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Have a question about end of life issues
Posted: Feb 6, 2015
I know it makes no difference what a person wants in their directives, the family can and does sometimes want something else but I want to talk about vent care, life support. Okay, so if a person is at end of life and has no directives, the doctor says to the next of kin you have to make a decision, this person is gone. I know you cannot live like forever on life support, not like you are living but remain on life support is what I mean. What if the family says no, absolutely not and refuses to have you removed, what then? I know medical personnel can talk and talk but what if the next of kin just refuses, then what? ;
I think you stay on. - sm
[ In Reply To ..]Seems possible that if you have an Advanced Directive on file with your record, stating your wishes to not be on a ventilator that the hospital can have a representative appointed to represent your wishes as stated.
Usually you appoint someone a Medical Power of Attorney who would carry out your wishes. But, I assume you are setting scenario that they are balking and not carrying out wishes detailed in Directive.
And, in this day and age, I wonder if it would come down to money perhaps. The hospital would push to have a person removed, if they had the backing of the Advanced Directive, if they had any question about whether payment is likely for all that expensive care.
Okay I read your message again. No directive at all. I think the family can keep you on as long as they like until someone tries to step in with a legal authority to represent the patient (or maybe really the hospital) to end the hemorrhaging financial situation.
Just my opinion. Thankfully, my mother had an advanced directive (I had spoken with her within 6 weeks of the car running over her) and I was power of attorney, and I stopped the medical care and turned off the vent, but not for a minute was that easy.
END OF LIFE ISSUES - Muzzy
[ In Reply To ..]This situation would eventually go to the Ethics Committee and a consult would be done by an ethicitation (sp?). That consult would give a recommendation (remove/stay) and that recommendation would be followed by medical staff. I have typed these reports and know this happens at some facilities. You may need to find out the guidelines of your facility in a case like this.
Directive Does Make a Difference - see msg
[ In Reply To ..]It's not true that whether you have a directive doesn't matter. It's a legal document, and at the very least, is something to make sure your wishes are carried through.
Hospitals don't want to get sued, so if you don't have a directive, they'll want to go with the family wishes--at least for a period of time.
My husband and I have no children, and he's an only child, and we still have a directive.
Even though there's no family to interfere on his side, we don't want the hospital making the decision to keep him alive in the event I am not there to make the decision--which they would opt to do just in case family "showed up."
It's very important to have these legal documents. We did it when we were in our 40s (in our 60s now). We're in good health, but horrible accidents do happen and we don't want either of us vegetating in a hospital bed in that event. OR, if one of us gets ill, the legal stuff is all taken care of and we don't have to worry about it during a time of extreme stress.
living will does make a difference - my mom had one
[ In Reply To ..]She had advanced directives saying no to ventilator, no to long-term antibiotic use, no to feeding tube, no to heroic acts (CPR, etc). Once she was placed on hospice care, they had to honor her legal directives. They did place her on oxygen by nasal cannula, though, which I wished she had thought to include in her directives. She slowly starved to death - it took 23 months for her body to accomplish that, all the time being on hospice care. Once she finally refused to stop eating or drinking fluids, it took her body a week for all her organs to shut down.
You really should be very specific in what you want in advanced directives.
Your posting is disturbing to hear and - family can override end of life issues
[ In Reply To ..]Disturbing in the sentence "took her 23 months to starve." That sounds horrible to me. Having said that, if the family wanted to say stop the non-feeding, hook up this and that, even with the directives hospitals/hospice, etc. go along with the family rather than run the risk of lawsuits.
I disagree - my mom had one
[ In Reply To ..]It is a legal document, one that can take the person wishing to override it to court to be held accountable. A hospital or care provider would rather avoid that possibility and honor the document. The person holding advanced directives should have a copy of it on file with his/her physician, as well as with the executor of his/her will.
There is no evidence that giving my mother high-flow O2 extended the time my mother spent on hospice, nor any to show it diminished the time she spent on hospice. It was obvious that she hated it because while she still had use of her arms she would remove it. BUT, she failed to put that in her advanced directives, so it was not a case of someone overriding her wishes. You can't override a specific request when you fail to make the request specific enough.
A friend of mine who is a doctor has an advanced directives where he specifies no use of long-term oxygen over a three month period of time. If fact, his directives specify all care is to be withdrawn if there is no hope that he could not recover without specific treatments.
I think you are getting all worked up about something that you have more control over than you are allowing yourself to believe that you have.
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