Artificial feeding-Terri Schiavo

Nurses General Nursing

Published

I posted this here becaue I think this subject is something that we as nurses deal with on a regular basis.....Many many people state that they have a big problem with the feeding being stopped "allowing her to starve to death" The Vatican says " To starve her to death is pitiless" Most everyone agrees that it is one's right to refuse to initiate artificial feeding but somehow this situation "is different" How? The patient "starves to death " in both cases-so why has this one galvanized the WORLD? My husband read me a quote from the Bible -forgive me because I can't remember it in detail-it was something along the lines that a woman marries and leaves her father's house and her husband becomes her family....My husband is my POA I hope no-one in my family questions his motives -He KNOWS exactly what I want....I can't question her husbands motives-I know that some suspect foul play and state the results of a bone scan support this...That bone scan was obtained 53 months after she went into her coma-after her body suffered the effects of her eating disorders for a number of years.... Her present level of responsiveness does not pertain to this matter IMHO-she CAN'T eat naturally--she did not ever want to "be kept alive like that " and she can't state otherwise at this point...So- #1 can someone PLEASE make me see why this case is" DIFFERENT" and #2 How do YOU support your patients and their loved ones when they are agonizing over this decision? ONe thing I always ask is "Did your loved one ever give you any idea of what they would want if something like this happened" and if they did then I advocate that stance for that pt as much possible.......I believe that death is the last great trip we'll go on and we should PLAN it as much as possible.The greatest GIFT we can give to our loved ones is an itinerary...........

This isn't a case of the government "interfering" . . . the government is simply living up to the Constitution, specifically Article III . . .

And people keep saying that if Terri didn't want her husband to speak for her she should have made some legal arrangement before she became brain damaged. That is just crazy - most people that young don't have anything written legally. So we allow a spouse to have the right to kill another spouse just because she forgot to write something down??

There has to be a legal avenue to protect everyone's right to life, liberty and the pursuit of happiness.

When someone gets sick without making plans then some authority has to step in and see that their rights are protected.

Otherwise we have chaos.

steph

Not that the right to life folks and some Christian right folks aren't posturing either, many of whom have offered money to keep her alive. Also, a bit of political posturing on the politicians fault. Can't help but wonder if their voting their conscious, what their consitutients want, or what will also gain them politically.

Of course you are right that the pro-life crowd is rallying behind Terri's parents.

I see nothing wrong with either side taking public stances .. . I was just theorizing about why Michael didn't take the money.

This is a serious issue for both sides and both are determined to win.

steph

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

There has to be a legal avenue to protect everyone's right to life, liberty and the pursuit of happiness.

Otherwise we have chaos.

steph

You're forgetting they used to court system to the max. Bringing all the way to the Supreme Court, which refused to hear the case. So yes, there is a legal avenue and they have persued it.

I'm not saying I 100% disagree with congress getting involved. It's not the first time the congress has made laws thwarting the courts, in favor of the best interests of the public. But I want to point out Terri and family weren't without any legal avenues, they just haven't gotten the answer they wanted to hear. That's not a judgement, I don't blame them.

And as you've pointed out, the court isn't without it's flaws.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

"So we allow a spouse to have the right to kill another spouse just because she forgot to write something down?? "

I wouldn't put it so harshly, but I suppose that's what it is. And yes, Steph, we must continue to allow spouses power of attorney and health care surrogacy even though nothing is written down. This is the way it's been and the way it should remain. Terri's case is not unique in this. In fact that's been Michael's ace in the hole, as there are many cases that support the spouses right to make medical decisions.

Suppose your son didn't have a living will and became head injured and confused, who should make medical decisions on his behalf? I think there needs to be an avenue in for people who don't have things written down, even if it involves something as drastic as stopping futile medical treatment.

Specializes in Critical Care.

I have to take issue with the following remarks quoted here. If this person had so many doubts, why didn't she go to someone higher up and express them? There are laws against retaliation for bring issues such as this to light. I would certainly think twice about placing a loved one in the care of soemone who would let alleged incidents like this occur and not do anything about them.

As for the divorce issue, if he had divorced her then there would be people ranting and raving about the fact that he abandoned his wife for another woman just because she was in this state. Not that I believe everything the man says, but on this matter he can't win. If he stays he gets comments made about his motives, if he leaves then his character is shredded. Rock and a hard place, you know.

Sigh.

Once again, the loving Michael Schiavo. Devoted, supportive and grieving husband.

And the information from Carla Sauer Iyer, R.N., Ms. Schiavo's nurse:

"It was clear to me at Palm Gardens that all decisions regarding Terri Schiavo were made by Michael Schiavo, with no allowance made for any discussion, debate or normal professional judgment. My initial training there consisted solely of the instruction "Do what Michael Schiavo tells you or you will be terminated." This struck me as extremely odd."

and

"I was very disturbed by the decision making protocol, as no allowance whatsoever was made for professional responsibility. The atmosphere throughout the facility was dominated by Mr. Schiavo's intimidation. Everyone there, with the exception of several people who seemed to be close to Michael, was intimidated by him. Michael Schiavo always had an overbearing attitude, yelling numerous times such things as "This is my order and you're going to follow it." He is very large and uses menacing body language, such as standing too close to you, getting right in your face and practically shouting."

and

"To the best of my recollection, rehabilitation had been ordered for Terri, but I never saw any being done or had any reason at all to believe that there was ever any rehab of Terri done at Palm Gardens while I was there. I became concerned because nothing was being done for Terri at all, no antibiotics, no tests, no range of motion therapy, no stimulation, no nothing. Michael said again and again that Terri should NOT get any rehab, that there should be no range of motion whatsoever, or anything else. I and a CNA named Roxy would give Terri range of motion anyway. One time I put a wash cloth in Terri's hand to keep her fingers from curling together, and Michael saw it and made me take it out, saying that was therapy."

and

"Throughout my time at Palm Gardens, Michael Schiavo was focused on Terri's death. Michael would say "When is she going to die?," "Has she died yet?" and "When is that ***** gonna die?" These statements were common knowledge at Palm Gardens, as he would make them casually in passing, without regard even for who he was talking to, as long as it was a staff member. Other statements which I recall him making include "Can't you do anything to accelerate her death - won't she ever die?" When she wouldn't die, Michael would be furious. Michael was also adamant that the family should not be given information. He made numerous statements such as "Make sure the parents aren't contacted." I recorded Michael's statements word for word in Terri's chart, but these entries were also deleted after the end of my shift. Standing orders were that the family wasn't to be contacted, in fact, there was a large sign in the front of her chart that said under no circumstances was her family to be called, call Michael immediately, but I would call them, anyway, because I thought they should know about their daughter."

and

"Any time Terri would be sick, like with a UTI or fluid buildup in her lungs, colds, pneumonia, Michael would be visibly excited, thrilled even, hoping that she would die. He would call me, as I was the nurse supervisor on the floor, and ask for every little detail about her temperature, blood pressure, etc., and would call back frequently asking if she was dead yet. He would blurt out "I'm going to be rich!," and would talk about all the things he would buy when Terri died, which included a new car, a new boat, and going to Europe, among other things."

and

"When Michael visited Terri, he always came alone and always had the door closed and locked while he was with Terri. He would typically be there about twenty minutes or so. When he left Terri would would be trembling, crying hysterically, and would be very pale and have cold sweats. It looked to me like Terri was having a hypoglycemic reaction, so I'd check her blood

sugar. The glucometer reading would be so low it was below the range where it would register an actual number reading. I would put dextrose in Terri's mouth to counteract it. This happened about five times on my shift as I recall. Normally Terri's blood sugar levels were very stable due to the uniformity of her diet through tube feeding. It is my belief that Michael injected Terri with Regular insulin, which is very fast acting."

and

"The longer I was employed at Palm Gardens the more concerned I became about patient care, both relating to Terri Schiavo, for the reasons I've said, and other patients, too. There was an LPN named Carolyn Adams, known as "Andy" Adams who was a particular concern. An unusual number of patients seemed to die on her shift, but she was completely unconcerned, making statements such as "They are old - let them die." I couldn't believe her attitude or the fact that it didn't seem to attract any attention. She made many comments about Terri being a waste of money, that she should die. She

said it was costing Michael a lot of money to keep her alive, and that he complained about it constantly (I heard him complain about it all the time, too.) Both Michael and Adams said that she would be worth more to him if she were dead. I ultimately called the police relative to this situation, and was terminated the next day. Other reasons were cited, but I was convinced it was because of my "rocking the boat.' "

and

"While at Palm Gardens, I became fearful for my personal safety. This was due to Michael's constant intimidation, including his menacing body language, vocal tone and mannerisms."

[end of quotes from Ms. Iyer]

I will be impressed with Michael Schiavo's loving, devoted attention when someone can cite concrete information rather than giving their own opinions.

Jim Huffman, RN

Well, I don't know about in Fl. But in Ca, you need to have 6 months or less to live (estimated by doctor) to be in hospise. If Terry does not have a terminal condition, she would not be in hospice in Ca.

Does the Hemlock Society purposly use words to make people think it is hospise?

-Dan

_______________

Here is a little information about Hemlock and its founder:

The career of Derek Humphry, founder of the Hemlock Society, demonstrates the natural progression from assisted suicide to murder. Humphry's career is outlined in Rita Marker's book, Deadly Compassion: The Death of Ann Humphry and the Truth about Euthanasia. Humphry assisted in the suicide of his first wife in 1975 by giving her an overdose of Seconal in a cup of coffee. She was dying of cancer. He later reportedly told his second wife that the Seconal did not work, and that he killed his first wife by suffocation.

Years later, Humphry married Ann Wickett. Together they helped cause the death of both her parents on the same day in 1986. When lethal drugs administered to her parents did not seem to be working, Wickett followed her husband's instructions and suffocated her mother with a plastic laundry bag. She later left her parents' house thinking: "We're both murderers and I can't live like this anymore."

Humphry later abandoned Wickett and filed for divorce after she discovered she had breast cancer. After two years of legal and medical problems, Wickett fell into despair and killed herself. She left a note accusing Humphry of doing everything conceivable to precipitate her death.

***

It is also interesting to note that this has to do with another husband/wife situation where one personality is the dictator leader.

On a note about mistakes in medicine, a story ran today in Canadian news. A woman woke up in the hospital morgue. She had been identified as dead...and probably with no consciousness either.

Sigh.

Once again, the loving Michael Schiavo. Devoted, supportive and grieving husband.

And the information from Carla Sauer Iyer, R.N., Ms. Schiavo's nurse:

"It was clear to me at Palm Gardens that all decisions regarding Terri Schiavo were made by Michael Schiavo, with no allowance made for any discussion, debate or normal professional judgment. My initial training there consisted solely of the instruction "Do what Michael Schiavo tells you or you will be terminated." This struck me as extremely odd."

and

"I was very disturbed by the decision making protocol, as no allowance whatsoever was made for professional responsibility. The atmosphere throughout the facility was dominated by Mr. Schiavo's intimidation. Everyone there, with the exception of several people who seemed to be close to Michael, was intimidated by him. Michael Schiavo always had an overbearing attitude, yelling numerous times such things as "This is my order and you're going to follow it." He is very large and uses menacing body language, such as standing too close to you, getting right in your face and practically shouting."

and

"To the best of my recollection, rehabilitation had been ordered for Terri, but I never saw any being done or had any reason at all to believe that there was ever any rehab of Terri done at Palm Gardens while I was there. I became concerned because nothing was being done for Terri at all, no antibiotics, no tests, no range of motion therapy, no stimulation, no nothing. Michael said again and again that Terri should NOT get any rehab, that there should be no range of motion whatsoever, or anything else. I and a CNA named Roxy would give Terri range of motion anyway. One time I put a wash cloth in Terri's hand to keep her fingers from curling together, and Michael saw it and made me take it out, saying that was therapy."

and

"Throughout my time at Palm Gardens, Michael Schiavo was focused on Terri's death. Michael would say "When is she going to die?," "Has she died yet?" and "When is that ***** gonna die?" These statements were common knowledge at Palm Gardens, as he would make them casually in passing, without regard even for who he was talking to, as long as it was a staff member. Other statements which I recall him making include "Can't you do anything to accelerate her death - won't she ever die?" When she wouldn't die, Michael would be furious. Michael was also adamant that the family should not be given information. He made numerous statements such as "Make sure the parents aren't contacted." I recorded Michael's statements word for word in Terri's chart, but these entries were also deleted after the end of my shift. Standing orders were that the family wasn't to be contacted, in fact, there was a large sign in the front of her chart that said under no circumstances was her family to be called, call Michael immediately, but I would call them, anyway, because I thought they should know about their daughter."

and

"Any time Terri would be sick, like with a UTI or fluid buildup in her lungs, colds, pneumonia, Michael would be visibly excited, thrilled even, hoping that she would die. He would call me, as I was the nurse supervisor on the floor, and ask for every little detail about her temperature, blood pressure, etc., and would call back frequently asking if she was dead yet. He would blurt out "I'm going to be rich!," and would talk about all the things he would buy when Terri died, which included a new car, a new boat, and going to Europe, among other things."

and

"When Michael visited Terri, he always came alone and always had the door closed and locked while he was with Terri. He would typically be there about twenty minutes or so. When he left Terri would would be trembling, crying hysterically, and would be very pale and have cold sweats. It looked to me like Terri was having a hypoglycemic reaction, so I'd check her blood

sugar. The glucometer reading would be so low it was below the range where it would register an actual number reading. I would put dextrose in Terri's mouth to counteract it. This happened about five times on my shift as I recall. Normally Terri's blood sugar levels were very stable due to the uniformity of her diet through tube feeding. It is my belief that Michael injected Terri with Regular insulin, which is very fast acting."

and

"The longer I was employed at Palm Gardens the more concerned I became about patient care, both relating to Terri Schiavo, for the reasons I've said, and other patients, too. There was an LPN named Carolyn Adams, known as "Andy" Adams who was a particular concern. An unusual number of patients seemed to die on her shift, but she was completely unconcerned, making statements such as "They are old - let them die." I couldn't believe her attitude or the fact that it didn't seem to attract any attention. She made many comments about Terri being a waste of money, that she should die. She

said it was costing Michael a lot of money to keep her alive, and that he complained about it constantly (I heard him complain about it all the time, too.) Both Michael and Adams said that she would be worth more to him if she were dead. I ultimately called the police relative to this situation, and was terminated the next day. Other reasons were cited, but I was convinced it was because of my "rocking the boat.' "

and

"While at Palm Gardens, I became fearful for my personal safety. This was due to Michael's constant intimidation, including his menacing body language, vocal tone and mannerisms."

[end of quotes from Ms. Iyer]

I will be impressed with Michael Schiavo's loving, devoted attention when someone can cite concrete information rather than giving their own opinions.

Jim Huffman, RN

_____________

There is a web site that supports Scott Peterson (run by women, no less) and there are pictures of he and laci posted all over the thing. The captions read, "you can tell they are in love", "they look so good together", "cant you tell he loves her"

There are so many issues in this case. Another issue that we sometimes forget is a certain aspect of PVE in this case. One big disagreement is that the parents are saying Terri is not in a PVE state and the husband say it is. Unfortunately, both side got their experts to support them.

Many of us probably side with either ther parents or the husband depending on whether we think Terri is in PVE or not. If you think Terri is in PVE, you probably say let her go. If you don't think Terri is in PVE, you probably will side with the parents.

If your love one is not in a PVE state and the power to be said pull the plug, wouldn't many of us will fight with all we got?

-Dan

I question his motives.

Last time she was removed from food/water, her parents wanted a priest to giver her last rites. The husband refused.

There has been a sworn statement from Terri's nurse that her husband came into the room and asked, "is the b*tch dead yet?" and "I am going to be rich!"

I don't believe that. I don't believe that at all. The whole world from Larry King to Oprah is trying to make this guy like an evil toad. According to Michael Shiavo's lawyer, this guy is going to get nothing from her death, and that I do believe. I also believe he wants to marry his new fiancee and Terri is in the way of that. Personally, I can understand how at this point Michael Shiavo would feel resentful. Even though he may have loved Terri she can't love him back anymore and he is a man, after all. I'm sure the first bottle neck I created for my husband he would resent me too. That is why I have a living will. I don't want to be a burden to anyone, even if it is a buden of love. It is still a burden and wears your loved ones down.

There will be no happy ending to this.

1. To repeat my earlier post:

"Michael Baden, top forensic pathologist in country and interviewed on Fox News National Television broadcast October 25, 2003 on Terri's bone scan and injuries states that:

a) Terri's injuries are not consistent with a heart attack; no cardiac evidence to support it

b) Extremely rare for potassium imbalance on woman her age and in her good health

c) Injuries are consistent with severe trauma possibly caused by a beating

d) The injuries in medical records warrant an immediate investigation"

2. If Ms. Schiavo's injuries indicate a possibilty of abuse on the part of Michael Schiavo, then let's investigate. And if -- as you said earlier, "he's not a criminal unless tried and convicted," then if there's enough evidence to warrant it, I hope the local DA has the guts to indict him. Sorry, but I have patience with a man who abuses his wife. If that's what went on here, it's high time that he be made to answer for his behavior.

Jim Huffman, RN

But she wasn't in good health was she? She was a bulimic and potassium imbalance is a consequence. Many anorexics and bulimics die of heart attacks.

Regarding the allegations of an eating disorder:

"Contrary to the account of writer Chachere, there was never a determination by any court nor the Florida Department of Health that Terri Schiavo ever suffered from any eating disorder, bulimia, anorexia or compulsive behavior that would lead to a heart failure at the age of 26.

Indeed, Florida's Department of Health had completely and absolutely cleared Terri's general practitioner of any negligence or wrong-doing in her case. This was after the physician had been accused by Terri's husband of ignoring evidence of an eating disorder.

Additionally, at the time of her mysterious medical episode, Terri Schiavo stood 5'3" and weighed somewhere between 115 and 118 pounds - a slim, but normal stature and weight.

Associated Press writer, Vickie Chachere cites not ONE medical document that would affirm her careless contention that Terri Schiavo was an irresponsible dieter or a compulsive victim of an eating disorder. The Terri Schindler-Schiavo Foundation asks Ms. Chachere to readily produce the facts upon which she penned such assertions.

The parents and siblings have repeatedly offered to media and press a copy of a bone scan conducted on Terri Schiavo just one year after her incident that reveals multiple sites of trauma and broken bones throughout Terri's body. Neither the law enforcement agencies nor the media or press have made any effort to investigate why Terri Schiavo's body was seemingly broken by battery.

Instead, they perpetuate the unsubstantiated claims that Terri Schiavo suffered from an eating disorder that rendered her healthy, 26 year-old heart incapable of carrying on."

[end of quote]

Jim Huffman,RN

Bulimics come in normal and above normal weights. It is very hard for anyone to know if someone is bulimic. They are experts at hiding it and because their weight is usually falls in the normal range no one suspects. Bulimics usually eat normally between binges, then ingest large amounts and throw it up.

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