“I don’t want to be on a breathing machine?”
How many times have you heard people say that? Yet everyday people are injured in accidents, and need the help of a ventilator or breathing machine to help them breath if they are severely injured.
When you have a loved one, involved in an accident your emotions are all over the place. You are confused, anxious,scared,distraught, numb and in shock. All of a sudden you are hearing big, medical words that you don’t have any clue what they mean from doctors and nurses caring for your loved one.
Trying to discover the meaning of what they are saying is like learning a foreign language.
I remember the first house my husband and I bought in Auburn, Alabama, we had no clue what all the terms meant, or what we were signing. Terms like, EMD (earnest money deposit) points,escrow,settlement were foreign to us. Now they are second nature to me having been an Ann Arbor Realtor for 18 years.
Seeing your family member on a ventilator can be frightening. But, it doesn’t have to be if you understand what it means and how it is aiding in your loved ones recovery. On my quest to understand “brain death” after my son’s car accident, I learned about ventilators and why the common term breathing machine is misunderstood.
Ventilators
1) The ventilator is a machine that moves air and oxygen into the body.
2) Being on a ventilator is a good thing when you are seriously injured.
3) Being on a ventilator that is effective at supporting the vital activity of respiration means that you are not dead. A dead person does not breathe OR HAVE RESPIRATION.
A ventilator uses pressure to blow air or a mixture of gases (like oxygen and air) into the lungs. This pressure is known as positive pressure. You MUST exhale (breathe out) the air on your own.
Ventilation is the movement of air, while respiration is the exchange of oxygen and carbon dioxide. This exchange occurs in the lungs, as well as in the living tissues throughout the body via the circulation. Ventilation and respiration are essential requirements for life on earth to continue. Respiration in the lungs takes oxygen out of the air to be used by the body in exchange for carbon dioxide exhaled out of the body into the air.
One critical thing to know about being on ventilation is that the ventilator does not cause you to respire. Respiration is being done by the patient. A dead person can not respire. If you encounter this situation don’t be afraid. The ventilator is helping your loved one…it is a good thing…it is helping them complete the whole cycle of breathing.
It is helping preserve the life of your love one.
Dr. Paul Byrne in this article, “In other words, a ventilator moves air; it does not and cannot cause the other part of breathing–respiration; that is, it does not and it cannot exchange oxygen and carbon dioxide that occurs in lungs and body tissues. Respiration can occur only when the body’s respiratory and circulatory systems are otherwise intact and functioning properly.Respiration is human function, not machine function.”
The ventilator is helping the patient to breathe easier thus allowing them time to recover. It is important to understand what is happening if you have a loved one on a breathing machine so you are not frightened and can grasp that if your loved one was truly dead it would not work. I wish I had understood what was really occurring while Jamie was on the Ventilator.
My questions for you are:
1) Do you think it is morally permissible to disconnect the ventilator?
2) Who should be making that decision? You via a written life directive, your family,or the doctors?
Let me know your thoughts in the comments, no right or wrong answer just curious.
***I’ll be linking to this post throughout different posts so you can remember why being on a ventilator is important.***
Please remember that without ventilators there would be no organ donation. So I don’t know how “in Gods hands” comes into this discussion specifically about ventilators. You should have a separate column called “Let’s put love instead of hatred into doctors’ hearts through God.” Or something like that. Extending life is not God’s job. Kindness and compassion which cause an educated doctor to do his best with today’s medical tools is “God’s hands.” YAY.
Removing the ventilator is a touchy subject for many. I work closely with this topic, both in my roles as a hospice chaplain and a chaplain in the hospital context. I worked in the Level One Trama Center, and am still associated with that hospital. Our facilities are the destination hospitals for Indiana and other nearby states when “the most terrible thing” happens. This pertains to auto accidents, race track crashes, and other sports injuries. Ventilators and other mechanical support is a big deal for us. I’m sure that I should say that I am not a spokesperson for our hospital system and they would likely reserve the right to disavow what I am about to say. I simply want to speak to what I have observed.
Simply put, most ethicists would agree that since ventilation is an addition to the normal, what is often termed ‘an heroic measure,’ removing it is not killing or murder. Many family members can feel like it is. This is why it is important for everyone to prepare their own Advance Directives; spokespeople are then doing just that, speaking on behalf of someone who cannot voice their own wishes. By the way, there is a new form passing through the state houses of most States, called POLST (Physician Orders for Life Sustaining Treatment) or POST in some places such as Indiana. POLST is very thorough in what a person can accept or decline (in collaboration with your doctor) with regard to mechanical and chemical support, especially for a code, but it also addresses treatment for infections at end-of-life, etc. I recommend you check it out.
Some might say “but if I can use the mechanical support, shouldn’t I?” I cannot speak for the practices of other places, but there is a time when ventilator support becomes ‘futile care’ (it is evident that the patient’s body is shutting down anyway), and our facilities would not remove someone from ventilation unless there was no hope for recovery. This tenacity to treat also extends to the indigent, by the way, since our care is not dependent on a patient’s ability to pay. Medicine is truly an art, and not a science, because this is a very gray period (as opposed to absolute black and white). There is no ‘right’ or ‘wrong’ here, because we are not God and cannot accurately predict a patient’s outcome. Consequently, when we enter into the futile care stage, the question is no longer prolonging life, but instead prolonging death.
At end-of-life, or when ventilation becomes futile care, it might be the most helpful to consider that removing the ventilator is simply allowing God to completely have His way without human participation. I have seen one person survive a ‘mechanical wean,’ what medical personnel call ‘pulling the plug.’ But I have been with possibly hundreds more who do not. In either case, it was left up to God.
Most hospitals have Futile Care Protocols, I found U of M’s online. People should try and find their hospitals and read it.
Yes, we are not God, YAY! That is why life is in His hands, and since brain death is not true death it is the deliberate killing of another person to give life to another one.
Ventilation can prolong the life of person, while they recover. If they can’t recover or are denied treatment to help them recover or don’t want to be on a Ventilator then your are correct a Life Directive is best. But, how many people have them?
My issue is not end of life with older people who have a disease that can not be treated, that is cruel to keep them ventilated. But for someone is an accident, ventilation is not extra ordinary treatment but life sustaining.
I’ll do some researching on POLST. Thank you!
You are correct, a ventilator is a good thing. But being on a ventilator puts your life in jeopardy, because the doctors will say that you are brain dead, that you have lost the ability to breathe on your own. This is not true. When you are in trauma and shock, your body needs help time until you can recover and mend. Thank you, Missy for telling the facts! I think you should write a mini, a survivors guide for when you find yourself or a loved one in the E. R., or I.C.U.
Carolyn, that is what I hope to do in the book. Started here on the blog. Hope all is well, think of you often.