Artificial feeding-Terri Schiavo

[ktwlpn]

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...........

[James Huffman]

However, once the families had time to come to terms with the situation they did what was best for their family member and let them go they didn't force them to live a life that was nothing but laying there in a shell they have no control over.

Precisely. When families "come to terms with the situation," there's no need for outside (governmental, or otherwise) intervention. But when -- for whatever reason -- there's no coming to terms, that's when someone must mediate.

Jim Huffman, RN

[bugsbee]

Yes it is difficult but when you work neuro nursing there are many of these decisions being made. And in most cases it seemed more humane to let go than hold on to something that would never be. Most families were able to come together and do what they felt was right, and you have to accept their wishes. Terris parents have involved far to many people and taken away Terris privacy. It is a sad situation.

[Tweety, BSN, RN]

Precisely. When families "come to terms with the situation," there's no need for outside (governmental, or otherwise) intervention. But when -- for whatever reason -- there's no coming to terms, that's when someone must mediate.

Jim Huffman, RN

Jim, I have to agree with you here. I've seen families torn apart over treatment of loved ones. Often they just need a little time, and yes mediation. Fortunately the cases I've seen have been handled very well by our social services/chaplain department. Whenever there is a conflict, we always opt for life and agreesive treatment until the family comes to some sort of agreement.

Mediation can be a good thing. It's just so sad it's gone to the level it has with Terri, and couldn't be resolved by now.

[Tweety, BSN, RN]

Yes it is difficult but when you work neuro nursing there are many of these decisions being made. And in most cases it seemed more humane to let go than hold on to something that would never be. Most families were able to come together and do what they felt was right, and you have to accept their wishes. Terris parents have involved far to many people and taken away Terris privacy. It is a sad situation.

I worked neuro, and these decisions are made all the time. I wonder how someone who had doubts about tube removal or stopping agressive treatment feel when they see protests and religious folks on tv comdemning them, calling them murderers. Must be a tough time for them.

Yes, indeed...a very sad situation. No winners here.

[tvccrn, ASN, RN]

Precisely. When families "come to terms with the situation," there's no need for outside (governmental, or otherwise) intervention. But when -- for whatever reason -- there's no coming to terms, that's when someone must mediate.

Jim Huffman, RN

Mediation is one thing. Wasting the time of Congress, wasting taxpayers money, and waking up the POTUS in the middle of the night to sign a bill that benefits exactly ONE family is quite another.

[ValerieB]

I've been a nurse for over 20 years also and I have about had it with hearing about this poor woman. I think it's sick to flash this woman all over the news every single day. I have a friend in her 40's who was in a very tragic car accident who suffered massive brain damage. What made her who she was was taken away from her. If she new what her fate was ( spitting at staff, unable to attend her children's marriages/graduations, unable to eat normally ( and she was a nurse for a long time), she would be mortified if her family plastered her pictures on the news daily. It is not NEWS. It is no one's business but her family's. Her parents are absolutely ridiculous for allowing this. It's ironic that she suffered cardiac arrest because of an eating disorder which we all know is usually caused by the patient feeling he has no control over her life and now the parents want to continue having control over her and FEED her. I don't believe that nurse's account of what was going on in the nursing home. If that's true, there is an agency called "the state" that oversee's nursing homes and that's who she should have called if she felt the patient's rights were being violated. That's her job. I worked in a nursing home and that was stressed all the time. Call the board of nursing, the police, etc. If she didn't care about losing her job, then why would she care about calling all of these agencies. This is why I find this woman very difficult to believe. I don't think her husband is a saint, nor do I think her parents are any better, but it should never have been in the news and the government should stay the heck out of this. I had a discussion with my husband the other night about living wills ( he has one) and about heroic measures and what we don't want to live like. My parents know now how I feel, but no one was in the room when we had these discussions so who's to say that Terri and Michael didn't have these discussions? We need to leave Terri alone and let her die with dignity and not a three ring circus.

[Katmease]

Regardless of how much "experience" J. Huffman has, I'd certainly rather have him as my nurse as opposed to Bugsbe. He has explained his thought process & reasoning instead of the attitude of if one doesn't agree, then they must be wrong or inexperienced.

I am so amazed at callousness of some of the posts. Do I have a living will, yes, I do but I think one should be on the side of life if there is any doubt of the patient's wishes. Think of the people that have come of situations like this, that were aware of their surroundings but couldn't express it & the docs said they couldn't possibly be aware. When I was in nursing school in 1981, we were taught that one can not know what the patient feels as we are not that person & everyone is different. It seems things have changed & I can't say for the better.

[caroladybelle, BSN, RN]

1. The "government" is brought in even in some cases of animal suffering. If, for example, you see a neighbor tormenting a cat, the police will deal with the situation, even arresting the neighbor if it's warranted.

2. An animal that is suffering may be gently put to sleep. The animal in question may NOT be tormented or tortured. More specifically, the animal may not be starved or have fluid withheld. We -- as a society -- arrest people who don't feed their animals. Again, why is Ms. Schiavo treated worse than an animal by being slowly and deliberately starved when she is not, in fact, dying, apart from being starved?

And when was the last time that you saw a cat or a dog in a persistant vegetative state, contracted and unable to give meaningful response, that someone continued tube feed or even force feed for 14 years?

Many would consider that torturing an animal.

Terri was a very vibrant woman with an eating disorder. She permitted this disorder to control her life and her being so much so that it notably impaired her health and fertility, as well as was obviously apparent in medical testing. Would she want to continue her life in this condition, given her past determination and behavior? Friends and her spouse have demonstrated evidence in court, numerous times that she would not want to live in this condition. If she had difficulty accepting herself as the healthy young woman that she was, so much so that she would risk her life/health to be some ideal of perfection that she held dear, what would she feel about herself now?

In addition, eating disorders tend to stem from feeling the need to be "perfect" and seeking control over one's life by controlling one's body. These issues frequently begin in early childhood. It is known that Terri was an overweight child and that these problems most likely were manifested in her late adolescence and early teens. It is also known that her family teased her about weight issues. Are they not negligent in that they may have played a serious role in her development of this disorder and her need to pursue this ideal?

Putting her now in a very passive condition into this family's total control and care....it quite likely would be her worst nightmare and a type of abuse in and of itself.

Her parents have also indicated that no matter what her wishes were, they would still push to keep her alive.

While I don't like her spouse, I feel that he is trying to do what she would wish. Otherwise, he would have already extricated himself from the situation, as he has plenty of reasons to do so and many lucritive opportunities.

There is only one person's wishes that should matter in this case...and they are Terri's desires for her life and how she might have wished to live/lose it.

[Healthone]

I just read where the appeal has once again been denied. The family is now looking back to the very same judge, Greer, who removed the tube last Friday as to whether he will allow investigation that Terri was abused by her husband. Gov. Bush is pushing as well for intervention by somehow pulling another medical review out of his.....pocket.

This woman has been in care without progress until 1998, when the husband began to petition to have the feeding tube removed. If the family believed at any point during that time that he had abused Terri, they should have addressed it then. Terri has been in medical care for years, and supporting information is available as to her state of mind. But again, now at the very last hour, someone somewhere is trying to pull one over so that the case can be delayed.

I personally as a taxpayer am being offended by the abuse of power with our legal systems. I don't believe either allegations, if for no other reason than noone acted upon them until the hours of desperation are at the greatest. It has reached a ridiculous level.

I stated earlier that I believe the Schindlers have an issue with letting go, and I still believe it now. I now shudder to think what law may come from it that will make my own passing a long drawn process when I would never want it that way. I have also recently wondered if this is a twist on Munchausen's by proxy, or at least in a sense. Their drama is attention and fullfilling their lives and keeping Terri still in the present tense. I think they are manipulating the situation and desperate to coax responses that are not there.

The courts are exhausted (honestly 5 visit to the Supreme level), indivudual efforts are exhausted. The case is reduced to grasping at straws and pushing through bills to help Terri. It makes me feels as if the meanings of laws really don't mean anything and can be changed at the drop of a hat. I see potential issues if this abuse of power continues.

[rn/writer, RN]

regardless of how much "experience" j. huffman has, i'd certainly rather have him as my nurse as opposed to bugsbe. he has explained his thought process & reasoning instead of the attitude of if one doesn't agree, then they must be wrong or inexperienced.

i couldn't agree more. i thought j. huffman's posts were articulate and thoughtful.

miranda f.

[tvccrn, ASN, RN]

regardless of how much "experience" j. huffman has, i'd certainly rather have him as my nurse as opposed to bugsbe. he has explained his thought process & reasoning instead of the attitude of if one doesn't agree, then they must be wrong or inexperienced.

i couldn't agree more. i thought j. huffman's posts were articulate and thoughtful.

miranda f.

i think it's healthy for us to have this discussion in such a manner. most of us are stating our opinions in a controlled, well-read way. i certainly enjoy the back-and-forth of a civilized debate to an out-and-out mudfest.

[Tweety, BSN, RN]

regardless of how much "experience" j. huffman has, i'd certainly rather have him as my nurse as opposed to bugsbe. he has explained his thought process & reasoning instead of the attitude of if one doesn't agree, then they must be wrong or inexperienced.

i couldn't agree more. i thought j. huffman's posts were articulate and thoughtful.

miranda f.

i agree. while i may not agree with much of what he says, he's been most thoughtful and intelligent and like us all, deserves to be listened to with respect regardless of whether we agree with him or not.

it's hard to vehemently disagree with someone though and not sound inflammatory. though we try. i agree with the above, most of this discussion has been mature, thoughtful and intelligent.