Switching off the life support

[askandanswer]

In Australia we have something called an advanced medical directive. Its basically a legally binding document giving instructions to medical staff about how you would like to be treated if you are no longer capable of making your own decisions. It also includes instructions about whether or not doctors should try to revive you if you suffer some sort of catastrophic event and nominates who should switch off the life support system.

My mum is far from being on life support or anything similar. However she is making preparations for the possibility that it might one day happen. She called me last night to ask if I would be the one willing to switch her off if she was ever in that situation. I told her I would need to think about it.

I’m a bit uncertain about it. On the one hand I would like to honour her wishes. On the other hand I see how it as akin to killing someone. I can also see how I would be the better person to ask compared with my siblings. One sibling would never do it under any circumstances, another sibling would do it without hesitation or consultation. I think my decision about whether or not to agree with mum’s request will be significantly influenced by church teachings and practices on this topic.

Does anyone know what the church’s teachings are on the cessation of life support systems?

[mordorbund]

29 minutes ago, askandanswer said:

In Australia we have something called an advanced medical directive. Its basically a legally binding document giving instructions to medical staff about how you would like to be treated if you are no longer capable of making your own decisions. It also includes instructions about whether or not doctors should try to revive you if you suffer some sort of catastrophic event and nominates who should switch off the life support system.

My mum is far from being on life support or anything similar. However she is making preparations for the possibility that it might one day happen. She called me last night to ask if I would be the one willing to switch her off if she was ever in that situation. I told her I would need to think about it.

I’m a bit uncertain about it. On the one hand I would like to honour her wishes. On the other hand I see how it as akin to killing someone. I can also see how I would be the better person to ask compared with my siblings. One sibling would never do it under any circumstances, another sibling would do it without hesitation or consultation. I think my decision about whether or not to agree with mum’s request will be significantly influenced by church teachings and practices on this topic.

Does anyone know what the church’s teachings are on the cessation of life support systems?

In the US that directive is called a living will.

The Church uses strong language against euthanasia (violates the commandments of God) but notes that what you describe is not euthanasia. Here’s the relevant section in the Handbook of Instruction:

Quote

Prolonging Life (Including Life Support)

 When facing severe illness, members should exercise faith in the Lord and seek competent medical assistance. However, when dying becomes inevitable, it should be seen as a blessing and a purposeful part of eternal existence (see 2 Nephi 9:6; Alma 42:8).

Members should not feel obligated to extend mortal life by extreme means. These decisions are best made by the person, if possible, or by family members. They should seek competent medical advice and divine guidance through prayer.

Leaders offer support to those who are deciding whether or not to remove life support for a family member.

 

Edited September 30, 2023 by mordorbund

[mikbone]

Oh there are all kinds of similar things in the USA

DNR (Do not Resuscitate) - Do not attempt any heroic life support options, mouth-to-mouth resussiciation, intubation, CRP, cardiac defibrilation, etc.   Essentially, if my body is so severely injured that I will die without medicial heroic intervention let me pass with dignity the way God intended.

DNR except during surgery - Sometimes a DNR patient will come into the hospital with a hip fracture that will not kill them but makes them miserable.  They elect to have surgery to fix the fracture which requires anesthesia and intubation and essentially life support.  During the surgery you are allowed to give them life support but as soon as they leave the operative suite, they revert to DNR.

Comfort care - Patients are allowed to have IV medications including narcotics to make them comfortable but not antibiotics, chemotherapy or dialysis to attempt to cure disease. 

Removal of life support - Sometimes a patient will get intubated and sedated and pumped full of fluids and medications to keep the body alive and at some point it becomes obvious that the patient will not recover or that brain function has ceased.  In these isntances a decision has to be made to remove the life support machines and drugs to allow the body a natural death.  

 

President Nelson is a MD and he firmly believes in all kinds of medical options to preserve life (heart surgery, COVID vaccines, etc).  

I am a bone surgeon and firmly believe in DNR.  If I get into a car accident and have a closed head injury, spinal cord injury, and multiple long bone fractures don't go saving my life.  Let nature take its course.  

[askandanswer]

1 hour ago, mordorbund said:

In the US that directive is called a living will.

The Church uses strong language against euthanasia (violates the commandments of God) but notes that what you describe is not euthanasia. Here’s the relevant section in the Handbook of Instruction:

 

Thanks @mordorbundthis is what I needed to see.

[Carborendum]

9 hours ago, askandanswer said:

Thanks @mordorbundthis is what I needed to see.

I'd point out the specific words that Mordor posted.

Quote

Members should not feel obligated to extend mortal life by extreme means. These decisions are best made by the person, if possible, or by family members. They should seek competent medical advice and divine guidance through prayer.

Leaders offer support to those who are deciding whether or not to remove life support for a family member.

The conversation you need to have with your mother is what she considers "extreme means."

A while back we had a "drive-by" post with someone crying out why the rest of the family "just couldn't see that she was dead already" when she was only being kept alive by machines.  He was adamant that they should pull the plug.

The very next day he said,"Oh, I found out that she's not just alive by machines. She is experiencing quality of life."

I'd sure hate for that kid to be the one deciding when to pull the plug.

Your mom probably asked you because you have the judgment that she trusts to know "when to say when."

[CV75]

17 hours ago, askandanswer said:

In Australia we have something called an advanced medical directive. Its basically a legally binding document giving instructions to medical staff about how you would like to be treated if you are no longer capable of making your own decisions. It also includes instructions about whether or not doctors should try to revive you if you suffer some sort of catastrophic event and nominates who should switch off the life support system.

My mum is far from being on life support or anything similar. However she is making preparations for the possibility that it might one day happen. She called me last night to ask if I would be the one willing to switch her off if she was ever in that situation. I told her I would need to think about it.

I’m a bit uncertain about it. On the one hand I would like to honour her wishes. On the other hand I see how it as akin to killing someone. I can also see how I would be the better person to ask compared with my siblings. One sibling would never do it under any circumstances, another sibling would do it without hesitation or consultation. I think my decision about whether or not to agree with mum’s request will be significantly influenced by church teachings and practices on this topic.

Does anyone know what the church’s teachings are on the cessation of life support systems?

My opinion, since the handbook has been shared: The decision and instructions are solely hers, and you are simply honoring her request for representation. The medical personnel in turn perform the procedures to remove life support in good faith. They consult with you, and you consult with the Lord.

[popatr]

My wife's favorite grandpa was on dialysis. Being on dialysis is a considerable drop in the quality of life by itself, but in time he started feeling worse because of whatever. He decided to end dialysis. He may have lived much longer but I'm convinced it wasn't unrighteous.

[popatr]

I think the Nephite apostles' requets to Jesus, just before his return to heaven, is instructive.  9 of the 12 requested that

'we may speedily come unto thee in thy kingdom.` after they had `lived unto the age of man`.

I don't want to be more sure than I should, but it sounds like they are talking about a quick death at a fixed age which is old enough by their standard.  They have no desire for exceptionally long lives, much less to have it miraculously sustained even though God could do so perfectly, far better than any doctor.  I am assured that this attitude is OK and righteous.

Therefore, I believe you don't need to fear that God will be upset with anyone who chooses not to extend their lives.

However, we also have 3 of the 12 who do want to stay alive and serve until the end of the world.  Jesus makes it clear that this is even better.  Therefore I'm persuaded that it is fitting and proper to strive for life as long as we can tolerate it and can serve God.  You should feel very very called to this world as long as you have children with a strong need for you.  If you want to be as good as the three nephites you should probably feel called to this world rather longer.

If you are leaving when you could stay, and are called to stay by children etc then I guess I do see that as probably displeasing to God.

Edited October 1, 2023 by popatr