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Military ? : who determines to pull the plug?


Widder, SASS #59054

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If a soldier is badly injured and put on life support,  and the injuries put him/her in a vegetated state

to require permanent life support...... WHO determines when and if the plug is pulled on the life supporting unit?

 

Because the soldier belongs to the Military, would the parents, wife, children, etc..... make the determination

or would the military doctors make the decision?

 

OR, if the injured soldiers service time ends while under doctors care, would the decision to 'pull the plug' or stay on

life support become the responsibility of the family?

 

..........Widder

 

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8 hours ago, Widder, SASS #59054 said:

If a soldier is badly injured and put on life support,  and the injuries put him/her in a vegetated state

to require permanent life support...... WHO determines when and if the plug is pulled on the life supporting unit?

 

Because the soldier belongs to the Military, would the parents, wife, children, etc..... make the determination

or would the military doctors make the decision?

 

OR, if the injured soldiers service time ends while under doctors care, would the decision to 'pull the plug' or stay on

life support become the responsibility of the family?

 

..........Widder

 

 

I suspect it depends on the circumstances.  If it is a non-combat related injury on a military base, then it is likely the family's decision, although if long term care is required the patient is likely to be transferred to a VA facility.

 

If it is non-combat related injury or combat related injury in the field, it will likely depend on if the patient can be transported with a reasonable chance of survival to a military hospital outside of the deployment area.

 

Only if the patient has no chance of recovery, can not be transported with a reasonable chance of survival and using resources that could be used for another patient that does have a chance of recovering will the doctor end life support, but that is considered triage.

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Many folks include such instructions in their wills, identifying who they trust to make that decision.  I expect the soldier’s wishes would be honored if they exist and are on record.

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Seriously??

 

Speculation.  Curiosity as well, but without access to actual military medical practice and instructions, who knows??  Based on some limited experience, some 45 years past, if the wounded weren't seen as "viable" they weren't treated except to ease pain.  

 

In the Gulf conflicts however, all bets are off.  Medical Science has "improved" to the point of creating the most expensive veterans on the Planet.  Right or Wrong.  A Quandry. 

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I learned something from a retired E9 buddy o' mine relating to this. IIRC, a young serviceman was critically injured in a car accident and had no hope of recovery. After a few days, the family made the decision to "pull the plug". My buddy went to the Colonel and asked if the man could be, or had been, medically retired yet. The Chief burned up the phone lines, and made quite a mad dash around the base for the next couple hours to get this done before the young airman died.

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3 hours ago, Three Foot Johnson said:

I learned something from a retired E9 buddy o' mine relating to this. IIRC, a young serviceman was critically injured in a car accident and had no hope of recovery. After a few days, the family made the decision to "pull the plug". My buddy went to the Colonel and asked if the man could be, or had been, medically retired yet. The Chief burned up the phone lines, and made quite a mad dash around the base for the next couple hours to get this done before the young airman died.

 

What is the advantage of having the serviceman medically retired before his death?  It must be something, otherwise why go to all the trouble to have it done?

 

Was he on duty at the time of the accident, or on leave?  Does that even make a difference?

 

You have filled me with questions.

 

Angus

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Exactly. He didn't die on active duty. He was injured on active duty and died after being medically retired.

 

 From militarypay.defense.gov - The Survivor Benefit Plan (SBP) allows a retiree to ensure, after death, a continuous lifetime annuity for their dependents. The annuity which is based on a percentage of retired pay is called SBP and is paid to an eligible beneficiary.

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Absolutely right on Three Foot!!

 

Bugler

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2 hours ago, Three Foot Johnson said:

Exactly. He didn't die on active duty. He was injured on active duty and died after being medically retired.

 

 From militarypay.defense.gov - The Survivor Benefit Plan (SBP) allows a retiree to ensure, after death, a continuous lifetime annuity for their dependents. The annuity which is based on a percentage of retired pay is called SBP and is paid to an eligible beneficiary.

 

I don't mean to be thick headed, but I'm still a little cloudy on this.  Supposing the poor guy gets shot fighting in some Sandistan somewhere but doesn't die.  He is transported back to a hospital in the states where he dies a month later from his injuries.  He isn't "medically retired" at the time so his family is not entitled to benefits?   But in the same circumstances, if he gets "medically retired" before he dies they ARE entitled to benefits?

 

IF that is the case, at what point does someone decide to "medically retire" a person?  What if he only makes it back to a MASH unit?  (Are there even still MASH units?)

 

I presume that if he's shot fighting in Sandistan and KIA  DRT the family is entitled to survivors benefits.  (oops, maybe not)

 

Wait, after re-reading your last post, it looks like only the family of a retiree is eligible for benefits.  Is that correct?  If that's right, what does the family of the guy KIA get?  Just a flag?

 

I'm missing the distinction.  Active duty - Injured in car accident - dies.  Not medically retired so no benefits. 

Active duty - gunshot injury - dies.  Not medically retired - No benefits?

Active duty - gunshot DRT.  No opportunity for medical retirement.  Benefits(?)

 

Could you explain the logic?

 

Widder, sorry to sidetrack your thread, but this got me really curious, Alpo curious, even.

 

Angus

 

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SBP is something you have to sign up for when you retire. It is not an automatic benefit. It is a form of life insurance and the military member must elect to enroll and pay premiums.

Survivor Benefit Plan Overview

 

The real deal is that if you are placed on the Permanent Disability Retirement List. (PDRL) You are entitled to severance pay. Won't go into how it is calculated here.

 

https://tricare.mil/LifeEvents/DeathinFamily

 

https://tricare.mil/LifeEvents/Retiring/MedicalRetirement

 

https://www.military.com/benefits/military-pay/military-disability-retirement.html

 

Being medically retired is not an easy process and generally takes takes considerable time. Took well over a year for my Grandson to be medically retired after suffering a multitude of injuries including Traumatic Brain Injury (TBI) when the MRAP he was in was destroyed by an IED made from an anti-tank mine. He also suffers from severe PTSD.

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23 hours ago, Three Foot Johnson said:

I learned something from a retired E9 buddy o' mine relating to this. IIRC, a young serviceman was critically injured in a car accident and had no hope of recovery. After a few days, the family made the decision to "pull the plug". My buddy went to the Colonel and asked if the man could be, or had been, medically retired yet. The Chief burned up the phone lines, and made quite a mad dash around the base for the next couple hours to get this done before the young airman died.

I had a soldier who was in dire straits and we ran through hoops to get him medically retired. He was in bad shape and it was, undoubtedly, the right thing to do at the time. He had a miraculous turn around and was discharged from the hospital after a lengthy stay and wanted to return to active duty status. It was a lot more difficult to undo his medical retirement than it was to implement it in the first place.

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If you die or are killed on active duty, your family gets a lump sum insurance payout. If you survive long enough to be medically retired (100% disabled), your family gets monthly payments for the rest of their lives. I have several friends who went through this, having the soldier medically retired at 100% disabled before their death makes a huge difference financially.

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V.A. ask you to file a living will which I have done. You can request complete care, or DNR, just let me die. I assigned a friend as caretaker with a copy of the living will with my instructions when incapacitated. V.A. also has copy within their computer system which my health records are world wide.

The only experience I have on this subject is when my first wife ended on life support. Doctor meet me as I was coming into the ICU and informed me on her situation and that she could only survive on life support. He then asked me what my wishes were, which I responded she had enough, unplug her. I went into the room where she died in my arms.

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