Artificial feeding-Terri Schiavo

Kyriaka · Mar 18, 2005

Think of the sheer monotony of her days. One day identical to the next. Never tasting food. Pleasure seeking is natural. What pleasure does she have? What does she have to look forward to---oral care? Being turned and positioned. Staring at mom for another decade. How natural is that for a life. Would you want to grow old that way?
Real living is enjoying new signs of spring outside, experiencing life, having coffee at the mall with friends, going for a new haircut. I wouldn't want my dog to live like she does. She has suffered enough. Let her rest in peace. She should be nominated for sainthood having endured hell on earth.
I think the clergy that what to "save" her have never worked with those in vegetative states. Let her go to a much better place with dignity.

___________________

In your opinion, should Christopher Reeve have been kept alive? He had to have a machine.

What about Steven Hawking? A truly brilliant man..but confined.

There was a story today that ran on the BBC of a late term abortion performed in Britain. The reason? Child would be born with a cleft lip. The Dr.'s felt they wouldnt want to be born that way...so to them there would be no quality of life.

jeepgirl, LPN, NP · Mar 18, 2005

JustaMaleRN,
Thank you! This man has been without his partner for 14 years and people are down on him for being engaged and having a life with someone else. This matter was supposed to have been settled long ago! Her spouse is trying to carry out her wishes and the parents can't let go. Legally, he is her next of kin. These people are supposed to be Christian. Even the Bible states that when we get married that is our new family, not the one we came from. Even is he gets money from life insurance or whatever, it won't be enough to pay all the legal fees and agony he has been through in his attempts to honor his wife's wishes! I only pray that my husband would be so steadfast if he needed to be,
Nancy2

he's had multiple partners and an engagement since her initial collapse. he actually was living with a woman before the malpractice case, however he then moved in with parents after he was told by his attorney that this behavior would put him in a less than favorable light. but this isn't the actual problem. besides, why won't he just divorce her so he can move on... get married to his fiance, etc. if you're engaged, WHY won't you divorce your ex so you can do that? that's an indication of an alterior motive if i ever saw one. does he have to wait until she's dead?

i could understand that position in the quote above if he weren't doing things such as denying her dental care, PT for her painful conditions, sunlight, cards and flowers. he's also been verbally demeaning to her in her presence to her caregivers and staff. Terri's injuries were most consistant with strangulation. the chemical imbalance / cardiac failure DX was given by the ER doc on the initial examination after collapse. She has no cardiac damage consistant with a heart attack.

just a lot of stuff that doesn't add up.

i have seen and been in abusive relationships. this just seems like another one of them... and she can't get out of it because of her state.

My biggest concern is that he wants to cremate her (something she had verbally not wanted and is against her religion) and he wants to move her ashes to Penn instead of having it near her family. Also, he doesn't want her to have anything by mouth after the TF is dc'd. From almost all reports, she's never had explicit dysphagia.

icyounurse, BSN, RN · Mar 18, 2005

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she is not brain dead.
right now many people are paying for her care. Her family wants to take her home to care for her. Dr.'s and nurses have offered their care FREE OF CHARGE. But the husband has refused even free physical therapy.

she only has use of her brain stem. that is why she can breathe. you see your brain stem contols breathing and blinking and other VERY basic life functions. terri has lost cognitive neurological functions, which are controlled by the upper part of the brain. basically, she cannot form words, thoughts or purposefully coordinate movements. this is called living in a persistive vegatative state. there is no evidence of anybody ever regaining brain function after brain death[the upper brain is what i mean, i know she still has a brain stem] she will never think or speak or feel pain again. I hardly think that breathing and blinking constitutes living or quality of life. I have never met anybody who wants to breathe and blink while family members suffer emotionally for years and years and tons of money and time are spent keeping you alive so you can poop on yourself, be covered in bed sores, be repositioned, have desitin smeared on you, be contracted and never do anything but breathe and blink. make involuntary movements. i cannot understand why anyone fights to keep somebody in a state of limbo. it is not natural. it seems to me that if you cannot feel pain because that part of your brain is dead, starving would not hurt. just common sense. i think she will be in a better place with no glucerna, desitin, diapers, diahrrea[tube feeding can cause HORRIBLE diahrrea] and other unpleasant realities. just give the woman some peace.

would you want to live like that honestly?

icyounurse, BSN, RN · Mar 18, 2005

___________________
In your opinion, should Christopher Reeve have been kept alive? He had to have a machine.
What about Steven Hawking? A truly brilliant man..but confined.
There was a story today that ran on the BBC of a late term abortion performed in Britain. The reason? Child would be born with a cleft lip. The Dr.'s felt they wouldnt want to be born that way...so to them there would be no quality of life.

um, not to state the obvious but they had undeniable brain functioning, THE WHOLE BRAIN, not just the brain stem. they could think, speak and well THINK.

jeepgirl, LPN, NP · Mar 18, 2005

she only has use of her brain stem. that is why she can breathe. you see your brain stem contols breathing and blinking and other VERY basic life functions. terri has lost cognitive neurological functions, which are controlled by the upper part of the brain. basically, she cannot form words, thoughts or purposefully coordinate movements. this is called living in a persistive vegatative state. there is no evidence of anybody ever regaining brain function after brain death[the upper brain is what i mean, i know she still has a brain stem] she will never think or speak or feel pain again. I hardly think that breathing and blinking constitutes living or quality of life. I have never met anybody who wants to breathe and blink while family members suffer emotionally for years and years and tons of money and time are spent keeping you alive so you can poop on yourself, be covered in bed sores, be repositioned, have desitin smeared on you, be contracted and never do anything but breathe and blink. make involuntary movements. i cannot understand why anyone fights to keep somebody in a state of limbo. it is not natural. it seems to me that if you cannot feel pain because that part of your brain is dead, starving would not hurt. just common sense. i think she will be in a better place with no glucerna, desitin, diapers, diahrrea[tube feeding can cause HORRIBLE diahrrea] and other unpleasant realities. just give the woman some peace.
would you want to live like that honestly?

yeah but she's been like this for 14 years (almost 15). of course, i'm not her nurse, but i have never seen reports of bedsores, etc. she does respond to stimuli as well as interacting with her enviroment. she tries to mouth words even... there's a video on the website www.terrisfight.org...

she can't do it and she seems to become preplexed and upset.

she also begins to cries when her parents leave occasionally.

i guess that there is some debate among her physicians about how much of her brain is damaged. some of them think that she could be higher functioning if given proper treatment. she's playful (goo goos and ga ga's) and laughs. all of her actions make me think that she does feel pain.

i think there is a difference after someone is acutely ill and when someone has been like this for almost 15 years. they should have done this stuff 15 years ago instead of dragging it out.

jeepgirl, LPN, NP · Mar 18, 2005

Think of the sheer monotony of her days. One day identical to the next. Never tasting food. Pleasure seeking is natural. What pleasure does she have? What does she have to look forward to---oral care? Being turned and positioned. Staring at mom for another decade. How natural is that for a life. Would you want to grow old that way?
Real living is enjoying new signs of spring outside, experiencing life, having coffee at the mall with friends, going for a new haircut. I wouldn't want my dog to live like she does. She has suffered enough. Let her rest in peace. She should be nominated for sainthood having endured hell on earth.
I think the clergy that what to "save" her have never worked with those in vegetative states. Let her go to a much better place with dignity.

but, her husband refuses for her to have Holy communion and wants her cremated which is against her religion.

hum. why would a loving spouse do such a thing?

icyounurse, BSN, RN · Mar 18, 2005

yeah but she's been like this for 14 years (almost 15). of course, i'm not her nurse, but i have never seen reports of bedsores, etc. she does respond to stimuli as well as interacting with her enviroment. she tries to mouth words even... there's a video on the website www.terrisfight.org...
she can't do it and she seems to become preplexed and upset.
she also begins to cries when her parents leave occasionally.
i guess that there is some debate among her physicians about how much of her brain is damaged. some of them think that she could be higher functioning if given proper treatment. she's playful (goo goos and ga ga's) and laughs. all of her actions make me think that she does feel pain.
i think there is a difference after someone is acutely ill and when someone has been like this for almost 15 years. they should have done this stuff 15 years ago instead of dragging it out.

i agree that yes these issues should definantly have been addressed a very long time ago. i also think there should be more focus on the PATIENT, and not the politicians, the family and the husbands motives. too many posts about gossip that has nothing to do with the patient and her state of mind and right to live or die, which is what it should be focused on.

icyounurse, BSN, RN · Mar 18, 2005

i challenge anybody to post that they would like to be kept alive in a persistive vegatative state for 14 years. anybody at all. has anybody put that in a living will ?

pkapple · Mar 18, 2005

I too have personal feelings and beliefs, but this post is just to clarify some misconceptions

#1 the Catholic Church does allow cremation.

#2 A coma is a profound or deep state of unconsciousness. The affected individual is alive but is not able to react or respond to life around him/her. Coma may occur as an expected progression or complication of an underlying illness, or as a result of an event such as head trauma.

#3 A persistent vegetative state refers to a condition in which individuals have lost cognitive neurological function and awareness of the environment but retain noncognitive function and a perserved sleep-wake cycle. In persistent vegetative state the individual loses the higher cerebral powers of the brain, but the functions of the brainstem, such as respiration (breathing) and circulation, remain relatively intact. Spontaneous movements may occur and the eyes may open in response to external stimuli, but the patient does not speak or obey commands. Patients in a vegetative state may appear somewhat normal. They may occasionally grimace, cry, or laugh.

#4 Brain death is defined as the irreversible loss of all functions of the brain. It can be determined in several ways, clinical and techno.

There are several ways in which a person can become brain dead, these include:

Anoxia caused by drowning, respiratory diseases, or drug overdose.

Ischemia - Blockage of an artery

Intracranial hematoma

A gunshot wound or other injury to the head

Intracranial Aneurysm

Brain tumors - can destroy brain tissue and increase pressure within the brain.

When any of the above occur, they cause swelling of the brain. Because the brain is enclosed in the skull, it does not have room to swell, thus pressure within the skull increases (this is "intracranial pressure"). This can stop blood flow to the brain, killing brain cells and causes herniation of the brain (pushing the brain outside of its normal space).

When brain cells die, they do not grow back, thus any damage caused is permanent and irreversable.

Some points to note:

A persons' heart can still be beating because of the ventilator and medications helping to keep the blood pressure normal.This is needed for organ donation.

A person who is declared brain dead is legally dead.

jeepgirl, LPN, NP · Mar 18, 2005

i challenge anybody to post that they would like to be kept alive in a persistive vegatative state for 14 years. anybody at all. has anybody put that in a living will ?

I wouldn't want to be in a persistant vegetative state and die of dehydration and starvation.

She shouldn't have been put in the position in the first place. But now that she is there must we give her a painful death?

jeepgirl, LPN, NP · Mar 18, 2005

I too have personal feelings and beliefs, but this post is just to clarify some misconceptions
#1 the Catholic Church does allow cremation.
#2 A coma is a profound or deep state of unconsciousness. The affected individual is alive but is not able to react or respond to life around him/her. Coma may occur as an expected progression or complication of an underlying illness, or as a result of an event such as head trauma.
#3 A persistent vegetative state refers to a condition in which individuals have lost cognitive neurological function and awareness of the environment but retain noncognitive function and a perserved sleep-wake cycle. In persistent vegetative state the individual loses the higher cerebral powers of the brain, but the functions of the brainstem, such as respiration (breathing) and circulation, remain relatively intact. Spontaneous movements may occur and the eyes may open in response to external stimuli, but the patient does not speak or obey commands. Patients in a vegetative state may appear somewhat normal. They may occasionally grimace, cry, or laugh.
#4 Brain death is defined as the irreversible loss of all functions of the brain. It can be determined in several ways, clinical and techno.
There are several ways in which a person can become brain dead, these include:
Anoxia caused by drowning, respiratory diseases, or drug overdose.
Ischemia - Blockage of an artery
Intracranial hematoma
A gunshot wound or other injury to the head
Intracranial Aneurysm
Brain tumors - can destroy brain tissue and increase pressure within the brain.
When any of the above occur, they cause swelling of the brain. Because the brain is enclosed in the skull, it does not have room to swell, thus pressure within the skull increases (this is "intracranial pressure"). This can stop blood flow to the brain, killing brain cells and causes herniation of the brain (pushing the brain outside of its normal space).
When brain cells die, they do not grow back, thus any damage caused is permanent and irreversable.
Some points to note:
A persons' heart can still be beating because of the ventilator and medications helping to keep the blood pressure normal.This is needed for organ donation.
A person who is declared brain dead is legally dead.

http://www.terrisfight.org/documents/022805EmMotionBurial.pdf

Here's a link to the court doc that explains the family's beliefs concerning cremation.

angieRN · Mar 18, 2005

I am amazed at the comments with seeminly no concrete evidence to back them up. I am a hospice nurse and realize that this is a complex case and emotional for all parties involved. It seems a lot of comments are being made from personal beliefs rather than looking at best practice from a nursing standpoint. I do not feel the need to state my position on this case, but found a link that may be of some interest. It gives a little insight into the philosophy of hospice/palliative care regarding this issue. Artificial hydration/feeding, I suspect, will always be a very emotionally-bound issue no matter how much evidence is out there due to our cultural/religious beliefs.

http://www.aahpm.org/education/arthy.pdf

Angie