Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
The question of triage became a problem when deciding who should be placed on a ventilator (or removed) during the Corona Pandemic.---
"Many states have developed strategies for rationing during pandemics. The New York Guidelines target saving the most lives, as defined by the patient’s short-term likelihood of surviving the acute medical episode.4 Rationing is performed by a triage officer or a triage committee composed of people who have no clinical responsibilities for the care of the patient. Triage proceeds in three steps: application of exclusion criteria, such as irreversible shock; assessment of mortality risk using the Sequential Organ Failure Assessment (SOFA) score, to determine priority for initiating ventilation; and repeat assessments over time, such that patients whose condition is not improving are removed from the ventilator to make it available for another patient.
Anticipating the need to allocate ventilators to the patients who are most likely to benefit, clinicians should proactively engage in discussions with patients and families regarding do-not-intubate orders for high-risk subgroups of patients before their health deteriorates. Once patients have already been placed on mechanical ventilation, decisions to withdraw it are especially fraught. Less than 50 years ago, physicians argued that withdrawing a ventilator was an act of killing, prohibited by both law and ethics. Today, withdrawal of ventilatory support is the most common proximate cause of death in ICU patients, and withdrawal of this support at the request of a patient or surrogate is considered an ethical and legal obligation. Withdrawal of a ventilator against the wishes of the patient or surrogate, however, is primarily done only in states and hospitals that permit physicians to unilaterally withdraw life support when treatment is determined to be futile."
"The sequential organ failure assessment score (SOFA score), previously known as the sepsis-related organ failure assessment score,[1] is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure.[2][3][4][5][6] The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems."
I think the only "cut and dried" case in which physicians should decide to just let someone die (meaning without getting the permission of the next of kin) is if the person is brain dead -- meaning that no activity has been detected in the cerebrum whatsoever for at least one hour. (I don't think that EMTs should make that decision.)
I do, however, fully support the idea of living wills in which the person decides what kind of life saving should be given under which circumstances.
And that being said, if I was in a position in which I had third degree burns over 20% or more of my body or if I was left permanently paralyzed as a result of an accident, I would want to die -- but I realize that I am probably in the minority here.
At what point is it best to not save the lives of accident victims?
Take for instance a young child, that had half their body crushed, sustained a TBI and won’t ever talk again because of trachea injuries.
The child will be a dependent for the rest of her life. She will never live a normal life. I just can’t imagine wanting to subject a child to a life of wheelchairs, never speaking, getting married, having children, eating without feeding tubes....Why do we do this to ourselves?
Being in a wheelchair is not the end of the world. People in wheelchairs get married and lead great lives.
There are a bunch of non-disabled people who never get married or have children. Some people have illnesses that require feeding tube or ostomy bags. Yet, they can also have great lives.
You seem to have a very narrow view of who can thrive in life.
I think it becomes apparent when someone survives a horrible accident, but they wish they did not.
Exactly.
This child has had a dozen life saving surgeries since October. She is still not much more than a vegetable. I would have said one of those dozen times, would have been the time to say no more...
This child has had a dozen life saving surgeries since October. She is still not much more than a vegetable. I would have said one of those dozen times, would have been the time to say no more...
We don't know who this child is to you, but I will say that i am sincere in my hope that she is not your child. Having spent 40 years as a disabled children's advocate and volunteer, I can understand and sympathize how truly difficult a path it can be for a parent and in many cases a marriage to have a child with a disability.
I know only too well the questions that arise, but I recently posted this in the parenting forum and I hope it is taken to heart.
We don't know who this child is to you, but I will say that i am sincere in my hope that she is not your child. Having spent 40 years as a disabled children's advocate and volunteer, I can understand and sympathize how truly difficult a path it can be for a parent and in many cases a marriage to have a child with a disability.
I know only too well the questions that arise, but I recently posted this in the parenting forum and I hope it is taken to heart.
I remember reading that essay a long time ago. I think that essay may be overly optimistic, considering the condition that some children wind up in after suffering a catastrophic injury.
Regardless, and no matter how catastrophic the injury that a child might suffer, I did find myself flinching at the OP's use of the word "vegetable" to describe the child. That's not a word I would use to describe any child, for any reason.
I remember reading that essay a long time ago. I think that essay may be overly optimistic, considering the condition that some children wind up in after suffering a catastrophic injury.
Regardless, and no matter how catastrophic the injury that a child might suffer, I did find myself flinching at the OP's use of the word "vegetable" to describe the child. That's not a word I would use to describe any child, for any reason.
Like I said, I have been party to many families and their struggles with a disabled child, but the one common denominator in all the ones that were successful was that while the work was hard and often times a struggle, they accepted the fact that their child was with them for a reason and wanted to make the best life they could for that child and themselves. Of course that essay is very optimistic, but the point (it was written by a parent of a Downs Syndrome child) was a universal one, that you have to remind yourself to enjoy every day with this child, who through no fault of their own are not only here, but here with a disability.
While it will never minimize the trials, tribulations and grief of a parent of special needs child, I believe it helps in all things in life to make the best of what ever life sends our way. The other quote often heard in the disabled community was the barn burned down but now I can see the sunrise.
Like I said, I have been party to many families and their struggles with a disabled child, but the one common denominator in all the ones that were successful was that while the work was hard and often times a struggle, they accepted the fact that their child was with them for a reason and wanted to make the best life they could for that child and themselves. Of course that essay is very optimistic, but the point (it was written by a parent of a Downs Syndrome child) was a universal one, that you have to remind yourself to enjoy every day with this child, who through no fault of their own are not only here, but here with a disability.
While it will never minimize the trials, tribulations and grief of a parent of special needs child, I believe it helps in all things in life to make the best of what ever life sends our way. The other quote often heard in the disabled community was the barn burned down but now I can see the sunrise.
I wonder whether people who have a strong faith are more likely to do better in such situations, than those without a strong faith or a connection to some kind of spiritual beliefs? Have you observed this in your experience (if you don't mind saying)? Thanks for your perspective on this painful subject.
Last edited by Rachel NewYork; 04-06-2021 at 02:19 PM..
Parents can't do all the parenting alone, and making them try is one of the huge mistakes of the USA. Extended families and communities that share parenting work also share the decision of maintaining or ending an invalid's life.
Parents can't do all the parenting alone, and making them try is one of the huge mistakes of the USA. Extended families and communities that share parenting work also share the decision of maintaining or ending an invalid's life.
I agree. That is how other cultures have handled it. The burden is shared, as are the decisions. Really alleviates the burden for the individual.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
