Who should decide?

Hannahbanana, BSN, MSN · May 13, 2021

On 5/11/2021 at 10:28 PM, PPediRN said:

Some times the compassionate thing to do is to let nature take its course. In cases like this I believe family members want to hang on to their dying loved one to avoid the pain of having to say goodbye. You have to know when its time to let go

If they consider the main ethical tenets, continuing this is not supportable.

The other thing to consider is that the family have had this as a major focus since her birth, to the point where it’s their identity now. When it goes away, they will lose an enormous part of their sense of who they are, and this is so disorienting. Many couples divorce when their chronically ill child finally dies because they can’t relate to each other anymore as other than parents of a sick child. The loss rips off the bandaid and they see what they don’t have.

Another factor is that there’s a whole industry of peripheral “caring” nowadays- prayer circles, vigils, websites, and all. I am not knocking anybody’s religious beliefs, but you have to realize that when this child is allowed to die a lot of people will be outraged, intrusive, inserting themselves into a private situation where they really have no business because it isn’t their actual struggle. Suffering Media, some call it, as addictive as any other kind. Avoiding that crowd’s backlash will be impossibly painful.

Last, there’s the “sunken costs” fallacy, by which I am not referring specifically to the spectacular number of dollars involved. It’s the idea that because we have done so much, we have to continue to do so much. This is why some people stay married long after they could have divorced and gone on to happier lives, why we keep fixing a broken first car long after it ought to have been gone, why scammers and Ponzi schemers can keep getting more after more from their marks, why futile wars go on forever. Cutting your losses sounds crassly financial but emotional losses count, too.

It’s an awful situation. Maintaining what is essentially a biological specimen isn’t care and love. Ceasing it will be traumatic for everybody involved.

NurseBlaq · May 13, 2021

Let Little Miss Tinslee rest. I personally wouldn't do this to my child. It's selfish. I'm not the one in bed and she has not had, nor will ever have, any quality of life. Her parents need to let her go, grieve, and move on. I'm not being hateful here. This is parental selfishness and financial abuse of the system. People on Medicaid get turned down for medications they need to sustain life and some forgo meds they desperately need because they can't afford the copays. Parents are denied necessary surgeries to improve their child's QOL. Meanwhile, this child who basically already deceased is being kept alive because her parents don't want to let go. It's not right, fair, and it's emotional greed. I hope the state steps in and allows Tinslee to be laid to rest.

Emergent, RN · May 13, 2021

I have been following on facebook the horrific tale of a facebook friend's infant grandchild posted by her daughter, the baby's mother. He became severely septic requiring life support, pressers, leading to dialysis, amputation of both legs, and a likely colostomy.

I'm convinced that the mother is getting hooked on the social media attention she's getting. She's posted graphic photos along with detailed reports, tagging her mother, a former coworker of mine. A good friend and I discuss this regularly and feel the same.

Of course, people are rallying to her, praising her virtue. I'm sure that there are plenty others like myself and my friend who are secretly appalled, but of course keep our mouths shut. Not only are the millions of dollars out of common resources being spent, but this child faces a life of suffering. It's really horrific. But mom is being lauded as mother of the year and seems to like the attention.

dzadzey, MSN, RN · May 15, 2021

On 5/11/2021 at 8:48 PM, yschon said:

That is your opinion, and someone with that view would have the right to make such a decision for a loved one. However, others might object and value life even when someone is long brain dead, and that decision is theirs. It’s the USA; we are all entitled to our opinions and religious/ethical beliefs.
My argument is not about spending government money.

Nor is my argument about "spending government money". It's about quality versus quantity. It's about the toll futility of care takes on us as nurses...on the patient's families. Being realistic about end of life issues and death is NOT something we, as a society, are very good at.

amoLucia · May 15, 2021

Great shades of Jahi McGrath!

JKL33 · May 16, 2021

On 5/11/2021 at 8:48 PM, yschon said:

However, others might object and value life even when someone is long brain dead

Can you elaborate on this comment?

yschon, BSN, EMT-B · May 16, 2021

3 hours ago, JKL33 said:

Can you elaborate on this comment?

I thinks that it’s self explanatory, but I can...

Even though, in certain instances, many of us might believe that the correct or compassionate thing to do is to let a patient die, many people might have cultural beliefs which disagree. As we all should have learned in school, there are many cultures, and everyone is entitled to practice their own, in their own way, without judgment.

let me ask you, is bringing flowers to a grave logical? Do you think a dead person can see or smell them? Of course they can’t, but that doesn’t mean that it’s a waste of money. People can make personal decisions which makes sense to them, even if it is article to others.

There are many cultures that value life even after a patient is brain dead. Even thought this may seem illogical to some, it shows respect of the patient to others. Family members have the right to allow their loved ones to remain alive, regardless of the life support needed.

I am not coming to say that every single patient should be left on a ventilator forever, and I am not denying that sometimes healthcare providers must awaken patients to the reality that their loved ones will never wake up, and now is a good time to let them go. I am simply saying that families have the right to keep their loved ones alive regardless of the extent of incapacity. This is still a reasonable option, even though some of us don’t understand it.

Hannahbanana, BSN, MSN · Dec 4, 2021

Does anyone have an update on this situation? Anyone from TX with insights?

allnurses Guide · Dec 5, 2021

As of September 2021 Tinslee was still alive - I am not sure where this case stands as of now.

subee, MSN, CRNA · Dec 7, 2021

Teach the mother how to care for the girl at home. Everybody wins. Taxpayers have rights as well as dead children being artifically kept alive.

subee, MSN, CRNA · Dec 7, 2021

On 5/16/2021 at 5:17 AM, yschon said:

I thinks that it’s self explanatory, but I can...

Even though, in certain instances, many of us might believe that the correct or compassionate thing to do is to let a patient die, many people might have cultural beliefs which disagree. As we all should have learned in school, there are many cultures, and everyone is entitled to practice their own, in their own way, without judgment.

let me ask you, is bringing flowers to a grave logical? Do you think a dead person can see or smell them? Of course they can’t, but that doesn’t mean that it’s a waste of money. People can make personal decisions which makes sense to them, even if it is article to others.

There are many cultures that value life even after a patient is brain dead. Even thought this may seem illogical to some, it shows respect of the patient to others. Family members have the right to allow their loved ones to remain alive, regardless of the life support needed.

I am not coming to say that every single patient should be left on a ventilator forever, and I am not denying that sometimes healthcare providers must awaken patients to the reality that their loved ones will never wake up, and now is a good time to let them go. I am simply saying that families have the right to keep their loved ones alive regardless of the extent of incapacity. This is still a reasonable option, even though some of us don’t understand it.

What if it were a 96 year old instead of a toddler? Following your logic we should keep EVERYBODY ventilated and hydrated just because a family member wants that? Putting flowers on a grave is not an analogy for what is going on here, in fact it's ridiculous.

toomuchbaloney · Dec 7, 2021

46 minutes ago, subee said:

What if it were a 96 year old instead of a toddler? Following your logic we should keep EVERYBODY ventilated and hydrated just because a family member wants that? Putting flowers on a grave is not an analogy for what is going on here, in fact it's ridiculous.

I don't agree that it's a ridiculous comparison. The actions are both based in emotional response, pain and grief...not in science or reality.

These matters are ethically and morally difficult and rarely simple. I believe that a good measure of the cultural of death denial and eternal hope needs to be better countered by realistic assessments from the medical and nursing professionals EARLY in the game for fragile patients. It's more complicated with children, of course.