This Article is About
difficult decision
life scenario
mind and body
realism
anguish
demise
miracles
attitude
confidence
A Difficult Decision – To Unplug The Support System Of A Loved One
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A Difficult Decision – To Unplug the Support System Of A Loved One

The patient's wish.

The life scenario occurs every day, somewhere, someone is in a place of discomfort and preparing to die. The facts of their demise, irrelevant, the realism being the machines that keep them alive. The rigour of support that these machines may supply, an unknown to the bystanders of the patient, but well-known to the attending Doctor.

Can the Doctor explain this support in an unbiased way, to an already grieving family? Is their knowledge of the activity occurring in the patients mind such, to override that of a written request? A patient lies upon a bed, comatose, the Last Will and Testament has a Living Will, this will states that the patient has no wish to stay alive if the only way is by life support system. This is clear and forthright, attested to and with witnesses, whilst the patient was of sound mind and body.

The patient, foreseeing the possible problem, has decided for themselves, as well as for their family. No need to debate among the remaining, no need for decisions by a Doctor. It is clear and written, the patient would rather live or die, unsupported by machines.

The families anguish.

The family remaining behind, knowing of the Living Will, obligated to tell the Doctor. This issue, the Doctor will not likely want to follow, more likely to recommend a wait-and-see attitude. His confidence in the unknown goings on of the body, insufficient to have the certainty of no recovery. After all miracles have happened, patients diagnosed as beyond help without the support systems, when disconnected, continued to live and recover.

The chances of this occurring must act as a rein on the family, do they switch off and let them go if they do not recover, or do they rescind the wish and keep the machines on? The chance to recover, indeterminable by both family and Doctor, requires a decision be made. How easy is it to switch off a life line and lose a beloved? A decision I hope never required of me. It is easy to say it's the wish of the patient, but is it the wish of those staying behind? At what time do you switch off? maybe a further week could be the difference between death or recovery.

The Doctors dilemma.

The Doctors decision is the last, after all they know more than the family. They are the ones that must decide if they have done all they can to aid the recovery of the patient. Their moral obligations, the Hippocratic Oath taken on qualification and registration and their simple self-confidence in the decisions they have made during treatment, their guide. But, and it's a big but, can they override the wish of a patient? Legally, this seems a bone of contention, and many a court case bares testament to this.

The Doctor must exhaust all possible treatments, be they a cost to the patient or not, his obligation to the family requires it. But in the end, he is the one that must tell the family that all possible treatment, exhausted, and the decision is now theirs to make.

The final decision.

This is where I find myself at two ends of the debate. I have a Living Will stating that it is my wish not to receive the support of machines. But am I in a place to decide if there is no chance of me surviving, and at what time must the life support be discontinued?

Is this not tantamount to a decision to commit suicide? A morally frowned upon practice. The debate within my family on this point has resulted in, the decision is mine, it is not suicide and as the machines are “life support” systems, I have the right to decide if I want them or not. The attitude of the family, “what will be, will be” if one is to recover without the support, you will. If it be Gods wish, either way, it will happen.

Protracting the argument seems senseless, as none of us have ever been required to make such a decision. The time might come when we will have to, and then, and only then, will we experience the trauma of such a terminating decision, one I hope we can make with a level head.


Street Talk

Good article - yes this is a hard decision. My brother they took off the machines and he lived for 10 more years, albeit not the life he would have wished to live. He had to have a feeding tube and could not get out of the bed except to shower when the help would push him to the showers. - It makes you wonder if he would rather have not lived.

Reply
  about 1 decade ago

Thanks for the feed back. The life we live, guided from above, begs the question of why? Something we'll never be able to answer, yet the wish of an individual to quietly die frowned upon.

Reply
  about 1 decade ago

Yes Heather this was our debate with the family, my wish is well known, but the more research I've done it appears almost as if the Doctor can over rule your wish? This is the dilemma. The comment Margret made below, one wonders if you can legally pull the plug or not, But a interesting debate has ensued.

Reply
  about 1 decade ago

It's a worthy topic to raise. I admire you that you've considered it and talked to your family about it. Now to the next big issue... organ donation? Or not?

Reply
  about 1 decade ago

Well done Heather, this is another issue not raised, and one wonders if this would not ease the burden somewhat if it was in the picture. But again although we debated all the ins and outs, and my family say "It's their decision" I wonder if it will be so easy if the time came.

Reply
  about 1 decade ago

Can guarantee it would never be easy.... surely on this issue though it would be easier if the wishes of the person involved was known.

  
  about 1 decade ago

Thanks for the thoughts, Rob. My Mom had ALS in the mid 90s. Mom had made her decision about not being put on the life support machines to start with and it was still one of the hardest decisions to live with as my Dad and my Sister and Daughter and I, all had to choose to honor her decision.

Reply
  about 1 decade ago

I feel for you Sherry, and God I hope I never have to be in the position, the mixed feelings must be difficult.

Reply
  about 1 decade ago

A very insightful and thought provoking article Rob. These are difficult decisions for all involved and i can only hope my loved ones will never be left with anguish over such issues. Proper planning and documentation of one's wishes should make some decisions easier but still lots of potential variables when the time comes to make these tough decisions. Hate to think about it but its probably wise to put some thought into these issues before these situations occur. Thanks for the article Rob

Reply
  about 1 decade ago

Thanks Jay, this is just what we as a family discussed, my friend who is going through this at the moment, the decisions and the legalities at a time of worry and grief, very difficult.

Reply
  about 1 decade ago
Margaret  

Finding yourself ACTUALLY faced with the situation, and I have been, the reality is very different from what we think will happen, although doing so is useful. The laws regarding the 'living will' are NOT what they are marketed as, and once signed, the doctor can do anything they want to regardless of the wishes of the patient, the wishes of the family, and many of them do act totally in opposition to it. It is NOT an easy situation to face in any circumstance. Far and away it is guaranteed to cause long term grief in the families involved, and sensitivity and support for them over the long haul will do much good.

Reply
  about 1 decade ago

Good point Margaret, without being in the position it is difficult to talk with authority on my behalf, and this is one of the points debated by my family, when do you now have the trauma of fighting the Dr for the patient's wish?

Reply
  about 1 decade ago

Thanks for a thoughtful article! Personally, I would not want to have suffering prolonged on those machines! Turn them off and let me go be with God. I believe Heaven is our real home.

Reply
  about 1 decade ago

Thanks Levada, yes that's how I feel, and if it's Gods wish for recovery you will. but consider the family having to say unplug.

Reply
  about 1 decade ago

I agree with you totally

Reply
  about 1 decade ago

This must be one of the hardest decision in someones life. Personally I would not want to be disconnected because I believe I could fight my way back. Then again the money issue would come up and they just might have too. This is something everyone should discuss even though it may be uncomfortable. Scary thoughts on this subject. Great article and will will plug you in with a tweet. Thanks Rob.

Reply
  about 1 decade ago

Thanks Rodney a friend is going through this difficult decision at present and the family got to debating the point. I'm still not convinced I would know what to do, and although I have such a will the family is also not sure what they would do.

Reply
  about 1 decade ago
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