Friso in Avalanche

[christina01]

It should be the family who decides in the end what happens. Things become very unpleasant when discussing withdrawing help from a patient. Everyone has a differing opinion and emotions run very high.

[whimsicalwriter]

It should be the family who decides in the end what happens. Things become very unpleasant when discussing withdrawing help from a patient. Everyone has a differing opinion and emotions run very high.

Well said 

[Hester]

It should be the family who decides in the end what happens. Things become very unpleasant when discussing withdrawing help from a patient. Everyone has a differing opinion and emotions run very high.

What if someone's family doesn't actually care about them enough to pay the cost of keeping them alive? I know there are families who value money over relationships! If a person hasn't specified "no intervention" I'm afraid they have to be assumed to wish to be kept alive ... otherwise how could we tell what their decision would be?

[christina01]

It should be the family who decides in the end what happens. Things become very unpleasant when discussing withdrawing help from a patient. Everyone has a differing opinion and emotions run very high.

What if someone's family doesn't actually care about them enough to pay the cost of keeping them alive? I know there are families who value money over relationships! If a person hasn't specified "no intervention" I'm afraid they have to be assumed to wish to be kept alive ... otherwise how could we tell what their decision would be?

Unfortunately this is where problems arise. But I am not sure it's right to keep someone alive if they really are brain dead in the case of Friso it appears. I guess if the family don't care enough then it is the right of the doctor or whoever to have a say in what happens. Again, its an unpleasant topic at the best of times, and I for one wouldn't like to be the one who makes the decision, especially not alone.

[SouthernBelle]

It should be the family who decides in the end what happens. Things become very unpleasant when discussing withdrawing help from a patient. Everyone has a differing opinion and emotions run very high.

What if someone's family doesn't actually care about them enough to pay the cost of keeping them alive? I know there are families who value money over relationships! If a person hasn't specified "no intervention" I'm afraid they have to be assumed to wish to be kept alive ... otherwise how could we tell what their decision would be?

Money is a finite source, whether the family or the government is paying for care. I'm not heartless but the money spent on someone who won't ever wake up could have been better spent on someone that can actually recover. This is a moral decision but other things go into making these decisions as well.

The DRF is wealthy so the money thing doesn't matter to them but for most people that's one of the bigger issues.

[bumbershoot]

It's not just money. It's also the physical deterioration (and possible pain suffered) of the comatose person that is very very very hard to witness. One wonders if continuing the life support is actually a form of slow-moving torture.  And there is the emotional wear and tear on families who put their lives on hold to keep vigil.

[TLLK]

It's not just money. It's also the physical deterioration (and possible pain suffered) of the comatose person that is very very very hard to witness. One wonders if continuing the life support is actually a form of slow-moving torture.  And there is the emotional wear and tear on families who put their lives on hold to keep vigil.

ITA.

[BessieWallis Warfield]

It's not just money. It's also the physical deterioration (and possible pain suffered) of the comatose person that is very very very hard to witness. One wonders if continuing the life support is actually a form of slow-moving torture.  And there is the emotional wear and tear on families who put their lives on hold to keep vigil.

ITA.

x2

[Clover]

We took care of this right after our youngest was born. Family trust was put in place mostly to designate the care of our then toddler and infant, but we knew that the medical directive was necessary too.
I understand that it can be a difficult topic to raise, but IMO it is much better to have the decisions made in advance.  

TLLK,
Thanks for reminding me that I need to complete our forums, such as guardianship for my little daughter.

Lady A for her insightful answer , Tinika, Chriss, Clover, BWW and Paddy and BS

G

Getafix,
 

It's not just money. It's also the physical deterioration (and possible pain suffered) of the comatose person that is very very very hard to witness. One wonders if continuing the life support is actually a form of slow-moving torture.  And there is the emotional wear and tear on families who put their lives on hold to keep vigil.

 

[PeDe]

there's an article in Bunte.de


12:13 o'clock | 15/08/2012
Prince Friso - The doctors have little hope!

Prince Johan Friso of the Netherlands is in a coma for six months now. His family is keeping guard at his bedside, praying for a miracle. And  with each passing day they hope that he wakes up. But the doctors are taking away any illusion that Queen Beatrix and Friso's wife Mabel might have.

Six months ago the life of the Dutch royal family changed forever. On February 17th, a Friday, the 43-year-old Prince Johan Friso was buried in an avalanche while skiing in Lech, Austria. The son of Queen Beatrix (74) was 25 minutes without oxygen under the snow, it took 50 minutes to resuscitated him. Far too long, because since that tragic accident Friso is lying in a coma in a London specialist clinic.

His family still hopes for a miracle, but the doctors made a shockingly clear statement - six months after the accident.
- "Six months is a critical level," said doctor Erwin Kompanje of the University of Rotterdam in an interview with news agency dpa, he clarified: "It can not be predicted whether he will ever reach consciousness again."

Just a few weeks ago, Friso's older brother Prince Willem Alexander (45) explained in an interview how much the family is hoping for a recovery. But it looks more and more that the family members will have to bow to Friso's harsh fate.
- "In the Netherlands it is considered to stop treatment after six months without changes" said Kompanje.
- "The royal family will be faced with a difficult decision."

Frisos wife Mabel and his daughters Luana (7) and Zaria (6) are living in the hope of enfolding him in their arms again. The entire royal family tried to keep up appearances in everyday life. Even on "Queensday" Queen Beatrix attended, with daughter-in-law Máxima and Crown Prince Willem Alexander. At that time they were hit with a big wave of sympathy. And it looks as if they will need, given the difficult decision that awaits them, even more support from the Dutch people.

Overshadowed by her concern for Friso, his wife celebrated on August 11th her 44th birthday. And on the eve of her birthday she even attended an Olympic women's hockey match of the Dutch players, who won the gold medal. Together with Luana and Zaria they could forget their worries for at least a short time, laughing, cheering and shouting loudly. The next day Mabel spent her birthday with the girls in peace in Italy.
  

[bumbershoot]

There's no way this can be anything but horrible for everyone involved. 

[Clover]

PeDe,
Thanks for the article. It sounds like things are still very tough for this family, far from settled. 

[PeDe]

you're welcome, Cover. Yes, it has to be agonizing.

[jusaca]

Alas, there's no way to do an advance directive after the fact.

I had to make some very very hard decisions about withdrawing hydration when my husband was dying in an incredibly lengthy and agonizing process. He had no advance directives because, of course, he wasn't ever planning to die. I think many many people fall into that category, alas.

Bumbershoot - I don't think that withdrawing hydration is the way in which a person's end of life is facilitated.  When end of life is approaching, it is not necessary to 'speed things up' in that way.  Pain relief is of value, but not the withdrawal of fluids.

[bumbershoot]

I believe the Hospice Foundation of American supports the withdrawal of hydration in an end-stage terminally ill patient. The medical ethicists with who I consulted said that dying patients are actually more comfortable when they are no longer artificially hydrated. And remember, IV hydration is an intervention, not part of the normal life process.

Cessation of hydration can decrease secretions from the lungs, limit urinary output -- and the patient's need to urinate and to have frequent cleanups related to that -- and can also decrease coughs and congestion.

I notice that the HFA is offering a presentation on the subject in October. I've been through this educational program and I recommend it highly to anyone who is in the difficult position as caregiver for someone who is terminally ill.
http://www.hospicefoundation.org/2012fallprogram