Hi there!

Today’s article is about, “Quick Tip for Families in Intensive Care: Is it Legal to Withhold Nutrition for My Critically Ill Dad in ICU in the USA?”

You may also watch the video here on our website https://intensivecarehotline.com/breathing-tube/quick-tip-for-families-in-intensive-care-is-it-legal-to-withhold-nutrition-for-my-critically-ill-dad-in-icu-in-the-usa/ or you can continue reading the article below.

Quick Tip for Families in Intensive Care: Is it Legal to Withhold Nutrition for My Critically Ill Dad in ICU in the USA?

If you want to know what’s really going on in ICUs around the world, in the U.S., in particular, when it comes to end of life care, stay tuned. I have news for you.

So currently, we are working with a client in the U.S. was their father in intensive care and he’s very sick, he’s critically ill, but he’s also turned the corner in terms of getting off the ventilator and extubate him on to BIPAP (Bi-level Positive Airway Pressure).

Now with BIPAP, there is a risk that when you do BIPAP, and especially with high pressures of BIPAP, there’s an increased risk that there could be aspiration, especially when you continue feeding with the nasogastric tube or PEG (Percutaneous Endoscopic Gastrostomy) tube, especially when someone is continuously BIPAP dependent.

So, the hospital decided in order to keep the patient on BIPAP to also not feed the patient. Basically, denying nutrition, in spite of TPN being an option. TPN stands for Total Parenteral Nutrition. It’s also meant to be intravenous nutrition.

Another option here could be a nasojejunostomy tube where the feeds go into the jejunum, in the small intestines. So, there are options to feed a patient in a situation like that.

The hospital has been denying this to the patient and the family and denying nutrition is a basic human right. We’ve been working with this client now for a few weeks and we have been under the impression from Day 1 that the ICU has one goal and one goal only that is to get the patient out of intensive care, either dead or alive, but either dead or alive needs to happen as quickly as possible.

Case in point, we’re pushing towards withdrawal of treatment from the get-go but with our advocacy, we make sure the intensive care team was held to account and was moving towards extubation, i.e., removal of the breathing tube which they succeeded with in the beginning, even though the patient is now BIPAP dependent.

So, the second goal, if they couldn’t end the life of the patient, was to do a tracheostomy, do a PEG and send him out LTAC (Long Term Acute Care). Either way, for the intensive care team it has always been about getting this patient out of ICU as quickly as possible. Like I said, we put a stop to that.

Now, this time around where he did man desperately needs nutrition, there’s plenty of research out there that a critically ill patient in intensive care needs nutrition irregardless of what nutrition.

So, with all of that said, we were in a meeting this week where we were advocating for TPN, and the intensive care team said they can’t give TPN because the infection risk is too high. Now, my take on that is, that’s like saying we stop eating and drinking in case food might be contaminated. Would you stop eating? There’s a risk for anything in life. If you don’t eat, you don’t get nutrition. If you do eat, there’s a very small risk that food might be contaminated.

Now, I’ve been working in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com.

I can confidently say that we have saved many lives as part of our consulting and advocacy, and you can verify that on our testimonial section or on our podcast section at intensivecarehotline.com where we’ve done some client interviews.

Next, so the intensive care team was basically denying TPN and also said that the risk for a jejunostomy tube or doing a jejunostomy tube is also reasonably high because the patient might need a general anesthetic, which is actually accurate. So, that is actually a risk. So, back to the drawing board and it comes down to TPN which they are denied.

Now in my eyes, that is the attempt to kill someone. That is an attempt to kill someone, especially since there has been plenty of research and evidence-based that nutrition is absolutely critical for critically ill patients in intensive care so they can fight critical illnesses.

Now, I called them out on it while we were in the meeting, and I was asked to keep the meeting civilized because I called them out on medical malpractice by not giving a patient nutrition. This is what the state of some ICUs are in in 2024 when you point out that they’re negligent, that they talk about, “We should keep the conversation civilized”, they want to shut you up and want to use euphemisms to sugarcoat that they’re trying to kill a patient by not giving nutrition. That’s the state of some intensive care units in the U.S. in 2024.

Now, I also want to highlight that last year, one of my podcast guests, Scott Schara who lost his 19-year-old daughter in intensive care, most likely due to medical malpractice. There’s currently a court case going in Wisconsin in the U.S. Type in Scott Schara or Grace Schara, you will find all the information about the case. Shout out to Scott here who put me on to an incredibly important podcast that he published on his own blog, and I highly encourage you to watch this podcast. I’m putting a link in the written version of this blog.

But, an NBC documentary U.S. NBC, the news channel made a documentary that patients who die in hospital, in ICU and in hospice don’t count in the mortality rate but even worse, they get hospitals get incentivized by some health insurances when patients die.

Now, I argue this is exactly what we might see with our client at the moment. I’m glad that NBC News has done some research there and put it out as a documentary. 

We will need to wake up what is really happening. This could be a form of population control. This could be a form of managing ICU beds instead of looking at prolonging people’s lives and also looking at services like Intensive Care at Home, for example.

Furthermore, especially in this particular case with our client, with intensive care teams, they have to follow laws and guidelines and policies and procedures, and I have not found guidelines or policies and procedures in the U.S. that allow them to withhold life support without patient or family consent. So, we have now advised our client to go to a medical malpractice lawyer or go to the Supreme Court to turn this situation around. Now, most of the time we can turn this situation around, but this particular hospital seems hell bent on killing this patient. That is what we’re dealing with. 

Once again, the stupidity of the argument from my perspective is, is saying they can’t give TPN because of infection risk. Yes, there is infection risk, that is accurate. But when you do a central line or put a central line in or a PICC line in or Hickman’s line, no big deal for ICU professionals to manage the center line or a PICC line or a Hickman’s line and manage TPN. We are doing that at home with our service Intensive Care at Home. You can find more information at intensivecareathome.com.

So, we are working with his client to turn this situation around. We’re hoping, we’re praying, we’re strategizing, but people need to wake up and people need to open their eyes of what is really happening in this world right now, and they need to be very, very vigilant.

Now, we have helped and saved lives of hundreds of members and clients over the years here at intensivecarehotline.com. Like I said, you can verify that on our testimony section and on our podcast section at intensivecarehotline.com, that’s also one of the reasons why we’ve created a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and by email and we answer all questions intensive care related.

In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded, and all of these resources will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always.

Now, I also do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. I also talk to doctors and directly. When I talk to doctors and directly, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care. I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to support@intensivecarehotline.com with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next and what questions and insights you have.

I also do a weekly YouTube live where I answer your questions live on a show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to my email newsletter at intensivecarehotline.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

• Email counselling/consulting with Patrik
   
• One on One phone/ Skype counselling/consulting with Patrik