Opinion / Columnist
When is it the right time to turn off life support machines?
27 Jun 2013 at 14:43hrs | Views
This is a topic not many people think about, but one that should be talked about amongst family members. If you were placed on life support, who would you want to be your legal representative? And when would be the right time to switch off the plug?
These issues usually come into play as with most unplanned events unexpectedly, as some involved in accidents find out when they are left brain dead. I'm sure no one thinks before getting into a car 'If I don't make it to work, so and so is who I want to be my representative'.
Brain death is very different from being in a vegetative state, according to the Centre for Neurocritical Care of University Hospitals Case Medical Centre, which is associated with Case Western Reserve University in Cleveland. According to the American Academy of Neurology, brain death occurs when the patient has no evidence of cortical brain activity or brain stem activity. This means the patient would be unable to cough or swallow or breathe on her own, whereas a patient in a vegetative state may be able to do one or all of those three things.
Once a patient is declared brain dead, the family usually opts to remove uncomfortable tubes and machines quickly, "Pulling the plug" renders the patient unable to breathe, and the heart stops beating within minutes.
If however a patient is not brain dead and instead has suffered a catastrophic neurological brain injury he or she could breathe spontaneously for one or two days before dying.
Physicians use the results of electroencephalogram (EEG) tests, which measure the patient's electrical activity in their brain, MRIs or positron emission tomography (PET) scans to determine when to turn off life support machines. You pull the plug when the person has no brain waves, and no hope of living a quality life.
But a problem can arise if the parties caring for the patient disagree on the decision to terminate life support. A well-known example was Terri Schiavo, the Florida woman who had been in a permanent vegetative state for eight years when her husband Michael argued in 1998 that he wanted her feeding tube removed. A seven-year battle ensued as Schiavo's parents fought against Michael Schiavo's wishes, saying their daughter's life still had quality. On March 18, 2005, Terri Schiavo's feeding tube was removed; she died 13 days later of dehydration.
To prevent a case like Schiavo's everyone should write and sign a living will that gives specific instructions on health care, which can be given to hospital administrators in the event of such a tragedy like being brain dead or being in a vegetative state.
This is a very interesting topic that raises a lot of other questions too. What did people do before there were life support machines? Is the ability to prolong a life the right thing to do? Is it wrong to pull the plug on a person's life who would already be dead if not for medical technology? Is it right to keep a body with no consciousness alive? I am sure all the moral aspects of this subject will be investigated and answers will depend on an individual's moral outlook.
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Velempini Ndlovu is a writer and photographer based in Johannesburg, South Africa he can be contacted on veapndlovu@gmail.com
These issues usually come into play as with most unplanned events unexpectedly, as some involved in accidents find out when they are left brain dead. I'm sure no one thinks before getting into a car 'If I don't make it to work, so and so is who I want to be my representative'.
Brain death is very different from being in a vegetative state, according to the Centre for Neurocritical Care of University Hospitals Case Medical Centre, which is associated with Case Western Reserve University in Cleveland. According to the American Academy of Neurology, brain death occurs when the patient has no evidence of cortical brain activity or brain stem activity. This means the patient would be unable to cough or swallow or breathe on her own, whereas a patient in a vegetative state may be able to do one or all of those three things.
Once a patient is declared brain dead, the family usually opts to remove uncomfortable tubes and machines quickly, "Pulling the plug" renders the patient unable to breathe, and the heart stops beating within minutes.
If however a patient is not brain dead and instead has suffered a catastrophic neurological brain injury he or she could breathe spontaneously for one or two days before dying.
But a problem can arise if the parties caring for the patient disagree on the decision to terminate life support. A well-known example was Terri Schiavo, the Florida woman who had been in a permanent vegetative state for eight years when her husband Michael argued in 1998 that he wanted her feeding tube removed. A seven-year battle ensued as Schiavo's parents fought against Michael Schiavo's wishes, saying their daughter's life still had quality. On March 18, 2005, Terri Schiavo's feeding tube was removed; she died 13 days later of dehydration.
To prevent a case like Schiavo's everyone should write and sign a living will that gives specific instructions on health care, which can be given to hospital administrators in the event of such a tragedy like being brain dead or being in a vegetative state.
This is a very interesting topic that raises a lot of other questions too. What did people do before there were life support machines? Is the ability to prolong a life the right thing to do? Is it wrong to pull the plug on a person's life who would already be dead if not for medical technology? Is it right to keep a body with no consciousness alive? I am sure all the moral aspects of this subject will be investigated and answers will depend on an individual's moral outlook.
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Velempini Ndlovu is a writer and photographer based in Johannesburg, South Africa he can be contacted on veapndlovu@gmail.com
Source - Velempini Ndlovu
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