YWN Coffee Room

YWN Coffee Room » Health & Fitness

1. feivel
   talmid

   OKLAHOMA CITY - Four months after he was declared brain dead and doctors were about to remove his organs for transplant, Zach Dunlap says he feels "pretty good."

   Dunlap was pronounced dead Nov. 19 at United Regional Healthcare System in Wichita Falls, Texas, after he was injured in an all-terrain vehicle accident. His family approved having his organs harvested.

   As family members were paying their last respects, he moved his foot and hand. He reacted to a pocketknife scraped across his foot and to pressure applied under a fingernail.

   "I feel pretty good. but it's just hard ... just ain't got the patience," Dunlap told NBC.

   Dunlap said one thing he does remember is hearing the doctors pronounce him dead.

   His father, Doug, said he saw the results of the brain scan.

   "There was no activity at all, no blood flow at all."

   His mother said her son is doing "amazingly well," but still has problems with his memory as his brain heals from the traumatic injury.

   "It may take a year or more ... before he completely recovers," she said. "But that's OK. It doesn't matter how long it takes. We're just all so thankful and blessed that we have him here."

   Posted 3 years ago #

2. qwertyuiop
   Member

   wow feivel this is mamish a neis.$

   Posted 3 years ago #

3. feivel
   talmid

   qwert

   not the first time this has happened, not by far.$

   Posted 3 years ago #

4. qwertyuiop
   Member

   feivel: so why doesn't it make it a neis, just because it happened moe than once??$

   Posted 3 years ago #

5. feivel
   talmid

   qwert
   i didnt mean to imply it wasnt a neis, just that it wasnt unique$

   Posted 3 years ago #

6. qwertyuiop
   Member

   feivel: i never said it was unique, i just said that it was a neis.$

   Posted 3 years ago #

7. Joseph
   Sometimes A Bit Over The Right

   This brings to mind the judicial murder of Terri Schiavo.

   Posted 3 years ago #

8. mw13
   Member

   why does everyone's post end in a $?

   Posted 3 years ago #

9. SJSinNYC
   always pleasant

   Unfortunately, it may take a long time until they learn.

   Add in the cost of keeping "brain dead" people alive for extended periods of time, insurance companies may write new terms that limits what they have to cover. This will make people decide if they have the funds to keep their loved ones on support.

   Posted 3 years ago #

10. moish01
    Member

    it costs a fortune. even wealthy people wouldn't be able to keep it up for more than a few years.
    joseph, yeh i was thinking the same thing when i was reading the first feivel's post.

    Posted 3 years ago #

11. notpashut
    Member

    Sjs,
    Just to start up with you, what does your MO Rav hold of brain death?

    Posted 3 years ago #

12. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    So why do we care about the injustice of cases like Terri Schiavo?

    SJS, you bring up a good point about healthcare that is SCARY to think about. Ultimately, healthcare is and must be rationed. The need for rationing will only increase with time (as more people gain access). Not everyone can get all the healthcare they need, so the obvious question is, isn't it a waste of care that could be applied to someone who could better use it???

    Posted 3 years ago #

13. moish01
    Member

    squeak, speak to someone who has a family member on life support. for them there is no "better use" than to keep their family member alive.

    i have a close friend whose grandfather was injured terribly. it must be over ten years ago by now. he's been on life support ever since. he's alive, but they claim he has no brain activity. the rabbonim even said to stop davening for a refua for him. but he's still here. speak to any of them - there's no way in the world they'd give it up.

    Posted 3 years ago #

14. Curious
    Member

    ames - each case is so different. You must ask a competent Rav!!

    Taking someone offlife support is so much more complex than signing a DNR/DNI with a Rav's consent. I know of a case of someone with a brain injury on life support, eventually declared competely brain ead, etc. The family consulted with many rabonim. Taking the person off the respirator was NOT an option. However, there was an opinion that perhaps they might be able to allow the bag of IV medication to run out and not replace it with a new one. Thus they wouldn't be actively ending life support, but rather it would come to a point where the meds would run out and they wouldn't start a new bag (similair concept to not initiating intubation as opposed to removing the tube).

    Posted 3 years ago #

15. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    Good point, moish, but that is exactly the issue. Rationing is necessary because every individual thinks that they should get everything that is possible to get. But from a broader perspective, that is not always the most utilitarian choice (not that I am endorsing that point of view).

    To give an example of rationing that goes on all the time, think of organ donation. There is a huge waiting list for organs. Hospitals have to prioritize people on the list - so people have to wait, sometimes for a long time, and sometimes they never get. Meanwhile, because of the current thinking in the medical field, the person whose need is the most immediate gets the first call, even if they may have no chance of surviving. Obviously, those people and their relatives think that they should get the organ, but is that really true? Wouldn't it be "better use" to give it to someone who could resume normal life with a transplant, rather than someone who will be buried with the transplant in 3 months?

    Posted 3 years ago #

16. moish01
    Member

    sure i agree with you. but you have to realize that it depends on who you're talking to.

    Posted 3 years ago #

17. Joseph
    Sometimes A Bit Over The Right

    squeak, can you clarify your point (and position) vis-a-vis Terri Schiavo?

    Do you agree she was murdered in cold blood by corrupt Judges and her abusive unfaithful husband?

    Posted 3 years ago #

18. Curious
    Member

    Meanwhile, because of the current thinking in the medical field, the person whose need is the most immediate gets the first call, even if they may have no chance of surviving

    That is totally not correct. The person with a poor prognosis is not even put on the transplant list in the first place.
    Similairly, in most overcrowded ICUs, those with a poor prognosis will get transfered to a regular unit with less life-saving interventions available, so that those with a better chance will get the better ICU care.

    I DO NOT know the halachic perspecitve on this issue, and I would be very interested to know.

    Posted 3 years ago #

19. kapusta
    CR Queen - “Best of luck. Avoid roasted cabbage, don’t eat earwax, and look on the bright side of life!”

    notpashut- I really dont want to start anything, but could we stick to more sensible comments?

    Posted 3 years ago #

20. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    Curious - you are mistaken. I know of one patient who received 3 organ transplants and never rose from the hospital bed (nor was expected to beforehand). The transplants merely extended the patient's life by a few months. The nurses indicated that this was not uncommon, and that the person with the most immediate need gets Priority 1.

    Joseph, I do agree that she should not have been removed from life support, considering the circumstances. But on a larger scale, I see the issue of healthcare rationing as a very big monster growling in the background. When this issue comes to the forefront, cases like this one may be an obvious cut and then the point will be moot.

    Posted 3 years ago #

21. anon for this
    Member

    squeak,
    In the incident you cited of the patient who received 3 organ transplants, which organ/ organs are/ were involved?

    Posted 3 years ago #

22. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    liver, kidney and heart.

    Posted 3 years ago #

23. areivimzehlazeh
    Member

    This is absolutely ridiculous. How can you/we take someone off life support? Where are our torah values? (yes, I read all the chalukei dayos when that Halberstam kid was going through just such a situation.)

    Posted 3 years ago #

24. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    Let me be more clear then.

    I/we cannot decide to take someone off life support in any circumstance. If such a question arises, it is the duty of the next-of-kin to get a psak from a competent Rov. End of story.

    I was talking about the issue that the world is facing about limited supply/unlimited demand for healthcare. My point was (is) that there will come a point where rationing will be a forefront issue, instead of a behind the scenes one as it is now. When that happens, the individual may not be able to decide to have a hospital dedicate resources to his/her relative just because he/she wants it that way.

    Hashem Yishmor.

    Posted 3 years ago #

25. Joseph
    Sometimes A Bit Over The Right

    squeak - why do you presume rationing will become more of a forefront issue than it currently is?

    Posted 3 years ago #

26. Curious
    Member

    squeak - You know of one case. I know of many. Yes, many people, including children, are not receving transplants because they have a poor prognosis and/or they have other conditions that will most likely cause the transplant to be rejected. Those that are determined to have a lasting benefit will be put on the transplant list. Of those, the one with the greatest need usually gets bumped up.

    In terms of rationing, it's happening already, every day. Read what I wrote about ICUs. Yes, families want more aggresive care, but the hospitals cannot give ICU care to everyone. The sickest with the most potential to recover will get that care.

    Posted 3 years ago #

27. havesomeseichel
    Member

    How is signing a DNR categorized? Is it allowing suicide?
    About rationing of organs, unfortunately there is a bigger demand then supply. Many people, whether for religious or other reasons, will not allow their organs to be harvested. I know of someone who was niftar because they needed a bone marrow transplant. In case you dont know, anyone who is a match can give it, and it does not harm the giver in the long run- and they save a life. This person found a match from a list and the would-be donor refused. This person died because they had no siblings and could not find another suitable donor. How can someone stand by and in effect kill someone?

    Posted 3 years ago #

28. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    Joseph and Curious - Because of two things:

    1) The current rules that govern the rationing are poorly constructed at best, corrupt at worst.
    2) I know a thing or two about the healthcare industry and there is stuff coming down the pipe.

    Besides for this, there is the obvious point that anyone can see - healthcare costs are rising at a pace that only property tax planning boards can keep up with. It won't be long before the entire system we have implodes and leaves us with a huge set of new problems. When the insurance company run healthcare dries up, there will be huge supply side issues and rationing will be necessary for even simple things like setting a bone in a cast (if you're lucky a nurse will do it, otherwise a PA or a pre-med student).

    Posted 3 years ago #

29. anon for this
    Member

    squeak,

    Most insurance companies have a "lifetime limit", usually about $1 mill, beyond which they don't cover medical costs for an individual. Very expensive drugs mean that more and more people are losing their coverage because they've exceeded these limits.

    Regarding distribution of organs, I think to some extent individual transplant centers make their own rules regarding who receives priority for transplants. Some hospitals may give stronger consideration to the recipient's future health prospects than others. (Generally these centers give priority to local residents, which is why someone waiting for a transplant may move to another city to improve his prospects of receiving an organ).

    Posted 3 years ago #

30. anon for this
    Member

    moish01,
    I have a question about your friend's grandfather, if you don't mind my asking. Is he being cared for in a hospital or in another facility?

    Posted 3 years ago #

31. asdfghjkl
    Member

    i actually met a guy last week that said his mother's been on life support in a local brooklyn hospital for 3 years now!!! i have no idea about her brain activity, i kinda felt weird to ask him!!!!

    Posted 3 years ago #

32. moish01
    Member

    he was in a home until about a year ago. he's actually being cared for now in their home. they have a whole wing of the house for him and his nurses and they have backup generators and equipment and all. why do you ask?

    Posted 3 years ago #

33. anon for this
    Member

    moish01,
    I'm sorry if you found my question intrusive. I was just curious about the procedure. From what I've seen as soon as a patient is diagnosed as brain dead, the hospital will generally try to remove life support, or failing that, moving him out of the ICU, to a nursing home or similar facility. I've also heard of hospitals conducting apnea testing (which requires taking the patient off the ventilator for a brief time) and then "forgetting" to put the patient back on the vent (although in this case a family member "reminded" them to turn the vent back on).

    Posted 3 years ago #

34. moish01
    Member

    well, happens to be they're very well off, but i don't think they're paying out of their pocket for this. it's been years. it would cost them billions.

    Posted 3 years ago #

35. moish01
    Member

    ok, maybe not billions. but millions. you know what i mean.

    Posted 3 years ago #

36. SJSinNYC
    always pleasant

    Notpashut, he does allow brain death to be used in very specific circumstances for certain things. I don't really know all the details.

    As far as I know, there is no Jewish Rabbi who says as a blanket rule that brain death can be used across the board.

    Posted 3 years ago #

37. areivimzehlazeh
    Member

    squeak- speakin of things comin down the pipes... obama just signed a law that is going to cause such extreme chaos in my industry... here go my spiked gloves

    Posted 3 years ago #

38. eyesopen
    Member

    Ariel Sharon is still on life support........

    Posted 3 years ago #

39. squeak
    Makes smalltalk with the 2 most intellegent beings on Earth

    glass ceiling? commercial liability?

    Posted 3 years ago #

40. areivimzehlazeh
    Member

    glass ceiling???? now you have me confused

    Posted 3 years ago #

RSS feed for this topic

Reply

You must log in to post.