Suppose a close family member of yours was in a vegetative state? However there is a small chance that the person may get out of the coma even if in several years. Would you still take him or her off life support?
If it were my wife, or my parents, yes…because all three of them have specifically told me that they do not want to be kept alive by extraordinary measures such as those. In the case of my parents, they have signed living wills, and given me durable power of attorney, for just such a reason.
But suppose you found out (hypothetically) from an omniscient being or information source that had he or she lived just a few months more they would have woken up? What if they wake up while you’re planning to “pull the plug”?
As for me, as soon I become an adult I would sign a document explicitly telling my family to keep me alive as long as possible even if I were in a vegetative state.
Sweet. Bankrupt your whole family.
Even if the brain is intact(extremely big if, you wouldn’t be in that state if the brain was intact), the body would be wasted away.
Nice, incredibly unlikely hypotheticals, Qin. In the real world, you have to make decisions with the information you have at hand at the time. May you never have to face the anguish of such a decision within your family.
And, yes, there are miracle stories about people who wake up after years in a “vegetative state”. But, those odds are usually incredibly small. My parents and wife, who are adults, have weighed those odds, and given instructions which indicate that they’d rather not be kept alive in such a situation.
If it’s your wish to be kept alive for as long as possible, just in case that miracle happens, make certain you have legal orders which explicitly state that, and a guardian who will enforce it. And, make sure that you purchase long-term care insurance for yourself, so that keeping you alive in a nursing facility for many years doesn’t become a financial burden on your family.
I have had this frank discussion with my family and I and most of them choose to be taken off life support. I have one brother who objected when this happened with my father, despite the fact that that no life support was also one of my father’s wishes. My father had Alzheimers. He knew it and he did not want to be kept alive. We respected his wishes. I would be appalled at someone who did not respect those wishes unless they had proof that could hold up in a court of law that the person’s life would be restored and raised to a better quality-of-life state.
Life at all costs is a view many people take. I disagree with it for myself. If you want me to keep you alive. I will do that. If I don’t want you to keep me alive by completely artificial means (not just an assist) I want you to respect my wishes - even if you disagree with me. And that is why Living Wills are so very important these days. Let those around you know what you want for yourself.
May you never either.
Well that is their decision I suppose.
Aren’t you a Christian though? I thought you were. I’m sorry if I have you confused with someone else.
I selfishly would like that too because I’m scared of the idea of dying, but I won’t do it to my family. If I’m meant to live I’ll live. Everybody’s gotta go some time.
Yes I’m a Christian but what does that have to do with anything. In fact it could be argued that pulling the plug is killing the person for largely financial considerations while there is even a remote chance of life.
Exactly so. For some people, the fact of being alive, with even a tiny chance of regaining some semblance of a normal life, is worth hanging onto, no matter what. For others, quality of life is what they believe is more important, and they don’t want to be kept lingering. In some ways, modern western medicine has gotten to be very good at prolonging the last years of one’s life, but not always making for quality living of those years.
You may also find that your view on the subject changes as you get older.
In these sorts of situations, you’re supposed to do what the individual who is in the situation would want, not what you would want. People really SHOULD talk about this stuff with their loved ones. If you haven’t ever told your family your wishes, stop reading this post and go do it now. It’s important!
I have tried to make my wishes clear to my SO. A while back I actually showed this article about the frequency of misdiagnosis of awareness to him and told him that, if by some chance I ever am in such a state, he should operate under the assumption that I have awareness even if it doesn’t appear that way. I have made it clear that I would want him to aggressively pursue experimental treatments for me. It’s exciting to think that maybe someday fMRI will help with establishing some basic communication with people in these terrible situations.
However, if there is nothing that can be done, I’ve also made it clear that I strongly believe in organ donation.
Being in a coma is not the same thing as being in a persistent vegetative state. People in a PVS have a minimal amount basic functional response. They can swallow, for example, where coma patients have to be fed intravenously. PVS patients sometimes open their eyes. They sometimes have regular sleep/waking cycles. etc. See here for more basic info about it:
What a PVS patient lacks is any sort of higher function. They can’t communicate or react normally to external stimuli.
PVS is caused by severe brain damage, either physical injury, a disease or illness, a birth defect. It’s a major trauma - not just a bump on the head like in soap operas. Sometimes the damage is limited to a portion of the brain with the remaining brain tissue working to some (currently not well understood) degree. The overall damage can’t be repaired.
Patients with PVS can regain consciousness, usually within six months. If the state persists beyond six months, the chance of recovery falls drastically. Patients who regain awareness usually suffer debilitation and need significant assistance. The physical brain damage still remains. Again, it’s not a soap opera - people who recover from a PVS don’t hop out of bed and head back into romancing at the country club.
So the question here is, do you want to be kept in a persistent state of semi-consciousness in hopes of one day waking up to severe brain damage and institutionalization? To which I would say - hell, no!
I was talking about for you, and I don’t understand why you wouldn’t want to die if you were Christian rather than being held in a suspended state. Many of the Christians I hang out with (most people I know are Christian) seem to be not at all worried about death. They are even looking forward to that heavenly reward. And when I was a Christian I assumed God would take me when He was ready; I would think keeping me alive would be people trying to fight God’s decision. It would be one thing if there was a big chance you’d recover, but you didn’t say that.
People die for financial reasons all the time. I mean, in the millions. Why should one person in a vegetative state with almost no hope of recovery get all the financial help to be kept alive via machines when another person can’t even get proper treatment for cancer because their insurance didn’t cover that treatment? There’s kids out there who die of easily treatable illnesses because their government will steal any money or meds trying to get to their little villages. If it was a choice between me saving 2000 children from dying of smallpox I’d do it over one person who’s been existing in a vegetative state for the past six months. It just seems more compassionate overall.
And you and everyone else should do exactly that. And you should assign someone Durable Power of Attorney for Health Care and you should - here’s the key - make sure they know about it and have a copy of the paperwork at all times!
I can’t tell you how many people come into the hospital and tell us they have a DNR or a Living Will or a PoA, but they don’t have it with them, and they’re not sure where it is. That sucks. We can’t follow it if we don’t have it!
People want different things, based on religion or philosophy, experience with healthcare and hospitals, optimism or pessimism…all of it’s fine, really, but you have to let people know what it is you want so we can provide that.
And yes, financial strain certainly is a valid consideration in health care across the spectrum, not just end-of-life care. It sucks, too, but it’s reality. I’m not going to try to talk you out of your position, but I will say that I, personally, am not willing to bankrupt my children or partner for a slim chance that I might survive in the long run, and I don’t want them struggling with that emotional/moral decision on their own, so I’ve stepped in and given them MY answer, in writing.
I don’t know much about these things. But there was a story I read not too long ago about a college student who got into a fight late one night, and got his head stomped in. Initially the kid was in a “coma” and it was my understanding that you can take traumatic head injury and “come back from it.” And if that is going to happen you will come out of the coma in a few weeks to a few months and can make a full or partial recovery.
In the case of the kid I’m thinking of, he just ended up in a state which sounds just like PVS as you describe it. He came out of the coma but aside from ability to breathe/swallow he really can’t do anything, he can’t control his movements, has no interaction or ability to interact with people or understand anything. Basically he’s just a living entity that can eat, digest, breathe, but not much more. My understanding is once a certain amount of time has passed from the initial head trauma, you either end up like that kid (which usually means you never get much better) or you come out of the initial coma and start showing signs of recovery and can eventually end up “okay.”
Perhaps God wants me to be on life support considering there is the technology, eh?
I would heartily say “yes” to that but the problem is we can’t do much about those children while we have control over ourselves and have influence over our family.
I’d pull the plug and expect the same for myself if I were in the situation, have told all my siblings and my partner that that’s what i want.
Calculated risk. Does one take the gamble that their life, in this situation, has a very small chance of returning to some level of functioning after being in such a state, or does one weigh the odds and decide the medical bills are too high for that tiny a chance? It’s up to each person to weigh these out for themselves.
The thought of dying is scary, especially if one believes, as I personally am inclined to, that it’s the same as having a complete, permanent brain shutdown. Yet the thought of having a partial, permanent brain shutdown is so much scarier that I’d rather they pull the plug.
After several months, pull the plug. For a few months there is a chance at some recovery. After that I don’t want to be a burden on my family. I’ve talked to my family, they feel the same.
Everyone has to die. I don’t even think that’s a scary thought (and I’m not an afterlife believer). I think being without those I love in this life is the scariest part of someone else dying (and thinking of them being without me is the scariest part of me dying). If someone is in a long term vegetative state, that’s already happened. And if they were to “wake up” - they wouldn’t be the same.
For me, it also hinges on the fact that “some level of functioning” isn’t the way I want to live my life. At a bare minimum, I want to be able to communicate - if not with my voice, then via a computer - and I want to be able to touch my loved ones and feel it. If I can recover far enough to eat and eliminate, but I can’t communicate or feel anything, that isn’t enough functioning for me to live with. And if I’m not at least *beginning *my recovery within a couple of weeks, that’s just not statistically likely.
“Living” like that is far, far scarier to me than death, even if money *were *no object.
And, just to add to the panic, I recently, thanks to a thread by **blinky **here on the Dope, learned about “Locked In Syndrome”, which is probably what at least some patients with long term “comas” or “persistent vegetative states” are actually suffering from. Ghastly, just ghastly. And, as far as I know, differential testing for Locked In Syndrome is NOT routinely done, so it’s impossible to know how many people in “comas” really aren’t, and are completely aware of everything going on around them but utterly unable to rouse anyone’s attention. shudder