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

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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.

I have developed a morbid fascination with the story of Jahi and have been following closely. It saddens and frustrates me at the same time. It makes me so sad because I doubt very much that Jahi would have wanted this fiasco. And it frustrates me that the family and the lawyer demonize the doctor's and nurses who cared for Jahi. In the state of California the hospital/doctors have the right to turn off the ventilator once a patient is declared brain dead it's not the family's right to say when the ventilator will or won't be turned off. So I don't think the CHO was doing Jahi's family a disservice or being insensitive. If she'd gone into cardiac arrest (again) it wouldn't be insensitive to inform the family that Jahi's body was being released to the coroner... And they never would have kept her on the unit for 3 weeks! I almost think using the term respirator in place of life support is acceptable. The ventilator is breathing for the patient which makes respirator easy to understand I think... Of course it doesn't help explain the fact that it's keeping the heart beating as well, but neither does ventilator. So many people don't understand that the heart can continue beating as long as it has oxygen. I've seen plenty of comments from people who think that the ventilator has nothing to do with why Jahi's heart is still beating which means she must still be alive... Maybe it could be called a "cardio-respirator"...

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Specializes in Labor/Delivery, Pediatrics, Peds ER.

I'm sorry, the idea of talking about people on life support being "cadavers" or speaking of them as just being on "organ support" gives me the chills. I imagine families would simply flip out at having their loved ones referred to in this manner, and I also think the effect would be the opposite of what is intended. They may just as well become more defensive than ever, not more accepting.

I don't think it is possible to be too empathetic to families in this situation.

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Specializes in Pediatrics, Emergency, Trauma.
I'm sorry the idea of talking about people on life support being "cadavers" or speaking of them as just being on "organ support" gives me the chills. I imagine families would simply flip out at having their loved ones referred to in this manner, and I also think the effect would be the opposite of what is intended. They may just as well become more defensive than ever, not more accepting. I don't think it is possible to be too empathetic to families in this situation.[/quote']

I'm not sure if you have interacted with families with members that are dying or in a critical state; we NEVER call them cadavers of say "life support"; a few posters (including myself) have already explained we don't even call it "support", we explain, we EDUCATE,and we do so in a respectful manner.

My support was for "organ support" due to my many years of working with SCI individuals and TBI individuals who needed vents to help recover and have go on to continue to live; I've also worked with children who have been vented and survived; on the flip side, I've worked in situations where they were less feasible, and the explanations were just the same; calling it "organ support", or rather "respiratory support" is MUCH more truthful than "life support" a phrase the public coined and needs to not be even ears of again...but I digress; NO ONE calls anyone a "cadaver" a "corpse", etc when caring for a critical population-EVER.

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I'm sorry, the idea of talking about people on life support being "cadavers" or speaking of them as just being on "organ support" gives me the chills. I imagine families would simply flip out at having their loved ones referred to in this manner, and I also think the effect would be the opposite of what is intended. They may just as well become more defensive than ever, not more accepting.

I don't think it is possible to be too empathetic to families in this situation.

I agree. I've already mentioned that "organ support" sends my brain right to "organ donation" and that's a very sensitive subject for many folks.

Even though some may really like a certain terminology, other folks input into why it may not be a good idea should be looked at too.

There is such a deep divide over organ donation, so I think this term should be culled from the list.

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Specializes in critcal care, CRNA.
I agree. I've already mentioned that "organ support" sends my brain right to "organ donation" and that's a very sensitive subject for many folks. Even though some may really like a certain terminology other folks input into why it may not be a good idea should be looked at too. There is such a deep divide over organ donation, so I think this term should be culled from the list.[/quote']

Agreed. It could also make the job of organ donation more difficult.

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Specializes in Oncology; medical specialty website.
I'm sorry, the idea of talking about people on life support being "cadavers" or speaking of them as just being on "organ support" gives me the chills. I imagine families would simply flip out at having their loved ones referred to in this manner, and I also think the effect would be the opposite of what is intended. They may just as well become more defensive than ever, not more accepting.

I don't think it is possible to be too empathetic to families in this situation.

Deleted.

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When my DH was brain dead the doctors gave me a choice. In 24 hrs. they would remove all machines (I do not recall exact wording) and allow him to die or, they would move him to a different floor where his ventilator care would be done until his body gave out. As he was no longer making urine, I suppose it is possible it would have happened soon. As it was, he and I had had the discussion many times about what we wanted. I knew he would want all efforts stopped, not moved to someplace where his body would die by inches.

It was the non-verbals I remember clearly. The intensivist who no longer considered my husband his problem. The nurses who supported me during those 24 hours, the other intensivist who shared the loss with us and helped to complete the process of allowing him to die rather than be maintained on some sort of horrible organ death watch.

Call it anything you want. Remember that someplace around 90% of what is taken in is non-verbals. In times of crisis I think that the number may be low. All we had was empathy from caring staff, and that has no words. It needs no words.

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Specializes in Labor/Delivery, Pediatrics, Peds ER.
I'm not sure if you have interacted with families with members that are dying or in a critical state; we NEVER call them cadavers of say "life support"; a few posters (including myself) have already explained we don't even call it "support", we explain, we EDUCATE,and we do so in a respectful manner.

My support was for "organ support" due to my many years of working with SCI individuals and TBI individuals who needed vents to help recover and have go on to continue to live; I've also worked with children who have been vented and survived; on the flip side, I've worked in situations where they were less feasible, and the explanations were just the same; calling it "organ support", or rather "respiratory support" is MUCH more truthful than "life support" a phrase the public coined and needs to not be even ears of again...but I digress; NO ONE calls anyone a "cadaver" a "corpse", etc when caring for a critical population-EVER.

My post was not directed at you or anyone in particular. Others brought the word "cadaver" into the conversation as an alternative term.

I've been on both sides of the situation and I've seen both patients and families treated with respect and with complete dispassion. I'm happy your facility is sensitive - it's not always that way, I'm sorry to say. Most often nurses are compassionate, but I've seen neuros who became completely disassociated and utterly cold.

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Re the differing view on referring to the dead body/cadaver/person/corpse/...and whether its appropriate or kind or a dose of reality...

It came to me that it might be useful to think of the family of the person who died as a person who just had their leg amputated (and the dead person as the leg).

The phantom pain that they are feeling is real. They may still feel like the person/limb is still there. We need to understand and respect the loss of something that over time influenced so many synaptic paths to form in the brains of friends and family.

Yes the sad events surrounding the death of the girl in CA have gone to the extreme in how we deal with death. And I believe/hope that this is an exception as to how we deal with death.

But I think it is appropriate to be kind and understanding to loved ones about how e refer to a recently/just died person. I am in no way advocating terms like 'passed, gone on, left us, ... But we have a responsibility to acknowledge the realities and feelings of the family in a way that helps them to achieve acceptance and closure.

I can come up with other analogies for this situation, but I believe most will get the point I am making.

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Re the differing view on referring to the dead body/cadaver/person/corpse/...and whether its appropriate or kind or a dose of reality...

It came to me that it might be useful to think of the family of the person who died as a person who just had their leg amputated (and the dead person as the leg).

The phantom pain that they are feeling is real. They may still feel like the person/limb is still there. We need to understand and respect the loss of something that over time influenced so many synaptic paths to form in the brains of friends and family.

Yes the sad events surrounding the death of the girl in CA have gone to the extreme in how we deal with death. And I believe/hope that this is an exception as to how we deal with death.

But I think it is appropriate to be kind and understanding to loved ones about how e refer to a recently/just died person. I am in no way advocating terms like 'passed, gone on, left us, ... But we have a responsibility to acknowledge the realities and feelings of the family in a way that helps them to achieve acceptance and closure.

I can come up with other analogies for this situation, but I believe most will get the point I am making.

There may be other ways of describing the relationships. I have never heard it described as similar to phantom pain, and I think in many ways it is similar. In a grief group I ran, it was described as if "someone had cut off my right arm".

For many couples both feel as though individually they are incomplete without the other. There are many cases where a spouse dies so quickly after losing the partner. Just recently a husband died from what my pastor calls "the old man's friend, pneumonia". While his wife was giving his eulogy she died. Another couple I recall quite well. I cared for both of them. One was quite ill with cancer. The other would sit quietly and hold her hand. The ill one passed away, and 5 days later her partner was dead. This woman had been healthy with few issues until she lost her partner of 50+ years.

I lost my soul mate when he had the strokes. We had been together for 28 years. I lost something intangible with his death. Recently I lost the second one in a very similar way. We were not married, had only been together 3 years, and we had a comfortable love. I grieved for him. I have never felt that same sense of loss of self.

As nurses we rarely see people at their best. We have a responsibility to be the ones who can ease the path for loved ones when a machine is the only thing keeping this person looking as if he were alive.

In both cases where I was the partner, I knew when each man died. It was long before the doctors said anything. I could feel the loss. Some call that the soul leaving the body. I have no name for what I felt. I just knew. Up until that time their lives were being supported by mechanical means. After that I felt they were artificially being kept for no good reason. Whatever one calls that time, it is not close to what the family sees and feels. Nurses can only do their best to present a horrible situation in a way that allows the family to grieve.

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