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because of the fear that they could never be withdrawn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


     Normally one week at a time should be satisfactory.
If the authorization form does not have such a provision, write it in:
"This treatment shall end on [a specific date] unless it is re-authorized."
This will avoid being attached to a machine for months or years
because no one wants to 'pull the plug'.
Life-supports should solve our medical ills, not create new problems.

     You might think of life-support systems as experimental treatments:
You will try them for a reasonable time to see if they do any good.
But if the life-support systems do not lead to recovery,
they will automatically terminate at the end of the trial period.


  The selection above is the beginning of Question 14 from the book:
Your Last Year: Creating Your Own Advance Directive for Medical Care.
If you click this title, you will see the complete table of contents.
This discussion of life-support systems continues for three more pages.
If you would like to see one person's Answer to this Question,
go to James Park's Advance Directive for Medical Care.
Scroll down to Answer 14.


If you would like to explore terminating life-support systems more deeply,
read Chapter 39 of How to Die: Safeguards for the Right-to-Die:
"Pulling the Plug: A Paradigm for Life-Ending Decisions".

Go to the index page for Your Last Year:
Creating Your Own Advance Directive for Medical Care.


Go to the Portal for Advance Directives.


Go to the Right-to-Die Portal.


Go to the Medical Ethics index page.


Go to the DEATH index page.


Go to the beginning of this website
James Leonard Park—Free Library