“A judge comes when there is a disagreement, and then you have a hearing,” Napolitano said, adding that there are sometimes cases where the family wants to cut off the maintenance of vital functions and the doctor does not. It`s a complicated question, but this article will help you understand the basic legal implications of the most serious brain injuries. According to the American Academy of Neurology, brain death occurs when the patient has no evidence of cortical brain activity or brainstem activity. That means the patient wouldn`t be able to cough, swallow or breathe on their own, whereas a patient in a vegetative state might be able to do one or all of those three things, DiGeorgia said. “You unplug the plug when the person has no brain waves and no hope of quality of life,” Braverman said. Once a patient is declared brain dead, the family usually chooses to quickly remove the uncomfortable tubes and machines, said DiGeorgia, who did not treat Richardson. “Pulling the cork” would render the patient unable to breathe and the heart would stop beating within minutes, he said. An important decision at the end of the lifespan is when to unplug the outlet. However, in order for your wishes to be met, you must explicitly and convincingly state in your power of attorney for health care that your patient advocate may make a decision to refuse or discontinue artificial life-sustaining treatment that could or would result in your death. These instructions are called provisions for living wills.
However, they are known by other names such as medical instructions, living wills or living wills. Created by FindLaw`s team of writers and legal writers| Last updated May 29, 2018 Contact a qualified healthcare lawyer to resolve legal issues related to your health care. With this communication and legal planning, you have a say in the decisions you make for your own body in end-of-life scenarios. In the worst-case scenario, your family may need to hire a lawyer without intending to go to court and get permission to act on your behalf. This can be a lengthy and costly process, leading to conflicts between family members, and ultimately resulting in granting authority to someone you wouldn`t have chosen. This is a question that few people like to think about, but one that should be addressed between family members: If you supported life, who would you want as your legal representative? And when is the right time to unplug the outlet? If doctors believe there is little or no chance of recovery, family and loved ones can apply for a court order to remove the patient from life support (which is not necessary if the patient or someone with power of attorney has signed a DNR order). In the absence of a court order or NRD, the hospital is required to keep the patient artificially alive until further notice. Napolitano said that when he was directing similar cases to Shiavo, he went to the patient`s hospital room after hearing testimonies to see the patient himself. A living will is a legal document that prescribes how you would like to be treated in the event of a disability injury, such as that resulting from the PVS. If you wish to die naturally by removing a feeding tube or fan, all parties are required by law to follow your wishes. Dr.
Eric Braverman, clinical assistant professor of integrative medicine at Cornell Weill Medical School in New York City, said doctors use the results of electroencephalogram (EEG) tests, which measure the patient`s electrical activity in their brain, MRI or positron emission tomography (PET), to determine when life support should be turned off. For people who do not have a family capable of making these decisions, or in cases where these people cannot be located, deciding who is responsible for end-of-life decisions becomes more complicated. In addition, the patient`s children or other family members may disagree. This can lead to lengthy legal proceedings in which the patient ends up with costly and sometimes painful life support. 47 states are living wills when these dispositions are contained in a separate document called a living will. Because Michigan is not a living will state, these living will provisions are generally included in your permanent health care authority. However, you can also include these instructions in a separate living will that you have with you if you travel in living wills such as Florida or Arizona. You need to choose a decision-maker with whom you can communicate with your health care professionals about your health choices.
He or she will make decisions on your behalf if you are unable to do so and will carry out your instructions in your legal planning. If the patient is diagnosed as brain dead, they are clinically and legally declared dead. If the patient is an organ donor, their other organs are usually treated on a ventilator until they can be removed. If in doubt about a patient`s condition, they can be kept alive until a second opinion is given (usually by court order). Someone who has been medically declared brain dead – meaning there is no brain activity – is legally considered dead. Otherwise, hospitals are generally not required by law to keep patients declared brain dead alive. This is regulated at the state level, but most states follow a similar protocol. New York law, for example, allows limited “reasonable precautions” (such as sustaining life for a limited period of time) in cases of religious objections to the brain death standard. Questions about life and death are literally decided by legal interpretations, while some legal documents (such as living wills) can give you and your loved ones more options.
If you have legal concerns or questions about the legal differences between brain death and persistent vegetative state, contact a local health advocate today. At the beginning of my career, the first healthy person to apply for an NRD was 94 years old. He didn`t need any help, not even a stick. He always drove and did his own shopping, cooking, cleaning and laundry. When I asked him, “Why do you want an NRD if you`re perfectly healthy?” He replied, “I`m 94! I`ve seen what happens when they do CPR on someone my age. You break all the ribs, which may or may not heal, and you have pain for years. I don`t want that to happen to me. Fortunately, he died quietly in his sleep. I know there is such a thing as physician-assisted suicide in states like Oregon. But in states where it`s not legal, why can`t I unplug someone considered a “human vegetable,” as opposed to someone who maintains life or is in a coma (unless otherwise stated in their precautionary directive)? The continuing power of attorney confers decision-making authority on a trusted person named in the document. This person must respect your living will, but may make other important legal decisions that are not expressly included in the living will. Some states refer to the combination of living will and continuing power of attorney as a “living will.” The way I see it, it should be the other way around, because someone who is considered brain dead doesn`t come back because someone might come out in a coma.
These issues usually come into play in unexpected ways, as actress Natasha Richardson`s family discovered this week when a skiing accident left the Tony Award winner brain dead. She died Wednesday night after being removed from the life support system. Ventilators, feeding tubes, and other medical technologies have made it much easier to support the lives of people with severe brain injuries. But has the law kept pace with medical progress? When is a person legally declared dead? The types of serious brain injury that raise these difficult questions often fall somewhere on the spectrum of persistent vegetative state and brain death. A person with severe brain damage who has been in a chronic state of unconsciousness for at least four weeks is considered to be in a persistent vegetative state (PVS). It is sometimes mistaken for a coma, but comatose patients are never conscious (whereas a person with WPV may show limited alertness, including eye movements, spontaneous body movements, and moans). PVS can be a controversial diagnosis because patients with locked-in syndrome are fully conscious, but equally unable to communicate or respond to stimuli. Without your clear written instructions, multiple family members can ask probate court to make your medical and psychiatric decisions. Often, these parties do not agree. Do you remember the Terry Schiavo case in Florida more than a decade ago, where the family struggled for fifteen years to decide to end the situation? Do you want you and your family to be that? Whatever your position on the use of life support, now, while you are alive and healthy, it is time to say what you want. A well-known example was Terri Schiavo, the Florida woman who had been in a vegetative state for eight years when her husband Michael argued in 1998 that he wanted to remove her feeding tube. A seven-year struggle ensued as Schiavo`s parents battled Michael Schiavo`s wishes, saying their daughter`s life still had quality.
