Posted on 03/19/2005 7:19:45 PM PST by ambrose
March 8, 2005, 12:33AM
Hospitals can end life support Decision hinges on patient's ability to pay, prognosis
By LEIGH HOPPER
Copyright 2005 Houston Chronicle
A patient's inability to pay for medical care combined with a prognosis that renders further care futile are two reasons a hospital might suggest cutting off life support, the chief medical officer at St. Luke's Episcopal Hospital said Monday.
Dr. David Pate's comments came as the family of Spiro Nikolouzos fights to keep St. Luke's from turning off the ventilator and artificial feedings keeping the 68-year-old grandfather alive.
St. Luke's notified Jannette Nikolouzos in a March 1 letter that it would withdraw life-sustaining care of her husband of 34 years in 10 days, which would be Friday. Mario Caba-llero, the attorney representing the family, said he is seeking a two-week extension, at minimum, to give the man more time to improve and to give his family more time to find an alternative facility.
Caballero said he would discuss that issue with hospital attorneys today.
Pate said he could not address Nikolouzos' case specifically because he doesn't have permission from the family but could talk about the situation in general.
"If there is agreement on the part of all the physicians that the patient does have an irreversible, terminal illness," he said, "we're not going to drag this on forever ...
"When the hospital is really correct and the care is futile ... you're not going to find many hospitals or long-term acute care facilities (that) want to take that case," he said. "Any facility that's going to be receiving a patient in that condition ... is going to want to be paid for it, of course."
Patient showed emotion
Caballero said he believes the hospital wants to discontinue care because Nikolouzos' Medicare funding is running out.
Spiro Nikolouzos, a retired electrical engineer for an oil drilling company, has been an invalid since 2001, when he experienced bleeding related to a shunt in his brain. Jannette Nikolouzos, 58, had cared for her husband at their Friendswood home, feeding him via a tube in his stomach. Her husband couldn't speak, she said, but recognized family members and showed emotion.
On Feb. 10, the area around the tube started bleeding, and Nikolouzos rushed her husband to St. Luke's for emergency care. Early the next morning, she said, the hospital called and said he had "coded" and stopped breathing and had to be placed on a ventilator.
A neurologist told her, she said, that he is not brain-dead and the part of the brain that controls breathing is still functioning. Although his eyes were open and fixed when he first was placed on the ventilator, he has started blinking, she said.
A missed opportunity
Dr. Marcia Levetown, director of palliative care at The Methodist Hospital, said moving Nikolouzos to a nursing home or other type of facility may not be an option if his body is dependent on several types of technology, such as mechanical ventilation and kidney dialysis.
Levetown said when families and hospitals take their disagreements to court, it often means the hospital has missed an important opportunity in the family's emotional healing.
Often missing from aggressive medical care is empathy for family members and acknowledgment of grief, she said.
"The acknowledgment of 'You clearly love your husband very much. You've done the good fight' " makes a difference, she said. Levetown also tells families, "Whatever might be beneficial, you've made sure he's gotten that. We all wish he could get better ... How can we best honor this man ... as we accompany him in his next journey?"
Law allows removal
State law allows doctors to remove patients from life support if the hospital's ethics committee agrees, but it requires that the hospital give families 10 days to find another facility.
A similar case is still in the courts. Texas Children's Hospital wants to discontinue life support on 5-month-old Sun Hudson, who was diagnosed shortly after birth with a fatal form of dwarfism. His mother, Wanda Hudson, wants her son's care to continue at the hospital.
On Wednesday, a judge will consider whether Harris County Probate Court judge William McCulloch may remain on the Hudson case. Caballero, who represents Wanda Hudson, filed a motion that McCulloch remove himself from the case after making what Caballero said were biased statements.
leigh.hopper@chron.com
With talent like I have, I don't need to. (And with my chest, it's just as well.)
Didn't stop Brandy Chastain...
Oh, alright. Go get your magnifying glass, and let me know when you're ready.
And how many of the screaming ravens that call for another civil war over Terri would have done so if she were, say, 102 yrs of age? Makes one wonder indeed.
I'm like a battery. Everready...
So youre a fan of Benny Hinn?
Apparently we are paying more during the last year of people's lives than for health care during the whole rest of their lives combined, and this is about 25%. Elderly, sick people get expensive surgeries that just makes the end of their lives miserable.
There are 6 million incompetent people in nursing homes @ $3000/mo. And Bush says 20% of the cost can be wrung out by using IT. I'll bet there is lots of this life-support dispute. I know my neighbor just got drunk and stayed drunk for 6 months when docs suggested it to her. While I uderstood it was hard to face, I also knew the public was paying.
Thank you for the English translation to that poster. It's pretty close to the original.
Sorry. Changed my mind. The crowd in here is getting bigger, and I'm getting stage fright.
Better said than I would have done. Thanks for your response to her.
There's always FReepmail...
Check yours.
WOW! That's some boob!
ma'am...
Yes. I certainly think so!
None, every red-blooded American male should have the right to a pliable judge so he can kill any parent, wife, child, dog, or cat that interferes with his pursuit of pleasure.
Did I forget anything ?
"So youre a fan of Benny Hinn?"
No, I am a follower of Jesus Christ, God the Son. If He choses to heal He can and will. Prayer is never a waste, even if the answer is no.
On the other hand, Benny Hinn is a heretic and fraud. Don't equate him with Christianity and Faith in God.
I assume it was a picture of one or both of the Clintons.
Estranged wife, ex-wife, mother-in-law, father-in-law, sister, brother, neighbor....
Close.
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