ethics Q's

[Arctic Char]

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suppose you have a patient on life support and the time comes to restrict care. the patient has an articifial respirator and has a feeding tube . . .

which do you remove first? the tube or the respirator?

mmy guess would be the repsirator, as its much quicked and doesn't allow much suffering . ..

anyway, i was recently asked this question and thought i'd throw it out for debate

 

[ginger60]

Actually, I have been told by healthcare professionals who deal with end-of-life issues that starving to death (I know it sounds horrible) is a decent way to die. It often happens in Alzheimer's patients who stop having the desire to eat, and it apparently induces some euphoria after the first couple of days or so and is not painful or stressful provided that you are not denying food to a patient who wants to physically eat. As far as restricting care or providing "comfort care only" goes, it is a personal decision that the patient and family's values should dictate--some patients would not want to be ventilator-dependent EVER for reasons of dignity and removing them from the ventilator would be most appropriate, whereas other people may struggle with the idea of doing something so drastic and quick as removing the patient from the ventilator and would feel more comfortable with just removing their source of nutrition. I'm pretty sure there is no clear answer and that what should be done should be determined by the patient's values and wishes regarding how their death should occur.

 

[Arctic Char]

i can see the answer choices on step 1 one now . . .

a) feeding tube
b) disengage respirator
c) administer high dose morphine
d) it is a personal decision that the patient and family's values should dictate--some patients would not want to be ventilator-dependent EVER for reasons of dignity and removing them from the ventilator would be most appropriate, whereas other people may struggle with the idea of doing something so drastic and quick as removing the patient from the ventilator and would feel more comfortable with just removing their source of nutrition. I'm pretty sure there is no clear answer and that what should be done should be determined by the patient's values and wishes regarding how their death should occur.

i'll go with "d". 😉