Moving thread from IMHO to Great Debates.
If there’s a realistic chance of recovery (let’s say 5% or greater, in the opinion of medical experts), I’d keep them plugged in for awhile and see what happens. But if a couple of years pass and there’s no apparent progress, I’d be willing to let them go. That’s what I’d do if I had Power of Attorney over a loved one, and what I’d expect a responsible person to do for me.
This may be apropros of nothing, but I’ve always found it odd that so many of the people who cling tenaciously to life at any cost are also very religious. If you truly believe you’ll have an eternity of bliss awaiting you, why would you want to linger in a barely conscious state (if there’s consciousness at all) for years and years? If you had any awareness at all, wouldn’t it be agonizingly boring?
A coma is different than a PVS - a coma is simply a state of prolonged unconsciousness. It can have many causes, not all of them related to permanent brain damage. So people do wake up from comas in pretty good shape sometimes. Some never regain consciousness and some do, even after many years. It depends on the severity of the injury which caused the unconsciousness. And of course, our understanding of neurology is still in its infancy.
The outcome and the difference between whether a patient has a mild or severe coma, or if the patient advances to the vegetative stage, and then recovers or fails to recover from that, all depend on the site and severity of the initial brain injury. Also, a deep coma is not necessarily more dangerous than a mild coma - it depends on the type of brain trauma. There’s so many more variables there’s no one answer, with a coma.
A vegetative state, with minimal reflexes and functioning, is sometimes a transition between unconsciousness and consciousness but sometimes it’s just an end to itself. Not all coma patients go through the vegetative state phase. A patient needs to be in a vegetative state for about four weeks before doctors will declare it a -persistent- vegetative state. (There are other criteria too.) Persistent vegetative states involve the most severe brain injuries.
Chance of recovery from a PVS is about 50% in adults in the first six months. Kids have a somewhat better chance of recovery since their brains are more plastic. After about six months, chance of recovery falls off. At the point, the brain has pretty much healed itself to the best of its ability - like an untreated broken bone will heal improperly - and what you see in the patient is likely to be all you ever get.
No freaking way – I’ve told my family if I’m ever in a PVS, that if they don’t pull the plug, when I DO eventually die, I’ll come back and haunt them for the rest of THEIR lives. 
My great-aunt called last week to talk to my father – she told me that my uncle is on various machines, and that if it comes down to putting him on a ventilator, there’s no way she’s going to do it. (He’s been sick for a while now)
Qin – that’s certainly your choice. However, there comes a time, I think, when there’s only so much modern medicine can do. And I’m not willing to take the risk that something MIGHT happen. I don’t want to “live” that way. And that’s MY choice. That’s not killing someone, but simply letting them die.
Let me ask you something – if one of YOUR family had a DNR, and simply said, “Please do not put me on a ventilator, or perform any extraordinary measures, or keep me alive as long as possible,” would YOU follow their wishes?
Well- how can I have them die-how can I order their death? I couldn’t do it to a stranger even more so to a family member.
So you would ignore their wishes?
Most people hold a distinction between actively killing (like putting a bullet in their head) and passively allowing someone to die. The latter is simply “letting nature take its course”. Having a feeding tube shoved down one’s throat is decidedly not natural. 100 years ago, the Terry Schiavo fiasco would have been impossible, because feeding tubes weren’t invented. She simply would have died shortly after going into that state, because she couldn’t swallow anything.
And if you don’t see a difference between actively killing someone and passively allowing them to die, you should carefully consider the logical consequence of that position. Perhaps you should start advocating Universal Healthcare. 45,000 people in this country die every year because they don’t have health insurance (we’re not actively killing them, but we’re allowing them to die nonetheless). Heck, there are about 25,000 people worldwide who starve to death every day. Why aren’t you busting your ass, working 16 hours a day and donating every penny you earn (beyond your basic subsistence need) to feed these starving people?
If they have a DNR, then that means, they tell you, “do NOT put me on a ventilator, do NOT do any extraordinary measures – LET me die.” You’re not ordering their death – you’re letting nature take its course.
You want people to honor you wishes – you’re having your own wishes drawn up in a will. But how is it all right for you to ignore the wishes and legal papers of others? In the situation with my uncle – should my aunt put him on a ventilator, even though he doesn’t want that?
There’s a difference between saying, “okay, kill them,” and “just let nature take its course.” There comes a time when you have to let go.
Look it as someone who has been battling cancer for years, and learns it’s returned. And they say, “no more chemo – I don’t want to do any more treatment.” Is that committing suicide?
If I’m ever in a permanent vegetative state, for the love of God, show me that way on national television. Sell all my assets to buy Super Bowl ad time.
How do you suppose your god is going to impart his wishes to you? E-mail, maybe? Graven stone tablets? A voice from a burning bush? Is there any chance you put too high a value on your (unlikely) survival?
Not be snarky, but… Cite? Scripture is fine for this purpose though I don’t think you could find anything to support that.
Qui, there are a number of reasons financial, ethical, and religious why a person might choose to decline extraordinary treatments, or remove a loved one from such a system. As many have pointed out, lots have people have made that decision in advance and you would be following their wishes, made of their own free will.
Let’s start with the religious argument. By interfering with that choice, you are not only disrespecting that person, but robbing them of the lone thing that supposedly is our greatest gift from god if you are of the religious persuasion. You not only are doing that, but you are presupposing the will of god. People who do this are just using god as a justification for their own choices regardless of what result they choose. As far as i know, there is nothing in the scriptures that implies an extreme sanctity of life other than “thou shall not murder”. Unfortunately god then goes on to allow an encourage the chosen people to slaughter loads of others in violent battles, provides the death peanalty for all sorts of minor infractions, and has sanctioned the killing of hundreds of thousands in the name of evangelism over time. You can’t have it both ways.
God, however, is not needed for this discussion to be made ethically. The argument can easily be made from a secular sense as well. As sapient beings, we make choices about how we wish to interact with society. Only very, very, recently have we developed both the technology and disposable income and resources to care for such people. In the past, it would be sad, but a person with such a condition would have to be allowed to die simply to preserve the rest of the family/ society from wasting resources on a useless member. That’s right, I said useless. People in comas, and PVS are useless. They contribute nothing at all. Moreover, science has proven that the recovery is extremely remote past a couple of weeks. After six months it’s nothing short of an aberration of the odds if it occurs. Logically speaking we know that nothing is going on there. We are preserving a broken machine against some hope of sudden resumation of function; one that in nearly all cases never returns. It is wrong to take that choice from the person, and wrong to squander resources that would be far better put to use treating others.
Lastly, financial considerations are also important. Are you so wealthy that paying for such care will not ruin your family? Is your arrogance and lack of ability to face reality so overriding that you would drive the others that you are responsible for into poverty? That is hardly ethical.
I couldn’t put them through it, so I’d definitely give it maybe a couple of months, then pull the plug. No one in my family wants life support anyway.