Wow, so a person could really be as extremely lucid and awake as you are now, but hooked up to an ECMO, knowing that there’s no hope and with one flick of the switch it’s all over?
Last summer a friend of mine had an accident while swimming at the beach, broke his neck, and spent six months on a a machine before he had a diaphragm pacemaker surgically installed. I visited him at a long-term care facility and there was a whole ward of people on ventilators.
I'm extremely grateful for the ability to breathe unassisted.
Go take a look at an ICU ward, conscious or not these people are seriously unwell and as close to death as humanly possible.
Even the rich ones.
The difference we are talking about with work is that a person gets paid if they do work, and doesn't get paid if they don't.
When someone is unwell enough to be placed in an ICU, it is important not to be flippant about suggesting they do things for money. Even putting aside the ethics of it, or the fact that in some caees additional burdens could literally kill them, if you get your worker to give your company an extra few thousand dollars value and that worker ends up taking an extra day in the ICU, how much do you imagine that extra day of ICU treatment costs? And what sort of other costs might there be that aren't captured in dollars?
He was 'seriously sick', but he had a certain quality of life that was unusual for ECMO patients.
...The boy was fully conscious, doing homework, texting friends and visiting with family. But after two months of living in the ICU, he was diagnosed with untreatable cancer that made him ineligible to receive new lungs.
Clinicians were deeply divided over what to do next, Truog said. Some wanted to stop ECMO immediately because its original goal — a bridge to transplantation — was no longer possible.
Others argued that even though he couldn’t survive outside the ICU, the boy seemed to have a good quality of life on ECMO, and his family and friends “derived benefits from his continued survival,” Truog wrote. They argued that the family should have the right to continue this form of life support, just as with dialysis, ventilation or an artificial heart.
A third argument arose, Truog said: If leaving this patient on ECMO was appropriate, then in fairness “why don’t we put everyone with respiratory failure on ECMO?”
For the parents, Truog said, it was “unbearable” to choose a day or moment to turn off ECMO, because they knew their child would immediately die.
Clinicians devised an alternative the family would agree to: They decided not to replace the ECMO oxygenator, a part that needs to be changed every week or two when it develops blood clots. After about a week, the oxygenator gradually failed and the patient lost consciousness and died, Truog said.
The solution “allowed him to die in a way where we didn’t feel like we were choosing the moment of his death,” he said....
That's not an argument against, that's an argument for. Why don't we? The only reason not to would be cost.
What would be really amazing is if we could replace defibrillators with these in stores, malls, etc... Instead of trying to restart someone's heart you have a system that's simple enough that a layperson can slap on a dying person to keep them alive while the ambulance arrives. Maybe in the form of a cuff that you clamp over someone's wrist that can use computer vision to identify veins and automatically insert the needles and run the machine. Too complex to be affordable with today's tech, but something that could definitely be possible in my lifetime I think.
There's a reason they put the lines in the femoral vessels - these cannulas are like hosepipes - you need to access the large vessels to get sufficient blood flow through the whole circulation.
The amount of flow needed to only sustain someone that hasn't been severely deoxygenated must be a lot less.
A smaller system might be able to initially infuse an oxygen-carrying booster (as Tour de France cyclists do) to get away with lower flow rates.
ECMO not only oxygenates, but pumps to assist the heart. Red blood cells would not resist infusion through small cannulas at high speed. Hemolysis already is a problem with the current size femoral cannulas.
So if what you're after is flow, size is a severe limitation.
I'm aware that's what's taught in med school, though. At the maroscopic level, it works ok.
Severe hypercapnia symptoms are bad.
What you describe only exists in very limited form in research labs.
Just whatever you do, make sure they did ask for it.