Artificial feeding-Terri Schiavo

beckymcrn · Mar 23, 2005

It's important for us to behave nonjudgementally when we nurse and leave our judgements at the door and treat everyone with dignity and equality. I think nurses do a fantastic job of that.
We're human, though and we're going to make judgements, but we gotta leave it at the door. :)

I couldn't have said it better my self!!!!

Chad_KY_SRNA · Mar 23, 2005

The emergency injunction to reinsert Terri Schiavo's feeding tube has been denied. After her mothers national pleas stating that Terri was fading fast last evening the federal panel in Atlanta refused to order the reinsertion of the feeding tube.

begalli · Mar 23, 2005

No winners in this case.

I wish only peace for this poor unfortunate woman.

BBFRN, BSN, PhD · Mar 23, 2005

Edited to add: I've seen conflicting stuff saying that he's an RN or a repiratory therapist.

http://www.choicetrust.com/servlet/com.kx.cs.servlets.CsServlet

According to that Choicetrust website, there is a Michael R. Schiavo, RN in Clearwater, FL.

Kyriaka · Mar 23, 2005

Well, well, well. An intersting tidbit today. The neurologist picked by Michael Shiavo is a member of the HEMLOCK SOCIETY (now called the Choice In Dying Society). Ah...

___________

Dr. Ronald Cranford

The neurologist chosen by Michael Schiavo to examine his estranged wife, Terri, is a right-to-die activist who has been a featured speaker for the pro-euthanasia Hemlock Society.

Dr. Ronald Cranford testified in the court cases before county court Judge George Greer that Terri Schiavo was in a persistent vegetative state with no hope of recovery.

"I've seen her," he told CNN. "There's no doubt in my mind, whatsoever, she's in a permanent vegetative state. Her CAT scan shows extremely severe atrophy to the brain. And her EEG is flat. It doesn't show any electrical activity at all."

His diagnosis has been disputed by Dr. William Hammesfahr, who said, "I spent about 10 hours across about three months and the woman is very aware of her surroundings. She's very aware. She's alert. She's not in a coma. She's not in PVS."

Hammesfahr added, "With proper therapy, she will have a tremendous improvement. I think, personally, that she'll be able to walk, eventually, and she will be able to use at least one of her arms."

"There's no way," responded Cranford. "That's totally bogus."

Cranford is a member of the board of directors of the Choice in Dying Society, which promotes doctor-assisted suicide and euthanasia.

He was also a featured speaker at the 1992 national conference of the Hemlock Society. The group recently changed its name to End of Life Choices.

In 1997, Cranford wrote an opinion piece in the Minneapolis Star Tribune titled: "When a feeding tube borders on barbaric."

"Just a few decades ago cases of brain death, vegetative state, and locked-in syndrome were rare," he wrote. "These days, medicine's 'therapeutic triumphs' have made these neurologic conditions rather frequent. For all its power to restore life and health, we now realize, modern medicine also has great potential for prolonging a dehumanizing existence for the patient."

He explained that while landmark legal cases like those of Karen Ann Quinlan and Nancy Cruzan demonstrated it was "sensible to stop treatment in patients lingering in permanent vegetative states," it was now time to look beyond those cases.

"The United States has thousands or tens of thousands of patients in vegetative states; nobody knows for sure exactly how many," he wrote. "But before long, this country will have several million patients with Alzheimer's dementia. The challenges and costs of maintaining vegetative state patients will pale in comparison to the problems presented by Alzheimer's disease."

The answer, he suggested, was physician-assisted suicide.

"So much in medicine today is driving the public towards physician-assisted suicide," he wrote. "Many onlookers are dismayed by doctors' fear of giving families responsibility in these cases; our failure to appreciate that families suffer a great deal too in making decisions; our archaic responses to pain and suffering; our failure to accept death as a reality and an inevitable outcome of life; our inability to be realistic and humane in treating irreversibly ill people. All of this has shaken the public's confidence in the medical profession."

He blamed "right-to-lifers" and "disability groups" for discouraging families from making the choice for euthanasia. He applauded European values that embrace euthanasia.

"But here in the United States, many caregivers wouldn't consider not placing a feeding tube in the same patients," he wrote. "It's hard to understand why. If we want our loved ones to live and die in dignity, we ought to think twice before suspending them in the last stage of irreversible dementia. At it is, it seems that we're not thinking at all."

riern · Mar 23, 2005

This is a very touchy subject and I personally would not want to live as Terri is living right now. I believe in looking at the quality of life, not quantity. I know her family loves her and as a mother I pray I'm never in that situation. However, chances are that she hasn't had any water or any po intake since the tube was placed, so she isn't thirsty as her mother is thinking and with her brain injury she probably isn't feeling hunger as we do either. In my opinion she's been suffering for a very long time either way you look at it.

My 10 year old was watching the news with me and looked at me and my husband and said, "what would you want me to do mama?" My children, my husband and my parents all know what I would or wouldn't want. That's the best thing for all of us to do is to talk to our families and make sure they are never put in this position.

Is the husband guilty of the things he's accused of, only he and God know. I feel certain that if he is he'll have to answer for that one day.

That's just my 2 cents!

Katydidit34 · Mar 23, 2005

I believe that this is a quality of life issue as well as a right to die issue. I can understand the level of denial that her family is operating with. However, I don't understand how they would want her to continue the life she is currently living. Terri has no life in her current condition. What life are they trying to save? Just because she has breath doesn't mean that she is alive and living. I had to let my dad go almost two years ago. It is the absolute most painful thing I have EVER had to endure, but I had to dig DEEP within myself and decide what was the right thing to do for HIM. I understand the family's heartbreak, my heart breaks for them, but Terri has been in this condition for 15 years. That's a long time to be stuck between life and death. Does anyone know why seven years passed before the legal battles started? It seems to me that if her husband knew that she didn't want to live this way that he would have let her go within a year or so of her heart attack. Just curious.

Home Health Columnist / Guide · Mar 23, 2005

well, well, well. an intersting tidbit today. the neurologist picked by michael shiavo is a member of the hemlock society (now called the choice in dying society). ah...

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.

allnurses Guide · Mar 23, 2005

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

allnurses Guide · Mar 23, 2005

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

camay1221_RN · Mar 23, 2005

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.

allnurses Guide · Mar 23, 2005

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