artificial feeding-Terri Schiavo - page 33

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... Read More

  1. by   Spidey's mom
    Quote from bugsbee
    Stevielynn
    Yes I do know what hospice is for so has see been terminal for 15 years? And if her parents truly loved her would they be able to watch her in this vegatative state for so long. Her husband is the one who truly loves her and wants her to be in peace and not on display like her parents want.
    Your first sentence is a little confusing . . but I'll try. Hospice is for people who are actively dying. Terminal for 15 years makes no sense. In that case all of us are terminal because we are all going to die someday.

    So you are saying that if her parents truly loved her, the manifestation of that love would be to "not be able to watch her"? So they should turn their back on her because she is brain damaged? That sounds alot like the old advice doctors gave parents of Down's Sydrome children . . if you love them put them in an institution for someone else to raise so you won't have to look at them.

    I can see, since I have personally experienced it, that allowing someone brain dead to be taken off a ventilator is a loving thing to do. But Terri is not brain dead. She responds. She is fairly healthy. She interacts, at times, with her parents. They want to care for her. And a feeding tube is not a ventilator.

    Regarding putting Terri on display, her husband has a part in the public airing of this issue since he is part of the legal case. He chose not to let Terri's parents take over care of Terri. It is his choice too. You can't blame just the parents.

    steph
  2. by   Spidey's mom
    Quote from beckymcrn
    Here is what I thnk about this whole thing.

    I do not know what her husbands motives are, but her parents want to take care of her. They will completely take her care out of his hands all he has to do is divorce her and go on with his life. (Which he obviously has already done). Problem is Terri never left a living will so we do not know what she may have wanted in this battle. I do not for a minute think that a feeding tube is a heroic measure. I have patients who have feeding tubes for years and years. The mere fact that she has lived this long with only a feeding tube tells me she has the will to live. So who am I to say we should starve her of food and water.
    So I would have to say I am on the parents side.
    Very simply and compassionately stated - this says it all. Thanks.

    I'll say it again - the problem is Terri never left any legal instructions.

    The problem for me is I don't believe that a feeding tube is heroic measures either.

    steph
  3. by   camay1221_RN
    Quote from bugsbee
    Have you ever worked neuro I doubt it. She is not responding to anyone. We are paying for her care not her parents. And have you not wondered why she is in Hospice being cared for. What a shame to have the courts tied up on this. I sure would believe her husband over her parents. They are keeping her alive for their own selfish reasons only, and yes I do realize how hard it is to let go. But would you like to go public in her condition and take away all your rights of privacy?
    bugsbee,

    I have never worked neuro, but, I am a mother, and as a mother, I certainly don't think Terri's parents intent is to be selfish! My goodness, this is their child! I can honestly say, I don't know how I would respond if one of my children were in the same state as Terri.
  4. by   Spidey's mom
    Quote from nrskarenrn
    dr. ronald cranford
    professor of neurology, university of minnesota medical school; associate physician, department of neurology, hennepin county medical center

    dr. cranford has specialized in the field of clinical ethics since the early 1970s. during this time, he served as a consultant to several national commissions on right-to-die issues. these included the president's commission for the study of ethical problems in medicine and biomedical and behavioral research, primarily the reports on "defining death" and "deciding to forego life-sustaining treatment" and the national conference of commissioners on uniform state laws on the uniform determination of death act and the uniform rights of the terminally ill act. he was a member of the panel that formulated the hastings center's "guidelines on termination of treatment and the care of the dying" and the project consultant to the national center of state courts' project on "guidelines for state court decision making in authorizing or withholding life-sustaining medical treatment." recently, he was co-chairman of the multisociety task force on medical aspects of the persistent vegetative state.
    http://www.bioethics.umn.edu/faculty/cranford_r.shtml

    this physician must be well thought of in his profession if he was appointed to a presidential commission.
    karen - i'm a member of a christian bio-ethics organization. people in bio-ethics run the gamut from pro-life christians to pro-euthanasia relativists.

    just because someone serves on a presidential committee doesn't mean we have to agree with his or her values.

    there is a large and open and contentious debate going on is this country regarding the direction we shall take in the future. all sides are part of it - even on presidential commissions.

    steph
  5. by   Spidey's mom
    Peter Singer has been professor of bioethics at Princeton University since 1999. Previously, he was professor of ethics at Monash University in Melbourne, Australia. He was a founding member of the Green Party in Victoria, Australia and was a Green Party senate candidate. He has taught at Oxford University and New York University, among others. His work in ethics is part of academic syllabuses around the world and his 1975 book Animal Liberation is the seminal work of that movement.


    Princeton Philosophy Professor Peter Singer is among the far extreme of right to die advocates but he is also working at a well-respected university and holds many well-respected offices. But his philosophy is barbaric. His belief that animals deserve more respect than human beings is well known. Here's just a little excerpt of his beliefs . . . and one of the reasons I'm afraid of the slippery slope this "right to kill" case with Terri Schiavo.

    Q. You have been quoted as saying: "Killing a defective infant is not morally equivalent to killing a person. Sometimes it is not wrong at all." Is that quote accurate?

    A. It is accurate, but can be misleading if read without an understanding of what I mean by the term "person" (which is discussed in Practical Ethics, from which that quotation is taken). I use the term "person" to refer to a being who is capable of anticipating the future, of having wants and desires for the future. As I have said in answer to the previous question, I think that it is generally a greater wrong to kill such a being than it is to kill a being that has no sense of existing over time. Newborn human babies have no sense of their own existence over time. So killing a newborn baby is never equivalent to killing a person, that is, a being who wants to go on living. That doesn't mean that it is not almost always a terrible thing to do. It is, but that is because most infants are loved and cherished by their parents, and to kill an infant is usually to do a great wrong to its parents.
    Sometimes, perhaps because the baby has a serious disability, parents think it better that their newborn infant should die. Many doctors will accept their wishes, to the extent of not giving the baby life-supporting medical treatment. That will often ensure that the baby dies. My view is different from this, only to the extent that if a decision is taken, by the parents and doctors, that it is better that a baby should die, I believe it should be possible to carry out that decision, not only by withholding or withdrawing life-support - which can lead to the baby dying slowly from dehydration or from an infection - but also by taking active steps to end the baby's life swiftly and humanely.

    Q. What about a normal baby? Doesn't your theory of personhood imply that parents can kill a healthy, normal baby that they do not want, because it has no sense of the future?

    A. Most parents, fortunately, love their children and would be horrified by the idea of killing it. And that's a good thing, of course. We want to encourage parents to care for their children, and help them to do so. Moreover, although a normal newborn baby has no sense of the future, and therefore is not a person, that does not mean that it is all right to kill such a baby. It only means that the wrong done to the infant is not as great as the wrong that would be done to a person who was killed. But in our society there are many couples who would be very happy to love and care for that child. Hence even if the parents do not want their own child, it would be wrong to kill it.

    ************

    A newborn baby is not a person?

    steph
    Last edit by Spidey's mom on Mar 23, '05
  6. by   fergus51
    Quote from stevielynn
    Karen - I'm a member of a Christian Bio-Ethics organization. People in bio-ethics run the gamut from pro-life Christians to pro-euthanasia relativists.

    Just because someone serves on a Presidential committee doesn't mean we have to agree with his or her values.

    There is a large and open and contentious debate going on is this country regarding the direction we shall take in the future. All sides are part of it - even on Presidential commissions.

    steph
    By the same token, a medical professionals diagnosis and ethics are not necessarily suspect because of their belonging to an organization. This man didn't fake her eeg. I find this to be a troubling part of our society nowadays. Attacking the messengers credibility because he has some opinions on end of life care and what that means is sad. I have a lot of opinions too, but it doesn't change my nursing care. I have looked after kids with a lot of ethical grey areas and I never tried to convince the parents to change their minds regarding treatment because it isn't what I would do in their place. Maybe I'm alone in this, but I do think it's possible to remain honest and compassionate with families even when you don't see every situation in the same way that they do.

    Edited to add: I think Singer is a little crazy Steph, but I thought he still thinks killing a baby is a "terrible thing to do". I've never heard him advocate killing any unwanted child for fun.
    Last edit by fergus51 on Mar 23, '05
  7. by   Spidey's mom
    Quote from fergus51
    By the same token, a medical professionals diagnosis and ethics are not necessarily suspect because of their belonging to an organization. This man didn't fake her eeg. I find this to be a troubling part of our society nowadays. Attacking the messengers credibility because he has some opinions on end of life care and what that means is sad. I have a lot of opinions too, but it doesn't change my nursing care. I have looked after kids with a lot of ethical grey areas and I never tried to convince the parents to change their minds regarding treatment because it isn't what I would do in their place. Maybe I'm alone in this, but I do think it's possible to remain honest and compassionate with families even when you don't see every situation in the same way that they do.

    Edited to add: I think Singer is a little crazy Steph, but I thought he still thinks killing a baby is a "terrible thing to do". I've never heard him advocate killing any unwanted child for fun.
    I'm not saying you do this, but there have been comments on the bulletin board and actually in the media, where someone's opinions are discounted because they come from a certain perspective.

    Heck, I've posted things from Townhall.com and some people discount it completely because it is a conservative site.

    Peter's opinions are worse than that example - I just thought that related to our discussion.

    He is nuts but he is listened to.

    steph
  8. by   fergus51
    I don't think it's right to do this either way, that was sort of my point. This MD is apparently basing his diagnosis on things like an EEG. If someone has a problem with his diagnosis, they should try to discuss the EEG, not the man. I work with pro-lifers, pro-choicers, Christians, atheists and everything in between. I don't know anyone I would not trust to be honest about a clinical diagnosis regardless of their philisophical beliefs.
  9. by   heart queen
    quoting all sides, aside. there is NO health care proxy. the hospital ethics committee needed to first appoint a law guardian and then go through the stages from hospital to law. There is no court appointed guardian as I know.

    In any conflict of interest in the family, a law guardian needs to be appointed, interview the family and continue in the judicial process as HER defendent.....

    My knowledge, correct me please, shows that this hasn't happened,(no legal guardian) yet it's so commonplace. all our theories be damned.... this is about what terri would want. Not the husband, or her parents..... period.

    if it can't be determined, against my personal beliefs, we need to carry on and let nature take its course along side a full medical regimine of treatment.

    not what I want, or would choose for her.... but by not deciding .... she has chosen, on full recusitation measures.... life support and yes feeding.

    I say pull the tube, but this is the process that must take place.... mind you I'm against leaving the tube in.... but unless she made it clear otherwise it is assumed that all measures to maintain life will continue.

    This cannot continue as a husband/ family... he said... she said war.... it seems to be done... and terri will loose albeit our attempt at either end.

    If guilty of wrong doing, the husband has not and will not be convicted of anything

    her family, god love 'em can't see that terri is gone. She is not able to substain life with oral feeding, (sure she can swallow, just not enough to keep her alive, therefore, her basic brain function of being able to substain life is gone and she requires LIFE support, in the form of feeding. hence the feeding tube to prevent deterioration which will result in death.

    working the ICU I see families keeping guppy breathing brain frazzled patients alive because at least the patient is still there.... the mourning, the loss does't have to come as long as the body is in the bed, no matter how little is left, and the focus from the patients right to die over the families right to not grieve, loss and morn can't be distinguished by them.

    I support a court appointed guardian to absolve the husband and family of their fight. If terri was able to substain life without life saving measures.... she would be fed by mouth...

    terri is incapable of substaining her own life. Neither the husband or parents are able to determine her wishes....

    it needs to be removed from all their hands, and yes the court must dedide.
  10. by   KRVRN
    I caught a little snippet of an interview with Dr. Ronald Cranford last night and I was surprised to hear in passing that her EEG had been flat. That is not something that I've heard before.

    Now, I'm not a neuro nurse, so can someone please review what the implications of a FLAT EEG are?
  11. by   tonalee
    Quote from fergus51
    I'm not saying spouses get to decide no matter what. But, barring any illegal acts and when they are in agreement with doctors, it's their decision. If your daughter marries a frog, then that's her choice. You don't get to be her decision maker forever because you are her parent. Sorry, that's just the way it is. It may not be ideal, but it's the system we have. There are a lot of jerk spouses and jerk parents out there.

    Would you feel the parents should get to make the decision if it was the other way around? (I mean if the parents wanted to remove the feeding tube and the husband wanted to keep it in).
    I don't think that the parents should let her go on like this.I just question the husbands real intetions and reasons for them.I think in this case it is best to look at who is in the best place to be making this kind of decision.This is so sad.Can I go as far as saying with the intense emotions behind this that God will just quietly take her in a way that isn't anyones fault?Is that possible?
  12. by   UnewmeB4
    Quote from stevielynn
    Very simply and compassionately stated - this says it all. Thanks.

    I'll say it again - the problem is Terri never left any legal instructions.

    The problem for me is I don't believe that a feeding tube is heroic measures either.

    steph
    Read the court documents. They tried to take care of her in 1990. It lasted 49 days. They were overwhelmed, and she was taken back to Bayfront hospital for additional aggressive rehab efforts. Her parents even encouraged Michael to date other women.

    This information was from the man appointed to be the "Guardian Ad Litem" for Terri, Jay Wolfson in the brief he sent to Gov Bush.
  13. by   tantalus
    Well, here goes....I understand the differences between her parents and her husband.....I also understand that her parents did once try to care for Terri.


    My problem is this.....surely starving someone to death is euthanasia/murder.

    Why has no-one suggested that Terri not receive further active treatment (maybe they have, feel free to correct me on this one). No more antibiotics for infections etc. Could this not have been a compromise between the two sides?

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