There are no laws, government agencies or private groups either compelling hospitals to report these events nor asking them to volunteer the information. For example, the data collection systems at both NCHS and the American Hospital Association do not even ask the question.
"It's not part of what the http://www.tffjewellerysales.co.uk/ state requires in standard reporting," said Kim Steit of the Florida Hospital Association. Steit said the issue of recording these events came up about a decade ago in discussions of tracking mortality rates but that the information was too difficult for hospitals to record in the current reporting system.
"There's no way you could collect this sort of data. It happens on such a daily basis," said Elizabeth Sjobert, a registered nurse and attorney who helped craft the 1999 Texas Futile Care Law, the legislation that allowed doctors last week to remove Sun Hudson, a terminally ill 6-month-old infant, from life support against his mother's wishes.
Asked why there wasn't more interest in this information or in revising reporting systems to make it easier experts in the medical and health care fields, as well as the data people at government agencies, cited privacy concerns for families and patients, as well as a lack of medical relevance.
very much run into privacy issues, said Tom Burke, director of public affairs for the American Health Care association, a professional association for nursing homes. Burke said his group tries to track legal issues and litigation associated with right-to-die issues but must rely on anecdotal reports from facilities. we try to talk to someone at a nursing home,Tiffany Bangles Sale the administrators are very reluctant, he said. are private matters. Himmelriech, a spokesperson for the Ohio Hospital Association, said the main goal of hospitals is to work with families and patients to decide what's best. "If it's not something required in reporting, they have no reason to record it," she said.
Experts also said that the number of patients removed from life support every year does not provide any useful medical insight in terms of understanding disease or treatment.
Medically, people do not die from life-support removal, they die from heart disease or cancer. Death certificates do not list "Removal from life support," or "car accident" or "drug overdose" as official causes of death. Death certificates say "heart failure" or "cardiac arrest."
Mary Jones, a spokesperson for the NCHS, said the government wants to know the number of specific procedures performed, how widespread disease is, mortality rates for specific diseases and conditions. They do not connect procedures or diagnoses to specific patients, Jones said.
"Having a tube removed is an action, not the illness or cause of death," Radulovic said. "Those are the statistics that are important, that help us understand disease."
But if the information is useless from a medical standpoint, does the lack of it raise a public policy question?
When the Florida Legislature and Congress enacted emergency legislation in response to the Schiavo case legislation in effect to save the life of a single person without knowing how many individuals and families they would be affecting, lawmakers had no way of assessing the ramifications and consequences of the legislation.
Even in Texas, where the furor and outrage over Sun Hudson's death brought national scrutiny to the state's futile care law, official records are not kept.
Though the law requires hospitals to convene ethics panels to determine patient treatment, it does not contain a reporting requirement. While individual hospitals would have records of the meetings convened by the ethics panels that determine patients' treatment, "there is no repository" for this information, Sjobert said.
Since Texas enacted the futile care Tiffany Rings
Discount law in 1999, Engler said she knew of only four cases, including Hudson's, where decisions to end life support resulted in disputes or litigation.
Because of Schiavo, the public has become much more familiar with issues surrounding the painful issue of removing life support. And it's likely other cases will enter the public's consciousness.
This week, the Pennsylvania Supreme Court will hear the case of John P. King, a 74-year-old man whose wife and daughter disagree about honoring his living will and removing his feeding tube. Experts say that the rash of cases in the media are aberrations. Doctors, patients and their families, they say, make these decisions quietly every day.
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