Is it sinful to remove a ventilator?

[Doc_Keele]

I have a youner sister who is diabetic. She had a crisis and had to be ventilated. She was unconscious for a month and breathed using the ventilator. When we were trying to decide what to do we asked the doctor what the prognosis was. His said that he had cases such as these in the past and that he had pulled them through. Therefore he has faith that he could pull my sister through. In that case, the ventialtor is proportionate, because there is hope that the person will survive. She may not have had to live her entire life with a ventilator, but she would have been alive. To take the ventilator away would have been immoral, because it would have killed someone when there was hope.

The end to the story is that after a month my sister recovered consciousness. Today, she is at home with her husband and son. She is still attached to a ventilator and she says that it is horrible. But she is happy to be with her husband and son. Will she ever recover lung function? No one knows. Is she alive? Very much so.

As I posted before, my wife, father and seven-year old son were in an auto accident. My wife and father were killed on impact. My son was in the hospital with irreperable damage to the brain stem. He was on a ventilator. In his case, the ventilator was disproportionate. There was not way that he would live, even as a person with a disability. I made the choice to terminate the ventilator support, but keep natural supports. The feeding tube was left in place, oxygen and medications were also in place. My son died within minutes.

Have you ever had to decide when to turn the ventilator off? I have, twice. Once the ventilator was disproportionate. The second time, the ventilaor was proportionate.

Not every case is the same. The rule is to determine what and when something is disproportionate or proportionae. What is proportionate in one case, is disproportionate in another.

Fraternally,

Br. JR, OSF

Obviously the medical prognosis makes a vast difference. I wasn’t saying that ventilation isn’t a valid treatment, having worked in ITU for 6 months. Some people do well. However some people don’t.

Some people don’t benefit from feeding via NG or PEG tube. By your criterion of proportionality this is extraordinary treatment. People with Alzheimer’s disease generally shouldn’t have tube feeding.

As a doctor I’ve been involved in decisions not to start ventilation quite a few times. Personally I’ve been involved in end of life decisions as well, including the decision to withdraw parenteral fluids from a family member. And that was very definitely for their benefit.

 

[JReducation]

Obviously the medical prognosis makes a vast difference. I wasn’t saying that ventilation isn’t a valid treatment, having worked in ITU for 6 months. Some people do well. However some people don’t.

Some people don’t benefit from feeding via NG or PEG tube. By your criterion of proportionality this is extraordinary treatment. People with Alzheimer’s disease generally shouldn’t have tube feeding.

Doc, it’s not my criteron. It’s the official criterion of the Catholic Church. As fars feeding tubes are concerned, the position is also very clear. The feeding tube is not a disproportionate measure unless it is causing physical harm. The official moral response of the Church is that you cannot take a feeding tube from a patient with Alzheimer’s. There are few exceptions where you can morally deprive the patient of water and food.

That’s the law, regardless of what anyone else wants or says. It may not be done or encouraged.

Fraternally,

Br. JR, OSF

 

[GEddie]

The person who is brain stem dead is comfortable, his other organs may well be functioning normally.

“Comfortable” is a feeling. The brain stem operates consciousness as well as breathing; therefore someone who is “brain stem dead” cannot have feeling, cannot be “comfortable.” In this situation, one may argue whether or not human life remains at all, since conscious being cannot be regained.

 

[JReducation]

“Comfortable” is a feeling. The brain stem operates consciousness as well as breathing; therefore someone who is “brain stem dead” cannot have feeling, cannot be “comfortable.” In this situation, one may argue whether or not human life remains at all, since conscious being cannot be regained.

The issue of consciousness is not a determinant for moral action. The determining factor is whether or not the person can live, even with a disability. In the case of a person who is brain dead, such a person cannot live. To keep a ventilaor is disproportionate.

We may never do anything that will terminate a person’s life. Meaning that if the person had the ventilator they would live. But in the case of brain death, to the best of our knowledge, the person is not really alive. Removing the ventilator is not killing the person.

I had the same situation with my 7-year old son… We removed the ventilator and left what every human being must have until the moment of death: food, water, oxygen and meds. He was gone in a few minutes. I remember hoping against hope that he would continue to breathe on his own. But that was the father in me hoping. I was not surprised, when his chest stopped moving.

My sister, on the other hand, had a ventilator, but her brain was very much alive. She was in coma, but there were brain waves. To take the ventilator away wold have killed her, because she was not gone. In fact, she came out of the coma after a month. Today, a year later, she is still on the ventilaor, but is home with her husband and son. She gets all kinds of infections, which are typical of people with ventilators. But she is very much alive and likes being alive.

Fraternally,

Br. JR, OSF

 

[Doc_Keele]

Doc, it’s not my criteron. It’s the official criterion of the Catholic Church. As fars feeding tubes are concerned, the position is also very clear. The feeding tube is not a disproportionate measure unless it is causing physical harm. The official moral response of the Church is that you cannot take a feeding tube from a patient with Alzheimer’s. There are few exceptions where you can morally deprive the patient of water and food.

That’s the law, regardless of what anyone else wants or says. It may not be done or encouraged.

Fraternally,

Br. JR, OSF

Well that shows that the medical (name removed by moderator)ut that the Church has had has been deficient, or been ignored. Tube feeding for people with Alzheimer’s disease rarely if ever does any good, and certainly does harm. If you’re wanting to shorten the life of the patient, tube feeding is one of the ways to do it.

 

[Doc_Keele]

“Comfortable” is a feeling. The brain stem operates consciousness as well as breathing; therefore someone who is “brain stem dead” cannot have feeling, cannot be “comfortable.” In this situation, one may argue whether or not human life remains at all, since conscious being cannot be regained.

Yes, of course you’re right - but they’re certainly not “uncomfortable”, put it that way!

I have been trying to argue that someone who is brain stem dead is not a human being on another thread, but to no avail.

 

[JReducation]

Well that shows that the medical (name removed by moderator)ut that the Church has had has been deficient, or been ignored. Tube feeding for people with Alzheimer’s disease rarely if ever does any good, and certainly does harm. If you’re wanting to shorten the life of the patient, tube feeding is one of the ways to do it.

If there is a legitimate concern that the tube will hasten death instead of doing what it is supposed to do, then the question is a valid question and the alternative can be considered. Here is a very good statement that clarifies the Official Catholic Position on such questions.

usccb.org/prolife/issues/euthanas/nutqa.shtml

Read it. I think it will help.

Fraternally,

Br. JR, OSF

 

[JReducation]

Yes, of course you’re right - but they’re certainly not “uncomfortable”, put it that way!

I have been trying to argue that someone who is brain stem dead is not a human being on another thread, but to no avail.

Actually, in the Judeo-Christian tradition we hold as an infallible truth that a person who is brain dead or dead, period, is truly a human being. Human is not qualified by being alive. It is qualified by being created in the image and likeness of God. Therefore, a person who is either bain dead or dead for any other reason, must be treated with the highest respect for his dignity.

If Christians were to hold that the dead aer not human, that would require that we rewrite our entire belief system about Jesus Christ. Jesus was truly dead for three days. The resurrection would not have been possible, had he ceased to be human.

Fraternally,

Br. JR, OSF

 

[Doc_Keele]

If there is a legitimate concern that the tube will hasten death instead of doing what it is supposed to do, then the question is a valid question and the alternative can be considered. Here is a very good statement that clarifies the Official Catholic Position on such questions.

usccb.org/prolife/issues/euthanas/nutqa.shtml

Read it. I think it will help.

Fraternally,

Br. JR, OSF

…but even if it doesn’t hasten death, merely failing to provide any benefit and indeed causing suffering as is the case in the most if not all Alzheimer’s disease sufferers who can’t swallow - the Church still thinks that feeding by a tube should be the norm? I find it worrying that the powers in the Church are so ill-informed about the medical facts.

 

[Doc_Keele]

Actually, in the Judeo-Christian tradition we hold as an infallible truth that a person who is brain dead or dead, period, is truly a human being. Human is not qualified by being alive. It is qualified by being created in the image and likeness of God. Therefore, a person who is either bain dead or dead for any other reason, must be treated with the highest respect for his dignity.

If Christians were to hold that the dead aer not human, that would require that we rewrite our entire belief system about Jesus Christ. Jesus was truly dead for three days. The resurrection would not have been possible, had he ceased to be human.

Fraternally,

Br. JR, OSF

I hope you understood what I was getting at, even if it was worded imprecisely.

 

[JReducation]

…but even if it doesn’t hasten death, merely failing to provide any benefit and indeed causing suffering as is the case in the most if not all Alzheimer’s disease sufferers who can’t swallow - the Church still thinks that feeding by a tube should be the norm? I find it worrying that the powers in the Church are so ill-informed about the medical facts.

Let’s do this; read the document first. It speaks to these questions much better than I can, because I’m not a moral theologian and the authors are. Then we can discuss any points from the document. Those points I can clarify very comfortably and knowledgeably. OK?

Fraternally,

Br. JR, OSF

 

[Doc_Keele]

What’s clear is that many people who quote “chapter and verse” about withdrawing nutrition and hydration don’t understand this document. It’s certainly not a model of clarity, to be fair. This stuff about suffering caused by dehydration shows a lack of understanding of the dying patient’s physiology.

 

[Petergee]

“cruel and inhumane” were the words used
People on the Atkins diet may or may not know that the ketosis produced by the diet suppresses hunger. This ketosis effects kicks after about 3 days of fasting, hence the reason why David Blaine managed to fast for so long. Experiments were also done on conscientious objectors in the US. When a dying person is not given food or drink, often this decreases suffering rather than increases it.

The operative word being “dying”. It is immoral to deprive someone of food and drink who is not dying but merely disabled so that he is unable to or has difficulty swallowing normally.

They don’t get the “death rattle” for example.

The “death rattle” has nothing to do with suffering. It occurs after death, if the person happened to have a lunful of air at the moment of death and if he is sitting/lying in such a position that his tongue falls back in his throat when he dies, creating a rattling sound, similar to snoring.

 

[JReducation]

The moral point is always to err on the side of life, you’re going to err at all.

Fraternally,

Br. JR, OSF

 

[Doc_Keele]

The “death rattle” has nothing to do with suffering. It occurs after death, if the person happened to have a lunful of air at the moment of death and if he is sitting/lying in such a position that his tongue falls back in his throat when he dies, creating a rattling sound, similar to snoring.

Naturally being a doctor who has attended many dying patients I don’t know what a “death rattle” is
Nor do all the MacMillan nurses

 

[Petergee]

Naturally being a doctor who has attended many dying patients I don’t know what a “death rattle” is
Nor do all the MacMillan nurses

Sorry if I misunderstood you, but your statement *“When a dying person is not given food or drink, often this decreases suffering rather than increases it. They don’t get the “death rattle” for example.” *seemed to imply that you thought that the death rattle is a sign of suffering.

 

[Doc_Keele]

Sorry if I misunderstood you, but your statement *“When a dying person is not given food or drink, often this decreases suffering rather than increases it. They don’t get the “death rattle” for example.” *seemed to imply that you thought that the death rattle is a sign of suffering.

It is a sign of suffering, it occurs before death rather than after it as you were saying.

 

[lp22]

I’m alive because of an artificial hormone pill. A ‘natural death’ for me would’ve been at 50. Moms alive because of an artificial heart valve. Her ‘natural death’ would’ve been at 67. My girlfriends alive because of a liver transplant at 42- but it’s not hers. My other girlfriends alive because of a dialysis machine she started on in high school.

Define’extraordinary?’ (Stephen Hawkings on vent 50 years)

The nurses at hospital are telling me to pull moms ventilator simply because she won’t have THEIR idea of quality of life.

That’s the thing: where does it end?

One last thing: we train people to talk people out of killing themselves.

 

[Iheartcoffee]

The National Catholic Bioethics Center will be the best provider of an answer to end of life questions.

 

[lp22]

More food for thought. Just researching myself. Brain dead patients revive

news.yahoo.com/brain-dead-doctors-said-yes-patients-proved-otherwise-221600587.html

Medical dictionary lists these as forms of life support, all artificial. Maybe cuz the vent is so bulky right now we consider it most burdensome. That will surely change.

The treatments of life support include:
Oxygen
Intravenous fluids with sugar and basic salts
Drugs to improve circulation and other body functions
Antibiotics
Transfusions
Surgery
Nutritional supplements by vein or stomach tube
Tubes in body cavities (chest or abdomen) to relieve fluid buildup
Dialysis
Pacemaker
Electrical defibrillation
Various machines to assist heart or lung function
Transplantation of organs or mechanical substitutes (artificial heart)
Sedation or even temporary paralysis to enable the patient to tolerate these procedures

They left out the particulars people are doing to stay alive daily. Like hormones in cases of gland failure.