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You think someone on ECMO is going to work? Go take a look at an ICU ward, conscious or not these people are seriously unwell and as close to death as humanly

You think someone on ECMO is going to work? Go take a look at an ICU ward, conscious or not these people are seriously unwell and as close to death as humanly possible. Even the rich ones.

whatshisface 7y ago
The article said a teenager did his homework while on one.
- pryce 7y ago
  And if he decided not to do it, no one would mind. I say this as someone who has worked (briefly) in ICU, as well as having volunteered in a hospital school for two years, and (unfortunately) have had my own teenager in the ICU. The difference we are talking about with work is that a person gets paid if they do work, and doesn't get paid if they don't. When someone is unwell enough to be placed in an ICU, it is important not to be flippant about suggesting they do things for money. Even putting aside the ethics of it, or the fact that in some caees additional burdens could literally kill them, if you get your worker to give your company an extra few thousand dollars value and that worker ends up taking an extra day in the ICU, how much do you imagine that extra day of ICU treatment costs? And what sort of other costs might there be that aren't captured in dollars?
  - whatshisface 7y ago
    You can't reasonably expect someone in the ER to work, but if your reasoning for unplugging them is cost, isn't working better than death?
snazz 7y ago
https://www.kansascity.com/news/business/health-care/article206206649.html https://www.kansascity.com/news/business/health-care/article...
serf 7y ago
Yeah, except the kid mentioned in the parent article which divided clinicians as to whether or not their quality of life allowed for their decision to pull the plug. He was 'seriously sick', but he had a certain quality of life that was unusual for ECMO patients. ...The boy was fully conscious, doing homework, texting friends and visiting with family. But after two months of living in the ICU, he was diagnosed with untreatable cancer that made him ineligible to receive new lungs. Clinicians were deeply divided over what to do next, Truog said. Some wanted to stop ECMO immediately because its original goal — a bridge to transplantation — was no longer possible. Others argued that even though he couldn’t survive outside the ICU, the boy seemed to have a good quality of life on ECMO, and his family and friends “derived benefits from his continued survival,” Truog wrote. They argued that the family should have the right to continue this form of life support, just as with dialysis, ventilation or an artificial heart. A third argument arose, Truog said: If leaving this patient on ECMO was appropriate, then in fairness “why don’t we put everyone with respiratory failure on ECMO?” For the parents, Truog said, it was “unbearable” to choose a day or moment to turn off ECMO, because they knew their child would immediately die. Clinicians devised an alternative the family would agree to: They decided not to replace the ECMO oxygenator, a part that needs to be changed every week or two when it develops blood clots. After about a week, the oxygenator gradually failed and the patient lost consciousness and died, Truog said. The solution “allowed him to die in a way where we didn’t feel like we were choosing the moment of his death,” he said....
- JoshTriplett 7y ago
  > A third argument arose, Truog said: If leaving this patient on ECMO was appropriate, then in fairness “why don’t we put everyone with respiratory failure on ECMO?” That's not an argument against, that's an argument for. Why don't we? The only reason not to would be cost.
  - deleted 7y ago
    [deleted]

You think someone on ECMO is going to work? Go take a look at an ICU ward, conscious or not these people are seriously unwell and as close to death as humanly possible. Even the rich ones.

whatshisface 7y ago

The article said a teenager did his homework while on one.

pryce 7y ago
And if he decided not to do it, no one would mind. I say this as someone who has worked (briefly) in ICU, as well as having volunteered in a hospital school for two years, and (unfortunately) have had my own teenager in the ICU. The difference we are talking about with work is that a person gets paid if they do work, and doesn't get paid if they don't. When someone is unwell enough to be placed in an ICU, it is important not to be flippant about suggesting they do things for money. Even putting aside the ethics of it, or the fact that in some caees additional burdens could literally kill them, if you get your worker to give your company an extra few thousand dollars value and that worker ends up taking an extra day in the ICU, how much do you imagine that extra day of ICU treatment costs? And what sort of other costs might there be that aren't captured in dollars?
- whatshisface 7y ago
  You can't reasonably expect someone in the ER to work, but if your reasoning for unplugging them is cost, isn't working better than death?

snazz 7y ago

https://www.kansascity.com/news/business/health-care/article206206649.html https://www.kansascity.com/news/business/health-care/article...

serf 7y ago

Yeah, except the kid mentioned in the parent article which divided clinicians as to whether or not their quality of life allowed for their decision to pull the plug. He was 'seriously sick', but he had a certain quality of life that was unusual for ECMO patients. ...The boy was fully conscious, doing homework, texting friends and visiting with family. But after two months of living in the ICU, he was diagnosed with untreatable cancer that made him ineligible to receive new lungs. Clinicians were deeply divided over what to do next, Truog said. Some wanted to stop ECMO immediately because its original goal — a bridge to transplantation — was no longer possible. Others argued that even though he couldn’t survive outside the ICU, the boy seemed to have a good quality of life on ECMO, and his family and friends “derived benefits from his continued survival,” Truog wrote. They argued that the family should have the right to continue this form of life support, just as with dialysis, ventilation or an artificial heart. A third argument arose, Truog said: If leaving this patient on ECMO was appropriate, then in fairness “why don’t we put everyone with respiratory failure on ECMO?” For the parents, Truog said, it was “unbearable” to choose a day or moment to turn off ECMO, because they knew their child would immediately die. Clinicians devised an alternative the family would agree to: They decided not to replace the ECMO oxygenator, a part that needs to be changed every week or two when it develops blood clots. After about a week, the oxygenator gradually failed and the patient lost consciousness and died, Truog said. The solution “allowed him to die in a way where we didn’t feel like we were choosing the moment of his death,” he said....

JoshTriplett 7y ago
> A third argument arose, Truog said: If leaving this patient on ECMO was appropriate, then in fairness “why don’t we put everyone with respiratory failure on ECMO?” That's not an argument against, that's an argument for. Why don't we? The only reason not to would be cost.
- deleted 7y ago
  [deleted]