MaxedOutMama
Monday, February 28, 2005
Terri's not alone
The things we do, oh the things we do. Terri is by no means the only person who is being starved to death based on a doubtful wish. The Florida Cracker has summed this one up neatly:
Rather than eye Mr. Cracker with suspicion, I did a living will saying I want my food and water any way I can get them. It's not too much to ask that you be fed and watered twice a day.A commenter responds:
The things you have to do these days to protect yourself from hearsay.
As far as societal opinion goes, I would say that people will pity you so much they'll kill you- but I don't think that's the case. I think there are new rules being formed as to who is and who is not a person. More accurately, I think these are just the old rules that are making a comeback.
The Ancient Greeks and Romans would recognize them: Expose the elderly and infirm on mountainsides, put the unwanted baby on the dungheap. The pre/post-Christian lifestyle choices.
I don't know how many Living Wills I've seen and even prepared myself for clients. A bunch. One of the effects of this case on me has been that I shudder now that in the vast majority of those cases the people signing their living wills chose "Cease providing nourishment" or " Cease providing hydration" or BOTH (among other options on the form). The standard form in Georgia doesn't give you all that many choices, and most people who sign them are just thinking "I don't want to be kept alive if I'm a vegetable and have no chance of recovering". No one envisions themselves as Terry Schiavo. They don't consider the possible agony of a long, slow death by starvation while you're conscious but can't communicate. That really bothers me.It bothers me too. But it gets worse. Some people have been starved to death while they were alert and begging for food and water. The comments at this post on Polipundit included this one (comment # 72):
I’m an RN who’s worked in the facility where Terry is. I’ve been working in Long Term Care for 20 years and have unfortunately seem quite a few Terry Schiavo’s. The latest patient I’ve had the pleasure to work with was a 76 year old woman with progressive swallowing problems.Right to die doesn't mean right to kill. This is the reason that if you support the right to die you should be very active in defending the limitations of the courts and others to make that decision for someone else.
It got to the point after extensive testing, that she was unable to take food by mouth without the risk of choking. She was aware of her surroundings but occasionally confused so her out of state family had power of attorney to make her medical/legal decisions. They denied doctors the right to place a feeding tube, saying she was “old, sick and tired.” We had instructions from the legal team to not give her food or water for fear of her choking. So we had a sweet little 76 y/o senior citizen that we were literally starving to death!! It was pathetic and pitiful. This poor soul would beg for food and water only to be told no. It was heartbreaking. Long story short, we nurses took the chance of her choking and gave her food and water when we could. The family knew something was up and came to move her from our facility to one near them. Found out she died 2 weeks later of dehydration. Her family threatened to sue all of us for not following their instructions. Hasn’t happened yet, we’ll see. It’s so sad to see someone pass away that way. It’s the rules of threes. Three minutes without air, three days without water and three weeks without food. The patient really ends up suffering greatly.
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Because this is such a complicated issue I don't feel I can say very much. I do have one thing to share. I had medical power of attorney for my father last year.I tried to follow his stated wishes and his unstated wishes as best as I could discern them. I also used my own conscience which is strongly pro-life on all counts.
What I found is that the "hospice" part of the equation seems to have a duality in their philosophy. I say 'seems' because it was not clear for the short time I dealt with this. One was an euthanasia ideal and one was a 'comfort for what remains of life' ideal. I found this confusing, to say the least.
We have a crisis in this country, and a wide spread between the mores of most people and the medical community, who are themselves divided. The legal community is out to lunch on this.
As a society we keep giving the seal of approval for death and then wonder at the fallout, such as this case.
What I found is that the "hospice" part of the equation seems to have a duality in their philosophy. I say 'seems' because it was not clear for the short time I dealt with this. One was an euthanasia ideal and one was a 'comfort for what remains of life' ideal. I found this confusing, to say the least.
We have a crisis in this country, and a wide spread between the mores of most people and the medical community, who are themselves divided. The legal community is out to lunch on this.
As a society we keep giving the seal of approval for death and then wonder at the fallout, such as this case.
# posted by 
: 4:25 PM
: 4:25 PM
Marty,
I have read a long compilation of the medical stuff, including some excerpts from Michael Schiavo's diary (before the judgements to him). I have read multiple reports by doctors. Therapists, nurses and many doctors over a period of more than a decade all seem to report relatively consistent facts, including the words that she says and the circumstances under which she says them. I have read the taskforce definition of PVS, and Terri doesn't fit it.
One of the most disturbing things about Terri's case to me is which evidence has been admitted and which has not been. I believe strongly in an individual's right to refuse treatment. I believe strongly that an individual has the right to execute a document saying that under certain circumstances she or he does not want to receive treatment, including food or water. In order to defend the exercise of this right, I also believe strongly that we have to defend the right of people not to die this way unwillingly, and I believe that the presumption has to be in favor of a person's right to live.
Ilona,
Vast sympathies. My mother has expressed very strong opinions, and I have promised her that I will carry them out, and I will. If my mother were in Terri's situation she would choose to receive anything by mouth but not be fed by tube. I would fight for her right to make that choice. When my grandmother was dying (my grandmother had executed all the documents, and made it clear to everyone what she wished) and lapsed into a state of unconsciousness we did have to fight not to put her on IV.
I am not some sort of religious dingbat on this issue. I strongly support the right to refuse medical treatment. I just don't support the right of society to dehydrate and starve people to death on the presumption that they would not want to live, which is what is happening in far too many cases.
I think to claim this right one must make the affirmative effort to fill out the paperwork. I also think that by supporting the right of people not to be put to death in this manner unless they have chosen it, we support the right of people to retain this choice if we do choose it. The backlash to what's happening now is going to be fierce. Cases such as Terri's have already caused a lot of people to make out living wills emphasizing that they do wish to receive food and water.
I have read a long compilation of the medical stuff, including some excerpts from Michael Schiavo's diary (before the judgements to him). I have read multiple reports by doctors. Therapists, nurses and many doctors over a period of more than a decade all seem to report relatively consistent facts, including the words that she says and the circumstances under which she says them. I have read the taskforce definition of PVS, and Terri doesn't fit it.
One of the most disturbing things about Terri's case to me is which evidence has been admitted and which has not been. I believe strongly in an individual's right to refuse treatment. I believe strongly that an individual has the right to execute a document saying that under certain circumstances she or he does not want to receive treatment, including food or water. In order to defend the exercise of this right, I also believe strongly that we have to defend the right of people not to die this way unwillingly, and I believe that the presumption has to be in favor of a person's right to live.
Ilona,
Vast sympathies. My mother has expressed very strong opinions, and I have promised her that I will carry them out, and I will. If my mother were in Terri's situation she would choose to receive anything by mouth but not be fed by tube. I would fight for her right to make that choice. When my grandmother was dying (my grandmother had executed all the documents, and made it clear to everyone what she wished) and lapsed into a state of unconsciousness we did have to fight not to put her on IV.
I am not some sort of religious dingbat on this issue. I strongly support the right to refuse medical treatment. I just don't support the right of society to dehydrate and starve people to death on the presumption that they would not want to live, which is what is happening in far too many cases.
I think to claim this right one must make the affirmative effort to fill out the paperwork. I also think that by supporting the right of people not to be put to death in this manner unless they have chosen it, we support the right of people to retain this choice if we do choose it. The backlash to what's happening now is going to be fierce. Cases such as Terri's have already caused a lot of people to make out living wills emphasizing that they do wish to receive food and water.
The technological advances and the changing philosophies of medicine have teamed up to produce the dilemma we now see epitomized in Terri S.'s case.
Living wills reduce the problem of mindlessly continuing processes that a person doesn't want. I think it is clear that this is not enough to conserve a persons dignity. A medical power of attorney helps, but as seen in this case the "loved one" in charge can act in opposition to ones best interest.
Laws might be on the books, but it is case law that tends to determine outcomes.[ How specific cases were judged.] That is probably why this one case is so important.
Since Terri is in hospice care, doesn't that mean someone made the decision that she be left to die? This shows the need for some legislated clarification for hospice.
I am one of the few I know dissatisfied with hospice outcome. I found it a pressure; and the contrary philosophy of hospice with the medical doctors (who themselves were of differing opinions) was unsatisfactory.
There are competing agendas on the professional levels, how is it surprising that M. Schiavo's conflicting agenda somehow was overlooked?
The fact is that medical science can do much, it is a matter of will and ability to pay. In Terri Schiavo's case it seems that the question ought to be how much the will of the determinant, in this case her husband, can weigh the balance toward death?
This dark day of valuing death over life is not contained in this one case or issue. Americans have to decide which will be the prevailing attitude of our society and laws.
I believe it is that black and white.
Living wills reduce the problem of mindlessly continuing processes that a person doesn't want. I think it is clear that this is not enough to conserve a persons dignity. A medical power of attorney helps, but as seen in this case the "loved one" in charge can act in opposition to ones best interest.
Laws might be on the books, but it is case law that tends to determine outcomes.[ How specific cases were judged.] That is probably why this one case is so important.
Since Terri is in hospice care, doesn't that mean someone made the decision that she be left to die? This shows the need for some legislated clarification for hospice.
I am one of the few I know dissatisfied with hospice outcome. I found it a pressure; and the contrary philosophy of hospice with the medical doctors (who themselves were of differing opinions) was unsatisfactory.
There are competing agendas on the professional levels, how is it surprising that M. Schiavo's conflicting agenda somehow was overlooked?
The fact is that medical science can do much, it is a matter of will and ability to pay. In Terri Schiavo's case it seems that the question ought to be how much the will of the determinant, in this case her husband, can weigh the balance toward death?
This dark day of valuing death over life is not contained in this one case or issue. Americans have to decide which will be the prevailing attitude of our society and laws.
I believe it is that black and white.
# posted by : 11:49 AM
: 11:49 AM
Ilona and Marty,
Please forgive my brief responses. I am so physically miserable that I'm having trouble dealing with the mental misery of this case.
Marty, thank you very much for the ruling you sent me. I haven't read it all, but I will. I do appreciate both your arguments and your intent.
Ilona, I suppose no institution can be perfect, and I suppose individual experiences differ as well. I have had a recent death in my family that was very troubling and that raised the possibility of medical ethical violations to me. I believe in giving the doctors the benefit of the doubt, but in this case I can't see how Terri qualifies for hospice either, except for Greer's ruling that she should be dead.
Just being on a feeding tube is not grounds for ruling that it should be removed unless recovery is expected. In Terri's case it is the combination that she has been ruled to be in PVS and the court has decided that she expressed the verbal preference to die under that circumstance.
Ilona, I share your concerns. I too believe that we have crossed the line in many of these cases. I was looking through DU for a posting within the last month by a woman fighting to save her brother. He had been in some sort of accident, and after three months the medical ethics committee met and told the family that they would give them 10 days to find another placement or they would withdraw life support. I can't find the link right now, but I'm not sure this is at all unusual.
I fear where we are going.
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Please forgive my brief responses. I am so physically miserable that I'm having trouble dealing with the mental misery of this case.
Marty, thank you very much for the ruling you sent me. I haven't read it all, but I will. I do appreciate both your arguments and your intent.
Ilona, I suppose no institution can be perfect, and I suppose individual experiences differ as well. I have had a recent death in my family that was very troubling and that raised the possibility of medical ethical violations to me. I believe in giving the doctors the benefit of the doubt, but in this case I can't see how Terri qualifies for hospice either, except for Greer's ruling that she should be dead.
Just being on a feeding tube is not grounds for ruling that it should be removed unless recovery is expected. In Terri's case it is the combination that she has been ruled to be in PVS and the court has decided that she expressed the verbal preference to die under that circumstance.
Ilona, I share your concerns. I too believe that we have crossed the line in many of these cases. I was looking through DU for a posting within the last month by a woman fighting to save her brother. He had been in some sort of accident, and after three months the medical ethics committee met and told the family that they would give them 10 days to find another placement or they would withdraw life support. I can't find the link right now, but I'm not sure this is at all unusual.
I fear where we are going.
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