Fwd: JAMA: Terminal Withdrawal of Life-Sustaining Supplemental Oxygen

This came from Nancy Valko, RN today, and I share her concern. I HAVE seen this done, and it has always boggled my mind that such a simple COMFORT MEASURE would be taken away from any one. I, too, have seen people gasping -- NOT Cheyne-Stokes.

Having asthma, I can assure you that it is NOT comfortable in the least.

God Bless!

-----Original Message-----

Comment: Although I can't get the entire article here, it's truly outrageous to consider withdrawing such a simple comfort treatment ALREADY in use when, apparently, the only possible reason is to hasten death.

Unfortunately, I've seen this done with the so-called "terminal weans" involving people who don't die fast enough after being removed from ventilators and I've seen people gasping for air even though apparently unconscious. I protested vigorously when this first happened and fortunately, this stopped in my hospital-for the time being.

Nancy V.

http://jama.ama-assn.org/cgi/content/extract/296/11/1397?etoc

Vol. 296 No. 11, September 20, 2006
Commentary
Terminal Withdrawal of Life-Sustaining Supplemental Oxygen

Scott D. Halpern, MD, PhD, MBioethics; John Hansen-Flaschen, MD

JAMA. 2006;296:1397-1400.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

An influential report released in 1983 defined life-sustaining therapies as "all health care interventions that have the effect of increasing the life span of the patient."¹ This definition is highly inclusive: aspirin for stable coronary artery disease, intravenous antibiotics for osteomyelitis, and mechanical ventilation for respiratory failure all qualify. However, when considering withholding or withdrawing life-sustaining interventions, clinicians commonly refer to a more discrete group of therapies intended to forestall impending death by augmenting or replacing a vital bodily function. A hallmark of life-sustaining therapies, therefore, is that withholding or withdrawing them leads to physiologic decompensation foreseeably to cardiac arrest.

Supplemental oxygen has not commonly been considered a life-sustaining therapy. Yet it clearly serves this purpose for spontaneously breathing patients in whom pulmonary gas exchange is so impaired that the needs of vital organs cannot be met with ambient air . . . [Full Text of this Article]

Concerns About Balancing the Burdens and Benefits of Supplemental Oxygen