Important Terms for a More Thorough Understanding of the Issues Related to Decision-Making
Coma: A coma is a profound or deep state of unconsciousness. The patient is alive, yet is not able to react or respond to the environment.
CPR: Abbreviation for cardiopulmonary resuscitation, an emergency procedure often employed after cardiac or respiratory arrest, in which cardiac massage, artificial respiration, and drugs are used to maintain the circulation of oxygenated blood to the brain.
DNR: Abbreviation for a Do-Not-Resuscitate order. A DNR is a specific physician order that alerts medical staff of your desire not to be resuscitated in the event that your heart stops beating (cardiac arrest) or you stop breathing (respiratory arrest).
Palliative Care: Also referred to as comfort care or hospice care. An active, compassionate approach to the care of the dying that emphasizes pain relief and comfort rather than curing or prolonging life. The goal is to achieve the best quality of life possible by relieving suffering and controlling pain and symptoms.
Persistent Vegetative State: Refers to a condition in which an individual has lost all cognitive function and awareness of the environment, but retains noncognitive function, including some sleep-wake cycles. A patient in this condition is still able to breathe and may exhibit various spontaneous movements.
POLST: Abbreviation for a Physician Order for Life-Sustaining Treatment. The POLST form is a brightly colored, one-page form your physician can use to turn your wishes into specific written medical orders. Your physician may use the POLST to write orders that reflect the types of life-sustaining treatment, such as CPR or tube-feeding, or focus on comfort that you do or do not want and that are appropriate for your medical situation. It is not an advance directive, but rather a means to translate an advance directive into physician orders to be followed by all medical personnel. Currently, only about one-third of all states have POLST forms available. Make sure to check with your physician, as more states are introducing them.
Total Sedation: Also referred to as palliative or terminal sedation. The continuous administration of medication to relieve severe, intractable symptoms that cannot be controlled while keeping the patient conscious. This treatment renders the patient unconscious and relieves suffering by inducing an artificial coma. The unconscious state is maintained until death occurs.
Ventilator: A ventilator is a mechanical device that supplies air to the lungs when natural breathing is impaired.
Voluntary Stopping of Eating or Drinking: This means voluntarily refusing food and liquids, with the understanding that this will result in death. If food and fluids are taken through a stomach tube, the decision would be to stop this treatment. Contrary to popular belief, the patient does not starve to death. Rather, death usually results from dehydration. It is important to note that hunger and thirst diminish and the desire for food becomes practically non-existent as death nears.
Withholding, Refusal or Withdrawal of Treatment: An ethically and legally accepted practice that may be specified in advance directives. You always have the right, as a mentally competent adult, to refuse, or discontinue any treatment or procedure such as ventilator support, kidney dialysis, cardiac pacemaker or an other intervention.
This article was provided by Compassion & Choices. It is a part of the publication Compassion & Choices Magazine.