You've probably seen someone in a movie or on TV being hooked up to a bunch of machines to help them breathe. We often call this 'life support.' But what is this really? Is this something to be scared of? Life support doesn't actually mean death. Today, we'll talk about this very simply, in a way that you can understand.
What exactly is Life Support?
Simply put, life support is the process of providing external support to an organ (such as the lungs, kidneys, or heart) that is not working properly, using a machine or other medical procedure, until the organ can function on its own again. This is similar to using a wheelchair for a short period of time when someone is unable to walk. It gives the body the time and support it needs to heal.
However, sometimes the body can never function on its own again without the help of those machines. It is at times like these that difficult decisions about life support have to be made. Here we need to look at the benefits of the treatment and the burden it entails.
When does life support start? Can it be stopped?
Usually, doctors start life support as soon as they realize your body needs it. This can happen at any time, such as in an accident or a sudden illness.
However, life support is not started in cases like these:
- If you say no to it yourself: If the patient is conscious, they can say that they do not need such treatment.
- Advance directives: Some people, even while they are healthy, have legal documents (advance directives) stating that they do not need life-sustaining treatment if they develop a terminal illness.
- If the family makes the decision: In cases where the patient is unable to make a decision, the closest family members can make the decision on the patient's behalf.
Stopping life support
This is the most sensitive part of this topic. A person can be on life support for a long time. But at some point, if the doctors realize that there is no chance of the patient getting better or living a good life with these treatments anymore, they will inform you or your family.
The most important thing for you and your family to understand here is that a person dies not because treatment is stopped, but because of the incurable condition they have. Withholding life support is simply allowing what is naturally going to happen.
This is a very personal decision. It is perfectly legal and morally right to stop medical treatment that is no longer beneficial.
What are the main types of life support?
When we think of life support, we often think of a machine that helps us breathe, but it is much more than that. Let's take a look at the main types.
| Support Method | Simply put, this is what happens... |
|---|---|
| Mechanical Ventilation | For someone who is unable to breathe, a machine called a ventilator pumps air into the lungs. For this, a tube is inserted into the windpipe through the mouth or nose (intubation). |
| ECMO (Extracorporeal Membrane Oxygenation) | This is a more advanced method than a ventilator. It takes blood from the body, uses a machine to add oxygen to that blood, remove carbon dioxide, and send it back to the body. It's like an artificial lung. |
| Cardiopulmonary resuscitation (CPR) | To try to restart the heart by giving chest compressions, defibrillation, and medication to someone whose heart and breathing have stopped. |
| Artificial Nutrition and Hydration | The provision of nutrition and fluids through a tube inserted through the nose into the stomach (tube feeding) or directly into a vein (TPN) for someone who is unable to eat or drink by mouth. |
| Kidney Dialysis | The blood of someone whose kidneys are not working is passed through a machine that removes waste products and extra fluid and purifies it. This is like an artificial kidney. |
A little more about these
- A ventilator: This can be used for short-term problems, such as severe pneumonia, or for long-term problems, such as those with spinal cord injuries. However, for someone in the final stages of a terminal illness, a ventilator will only prolong the dying process. It will not cure the underlying disease.
- Dialysis: This is not a cure for kidney failure. It simply replaces the work of the kidneys with a machine. If dialysis is stopped, the kidneys will fail again. No one can live without functioning kidneys. For some people, the quality of life that dialysis treatment provides is worth the effort. But for some people, especially those with other incurable diseases, dialysis can be more stressful than beneficial.
What are BLS and ALS?
This is also an important part to know about life support.
Basic Life Support (BLS)
This refers to basic life-saving techniques that anyone can provide in an emergency. For example, if someone is having a heart attack on the road and is dragged, a first aider or medical staff who arrives at the scene will perform CPR . These techniques can be learned by anyone.
Advanced Life Support (ALS)
This is an advanced medical procedure that goes beyond BLS. It is performed only by doctors and trained medical staff. This ALS treatment is performed in the Emergency Treatment Unit (ETU) or Intensive Care Unit (ICU) of a hospital. It uses advanced drugs, machines, and methods. This type of treatment for young children is called Pediatric Advanced Life Support (PALS) .
Life support is something that can help you or your loved one in an emergency or during a long-term illness. It can give the body time to heal. But sometimes, it just prolongs the dying process.
The most important thing is to talk about this openly and honestly with your doctor and family. Starting, refusing, and stopping life support are all very personal, serious decisions.
Take-Home Message
- Life support is a temporary aid to an organ in the body, and it is not a symbol of death.
- This is to give the body the time and support it needs to heal.
- In the final stages of a terminal illness, life support may only prolong the dying process.
- Whether to start or stop life support is a very personal decision. It is important to discuss this with your doctor and family.
- The most important thing: A person does not die because treatment is stopped. The cause of death is the underlying incurable condition.
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