Artificial feeding-Terri Schiavo

Nurses General Nursing

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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...........

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

The ironic part of this is that he won't have a red cent left over. The vast majority of the $1 million was spend on her care for the past 15 years. Come on people, we know what healthcare costs don't we?

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In our society, NO ONE is given such an ultimate right by law. In every situation, decisions -- especially life or death ones, such as in Ms. Schiavo's case -- are subject to review, evaluation, and due process.

For example, parents have "legal guardianship" over their minor children. But if the parent abuses a child, then that action must be answered to. Michael Schiavo has no ULTIMATE right to make decisions for Ms. Schiavo and her care. Most especially, he has such right when he stands to gain by his decision about her care.

Jim Huffman, RN

There is a difference when it comes to family law. Our legal system is based on the fact that men are the only ones that count, and that women and children are chattel, property. As gross and disgusting as that may sound, that is what our rule of law was built upon.

The biggest issue I have over this whole mess is having some Putz in Washington D.C. write/sign into law a mess that will not allow me to die with dignity.

If they have three witnesses that state that Terri didn't want to live this way, then button it, and let the poor woman go to her rest. Again, think of the costs of healthcare. The $1 million is already gone to healthcare costs, legal costs, costs of guardianship. Her family has burnt through the money from the malpractice case by trying to bankrupt the husband.

To those who think dying of dehydration is such a terrible death, I would reccomend you start looking at how cancer patients die while they are in hospice. Start reading up on the end of life issues. You will find that the vast majority of our cancer deaths end up in this fashion. It is very peaceful, more so than keeping the body hydrated and twarting the body's means of handling the disease and all of the associated chemical changes that come with dying.

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It makes me sick to think of what if's in this case....what if he is just money hungry...what if the parents just can't let go...what if Terri suffers horribly until she dies but is unable to express it.... But what it all comes down to is that according to Florida law this woman is PVS. The husband is the guardian and he has the legal right to make this decision. That is why the court keeps deciding with him even though all these politicians are involved. Personally, I would not want a law in place that would REQUIRE me to live on a feeding tube. Each case is different. We will probably never know what exactly happened to Terri and what the real intentions of everyone involved are. This attempt to keep the feeding tube in place is just as cruel if its is merely for their own selfishness. I have read several documents on removing artificial hydration from a terminally ill and severyly brain damaged person and it is not like starving a healthy person....or animal for that matter as some have compared it to. It is actually a natural process of dying that people go through that stimulates the brain to release endorphins to create a state of peace and euphoria as you die. It works sort of like accupuncture that people view as barbaric and seems like it would be excruciating....but actually has the opposite effect. If this woman's family is so religious then why do they not let her go? Because they believe her death will be painful and they are not ready to let go of her....some could say that is almost selfish but I think it is natural. But if they love her they know she will receive no better care than in the Kingdom of God.

___________________

Since I have flatlined (twice) and been brought back I can truly say that death IS natural.

But even if the so called "experts" say there is no pain, they cannot know this for sure. Throughout the ages "experts" have been wrong many many times. And I am sure the parents know this. Dr.'s can be wrong.

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As a person dies from lack of food and fluids, his or her

Mouth would dry out and become caked or coated with thick material.

Lips would become parched and cracked.

Tongue would swell, and might crack.

Eyes would recede back into their orbits.

Cheeks would become hollow.

Lining of the nose might crack and cause the nose to bleed.

Skin would hang loose on the body and become dry and scaly.

Urine would become highly concentrated, leading to burning of the bladder.

Lining of the stomach would dry out and he or she would experience dry heaves and vomiting.

Body temperature would become very high.

Brain cells would dry out, causing convulsions.

Respiratory tract would dry out, and the thick secretions that would result could plug the lungs and cause death.

At some point within five days to three weeks, the person's major organs, including the lungs, heart, and brain, would give out and death would occur.

[source: Brophy v. New England Sinai Hosp., 398 Mass. 417, 444 n.2,

:chair:

Interesting, I never saw even half of these problems in dealing with terminal patients in palliative care/hospice. I have been fortunate to witness some of these brave, wonderful souls pass on. They are not suffering, especially not to the point you are taking it. You are listing a reference for what? Looks like a legal case to me. I don't think it really applies here. Suggest you read up on palliative care, end-of-life care and hospice. We have thousands of people in this country die every day from dehydration.

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How come some religions (I'm thinking mostly Judeo-Christian) would have us believe that heaven +/or the afterlife is so wonderful, but the people practicing these religions are in no hurry to get there?!?! Why are they afraid of death?

Also...if heaven/afterlife is so great, why does death (sometimes) hurt so much?

Shouldn't it be easier to get to whatever waits for us?

Sorry to stray off topic, but after reading some of these posts from some people worring about Terri suffering from a horrible, painful death from dehydration and then some about 'going with G*d', it leaves me confused. :confused:

______________

I will try to answer this question the best that I can.

I have flatlined twice. I used to be afraid of dying, but I am no longer. At the same time, I know I am not suppose to hasten this in any way for myself or for others.

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Specializes in hospice, pediatrics.
I think that thing that bothers me most is not the fact that people are fighting over Terri's life but the way that she is expected to die. She is to be deprived of water and food. To me this is slow, possibly painful and barbaric. If I were to euthanize a beloved pet by this method I could be jailed and fined if convicted for animal cruelty and neglect. This will take days of being dehydrated as well as hungry. Someone in an earlier post felt that dehydration was considered painless. Not so IMHO. I have seen dehydrated animals from abuse cases and they are in mental anguish looking, begging, and desiring a drink of water for their dry, agonized bodies. I would also imagine that the pain would be horrible as the end became nearer as the body tissues dried out. I know that when I have worked for hours in the hot, summer sun without much water, I have severe muscle cramping, dizziness, dry painful eys, and other painful aspects of dehydration. I cannot imagine going for days feeling like that. Why not deprive Terri of oxygen? The suffering lasts for only minutes instead of days.

Fuzzy

Fuzzy,

If you would have read my earlier post that had this link in it,

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

you would see that I was not making a specific statement about Terri, just trying to give a little additional info on what dehydration/lack of nutrition cause the body to do. I suggest you read the short article and then you will see why I made the statement that dehydration/lack of nutrition is not necessarily a horrible, painful death as many people perceive.

Angie

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Interesting, I never saw even half of these problems in dealing with terminal patients in palliative care/hospice. I have been fortunate to witness some of these brave, wonderful souls pass on. They are not suffering, especially not to the point you are taking it. You are listing a reference for what? Looks like a legal case to me. I don't think it really applies here. Suggest you read up on palliative care, end-of-life care and hospice. We have thousands of people in this country die every day from dehydration.

___________

My grandmother died of cancer in hospice. She would gasp "thirsty" all the time. My mom would wet her lips because she could not swallow. They kept her "pain free" yet she still was thirsty. The whole experiance still haunts my mother.

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I was addressing the aspect of the original thread which questioned, essentially, why anyone would question her ex-husband's motives. I was agreeing with the points made by another writer and would add that beyond his derogatory treatment of nursing staff and the comments he's made about the pt. - which again has been reported under oath and penalty of perjury - he was awarded a sum of money which originally was calculated based on the money being used to care for Ms. Schiavo for her anticipated life expectancy (several additional decades). He agreed to those terms, then shortly after receiving the money, changed his position (and apparently hers). He also has two children by another woman. It is clear to me and others familiar with his behavior in this case that his motives ought to be seriously questioned. As to the theological implications of your post you are best referred to Jewish and Christian writers that have amply addressed such, if your interest is sincere; such writings are easily researched. Thanks for the post. Now, as someone that just "joined" Allnurses.com, I need to figure out how to prevent getting an e-mail everytime someone posts something. Do good. ;).

How come some religions (I'm thinking mostly Judeo-Christian) would have us believe that heaven +/or the afterlife is so wonderful, but the people practicing these religions are in no hurry to get there?!?! Why are they afraid of death?

Also...if heaven/afterlife is so great, why does death (sometimes) hurt so much?

Shouldn't it be easier to get to whatever waits for us?

Sorry to stray off topic, but after reading some of these posts from some people worring about Terri suffering from a horrible, painful death from dehydration and then some about 'going with G*d', it leaves me confused. :confused:

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I just have a hard time accepting what the "experts" say about pain, dehydration/starvation in people who cannot communicate back.

How do they know?? They dont. It is an educated guess. That is all.

All my life the "experts" have said all kinds of things about me that turned out not to be true.

You see..the "experts" are only self proclaimed.

I have absolutly no problem with the feeding tube being removed IF she had left a written directive and/or told more than one person orally this is how she felt. But she didnt.

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This honestly sucks! I am just so floored. If I tell my family that I want to die if I ever get like that you better let me die. I am so tired of the constant battle back and forth. I don't think it should have ever gone this far.

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How come some religions (I'm thinking mostly Judeo-Christian) would have us believe that heaven +/or the afterlife is so wonderful, but the people practicing these religions are in no hurry to get there?!?! Why are they afraid of death?

Also...if heaven/afterlife is so great, why does death (sometimes) hurt so much?

These are questions that have been pondered and argued throughout the history of man. If you want conclusive answers to these questions before we can act and believe accordingly, I don't think you would recognize the answer if it were right in front of you. And that is not an insult by any means. I probably wouldn't either. But you have to work on your best information and reasoning, or do nothing, death of civilization being the by-product.

Many influential and otherwise well versed people throughout the centuries have denied the truth due to their passions and predudices, their vested interests et.c and such is history. It is said "Time loves a hero". Had the founding fathers of this country not prevailed, they would be the Benedict Arnolds, and Benny would be the patriot. Galleleo (who had the sense at least to cover his butt, recognize that he had more vested interest in living than dying, and so recant) is another interesting example. The majority of civilizations did not/would not accept zero or infinity as valid, and to their detrement. (Finally double entry bookkeeping cleared that up in the case of zero.)

Assuming you are a non-theist of good will, I assert that it would be more profitable to present an argument which accepts that what you have stated above regarding the misery of death as the case, and that evil exists in the world, just as surely as gravitydoes, and that is the case. Complaining that a fact that we don't like exists leads us to no conclusion. Perhaps within the framework of religion, there are those who accept the facts, and somehow love living anyway. Perhaps they are even motivated to help others learn to love living, and so find purpose in this. The alternative would entail killing off the Steven Hawkings and Helen Kellers of the world because they lack 'quality of life' as you understand it to be.

Now, off to other things, if Terri were a prisoner or pregnant, her death by starvation would be unallowed. A baby has little or no cogition and can't obtain it's own needs, and we can't guarantee that it will progress normally beyond that state, yet to withold nutrition would be murder. If Terri were a horse or dog it would be unallowed.

If her case is appealed, and she is to be presented to the jury in her own behalf, how can the court kill a witness as a mob enforcer would do? That constitutes destruction of evidence, jury tampering, possibly a violation of habeus corpus, and probably more if we at least afford her the status of an "object", the same as we do a weapon, a written statement, OJ's glove or anything else presented to the court as evidence. Am I seeing a conven-ient 'legal fiction' in which this woman is neither a person or a lifeless physical object, nor dead or alive? Neither animal mineral or vegetable? The ways of corrupt and arrogant men on the public dole never fail to amaze me, unless they were to be required to obseve the same regulations they make.

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I just have a hard time accepting what the "experts" say about pain, dehydration/starvation in people who cannot communicate back.

How do they know?? They dont. It is an educated guess. That is all.

All my life the "experts" have said all kinds of things about me that turned out not to be true.

You see..the "experts" are only self proclaimed.

I have absolutly no problem with the feeding tube being removed IF she had left a written directive and/or told more than one person orally this is how she felt. But she didnt.

Its O.K. I feel the same way. I dislike self-proclaimed experts. That is one of the reasons I have followed this case. We have seen "experts" perjure themselves as they write out afidavits on this case, without seeing the pt, examining her or reviewing the chart, films or history.

The issue of leaving something in writing would have simplified this whole mess, but...if this had happened 30 years ago, she would have died. We didn't have half of the techniques and treatments for dealing with this much brain damage. We have to admit we don't have the answer for everything.

At the same time, we have to realize that we can not force our values on this husband or family. This is a personal decision that has been taken out of privacy of a family, and thrown across the media. To me this is the greatest issue of all. This is a private issue.

TPOTUS, religious groups and congress need to see their way out of this and stop using it for their own personal ends. Lets face it, your or my opinion shouldn't mean a thing in this case.

This is between Michael, Terri and God.

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