Tuesday, November 16, 2010

Keeping Them Alive Because You Love Them.

Michael Vitez writes for the Philadelphia Inquirer's online site, philly.com, about the legal and emotional challenges of end of life care that often looks like undue pain and stress for the dying. It's a shocking article about futile care and medical proxies. I suggest you read the entire thing at the link above but here's a clip, below.

I ask, in all sincerity, what the difference is between Prince and Terri Schiavo's family who wished to keep Schiavo alive because she was "completely vulnerable" to them? Not only does the conundrum of futile care and proxy decision-making cause us to think about the economics of health care but, more importantly, about how we love.

And how, as Vitez rightly asks, do we as a culture determine what is best for the patient?

Prince Pulido loved his mother. She named him Prince, after all.

And he couldn't let her go.

It didn't matter to him that nurses at Abington Memorial Hospital thought he was harming her by keeping her alive, or felt he was unrealistic - believing that stem cells could regenerate her brain.

This was his mother, she wanted to live, and she had always bounced back.

For more than a year, Maria Pulido was kept alive on a ventilator. She had respiratory failure, heart disease, dementia, and diabetes, and had both legs amputated, one after gangrene. By last winter, medical records show, she was in or near a coma - unresponsive, couldn't follow commands, would react only to pain.

Prince knew different. She smiled at him. He saw the gleam in her eye.

On May 14, the breathing tube in her throat got clogged and fell out during suctioning at a nursing home. She went without oxygen for 10 minutes and suffered brain damage. Even Prince could see her stare was blank. Still, he continued life support.

He believes in God and in miracles. He's a Philadelphia fireman who races into burning buildings. There's always hope.

Ten times between June 2009 and July 2010, Maria Pulido went by ambulance from a nursing home for ventilator-dependent patients to Abington's intensive care unit, where she spent 69 days and accumulated charges of $1.2 million.

What, if anything, should America do when families insist on continuing life support even though doctors and nurses believe it just prolongs dying?

(h/t Carla Axtman)

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