Artificial feeding-Terri Schiavo

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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...........

All I can say is right or wrong, the husband has the legal rights, not the parents. He says she would not want to be in that state and if he's lying, he'll have to answer for it eventually. If it were me and I had not written a will, I would not want my parents or any other family or friends trying to over-rule my husband's decision because he knows what I want and legally he is my next of kin. I read on MSNBC that someone offered the husband one million to leave it in and he refused which leads me to believe money is not his motive. Really his motive is not an issue because legally, if there is no will the spouse's decision is the one upheld by the law.

1. No, Ms. Schiavo has the legal rights. No one -- husband, parents, whomever -- holds life and death powers over another.

2. "If he's lying"? Then the authorities need to figure this out. Ms. Schiavo is not dying, but her husband for some reason wants her dead. Removing the feeding tube will make that happen quickly.

3. Some who have examined Ms. Schiavo have suggested that neck injuries she had were consistent with attempted strangulation. If Mr. Schiavo did that, then he has a reason to not want his wife to regain the ability to speak.

Jim Huffman, RN

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Specializes in OB, M/S, HH, Medical Imaging RN.

I agree that the husband as the POA has the right to decide but I can't help feeling so bad for her parents. They are very devoted to her and her care. If I were in that shape I would want to be let go. I wish the parents could realize that letting her go is an "unselfish" expression of love.

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ITA. Great post.

______________

I agree.

Death today is a very grey area.

When I was injured I went without oxygen for 2-3 min (we will never know for sure). There were "experts" who said I would be in a wheelchair. They were wrong. There were "experts" that said all kinds of things about me. And they were wrong.

It is true that there are many phases of coma and many phases of brain damage. But our technology today cannot tell us what Terri can comprehend. So we MUST err on the side of caution. First, do no harm.

I know that there is an organization called Nurses for Life (or something like that) but they oppose removal of feeding tubes even if there is a written directive from the patient. I disagree with that stance so I cannot in good faith belong to that organization.

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The Congress and the house are both trying get the tube re-inserted.....

And the State is trying to keep the tube out. The "government" is involved. On both sides. As I mentioned, I'd rather err on the side of life.

Great post Triage!

steph

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My mom died under hospice and so I have some involvement in it. The above link is my understanding also - that is when a person is dying and the system is shutting down, hydration can actually increase suffering.

However, in the conxted of schivao case, is she dying? If she is dying, then forcing hydration is not doing any good. If she is not dying, however, withholding hydration can be a cruel way to die (if I am understanding it correctly). When people quote hospice literature about hydration, we have to agree that Terri is dying and not just severly disabled before the hospice literature can be used in its proper context.

-Dan

Exactly!! She is not dying. She is not terminal. Not the same as Hospice care. At all.

I enjoyed your post. Thanks.

steph

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I agree that the husband as the POA has the right to decide but I can't help feeling so bad for her parents. They are very devoted to her and her care. If I were in that shape I would want to be let go. I wish the parents could realize that letting her go is an "unselfish" expression of love.

Those horrible hypocites, the Bush family. 2 wars at exteme human expense, execution of retarded peole in TX and now this. Jeb or George could grant clemency. Nobody wants to die this way. Either authorize quick death by lethal injection for the crime of 'inconvienience' and say what they mean,and get off the pot.

These people have a death fetish no less than Hitler or Stalin. This self proclaimed "pro-life" and "Christian" President had no problem pushing his pregnant girlfriend into an abortion. And now he would have us believe he has changed? He may hawk for the fetus or the fertilized egg that no one sees, that no one can know, however, the inconvienient human is an object of disposal. This entire family is showing it's colors now, and may God help us that any of them ever attained power. I personally voted Liberatarian, a party that would at least have allowed this poor person to live their life out win, lose or draw. This is no endorsement of any party, it is only the lesser of all evils. I hope and pray that the hottest spot in Hell is reserved for the lot of these sort of people-white trash with power and money, ethics be damned except for a vote. And we know Terri can't pull a lever. Now I truly know what the term "The Ugly American" means, and he is not my President.

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Those horrible hypocites, the Bush family. 2 wars at exteme human expense, execution of retarded peole in TX and now this. Jeb or George could grant clemency. Nobody wants to die this way. Either authorize quick death by lethal injection for the crime of 'inconvienience' and say what they mean,and get off the pot.

These people have a death fetish no less than Hitler or Stalin. This self proclaimed "pro-life" and "Christian" President had no problem pushing his pregnant girlfriend into an abortion. And now he would have us believe he has changed? He may hawk for the fetus or the fertilized egg that no one sees, that no one can know, however, the inconvienient human is an object of disposal. This entire family is showing it's colors now, and may God help us that any of them ever attained power. I personally voted Liberatarian, a party that would at least have allowed this poor person to live their life out win, lose or draw. This is no endorsement of any party, it is only the lesser of all evils. I hope and pray that the hottest spot in Hell is reserved for the lot of these sort of people-white trash with power and money, ethics be damned except for a vote. And we know Terri can't pull a lever. Now I truly know what the term "The Ugly American" means, and he is not my President.

Well, I am proud to say he IS my president. I'm sorry that you resort to unfounded rumors. I suppose you don't think Jeb tried? President Bush made a statement:

STATEMENT BY THE PRESIDENT

The case of Terri Schiavo raises complex issues. Yet in instances like this one, where there are serious questions and substantial doubts, our society, our laws, and our courts should have a presumption in favor of life. Those who live at the mercy of others deserve our special care and concern. It should be our goal as a nation to build a culture of life, where all Americans are valued, welcomed, and protected and that culture of life must extend to individuals with disabilities.

Just how do you think the President can order the things done that you suggested? The President does not have unlimited powers; be realistic instead of so bitter because you didn't get your way in the election.

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I suppose it was nice of him to allow a Priest this time.

But I do find it very odd that he wasnt even there. Then the girlfriend giving information to the press??

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Specializes in LTC,Hospice/palliative care,acute care.
And the State is trying to keep the tube out. The "government" is involved. On both sides. As I mentioned, I'd rather err on the side of life.

Great post Triage!

steph

The state is trying to see that her wishes are honored-her wishes based on the evidence that they have been presented according to applicable law....I would rather err on the side of choice...we'll just have to disagree.....
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I have never believed it was "all about the money" when it came to the husband, but I do believe it is all about hurting her.

He has refused to allow her wheelchair to be repaired and has refused offers of a free new wheelchair.

He refuses to let light into the room and has demanded the blinds be kept shut.

He refused to allow anyone to take her out in the sunshine.

Why refuse to allow a Priest to visit??

He wants to have her cremated even though her religion is against it.

You are so right. He has shown no concern for her well being at all.

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Specializes in ER (My favorite), NICU, Hospice.

My heart goes out to her family and her. For her sake, I hope her death is a quick thing if the feeding tube is not replaced. That is a terrible way to die.

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Contrary to popular belief, if the feeding tube was removed she would not starve to death but die of dehydration. Dehydration is a peaceful and painless death.I did a hugh research paper on this subject and people are misinformed.

There's a website that has the husband's interview with Larry King. Here's the husband's response to a caller:

"CALLER: Does it bother you that the death is so slow?

SCHIAVO: Removing somebody's feeding tube is very painless. It is a very easy way to die. Probably the second best way to die, the first being an aneurysm."

Blowing an Aneurysm is not what I consider an easy way to go.

This is Florida's Statute for when a guardian is involved. I think the operative word here is "valid" Advance directive. I just find it hard to believe that if Terri felt that strongly about "not wanting to live like that" she would have mentioned it to someone other than a man she was married to for such a short while.

F.S. 744.3115 Advance directives for health care.--In each proceeding in which a guardian is appointed under this chapter, the court shall determine whether the ward, prior to incapacity, has executed any valid Advance directive pursuant to chapter 765. If any such Advance directive exists, the court shall specify in its order and letters of guardianship what authority, if any, the guardian shall exercise over the surrogate. Pursuant to the grounds listed in s. 765.105, the court, upon its own motion, may, with notice to the surrogate and any other appropriate parties, modify or revoke the authority of the surrogate to make health care decisions for the ward.

I heard Kate Adamson speak today. She's mentioned in the article with the husband's interview:

http://www.discovery.org/scripts/viewDB/index.php?command=view&program=Bioethics&id=1641

She's had personal experience with having a tube pulled. Her story is remarkable. I was in a SNF yesterday interviewing a resident. She was 86 years old. I looked above her bed and saw an old newspaper article taped up. Years ago she was in a coma for over two years and made the front page when she woke up.

You just never know....

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