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...........

[bugsbee]

Mr Huffman

Obviously you have not been a nurse for long or you would understand dehydration better. And yes this is a very emotional time for all including the husband. It is just sad the parents had to take away all of Terris privacy. Isn't there a law against that?

[James Huffman]

Mr Huffman

Obviously you have not been a nurse for long or you would understand dehydration better. And yes this is a very emotional time for all including the husband. It is just sad the parents had to take away all of Terris privacy. Isn't there a law against that?

1. Your "obviously" is wrong. Since 1981, to be exact. Perhaps you will enlighten me as to what I am supposedly not understanding about the dehydration process.

2. Emotions are not what I'm discussing. We're talking about someone attempting to kill Ms. Schiavo.

3. I suspect that Ms. Schiavo would prefer her privacy to be taken away than to have her husband take her life away.

4. I'm not sure what law you might be referring to. Again, please inform us. There's no law against seeking to have one's child fed and hydrated.

Jim Huffman, RN

[Kabin]

1. There is difference of opinion with those who have examined Ms. Schiavo as to whether she is in PVS.

2. Even given that, at our stage of knowledge, we simply don't know enough about the perceptions of those in PVS. I am unwilling to risk someone's pain and suffering from dying of starvation on uncertain knowledge.

There is no difference of opinion regarding the state of her brain scan. And based on that, the courts ruled there is no reasonable chance of recovery.

4. Let's remember that there's a certain dignity involved here. Ms. Schiavo is not a dog. No matter what her state of living might currently be.

There is no diginity in medically maintaining a body's existance against one's own wishes. Each of us have a right to live within an identifiable quality of life standard and to die if our expectations are not met.

[Stitchie]

I've heard from physical therapists that sometimes bright sunshine can cause brain - damaged people discomfort. Maybe that's why the blinds stay closed; the dark room may keep her more comfortable. This is speculation on my part.

As for the media, just remember that they are in the business of selling news, not reporting news. The media is NOT unbiased, and there is a huge amount of spin on every news story. You can't believe everything you read; I know this from personal experience. I have enormous distrust of media, lawyers, and those that make a buck from capitalizing on the tragedy of others..

There are two sides to every story. If the nurse who became close to the family is talking about this poor soul's condition to the media, she is guilty of ethical and HIPPA violations, and deserves to be held accountable for that.

If I were ever in that state, I would hope that my husband would move on with his life and find love again. I'd never want him to be alone or without companionship. While I can't fathom why he hasn't divorced her, perhaps there are legal reasons that the media has chosen not to disclose? Perhaps he has his own motives, not all of evil? Only her husband knows for sure, and 15 years is a long time to carry a torch for someone. Any person out there can have her life change permanently in an instant, and we have to have faith that our families will honor our wishes and keep our best interests at heart.

As for end of life issues, if this woman is as brain-damaged as her physicians say she is, with no chance of a meaningful recovery, I think the kindest thing is to let the woman go. It seems that much of this nation-wide 'discussion' has turned into a political issue and poor Terry's condition has been forgotten. We've all taken care of those patients with no chance of a meaningful recovery. I, at least, have hoped for a peaceful, painless end for those patients.

I do agree that this is a power struggle between the parents and her husband, the courts were right to step out of it and Congress has absolutely no business in this whatsoever.

None of us is granted endless tomorrows.

[tvccrn, ASN, RN]

The problem here is that we have defined this as being merely a family's personal decision. However, decisions involving life and death are NEVER simply family decisions. And in the absence of clearly defined directives from Ms. Schiavo, starving her to death on orders from a husband who has clearly shown that he merely wants her to die, has forbidden simple, ordinary nursing and medical interventions, and has refused to allow impartial medical evaluations -- well, that's the reason the government is involved in this.

If someone decides to starve their dog, they can be arrested for abuse. Even the way we treat an animal is never just a "family's personal decision."

Why should we allow Ms. Schiavo to be treated worse than an animal?

Jim Huffman, RN

I'm sorry, but you are incorrect. This IS a family's personal decision and THEY are the ones who have chosen to make it into a government thing. I have seen decisions like this made many, many times without involving the government. It's doesn't have to be a public spectacle, but it is what they have made it.

As for the dog analogy, if you really want to go there then consider that fact that when a dog or any animal is suffering (and it's that animal's family that decides when they are suffering , not the government) then they are gentle put to sleep. Yet, there are people in this country against assisted euthanasia because it's murder. If you can help relieve an animals suffering, but not a person's it goes to show who we hold in higher regard. It's also shows that Ms. Shiavo is, in fact, being treated worse than an animal.

[James Huffman]

I'm sorry, but you are incorrect. This IS a family's personal decision and THEY are the ones who have chosen to make it into a government thing. I have seen decisions like this made many, many times without involving the government. It's doesn't have to be a public spectacle, but it is what they have made it.

As for the dog analogy, if you really want to go there then consider that fact that when a dog or any animal is suffering (and it's that animal's family that decides when they are suffering , not the government) then they are gentle put to sleep. Yet, there are people in this country against assisted euthanasia because it's murder. If you can help relieve an animals suffering, but not a person's it goes to show who we hold in higher regard. It's also shows that Ms. Shiavo is, in fact, being treated worse than an animal.

As I noted in my original post, family decisions are never just that. In our society, we have all kinds of limits on what families can do, and if the family goes beyond those limits, society -- in the arm of the courts, police, whomever -- gets involved. So here with Ms. Schiavo.

At its basis, there is a disagreement between family members: her parents and siblings, and Michael Schiavo. The "government" -- courts, policy, protective services, etc. -- came in because of that disagreement.

You may well have seen decisions like this made without involving the "government," but I can guarantee you that the ones you saw did not involve family disagreements. Life is sometimes not so cut and dried, and if there are disagreements, someone has to step in and mediate. In our society, it's usually some agency of the government.

As to your second point, regarding animals.

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?

3. Why are some people against "assisted suicide because it's murder"? Perhaps because, as you said, it IS murder.

Jim Huffman, RN

[bugsbee]

James Huffman is not an experienced nurse or he would understand this a little more. I bet he just graduated. This is not a personal but family decision with not a place in the courts or government for this decision.

[LydiaNN]

James Huffman is not an experienced nurse or he would understand this a little more. I bet he just graduated. This is not a personal but family decision with not a place in the courts or government for this decision.

I have been a nurse for over 20 years. Many of us have never had experience with this particular issue, and our opinions on this issue run the gamut. I am bewildered as to why you would think otherwise.

[Kabin]

I'd bet more often than not it doesn't come down to experience, but rather how one's thought process is, or is not, influenced by philosophical views on such things as faith, religion, culture, etc.

[tvccrn, ASN, RN]

You may well have seen decisions like this made without involving the "government," but I can guarantee you that the ones you saw did not involve family disagreements. Life is sometimes not so cut and dried, and if there are disagreements, someone has to step in and mediate. In our society, it's usually some agency of the government.

And I can guarantee that you are wrong in saying that the ones I saw didn't involve disagreements. I worked in the PICU for 3 years and I saw it all the time. 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.

As to your second point, regarding animals.

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?

3. Why are some people against "assisted suicide because it's murder"? Perhaps because, as you said, it IS murder.

Jim Huffman, RN

In this case many people feel that this family is doing exactly that..tomenting and torturing Ms. Shiavo by keeping her alive in a state of helplessness. You ask why is she being treated worse than an animal by being slowly and deliberately starved, I ask why is she being treated worsemthan an animal by having to live at the mercy of her parents and her husband.

Yes, assisted euthanasia as I said, not assisted suicide as the about quote marks imply, is murder. However, then it can be said that so is putting an aminal gently to sleep, yet we do so to keep them from suffering.

[LydiaNN]

I'd bet more often than not it doesn't come down to experience, but rather how one's thought process is, or is not, influenced by philosophical views on such things as faith, religion, culture, etc.

Precisely.

[Tweety, BSN, RN]

I'd bet more often than not it doesn't come down to experience, but rather how one's thought process is, or is not, influenced by philosophical views on such things as faith, religion, culture, etc.

Very true. Many nurses who have taken care of these kinds of patients for years, still vote for life at all costs. Others who may have thought one way prior to their experiences as nurses, now have a differing point of view based on experience. But I do agree, it's a bit more complicated in how we come to our belief system about life, quality of life, end of life, etc.

I've also noticed on this board many of us have differing definitions as to what it is to suffer. Some say Terri is suffering, and others say she is not. I don't think it only comes down to experience.

I do however, think that some of those on the picket lines, and see only the pictures of Terri smiling on TV don't have a grasp as to what her life is really like on a day to day basis. Nurses with experience do. I can definately say that it's my experience with these types of patients, coupled with my own personal philosophies about life, that form my opinion.