Taking a child off life support

tencat · May 16, 2006

Why keep the poor kid alive if he's brain dead? It is very sad, but the mother needs to understand that the kid IS dead, just being kept alive by machines. It is not a wise use of resources to keep someone alive who is for all practical purposes dead and not going to improve.

QuilterLPN · May 16, 2006

Doctors are not obligated to provide futile care. Sounds like this is futile care.

hospitalstaph · May 16, 2006

What do you think? This 14 year old boy accidently shot himself in the neck. The local news is reporting that the hospital is trying to take the patient off life support without parents approval. The mom wants to transfer the patient to another hospital but no one will accept the brain dead child. Stating there is nothing else that can be done. Mom reports the patient responds to her, tries to open his eyes and squeezes her hand. Either way isn't it ultimately up to the family and not the hospital to withdrawl life support. I mean as soon as the patient stabilizes enough, he should be able to go to a long term facility on the vent, if mom wants to keep the poor kid alive.
http://www.thekansascitychannel.com/health/9219847/detail.html

I find this to be such a sad case. However, the mother did not report that the child was doing these things until the hospital declared him brain dead. I am sure that she is so sad that she is losing her son and since anger is an easier emotion for many, she is focusing her grief on the hospital. I have not read the link above, but I know that on the news here in KC she was accusing the hospital of just wanting to harvest organs and not wanting to save her sons life.

T

Messink · May 16, 2006

I can understand that the mother does not want to let her son go but the kid's braindead which is pretty logical when you consider the fact that he shot himself in the neck with a 9mm round.

As an outsider I would say that the hospital is completely right in this case and they should take the boy off life support. It's senseless to keep someone alive who is already dead.

Balder_LPN, LPN · May 16, 2006

Why keep the poor kid alive if he's brain dead? It is very sad, but the mother needs to understand that the kid IS dead, just being kept alive by machines. It is not a wise use of resources to keep someone alive who is for all practical purposes dead and not going to improve.

I am not picking on your answer tencat, it seems to be the consensus here, but The OP's question wasnt "should" the life support be removed. But wether or not it is the hospitals choice or the family's. I think obviously it it the family choice, not the hospital. This is more of an ethical decision than a medical decision and that is left up to the pt's family.

DorkyStudentNurse · May 16, 2006

Sounds like the boy's mother is in denial ("I'm very hopeful he'll walk right out of here"). Although I think it's sad to keep this child alive, I also think it's up to the family. It's still fresh grief and the mother is obviously using some defense mechanisms to try to avoid facing the truth. I think she should be allowed to keep her child physically alive as long as she wishes and I think once the truth sets in, she may change her mind. I couldn't imagine being a parent in that situation. Everything in you would want to hold on and hope that the doctor's are wrong. The hospital should not be able to make this decision IMO.

elkpark · May 16, 2006

I think obviously it it the family choice, not the hospital. This is more of an ethical decision than a medical decision and that is left up to the pt's family.

Not necessarily -- it sounds like more of a medical decision to me, and, as QuilterLPN point out, no physician or hospital is obligated to provide futile care. Even if it were purely an ethical decision rather than a medical one, the family does not always have the final say. Many factors must be considered -- this is why hospitals are required by state and Federal rules to have ethics committees, to make these kind of difficult decisions (now, I'm certainly not saying that every hospital's committee does a great job every time, but ...).

buildingmyfaith57 · May 16, 2006

i really for sorry for the mother. its not easy to say goodbye to your children.

TazziRN, RN · May 16, 2006

I remember when my brother was comatose my mom got so excited because he squeezed her hand. The neuro told her that squeezing is a reflex. It's when the pt releases on command that it's time to get excited.

While it is ultimately the family's choice whether or not to discontinue life support, the hospital does not have the obligation to provide further care. It would be the same for a comatose pt that is not brain dead....they can be discharged to a long term care if there is nothing more that docs can do. If this mom truly insists that life support not be removed, then the hospital can insist the pt be moved to LTC.

tryingtomakeit, RN · May 16, 2006

I just can't imagine being in her shoes ...

ZASHAGALKA, RN · May 16, 2006

Another thread on futile care theory:

https://allnurses.com/forums/f8/futile-care-theory-118006.html

The parents have the right to all the care they want; providing that they PAY for it.

If they expect thousands and hundreds of thousands of dollars to be spent for an ultimately FUTILE cause; who's being unethical?

I feel for the family. But futile care is not only a high reason of professional burn-out, it is a tremendous drain on our system. Part of the problem with our current healthcare system is this 'entitlement' to hundreds of thousands of dollars in care, regardless the outcome or even POTENTIAL outcome.

This total disconnect between cost and benefit is our 'tipping point'. This is the problem with our health care system: I don't care about the costs because I don't pay for them. . .

I agree that reasonable healthcare should not be directly tagged to price.

But the costs of UNREASONABLE healthcare must be factored, lest it bring the entire system down.

~faith,

Timothy.