Use of a Ventilator
Development of a variety of pulmonary Rehabilitation devices and technologies
Currently being implemented for patients without requiring a tracheostomy
There are numerous cases where the use of a ventilator is required, due to the weakening of respiratory muscles, at the end stage of neuromuscular diseases, such as myopathy, amyotrophic lateral sclerosis and spinal muscular atrophy, whose symptoms include the progressive weakening of muscles.
However, ethical and economical aspects must be also considered along with medical aspects when determining whether to use a ventilator or not.
Extending the life span of patients with advanced diseases via the use of a ventilator causes social controversy and research findings are thus reported differently.
In other words, a number of studies showed that long-term use of a ventilator must be limited because when patients with neuromuscular diseases depend on ventilators for long periods of time it may cause incalculable ethical and economical dilemmas, whereas some studies proved that patients can still live a meaningful life while using a ventilator.
Therefore, patients, guardians and medical teams agonize quite seriously at the point where the use of a ventilator is necessary. Patients with neuromuscular diseases, unlike patients who remain in a vegetative state, have clear consciousness, thus it is an undeniable fact that the use of a ventilator for the purpose of lengthening one’s life triggers controversy in relation to euthanasia.
Many medical personnel have negative opinions about extending the life span with the use of a ventilator, but in a study of patients with amyotrophic lateral sclerosis who are currently using ventilators, researchers found that 90% of the patients who use a ventilator for long periods of time had favorable attitudes towards the application of mechanical aids and said that they will use it again if they were to be put in a situation where they must decide whether to use it or not.
A study of patients suffering from Duchenne’s muscular dystrophy also showed much higher levels of a patients’ satisfaction than expected. Unlike medical personnel and people’s expectation that most of the patients would have negative and skeptical attitudes towards their lives that require a mechanical ventilation in order to save their lives showed positive attitudes. These research findings suggest that determining the standards for the value of life of these patients based on opinions of people other than actual patients may lead to wrong results.
Opinions of medical personnel on the quality of a patients’ life carry significant implications. When explaining a patients’ situation or the future course of treatments, preconceived opinions of medical personnel on the quality of patients’ life can greatly influence on the determination of patients themselves or their guardians who may take such opinions into account for their decisions.
This is not to say that it is always right to generalize the results from particular studies since a standard of value or surrounding situation of each patient varies, but what is certain is that most medical personnel do not take initiative on treatments because as life satisfaction and the values of patients are assessed to be very low.
A patients’ scope of options has been widened and conditions for the use of devices have been improved by the development of a variety of pulmonary rehabilitation devices and technologies that now the patients can use a ventilator without having undergo a tracheotomy.
In addition to that, there are many cases where matters that used to hinder a patients’ life are no longer obstacles as devices capable of relieving peoples obstacles are consistently being developed via the development of information science technologies and mechanical engineering.
Hence if medical personnel actively participate in providing treatments, patients will be able to extend their lives while maintaining an improved quality of life.
