Question 14: How long should you be maintained by life-supports?
Life-support systems are useful for supporting some bodily functions,
keeping the patient alive during periods of serious physical collapse.
Life-supports were invented for acute care.
But more and more they are being used for terminal care.
In fact, when we hear that people has been put on "life-support",
we often take this to mean that they are dying.
Life-support systems include several machines and procedures:
(1) respirators—which provide mechanical assistance with breathing;
(2) heart-lung machines—which circulate oxygenated blood
(which is essential, for instance, during heart operations);
(3) drugs that can stimulate the heart or dilate arteries;
(4) intravenous fluids that can provide nutrition and hydration
during periods when the patient cannot eat, &
(5) feeding tubes inserted into the stomach or intestines,
so the patient can be fed even when unconscious
or otherwise unable to eat enough to sustain life.
In the future, new life-support systems will be invented.
From the layperson's point of view, these are "tubes and machines".
Before we discuss when to withdraw life-support systems,
we should dispose of a common misunderstanding
concerning initiating life-support systems.
Some laypeople believe that once a machine has been attached,
it is not permissible to detach it.
Some doctors and nurses have also shown this misapprehension.
But it is not true. The right to attach or detach life-support systems
is not controlled by any previous facts of being attached or not.
Thus there should be no reluctance to begin life-support systems
because of the fear that they could never be withdrawn
if they do not fulfill their intended purpose.
This false worry could lead some people to forgo life-saving measures
because they believe "once you start, you can't stop".
Whenever you authorize life-support systems
—for yourself or for others—you ought to set a termination date
for such treatment if it does not prove to be successful.
If the termination date arrives
and it still seems wise to use the life-support system,
you can re-authorize life-supports for another period of time.
138 YOUR LAST YEAR: CREATING YOUR ADVANCE DIRECTIVE FOR MEDICAL CARE