Question: Would like some advice for a relative of mine who suffered an anoxic brain injury

Hi Doctor,

The situation is very serious and urgent. He was left without oxygen for a few mintues. According to the local neurologist, there is brain damage and he is left in a depressed level of consciousness where he does not respond to any external stimuli such as noise, touch, pain, etc. He is in the ICU in Las Vegas, Nevada for about two weeks now. He is 33 years old, has no health issues and all his vitals are good. Can you please let me know what you think of the current situation in terms of patient survivability? I have heard that 50% of patients after a year surive this type of injury according to one of the medical journals. The issue we are facing here is that the person who is in charge of what happens to him legally is his wife. Our family and her have conflicting interests. She is focused on the fact that my cousin is signed up to be an organ donor as well as the fact that she wants to do a post-mortem sperm retrieval. The issue is that we are being rushed to do both. We are being told that in order to collect sperm, it has to be post-mortem to have a higher success rate. So in order to do this they want to transfer him to a different hospital which allows them to stop his life support machines for 90 minutes and let him pass, if he doesn't pass they will take him to start comfort care. We as a family support both organ donation and sperm retrieval if he passes away naturally, however we think this method of doing it forcefully is very unethical as he is in a state where he is alive and all vitals are working. The sperm clinic told us that due to the antibiotics the chance of his sperm working has gotten lower. The organ donor representative said the same for the organs. Basically the more time that passes the less you can do either. We understand this however, we do not think a higher chance of conception or more organs donated are equivalent to taking his life away. We recently even received news that his eyes react to light, his legs shake, and his sleep cycles are getting better. I have talked to the organ donation representative and I explained to him that as a collective goal of doing what is best for him we need time and multiple expert opinions. So far we have some positive opinions from the people we have talked to. The neurologist that worked on him in the hospital said that if they take his life support away, he will last the 90 minutes as he is partially breathing on his own thereby I understand that this process is only cruel and counter productive. What I would like to ask is what do you think we should do as I want to do what is only and entirely best for him. What would you do if you were the decision maker and this is your wife or close relative. What do you think is ethical to do? Any advice you can give me would be immensely appreciated. Thank you so much for your time and consideration.