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End of Life Support: Pulling the Plug

KP

Kiarita Porro

Transcript

End of Life Support: Pulling the Plug

References

Butts, J. B., & Rich, K. L. (2008). Nursing ethics across the curriculum and into practice

(2nd ed., pp. 21-22). Sunbury, MA: Jones and Bartlett.

Carrese, J. A., & Rhodes, L. A. (1995). Western bioethics on the Navajo reservation. JAMA,

274(1), 826-829.

Goila, A. K., & Pawar, M. (2009). The diagnosis of brain death. Indian J Crit Care Medicine,

13(1), 7-11.

James, S. D., via Good Morning American (2011, December 22). Poised to Donate Organs, 21-

Year-Old Emerges From Coma [Video file]. Retrieved from http://abcnews.go.com/ Health/arizona-accident-victim-emerges-coma-poised-donate-organs/story?id=1520 8351&singlePage=true

Mani, R. K. (2003). Limitation of life support in the ICU: Ethical issues relating to end of life

care. Indian J Crit Care Medicine, 7(2),112-117

Morrow, A. (2009, November 9). Deciding to Withhold or Withdraw Life Sustaining Measures

Life Support for the Terminally Ill. Retrieved September 20, 2013, from http://dying.about.com/od/lifesupport/a/life_support1.h

Park, J. L. (2013). Pulling the Plug: A Paradigm for Life-Ending Decisions. In How to Die:

Safeguards for Life-Ending Decisions. Minneapolis, MN: Existential Books.

Szalados, J. (2007). Discontinuation of mechanical ventilation at end-of-life: the ethical and legal

boundaries of physician conduct in termination of life support. Critical Care Clinics,

23(2), 34-40.

Video Clip

http://abcnews.go.com/Health/arizona-accident-victim-emerges-coma-poised-donate-organs/story?id=15208351

Legality

Advance Directive

What is Life Support?

  • Living Will
  • Health-Care Proxy
  • Power of Attorney
  • Assists failing systems in the body

  • Creating stabilization for patients that have conditions considered treatable

  • Mechanical measures such as ventilators, blood products, nutrition, and CPR

Comatose Patient on Life Support

Brain Death

Ethical Implications in Nursing

  • veracity
  • Irreversible loss of all brain and brain stem functioning
  • Confidentiality
  • Justice
  • Autonomy
  • What is the clinical definition of brain death?
  • What is life support?
  • Pros and Cons of support and withdrawal
  • Critical decision & those involved

  • Beneficence
  • Three main components include coma state, loss of brain stem reflexes, and apnea
  • Nonmaleficence
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