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His heart was in poor shape, but actions can either reinforce decline or struggle against decline. The actions chosen appeared to support the former and prevent the latter.
Pretty sure the adrenaline infusion was attempting to do the opposite, with a view to keeping your father alive long enough for his heart to make some kind of recovery. Sounds like that was the only thing giving him enough oomph to get blood to his vital organs. Adding in the extra metabolic demand of exercise would be an excellent way of killing him.
 

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OMG what an absolute nutcase. It scares me that people like him target vulnerable people. This sort of thing is worse than the 5G stupidity imo.
Woah, hang on a minute before you rubbish the opinions of the majority of planet earth and almost everyone who has lived before.

Two fundamental points were made, one was wholly objective.

Up to 1967, no-one did heart operations because the definition of death what when the heart stopped. Ergo, if you transplanted a working heart then you've just killed the person you took it from, by definition.

Having been outdone by a third world country, the western countries immediately changed their definition of death so they could get on the case.

Doesn't it seem odd that a bunch of doctors could change the very meaning of 'being alive' overnight, by their say-so?

Which swiftly moves us on to the second point; doctors are Gods, as @RunningStrong has shown above, their omniscience is all and towers above mortals, thus it is only logical that they can rule on what is or is not 'death'. But if that note of sarcasm doesn't quite swing it for you, then, sure, you can scoff all you like about whether we have a 'soul' or not, and how it may or may not be 'attached', but it's the basis of Christianity, Islam, Hinduism, Judaism, Buddhism, and others, to which the majority of the world's population ascribes.

If anyone wants to report this to youtube, then make sure you ask them to remove all religious videos, anything even suggesting a God exists. I am not proposing to evidence the existence of God, but that;-
a) doctors aren't 'them' no matter what you or the doctors (or the real gods) think, and
b) why would you seek to enforce and impose your own belief systems on others when you don't have the slightest bit of evidence that we do not have attached souls?
c) as humans, we can re-define what 'life' and 'death' mean, we have done it many many times already, which basically serves to prove there isn't really any such 'true' definition.
 

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Pretty sure the adrenaline infusion was attempting to do the opposite, with a view to keeping your father alive long enough for his heart to make some kind of recovery. Sounds like that was the only thing giving him enough oomph to get blood to his vital organs. Adding in the extra metabolic demand of exercise would be an excellent way of killing him.
Sometimes it is better to let someone do what they want, just before they die, so they can die like they want to rather than force them to die like you want them to?

Like I say, this strange thing where people respect the will of a person after their death to a letter, but seem to go out of their way to ignore their will just before it.

It is better to live a moment longer in pleasure than a week longer in pain.
 

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I am only hurt that someone would propose it's 'above my station' to want more say-so over my last few moments of life than a medical doctor.
 

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Pretty sure the adrenaline infusion was attempting to do the opposite, with a view to keeping your father alive long enough for his heart to make some kind of recovery. Sounds like that was the only thing giving him enough oomph to get blood to his vital organs. Adding in the extra metabolic demand of exercise would be an excellent way of killing him.
I strongly disagree. One key requirement of recovery is walking away. This key requirement is undermined by the side-effects of artificially infusing adrenaline.

The side-effects of adrenaline include overstimulation of the heart causing inefficient blood circulation in a body that is already stressed. The increased inefficiency reduces blood flow to all organs. The patient's condition gradually weakens while nothing is being done to address the key requirement - that is a guarantee to kill the patient.

In life, the right actions are rarely the easy actions. Attaching a supply of adrenaline and doing nothing else to help the patient is, in my humble opinion, too easy.
 

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... in a medical environment you have to realise the limitations of this.
If by this we mean due diligence and good governance, then we are unlikely to agree.

Take an urgent blood transfusion to an unconscious adult.
Your argument appears to be that every clinical decision needs to treated as a reactive emergency. In other words that time, planning, strategy are irrelevant to doctors. I am not buying it.
 

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If by this we mean due diligence and good governance, then we are unlikely to agree.
Depends how you define due diligence and governance. Should all medical decisions go through comprehensive review boards? What responsibility does the chair person have? What happens if there's split decision?

Your argument appears to be that every clinical decision needs to treated as a reactive emergency. In other words that time, planning, strategy are irrelevant to doctors. I am not buying it.
Because I provided an example you think that's the context of my entire argument? How peculiar.

I think there's a good argument to be made that doctors should be provided with more time to review and discuss. However, I don't agree that moving the decision point from a person or team that is providing front line care to the patient, to a governance function that sees the "facts" on a report is a viable or sustainable way forward for reasons of effectiveness and efficiency.
 

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Depends how you define due diligence and governance. Should all medical decisions go through comprehensive review boards? What responsibility does the chair person have? What happens if there's split decision?


Because I provided an example you think that's the context of my entire argument? How peculiar.

I think there's a good argument to be made that doctors should be provided with more time to review and discuss. However, I don't agree that moving the decision point from a person or team that is providing front line care to the patient, to a governance function that sees the "facts" on a report is a viable or sustainable way forward for reasons of effectiveness and efficiency.
Well, what DO you propose, then?

Even mass murderers have a right of appeal, and even in countries that observe death penalties.

Whereas a doctor can sentence their patient to death by their decision, and yet no relative, nor often even the patient, has a right of appeal. There is no process = there is no right.

What is your proposal to right that wrong?
 

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Because I provided an example you think that's the context of my entire argument? How peculiar.
Would you like to replace your current example with one that is reflective of your argument?

Should all medical decisions go through comprehensive review boards?
It is difficult to change something we cannot observe. Perhaps the first step is to make existing review processes transparent and/or accessible to patients and their legal representatives?
 

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I strongly disagree. One key requirement of recovery is walking away. This key requirement is undermined by the side-effects of artificially infusing adrenaline.

The side-effects of adrenaline include overstimulation of the heart causing inefficient blood circulation in a body that is already stressed. The increased inefficiency reduces blood flow to all organs. The patient's condition gradually weakens while nothing is being done to address the key requirement - that is a guarantee to kill the patient.
Sort of, kind of, not really.

Adrenaline causes, grossly speaking: increased heart muscle contractility; increased heart rate; and increased blood vessel constriction. It does not do all three things to the same degree, with the degree of each varying with the dosage and from patient to patient.

The first two result in an increase in cardiac output, delivering more blood to the organs. This is the primary intent, with the view that in time the underlying cause of the heart failure (be it myocardial "stunning" post cardiac arrest, or a concurrent infection being treated, or what have you) will improve for the adrenaline to be weaned off and the patient still alive at the end of it.

The increased heart rate is beneficial, but only to a point, as the heart chambers need enough time to refill with blood before they pump again.

The increase in blood vessel constriction is both beneficial and detrimental. Typically this maintains the necessary perfusion pressure to the vital organs, but again, only to a point. It depends on the underlying pathologies. And it can come at the "cost" of underperfusing other parts of the body (typically the peripheries).

In summary: the underlying purpose of the adrenaline was to keep the rest of your father's organs alive until his heart hopefully improved enough that it didn't need it. The alternative, as described, was not to give it: in which case his heart would have failed to perfuse the rest of his body, and he'd have died sooner.
 

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@Chutney, I appreciate you taking your time to provide detailed replies.

... until his heart hopefully improved enough ...
This statement perplexes me because I struggle to piece together even a simplified simulated recovery. My view is that the heart exists in its own environment of internal stocks and exogenous supplies - those stocks and supplies being artificially manipulated by adrenalin infusion.

Can a heart's health improve when its muscle is beating more rapidly and its capillaries are more constricted? Would expanding capillaries in this setting cause fatal ruptures?

While exposed to elevated adrenalin levels, are a heart muscles ever fully extended or fully contracted? Does the scope of movement influence muscle fatigue or muscle repair?

Beyond the heart, I recall my father suffered an "unrelated" bleed in the duodenum while in ICU. I am suspicious of the view that such events cannot stem from adrenalin treatment, and cannot stem from being bed-bound.

Managing a body is clearly non-trivial and I am setting-aside risks of implementation failure. My view is that the vision and plan need to be coherent. If the vision is not for the patient to walk way, then patient-doctor intentions are not aligned.
 

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Do you believe the video about the soul Donald?
Which bit?

Are you asking if I believe in a soul represented by a floaty angel with strings attached?
 

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@Chutney, I appreciate you taking your time to provide detailed replies.


This statement perplexes me because I struggle to piece together even a simplified simulated recovery. My view is that the heart exists in its own environment of internal stocks and exogenous supplies - those stocks and supplies being artificially manipulated by adrenalin infusion.

Can a heart's health improve when its muscle is beating more rapidly and its capillaries are more constricted? Would expanding capillaries in this setting cause fatal ruptures?
Adrenaline, along with nearly all such vasoactive drugs, exerts its effects at the larger blood vessels in the body; it will not be directly causing constriction of capillaries anywhere. The heart muscle “autoregulates” its blood supply, so the increasing workload will be met by reciprocal changes at the capillary level to facilitate better blood flow. Crucially, however, that relies on the heart itself pumping both a sufficient quantity of blood, and at a significant pressure (with sufficient back pressure from the aorta and great vessels) to divert some blood ejected from the ventricle straight back down the coronary arteries. Along with the previous observation that too fast a heart rate becomes less and less efficient (not enough time for the heart to fill), such rapidity also compromises coronary blood flow, as this can only occur when the heart is relaxed—and in terms of the ratio of contraction:relaxation, as the heart rate increases, the relative time spent in relaxation decreases.

While exposed to elevated adrenalin levels, are a heart muscles ever fully extended or fully contracted? Does the scope of movement influence muscle fatigue or muscle repair?
The heart muscle is distinct from normal, skeletal muscle, and the concept of muscle fatigue (as we classical understand it) isn’t really applicable as far as I’m aware. Similarly, the degree to which the muscle is “fully extended or contracted” is complicated, and relates both to the degree of adrenaline/other agent and also the volume of blood entering the ventricle per beat. The adrenaline will make the heart muscle contract more, limiting the filling volume slightly, but also makes the muscle contract “harder”, for lack of a better term. However, muscle repair (really, remodelling) is still possible under such conditions — but it requires quite a bit of physiological reserve.

Absolutely, an adrenaline infusion in heart failure is flogging a failing organ. Ventilators flog failing lungs. The trick is to do the least amount of harm whilst waiting for the body to heal itself.

Beyond the heart, I recall my father suffered an "unrelated" bleed in the duodenum while in ICU. I am suspicious of the view that such events cannot stem from adrenalin treatment, and cannot stem from being bed-bound.
Sadly, “critical care stress ulceration” is a very real phenomenon. Stress ulcer prophylaxis in the intensive care unit

It seems to relate to the profound physiological upset that stems from being so ill that you’re admitted to an ICU for vasoactive support. Standard practice is prophylaxis with one of two classes of drug to neutralise stomach acid. I’d argue that the need for adrenaline and the resulting bleed both stem from the underlying pathology...but then I would say that, wouldn’t I?
 
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