His tumor may have grown to an inoperable size so that even with insurance, no surgeon wants to touch him. The tumor is said to be ‘squeezing off his small intestine and pancreas’ A tumor that size would put pressure on his diaphragm so he couldn’t breath properly,thus pneumonia and the need for high pressure vent support to help what lung capacity was left to exchange gases. The morphine would be for pain as it would be excruciating but it would also reduce his respiratory drive, hence another reason for the vent. The small intestine is being crushed to a point that the intestinal wall will become necrotic and soon perforate causing massive infection and hemorrhage. The crushing of the pancreatic ducts causes the pancreas to become inflamed with leakage of the pancreatic enzymes into the abdominal space causing peritonitis and autodigestion syndrome. The patient’s insulin production would be affected causing either extreme highs or lows in his glucose levels. His blood protein stores and his albumin will fall because he is not receiving much nourishment unless fed intravenously but that can stress his liver over time. Then there is the case of cytokines and release of dangerous levels of myoglobin which are strands of degraded muscle fibers cause by the ongoing damage by the tumor which eventually clog the kidneys and destroy them.
He probably needed venting and airway support because of he may have gone into respiratory failure related to the above. They probably ran tests and cat scans and concluded he was too far gone medically to attempt to do anything with him. Emergency Medicaid can be gotten for such cases if they are treatable. Making him comfortable and withdrawing treatment might be the only kindness left, but that is usually done once a patient has slipped past sentient consciousness.(it will happen anyway, vented or not, just isn’t happening as quickly as the hospital administrators are wishing for.) Hence the real horror of this case...to actively attempt to end a sentient life when that person has not consented to it!
The man is screwed...but I don’t have any info about whether the tumor is operable but they won’t operate because he can’t pay or if they wouldn’t operate(able to pay or not) because the tumor is so big and the damage is just too extensive. Sometimes comfort care is the only option but the hospital is just being too hamfisted in it’s approach. I know that as an RN, relatives have pleaded with us to try to get mom or sweetheart past the Christmas season...no one wants to remember their relative as having died every time Christmas comes along! Hospital systems need to make adjustments and to realize that it may make fiscal sense in the long run in how they help their patients and patients’ families to accept their impending deaths instead of just brutally setting a fiscal “dead”line(sarcasm intended) and enforcing it as though it were a guillotine!
A hospital may have been given legislatively some “legal and arbitrary” right to override family concerns over the cessation of treatment, but a pubic health market may also note how that hospital system treats a given family and decide to go to other hospitals elsewhere...politicians may also lose votes as well!
The man is screwed...but I don't have any info about whether the tumor is operable but they won't operate because he can't pay or if they wouldn't operate(able to pay or not) because the tumor is so big and the damage is just too extensive. Sometimes comfort care is the only option but the hospital is just being too hamfisted in it's approach. I know that as an RN, relatives have pleaded with us to try to get mom or sweetheart past the Christmas season...no one wants to remember their relative as having died every time Christmas comes along! Hospital systems need to make adjustments and to realize that it may make fiscal sense in the long run in how they help their patients and patients' families to accept their impending deaths instead of just brutally setting a fiscal "dead"line(sarcasm intended) and enforcing it as though it were a guillotine!
If you read my post above at # 79 about my mother's acute pancreatitis, it is very much as what you described. And while I used the term that her pancreas was "liquefying" her other internal organs, from your post I now recall her doctors using the term "peritonitis" and especially "autodigestion syndrome" in my mother's case.
My mother was however completely unresponsive when her life support was removed but as her birthday was January 7th and was during a major blizzard (and FWIW, my husband volunteered to use his 4WD vehicle to transport doctors and nurses back and forth and did so for nearly 24 hours straight as I sat at my mother's bedside the entire time, sometimes catching a few winks of sleep in a chair and also spending a lot of time talking to the nurses and thanking them for being there and even helping fill in where I could, if only just to stop by and talk to and spend a little time other patients whose family couldn't make it to the hospital) the doctors did not even approach us about removing her life support until several days later, even as by now, I was coming to the realization that she would not live through this. I also recall several of the nurses and some of the doctors actually crying as we, the family despite the major blizzard going on, still all made it to the hospital to be with her and brought her hand made cards from her grand and great grand children and as we all stood at her bedside and all sung her "Happy Birthday."
If this man is indeed terminal and without any reasonable or medically supported hope of recovery; I would agree with the doctors and the hospital with not continuing further treatments or any extraordinary measures and only palliative care and pain relief. But I also agree that while he is still conscious and able to communicate that his life support should not be removed or his eventual death hastened in any way.