Sunday, November 22, 2009

When Things Go Badly

For ethics class I'm writing up a case study of a patient who is brain dead, but whose family does not believe in brain death as a criterion for determining "actual death". This is the sort of thing that is quite tricky in modern medicine- after all, "brain death" never used to happen: as soon as your brain lost control of your breathing center, YOU DIED. We never used to have the problem of a dead brain with a body kept more-or-less fresh with Science. While the part of me that LOVES a little Mad Science thinks that this is actually pretty nifty in a Frankenstein's Monster sort of way, the part of me that hates to see wasteful useless medicine practiced cringes at the thought that people are "maintained" on ventilators when they are actually corpses, all because the family simply does not believe that they are gone.

Plus- if they're DEAD, who is PAYING for all these interventions? Probably not insurance, as I'm fairly certain that they stop paying for procedures for deceased people.

Its not an easy decision though, because families may have valid religious reasoning behind their views on death, but that should never trump the fact that we CANNOT allow ONE person to be dead and ONE to be alive under the same conditions and circumstances. Death HAS to be universally applied, or things go downhill fast.


TirzahLaughs said...

It's because there are always those rare instances when people do wake up from comas. And that's why they hold on, hope, however misguided. This is one of the reasons I have a DNR. My family is full of diseases you don't bounce back from, I don't want to be trapped in my own body just because they won't let me go.

That's life.


nancy said...

My fourth child became ill w/flu-like symptoms (no fever, no cough, just blah) on a Monday. On Tuesday morning she was un-arousable. Called 911, hosp pedi (she was 16) said she was brain dead. I wanted her to remain on life support till her siblings could say their good-byes. Then we all "held" her as she was taken off the vent, IV drugs were stopped and we felt that she had "died in our arms". That was and is a very powerful feeling. We needed some time to process her very unexpected and quick demise. Don't know what we would do/have done if it had not been in a hosp. ..she would just have been found to have died...?
But many folks experience sudden death every day.I was grateful to the drs and nrses...

little d, S.N. said...

I'm terribly sorry for your loss. I have no problem with ventilators being used in these circumstances, while the family says goodbye. The problem for me comes in on the legal definitions being used- i think they have to apply to EVERYONE equally, or we face ethical issues.