wishes. These wishes were over ruled when the legalities became involved.

((HUGS))

[manusko]

Call it what you want but do you really think the avg pt family will call it anything but life support?

[Spidey's mom, ADN, BSN, RN]

I vote for mechanical support. Completely descriptive and removes the connotation of life.

I agree with mechanical support.

I would like likely sucker punch anyone calling a loved one of mine as 'maintaining a cadaver'.

That is so dehumanizing.

Yep - I already mentioned that in this discussion when someone said "corpse". You have to think of how those words sound to family members and be compassionate. We don't just "treat" the patient but the family as well.

Organ support.

I like it.

I don't like it for the reasons aky mentioned. People are very touchy when it comes to organ donation and this sounds like you are merely describing a human being as a source for organs.

[Rose_Queen, BSN, MSN, RN]

I agree with mechanical support.

I don't like it for the reasons aky mentioned. People are very touchy when it comes to organ donation and this sounds like you are merely describing a human being as a source for organs.

Those are the reasons I vote for mechanical support over organ support. Organ support makes it sound as though the facility just wants the organs.