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.

[amoLucia]

Regardless of what terms we use (life support, organ support, cadaver, corpse, brain-dead, vegetative, passed, dead, etc), someone, somewhere will be offended, confused, angered, insulted, misunderstand, etc because of the terminology used.

Words DO matter. Case in point - spontaneous abortion versus miscarriage. Very early in my career a Mom was devastated & indignant that the wrong term was used by a practitioner. No ill will or offense was meant, no judgmental opinion was involved but it was a major issue where I was at the time. I learned then it's not WHAT you say, but HOW you say it.

[morte, LPN, LVN]

No, are you?

What made them human, ie, their brain, is GONE. No lack of respect implied. We need to respect language as well.

It is still a human body.

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

Are you trying to be provocative?

[wanderlust99]

I think "life support" is more a term families use, probably from television or movies. I've heard families call a ventilator life support before and will correct them. I don't recall hearing a doctor or nurse use this term.

[anon456, BSN, RN]

When I was trained as a volunteer for a local organ donor network, I was taught to say "ventilator support" and not "life support."

[nurseprnRN, BSN, RN]

Grntea, I like the new terminology/idea. When I grow up, I want to be smart just like you. Love your advice and honesty :)

disclaimer: It wasn't my idea, but I thought it was worth passing around as widely as possible, and what better place than AN? This has been a terrific discussion.

[SpEdtacular, MSN, RN, EMT-P]

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.

This is a great thread on a really important topic with good arguments on both sides. I think allow natural death is a wonderful terminology because I'm sure if you asked lay people what they think resuscitation means you'd get a variety of answers some right on the money and some that are waaaay out there. While I'm among those who cringe when I hear a patient referred to as "the body" (or some other depersonalizing term) I think we need to make sure people have a clear understanding of what "death" is and what is beyond our ability to help. CPR, as one poster commented, is what we do when someone is already dead not something to prevent death, but that's not usually how we present it. It usually goes something like if they need a breathing tube or their heart stops beating do you want us to do everything?

I work in the ER and someone asked me what I thought about Jahi McMath and I said I heard something about the family wanting treatment for a little girl who was dead but never heard the whole story. They told me that they (doctors, hospitals, etc.,) were refusing to let the family get her treatment and wanted to take her off life support because she was brain dead. Suddenly the whole "controversy" made sense to me. I explained that being brain dead is not the same thing as being in a coma or a persistent vegetative state. When I explained that in brain death there is no brain activity and there is no longer any blood flow to the brain. Just like any other organ or body part that loses blood flow the brain literally dies. Then it made sense to them. Medical professionals weren't being cruel or worrying about the expense of caring for her; she was really dead. Before taking a course on brain injuries and criteria for determining brain death I didn't completely understand what brain dead meant and I'm a nurse so I can imagine how confusing it is for the public, especially grieving families.

I think life support is a terrible and ambiguous term. Most people associate it with being on a vent which can be necessary for any number of reasons. Organ support certainly sounds accurate but I can see the we just want to harvest your organs connotation some people are talking about. When I hear mechanical support I think mechanical what support, what are we supporting? Body support sounds cold. Metabolic support maybe? Support feels like something that will help you recover so maybe we need to lose the support part all together and call it maintenance or something less hopeful? I don't know. People will hear what they want to hear so a name change probably won't do it and since many people lack even the most basic knowledge of anatomy and physiology there's no easy explanations.

What really frustrates and angers me about cases like Jahi McMath is that some entity is willing to exploit the family's grief by accepting a dead little girl as a patient. All this does is create more public confusion about brain death, prolong the family's suffering, and keep them from getting closure. And who's going to pay for her care? I highly doubt an insurance company is going to pay for the care of someone who is not only receiving futile treatment but is also deceased. That sort of thing just disgusts me.

[Psychtrish39, BSN, RN]

I unfortunately understand this better than most my son committed suicide in August of last year in jail as such he was a young healthy man other than having bipolar disorder newly diagnosed and after they resuscitated him he coded three times on the way to the hospital and they did neurologic testing and he was pronounced brain dead they tried to wean him off the vent and he didn't even have enough brain stem activity to maintain or even take a breath. It was hard for me to understand he was brain dead even though I am a nurse until I saw him in his bed in ICU and I knew the machines were what was keeping him alive. He would not have been breathing if not for the ventilator and the only reason he had a heartbeat was the multiple meds he was being given to do so.

I feel first of all the physician did not explain the concept of "brain dead" to the family and the ICU nurses failed to show and teach the family what the machines were doing and the hospital last of all by threatening to turn the girls life support off was wrong. I am saddened that the hospital thought they had that right my son died in a hospital system in the Midwest and the hospital administrators or nursing staff never at any time suggested we turn off the life support .

We, my ex husband and my daughters decided on organ donation and as such he was kept on life support until organ harvesting could happen its a delicate dance because the transplant team had to fly in and do their harvesting then release him to the coroner and the funeral home. As a parent of a child brain dead it made all the difference to me and my family in how the medical team at the hospital treated us and how they respected it took time to make decisions. I feel the medical team and the hospital did this family a disservice and then threatening to cut the life support off is inhumane and I would be acting the same way as that Mother is.

I do believe they should change the terminology because the machines are forcing air and medications maintain heartbeats and life is a misnomer in this instance. Sorry this is so long and I haven't been on Allnurses for some time but I wanted to share what is like on the other side of the bed as well. I hope this family gets some closure and comes to a decision soon.

[nurseprnRN, BSN, RN]

{{Psychtrish39}}

Bless you for sharing. Peace be with you.

[Esme12, ASN, BSN, RN]

I unfortunately understand this better than most my son committed suicide in August of last year in jail as such he was a young healthy man other than having bipolar disorder newly diagnosed and after they resuscitated him he coded three times on the way to the hospital and they did neurologic testing and he was pronounced brain dead they tried to wean him off the vent and he didn't even have enough brain stem activity to maintain or even take a breath. It was hard for me to understand he was brain dead even though I am a nurse until I saw him in his bed in ICU and I knew the machines were what was keeping him alive. He would not have been breathing if not for the ventilator and the only reason he had a heartbeat was the multiple meds he was being given to do so.

I feel first of all the physician did not explain the concept of "brain dead" to the family and the ICU nurses failed to show and teach the family what the machines were doing and the hospital last of all by threatening to turn the girls life support off was wrong. I am saddened that the hospital thought they had that right my son died in a hospital system in the Midwest and the hospital administrators or nursing staff never at any time suggested we turn off the life support .

We, my ex husband and my daughters decided on organ donation and as such he was kept on life support until organ harvesting could happen its a delicate dance because the transplant team had to fly in and do their harvesting then release him to the coroner and the funeral home. As a parent of a child brain dead it made all the difference to me and my family in how the medical team at the hospital treated us and how they respected it took time to make decisions. I feel the medical team and the hospital did this family a disservice and then threatening to cut the life support off is inhumane and I would be acting the same way as that Mother is.

I do believe they should change the terminology because the machines are forcing air and medications maintain heartbeats and life is a misnomer in this instance. Sorry this is so long and I haven't been on Allnurses for some time but I wanted to share what is like on the other side of the bed as well. I hope this family gets some closure and comes to a decision soon.

I am hoping that CHO did their best and the families disbelief lead to become frustrated. I would think that a children's hospital would have an expertise in this area but you are right....we just don't know.

Thank you for sharing your story...I am so sorry for your loss. ((HUGS))

[Morainey, BSN, RN]

I agree, I never heard an MD or an RN refer to a ventilator as life support.

With regard to the 'sack of organs' idea, I think that we should afford that person the same respect as if they had recently died and we were providing post-mortem care, or if they were living and breathing and conversing patients.

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

Psychtrish39 - thank you for sharing your story. I agree with you. Wishing you peace.

[BrandonLPN, LPN]

Really who cares what we say. The majority of pts families will call it life support. They will also refer to end of life as pulling the plug. Our job is to help educate so the understand what exactly is going on. Renaming it does not educate.

But if healthcare providers/facilities moved to change the terminology to "organ support", that really would carry a very different conotation.

Terminology changes all the time. Read any sort of medical/nursing text from the 1920's and you'll be bombarded with archaic words and phrases. Words have power.

The pumping of blood or the production of urine are no more than complex mechanical processes. When these processes are artifically set in motion by machines, that's not life. Put in that light, I think the general public would realize that. Changing the phrase to "organ support" would help in hammering that home.