Coma is a pathological state of a total loss of consciousness accompanied by the absence of purposeful reactions to external influences. A life support system is a device or arrangement designed to maintain living conditions for organisms connected to it or within its range. This system makes it possible to maintain a viable body station artificially, which provides a chance for a person to survive. However, it is impossible to predict the consequences for patients and their families accurately. Therefore, the low probability of survival and psychological and physical issues of the person after the unconscious state are arguments against a long-term connection of the patient to the device.
Various Conditions
Coma is a threatening state of impaired consciousness caused by damage to specific brain structures and characterized by the complete absence of patient contact with the outside world. Modern technology in medicine has made an instrumental diagnosis of the reasons for comatose states. Accordingly, if patients have progress and positive dynamics, it is essential to preserve their life. If the condition only worsens and the tests indicate negative dynamics, it is necessary to disconnect their apparatuses (Wijdicks, 2018). Notably, the root cause of a vegetative state is ischemia, cardiac arrest, or stroke. Thus, the brain does not receive oxygen for more than 6 minutes, and there are irreversible changes, resulting in a pathological state (Wijdicks, 2018, p. 695). According to medical statistics, 30% of patients diagnosed with a vegetative state are caused by ischemia; in 6 out of 10 of these patients, doctors record a fatal outcome (Wijdicks, 2018, p. 695). However, recovery does not occur within a year after the injury, in this case, the prognosis is disappointing, and the recovery, if it appears, is extremely rare.
In other cases, a patient in a persistent vegetative state may live for several or tens of years. The patient will have to be turn regularly to avoid bedsores, necessary hygienic procedures, and lung sanitation. Thus, it is essential to disconnect from the machine depending on the length of stay and doctors’ prognosis (Wijdicks, 2018, p. 695). The life of the patient’s relative will only become one of hope and care for the person. A minimally conscious state should not be confused with a waking coma, although the two conditions are similar. Affected persons are temporarily awake because their eyes are open, and movements and facial expressions are present. This may be temporary, but after about 12 months, the likelihood of the person waking up from a minimally conscious state decreases and becomes a permanent state (Wijdicks, 2018, p. 696). Although, if the affected person awakens from MCS (Minimally Conscious State), serious damage usually remains; the longer the MCS lasts, the more severe the physical and psychological defects will be.
Nonetheless, the risk of long-term brain injury, including possible psychological consequences for the family, should be considered. Patients’ families need to start teaching them to walk and eat on their own again (Morales, 2005). There is also the possibility that these patients will not develop psychologically and have trouble in adulthood with maladjustment to life and a lack of learning ability. For parents or relatives, this condition is psychologically difficult because their lives will consist only of caring for the patient.
Indeed, there are positive cases in which patients have recovered. For example, Melendez regained consciousness, which sparked discussions and physicians referred to this case as a medical miracle Time, 2013). This is because there is a statistic that doctors can only help 1 out of 15 patients (Time, 2013). Thus, the moral issues are that the family, the medical, and the patient cannot accurately predict the effect of the treatment on the patient. Accordingly, they hope the person has a chance of recovery and disconnecting from the device is premature death. It is essential to mention that Anna spent 10 years in a coma, and the relatives made a decision to remove the woman from the life support machine (Updoot Studios, 2019). This was because the physicians had not seen any signs of the body’s vitality and indicated that the female had no chance of survival. In this way, according to statistics, only a small number of people can return to life after the comma. Therefore, it is essential to assess the patient’s health and body condition in order to decide whether to remove the individual from the life support device.
Conclusion
Thus, statistics indicate that surviving comma, persistent vegetative state, and MCS are less than the probability of remaining on life support for many years. Even in cases where patients have a positive outcome, their loved ones’ lives become only a state of waiting and care. This will often lead to a lifetime of worrying about the care of patients with physical and psychological developmental problems. Accordingly, it is important to evaluate the prognoses and opinions of physicians about the patient’s health and, in case of negative prospects, to remove them from the device. This will enable families to learn to live without vain hopes of curing their loved ones.
References
Morales T. (2005). Awake after 20 years, Sarah Speaks. CBS News.
Time. (2013).Bringing back the unconscious: The latest science on awakenings.
Updoot Studios. (2019). What was it like being in a coma? [Video]. YouTube.
Wijdicks, E. F. (2018). Who improves from coma, how do they improve, and then what?. Nature Reviews Neurology, 14(12), 694-696.