Should life support be withdrawn against a patient's wishes?

[Faithful83]

We have the Terri Schiavo case, where it is debated, well, first, if Terri Schiavo had wishes not be kept on life support. Of course then there are debates as to whether it's right despite her wishes.

Here's an article turning the tables a little bit.

http://www.nytimes.com/2005/03/27/national/27death.html

Should it be allowed to take a person off of life support, if doctors feel it is time, even if the patient has a living will directing that the patient remain on life support?

 

[Antoninus Verus]

If the patient can actually look at you and TELL you "I want to remain on life support" then yes. Respect thier wishes. But if they cannot indicate to you if they do or do not want to remain on life support, then its probably best to take them off. A person may say at one point "I want to NEVER be taken off life support" but once they have been suffering for weeks or months, they may change thier opinion.

 

[meebs]

agreeing with antoninus

i know for sure that im gonna write in my will, in case of brain damage and being put on life support 24/7 and very little chance of recovery...dont.

 

[Faithful83]

So, if someone is very specific in their will that they WANT to be on life support should they become incapacitated, we should assume they have changed their minds when they become incapacitated?

 

[meebs]

...

 

[ebonicsonly]

If they made a will saying they want to stay on life support then its set in stone let them. If they are suffering -hey it was their choice.

 

[Faithful83]

oops misread the quote

Okay...let me try to clarify...

If I write down in a living will that I want to remain on life support, at least until I have absolutely no brain activity, then I become incapacitated, and require some form of life support, let's say I'm basically in Terri's condition and require a feeding tube. They look at my living will and see that I want to remain on the tube.

Are you, (jellybean and Antoninus) saying that they should disregard the living will and pull the tube because, well, gee, I may have changed my mind?

 

[Rae]

There already is more than one law on the books that poor people who can't afford to pay for life support WILL be taken off it once they can't pay for it any more. One of those laws was signed by the then-governor of Texas, George W. Bush.

So guys, it may not matter if you have a living will or not. You can have as much documentation of your desire to stay on life support forever as you wish, but you'll be cut off when you can no longer pay for it. Nice, eh? Very respectful of life.

 

[HouseApe]

There already is more than one law on the books that poor people who can't afford to pay for life support WILL be taken off it once they can't pay for it any more. One of those laws was signed by the then-governor of Texas, George W. Bush.

So guys, it may not matter if you have a living will or not. You can have as much documentation of your desire to stay on life support forever as you wish, but you'll be cut off when you can no longer pay for it. Nice, eh? Very respectful of life.

It may not be nice, but it is exactly the way it should be. Unless, of course, it's someone I love.

 

[Ledifni]

We have the Terri Schiavo case, where it is debated, well, first, if Terri Schiavo had wishes not be kept on life support. Of course then there are debates as to whether it's right despite her wishes.

Here's an article turning the tables a little bit.

http://www.nytimes.com/2005/03/27/national/27death.html

Should it be allowed to take a person off of life support, if doctors feel it is time, even if the patient has a living will directing that the patient remain on life support?

Well, let me put it this way -- with the treatments we could potentially develop from stem cell research, it could be possible to cut somebody's head off and keep their body alive forever. Now, if that happened to somebody, and they had a living will directing the doctors to keep them on life support, would you say that the patient's decapitated body should be kept animated for the entire life of the human race?

So yes, I think there is a point at which keeping someone on life support is simply pointless. However, if somebody has asked to be kept on life support and there is any chance that they might recover, then they should not be allowed to die.

 

[jayem]

It's a tough situation when a patient or family wants the full court press, and when the clear medical facts indicate that such treatment is futile. Though a patient may want to have everything done, a physician has no ethical obligation to provide treatment that, in his good faith medical judgement, is not indicated. If the family and the providers cannot agree on a plan, then the physician can withdraw from the case and request that the family find another provider who may be willing to follow their wishes. (Though as a practical matter, it can be difficult--and likely impossible--to find another physician or facility willing to take on such a patient.) But also as a practical matter, if the underlying medical condition for which a patient needs life support is incurable, it is highly unlikely that intensive life support (like total ventilator support, kidney dialysis, etc) will be needed for very long. There is actual data on this which I'd need to review. But IIRC, if, the underlying illness is not reversible, and if, a patient requires life support for more than one organ system, the 4 week mortality is something like 98%. Even with life support, nature will take it's course, and usually sooner rather than later.

 

[Ampoliros]

Should it be allowed to take a person off of life support, if doctors feel it is time, even if the patient has a living will directing that the patient remain on life support?

No - the patient makes decisions regarding his/her care, or someone the patient has appointed to make decisions regarding his or her care makes the decision.

Anything else violates the rights of the patient, imho.

 

[meebs]

Are you, (jellybean and Antoninus) saying that they should disregard the living will and pull the tube because, well, gee, I may have changed my mind?

well, ok no. But only because they'd made that clear in the will.

 

[Antoninus Verus]

Are you, (jellybean and Antoninus) saying that they should disregard the living will and pull the tube because, well, gee, I may have changed my mind?

If you were someone on lifesupport and you had indicated before that that you wanted to remain on lifesupport, I would put you on lifesupport but after a few months of being incapacitated and in pain, you might change your mind. And if you could indicate that you had infact changed your mind, then yes I would yank the plug. Several months of pain do WONDERS to change a person's mind