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Relatives need to know that "it's not that you don't want a miracle to happen, it's just that is not going to happen today with this patient," he said.
Families occasionally persist and hospitals have gone to court seeking to stop medical treatment doctors believe is futile, but such cases are quite rare.
Dr. Michael Sise, trauma medical director at Scripps Mercy Hospital in San Diego, called the study "a great contribution" to one of the most intense issues doctors face.
Sise, a Catholic doctor working in a Catholic hospital, said miracles don't happen when medical evidence shows death is near.
"That's just not a realistic situation," he said.
Sise recalled a teenager severely injured in a gang beating who died soon afterward at his hospital.
The mother "absolutely did not want to withdraw" medical equipment despite the severity of her child's brain injuries, which ensured the child would never wake up, Sise said. "The mom was playing religious tapes in the room, and obviously was very focused on looking for a miracle."
Claudia McCormick, a nurse and trauma program director at Duke University Hospital, said she also has never seen that kind of miracle. But her niece's recovery after being hit by a boat while inner-tubing earlier this year came close.
The boat backed into her and its propeller "caught her in the side of the head. She had no pulse when they pulled her out of the water," McCormick said.
Doctors at the hospital where she was airlifted said "it really doesn't look good." And while it never reached the point where withdrawing lifesaving equipment was discussed, McCormick recalled one of her doctors saying later: '"God has plans for this child. I never thought she'd be here.'"
Like many hospitals, Duke uses a team approach to help relatives deal with dying trauma victims, enlisting social workers, grief counselors and chaplains to work with doctors and nurses.
If the family still says, "We just can't shut that machine off, then, you know what, we can't shut that machine off," McCormick said.
"Sometimes," she said, "you might have a family that's having a hard time and it might take another day, and that's OK."
On the Net:
Archives of Surgery: http://www.archsurg.com/
Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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