Unplug or not unplug, that is the question. (Coma)

[alingy1]

There is a hypothetical case of a coma.
I want to know if doctors have the right to unplug the person.
What happens when the chances of waking up are very nil?
What happens when the chances of waking up are low and it can take several years for the person to wake up?
I read this article which says medically futile life sustaining treatments are left to the doctor's choice. http://www.fammed.ouhsc.edu/Palliative-Care/documents/Medically Futile Care.ppt

But, I heard doctors cannot unplug people like that. What's the deal?

 

[Pythagorean]

Once all that remains is the hindbrain, then it's just autonomous functions (heart/lungs). The person is essentially lost. I have heard stories of people "coming back" from brain death (such as Suzanne Chin) but they are very rare and are most likely cases of misdiagnosis rather than genuine recovery.

While Dr Kwek said he could not comment as he did not know the full details of Ms Chin's case, he reiterated that it is not possible to recover and regain consciousness after brain death has occurred.
He added that no such case has ever been reported in medical journals.
"So if anyone were to claim so, it would only be logical to presume that either the diagnosis of brain death had been made in error, or that the patient's family had misunderstood what had been told to them by the doctors," he said.

http://yourhealth.asiaone.com/content/meet-brain-death-expert#sthash.KuKl0Jw7.dpuf

 

[TheAbsoluTurk]

I say one should leave the choice to immediate relatives. Personally, I would not take a relative off of life-support. Arguments that keeping 'brain dead' people alive are straining the system are fundamentally wrong because tax-funded medicine should not have taken up that responsibility (if they would later claim that the comatose are straining the budget.)

 

['roidbreaker]

... most likely cases of misdiagnosis rather than genuine recovery.
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do you know if a biopsy is performed during diagnosis?

 

[turbo]

This would be a great time to explore the value of a living will. Would you want extreme efforts made to prolong your life, and under what circumstances? My mother was vegetative (at best) for a week before our family could come to grips with the situation. Not good. Internal strife in the family was horrible, at best.

My wife and I have living wills drawn up by a lawyer friend of ours, and at least they give some guidance to family as to our wishes should really bad stuff come down.

Good luck.

 

[Evo]

I need to get another living will done and hide it from Evo Child, she destroyed the last DNR I had drawn up. She says she will not let then pull the plug on me. :( I want no extraordinary measures taken to try to resuscitate me. I don't want my family paying to keep me on life support.

 

[russ_watters]

I read this article which says medically futile life sustaining treatments are left to the doctor's choice. http://www.fammed.ouhsc.edu/Palliative-Care/documents/Medically Futile Care.ppt

That's not really what it says. It says that futile treatments can be refused, but only in two states and only after attempting to transfer the patient to another facility willing to comply with the patient's/power of attorney holder's wishes.

 

[Pythagorean]

do you know if a biopsy is performed during diagnosis?

Not that I'm aware of:

In 1968, an ad hoc committee at Harvard Medical School reexamined the definition of brain death and defined irreversible coma, or brain death, as unresponsiveness and lack of receptivity, the absence of movement and breathing, the absence of brain-stem reflexes, and coma whose cause has been identified.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772257/

The above review also includes a lengthy description of the determination process; I haven't read it word-for-word, but it looks like it's mostly nonintrusive tests and a blood sample. Basically, a properly functioning brain should still reproduce standard reflexes that can be tested behaviorally.

 

['roidbreaker]

sage

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772257/

this disturbs me greatly!

I'm not qualified to argue against these practices though.

 

[Evo]

this disturbs me greatly!

I'm not qualified to argue against these practices though.

That is only for policy in India.

Measures vary worldwide.

http://www.ncbi.nlm.nih.gov/pubmed/11781400