Ethics of mechanical/ life support vs family/patient wishes

[uppityperson]

There are 2 cases currently in the news involving people's wishes, and their family's wishes and legal/medical decisions. One of the classes I took first year nursing school was about ethics in health care. There are legally mandated actions and ethical actions. Sometimes they fit closely, other times they jar.

In the first case a girl's family wanted to keep her on life support while legally they were being denied that. The second case involves a young woman whose family wants her taken off life support, while legally they are being denied that.

My question to DUers is not to argue the merits of either of these cases, to decide how dead those involved are, but to question the ethics of denying person via the family the right to autonomy, to decide what health care they wanted. My question is not to ask if it is legal, but is it ethical, in your opinion?

Is it ethical to go against a person's wishes, either previously stated or not, and/or the family's wishes?

It is ethical to keep someone on life support against their and their family's wishes?
It is ethical to take someone off life support against their and their family's wishes?
Both are ethical or unethical?

ETA, I should have written mechanical/life support, please consider my questions as that.

3 votes, 2 passes | Time left: Unlimited
	Both are ethical
	0 (0%)
	It is ethical to do one of those but unethical to do the other
	1 (33%)
	Both are unethical
	2 (67%)
	2 DU members did not wish to select any of the options provided.
Show usernames Disclaimer: This is an Internet poll

[hrmjustin]

1. I am my mother's proxy and she made clear to me that if there is no real hope for recovery then no

heroic measures and no life support.

She had many surgeries this year and we joked all year that I get to pull the plug. She has a great sense of humor.

[uppityperson]

3. It can be a very hard thing to do, much nicer being on the caregiver side than family side,

still not easy.

[hrmjustin]

4. The good thing is she is recovering.

[uppityperson]

5. That is good. Parents are hard to come by these days.

[hrmjustin]

6. Yes they are.

[Warpy]

7. My mother said if she ever woke up in a hospital on a vent

she'd die out of sheer spite and come back and haunt me.

My dad was a little less forthcoming, but when he said he was tired and wanted to go, I assembled the troops so he could talk to them and make himself DNR.

In the case in Texas, they're giving a fetus which is 10 weeks away from barely possible viability more rights than the woman, her husband, or her family. Clearly, this is nuts.

And yeah, Texas is now a state I wouldn't want to be caught dead in.

[hrmjustin]

8. My mom always says she will haunt me if I make her linger.

[MADem]

2. It depends....and of course you are gonna want an example.

I don't blame you!!

Say you have a person who has always insisted that they want everything possible done to spare their life, but, while unmedicated for a psychiatric condition not immediately apparent, signs a DNR, and then things go wobbly.

The family of this person knows that were the individual compliant with their course of medications they never would have signed the DNR. They can show you videos and letters of the guy saying as much, but they don't have anything as "solid" as that recently signed DNR.

I'd hesitate. I can't lie. I'd feel like shit obeying my "last order first" on what might appear to be a technicality.

[magical thyme]

9. when somebody is brain-dead, it is not "life support."

"Whole brain dead" is as dead as "cardiac dead." Mechanical support of a lifeless body is not life support.

[uppityperson]

10. Then make it mechanical support. Consider it the same for this poll, thanks.

[magical thyme]

11. the family that wanted their daughter's body kept on the ventilator got their wish

I don't think it would be right to force that particular hospital to keep the body on the ventilator until it completely broke down, and apparently the judge agreed. But the judge also required the family to take full responsibility for moving their daughter's body and finding a place to move it to. So I think that is for the best.

So I vguess I vote that it is unethical to force either situation.

[uppityperson]

12. Thanks, that is my take also. If they were willing to take responsibility, up to them.

If they had to move her to another facility, they needed time and support to get it done. Or home.

[pnwmom]

13. I agree. In both cases the family should be deciding, not the hospital or the State. n/t

[justiceischeap]

14. With modern medicine growing by leaps and bounds

we're going to come across situations like this more often. The real question to be asked is should you keep someone "alive" just because you can? What about quality of life? It kinda reminds me of Walt Disney having his head frozen, waiting on the day for medicine to transplant it. Those were his wishes, so his head is being frozen (unless that's an urban myth). If the power is given to the next of kin to make decisions when it comes to life support, then there shouldn't be exceptions where the hospital or state government or federal government should intervene--unless there are very valid reasons to do so (for example, a spouse or family member is a suspect in the harming of said individual). But in the case of the Texas woman, where they are specifically keeping her on "life" support to see if the baby will become viable, because lets be honest, this is nothing more than a ghoulish experiment by the anti-choicer's, then I think we really need to address this legislatively.

[LongTomH]

16. Walt Disney being frozen IS an urban legend....albeit a persistant one

His ashes are interred at Forest Lawn:

A long-standing urban legend maintains that Disney was cryonically frozen, and that his frozen corpse was stored beneath the Pirates of the Caribbean ride at Disneyland, but Disney's remains were cremated on December 17, 1966, and his ashes interred at the Forest Lawn Memorial Park in Glendale, California. The first known human cryonic freezing was in January 1967, more than a month after Disney's death.

According to "at least one Disney publicist", as reported in the French magazine Ici Paris in 1969, the source of the rumor was a group of Disney Studio animators with "a bizarre sense of humor" who were playing a final prank on their late boss.

His daughter Diane wrote in 1972, "There is absolutely no truth to the rumor that my father, Walt Disney, wished to be frozen. I doubt that my father had ever heard of cryonics."

[davidpdx]

15. I think it's always better if the family makes the decision

rather than the hospital or the government. The question for me always comes down to prognosis and the family's wish.

My vote is both are unethical.

Both of the cases mentioned I disagree with what is being done. The girl was dead and her family was allowed to drag her corpse around which is sick. The pregnant woman is being used as a incubator and (to borrow the words of Mark Garagos) is ghoulish.

[DevonRex]

17. It is possible for it to be unethical to keep the body on support

after brain death. Sometimes the body deteriorates fairly soon (decays). Brain death is not a coma or vegetative state. In that case it can be unethical to continue past a certain point for obvious reasons.

[Humanist_Activist]

18. I didn't vote because I find the poll choices to be inadequate...

For example, is it ethical to keep a brain dead person on mechanical support until their body breaks down on its own, which can take up months. Tying up a ventilator that can be better used on a patient with a chance for recovery, along with tying up the time for staff.

Generally we should cede to any request of a patient or patient's family, unless it is not in the patient's best interests.

[uppityperson]

19. one kick