A machine such as a ventilator keeping a comatose patient alive is called life support because it supports the organs until the patient is able to do so on its own. I think even after a death, the same machines are used to keep organs viable for any transplant if needed but I may be wrong.
After a patient is determined to be brain dead, I think the use of the words "life support" by medical personnel and/or judges should be discontinued because the words can confuse the families/situation as it seems to support life. Maybe the ventilator still running to supply oxygen to the organs of the patient should be referred to simply as a ventilator or a mechanical support rather than life support?
Just did a search to make sure the terminology was correct before posting and found this article which supports my thoughts. WOW
Now I'm questioning myself - is this my thoughts or just memory resurfacing from maybe reading this back then.
I guess either way it still makes sense.
http://www.cnn.com/2013/12/28/health/life-support-ethics/
The term "life support" is not a medical term, it is lay terminology. It means different things to different people. Ventilators are "breathing machines" that have far more settings than simply on and off. Ventilators can be set to help a breath that is initiated, but weak, pushing the air into the lungs. Vents can be set for "pressure support" only, which is somewhat analagous to what many people know as CPAP/ BiPAP, which is a steady stream of air under pressure that helps hold upper respiratory passages open. Vents can be set to assist/ control-- meaning the patient breathes, but if their respiratory rate or effort drops off, the machine takes over. Vents can be set to "SIMV", which synchronizes the push of air with the respiratory efforts of the patient. Vents can be set to maintain a steady stream of pressurized air at the end of a breath, to hold distant airways open ("PEEP").
Israel is on "control" settings-- he is not capable of initiating breaths at all, so the machine does all of the work. Jonee says she has "seen" Israel take 2 breaths over and above the vent, which, IMO, is not possible. Jonee doesn't understand all of the things that can influence the respiratory wave form she watches on the monitor, such as her stimulating Israel in the video under his left arm ("tickling"). Any external movement of the patient, or the bed, or the oral endotracheal tube, or the "hoses" in the ventilator circuit, turning the patient, holding them, etc., can cause a temporary change in the waveform. If, for example, a hose is impeded or kinked, an alarm will sound. If a patient (consicious or unconscious) bites down, or "tongues" the oral breathing tube, the waveform will change, and if severe enough, will cause an alarm to sound. If the resistance inside the lungs changes, such as from a bronchospasm (asthma) the machine will also alarm that the upper limits of pressure have been reached. Etc. Etc.
There is a movement within the critical care community to change the terminology from "life support" to "organ support", or even more correctly, "somatic support", to distinguish a body being optimized for organ procurement from a living person receiving critical care.
By the way, it's not just the ventilator keeping Israel's heart going. He is on very significant doses of vasopressin and levophed (norepinephrine, pronounced "leave-oh-fed", often called colloquially "leave 'em dead"). Levophed is a potent vasoconstrictor, and is a sort of last resort med. It can cause such severe vasoconstriction patients fingers and toes die and blacken, patches of skin, etc.
In the state court documents (272 pages on Prof. Pope's website) the court recorder has the extensive testimony of the head ICU intensivist at Kaiser, Dr. Myette. Israel at that point in time was so unstable that Dr. Myette or another doc was within 30 feet of him 24/7 to continuously titrate the meds to keep his BP up enough to keep his organs functioning. If the levophed or vasopressin was turned off, Israel's heart would stop, even if the vent kept pumping air. Israel's body temp is very unstable, and he arrived to Kaiser with a temp of 33 celcius (91 fahrenheit). He has to be kept on several warming devices. This is called "poikilothermia"-- tendency of a brain dead body to acclimate to room/ ambient temperature. All of these things (temp instability, diabetes insipidis, BP instability) are typical and "normal" for brain dead patients.
At some point, Jahi McMath somewhat stabilized so that she came off the norepi and vasopressin. I think they could probably keep Israel's heart pumping for quite a while as well, perhaps years, since he coded in an ICU and his heart had not stopped for long (if at all-- he had a severe bronchospasm, and it appears he was pretty promptly put on ECMO). He is very young-- his heart could go on a long time. But he is still brain dead, and that will never change or improve.