http://www.kevinmd.com/blog/2008/03/should-we-charge-families-for-futile.html Tue, 14 Feb 2012 22:28:00 +0000 hourly 1 http://www.kevinmd.com/blog/2008/03/should-we-charge-families-for-futile.html#comment-83954 undisonus Mon, 03 Mar 2008 17:04:00 +0000 http://clients.emmense.com/kevinmd/2008/03/should-we-charge-families-for-futile-care.html#comment-83954 I don't think they should be charged. This would only legitimize the idea of keeping someone around even though they have no quality of life whatsoever. If the care team does decide it's medically futile and the prognosis is essentially instant death the moment full care is stopped, we should always just pull the plug and not hedge. On the other hand, if the patient can be wheeled out of the hospital, even if they're trach'ed and on a vent, and even if they have no cognitive function with no chance of meaninful recovery, then it can be argued that this is palliative care and not completely futile (and they'll aspirate and die eventually in any case.) I don’t think they should be charged. This would only legitimize the idea of keeping someone around even though they have no quality of life whatsoever. If the care team does decide it’s medically futile and the prognosis is essentially instant death the moment full care is stopped, we should always just pull the plug and not hedge. On the other hand, if the patient can be wheeled out of the hospital, even if they’re trach’ed and on a vent, and even if they have no cognitive function with no chance of meaninful recovery, then it can be argued that this is palliative care and not completely futile (and they’ll aspirate and die eventually in any case.)

]]> http://www.kevinmd.com/blog/2008/03/should-we-charge-families-for-futile.html#comment-83952 Anonymous Mon, 03 Mar 2008 16:50:00 +0000 http://clients.emmense.com/kevinmd/2008/03/should-we-charge-families-for-futile-care.html#comment-83952 I differ from panda on that one. I don't have a problem keeping an already intubated (DNR) patient without de-escalation of care for family to arrive. Let's be honest that is typically within 24 hours. I do have a problem extending the death of a patient in a futile situation on family wishes. I differ from panda on that one. I don’t have a problem keeping an already intubated (DNR) patient without de-escalation of care for family to arrive. Let’s be honest that is typically within 24 hours. I do have a problem extending the death of a patient in a futile situation on family wishes.

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