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...........

[danu3]

http://www.dlnets.com/hfa_20apr05.htm

given the discussion of this case, the teleconference in the above link might be of interests to many of us.

the title is "living with grief: ethical dilemmas at the end of life" and it is on wed 20 april, 2005 from 1330-1600 et

it is sponsored by hospice foundation of america.

-dan

[Tweety, BSN, RN]

sorry. nevermind.

note to self: think before you type.

[danu3]

sorry. nevermind.

note to self: think before you type.

This reminded me of one of my math prof. He said sometimes he think "1", say "2", and write down "3" in class.

-Dan

[icyounurse, BSN, RN]

______________

She has had no MRI. Wouldnt the husband want the most up to date information?

And so what if it was.

You know, I am a nursing student. I am a high 4.0.

Since this case, I am questioning whether I need to be a nurse because I dont believe in the murder of he handicapped. Nothing that I read about nursing told me that I needed to be pro-euthanasia.

Yest. I talked with my favorite teacher about changing my major to chemistry. At least I can make drugs to help people live.

i have read in some articles she has fluid instead of a cerebral cortex. is that not true? thats a pretty big statement to make if its not based on hard evidence. i would hope that it would not be printed this way if it was not true, but who knows, you could very well be right. but if you are wrong and she has no cerebral cortex, she will never regain function or do anything besides what the brain stem allows. this is what i base my opinion on. i would never advocate for the death of the handicapped, but those with only primitive brainstem function, yes.i see too many people who are suffering and being kept alive for selfish reasons by family. i am glad you are in nursing school because you seem compassionate and dedicated and will no doubt be a great advocate for your patients one day. i also live in mobile, i work at mobile infirmary. you must be pre-nursing if you have a 4.0. either that or a genius. no one in our class of 60+ graduates had a 4.0, although one or two came close. i went to university of mobile.

[icyounurse, BSN, RN]

I've been a nurse for over 20 years also and I have about had it with hearing about this poor woman. I think it's sick to flash this woman all over the news every single day. I have a friend in her 40's who was in a very tragic car accident who suffered massive brain damage. What made her who she was was taken away from her. If she new what her fate was ( spitting at staff, unable to attend her children's marriages/graduations, unable to eat normally ( and she was a nurse for a long time), she would be mortified if her family plastered her pictures on the news daily. It is not NEWS. It is no one's business but her family's. Her parents are absolutely ridiculous for allowing this. It's ironic that she suffered cardiac arrest because of an eating disorder which we all know is usually caused by the patient feeling he has no control over her life and now the parents want to continue having control over her and FEED her. I don't believe that nurse's account of what was going on in the nursing home. If that's true, there is an agency called "the state" that oversee's nursing homes and that's who she should have called if she felt the patient's rights were being violated. That's her job. I worked in a nursing home and that was stressed all the time. Call the board of nursing, the police, etc. If she didn't care about losing her job, then why would she care about calling all of these agencies. This is why I find this woman very difficult to believe. I don't think her husband is a saint, nor do I think her parents are any better, but it should never have been in the news and the government should stay the heck out of this. I had a discussion with my husband the other night about living wills ( he has one) and about heroic measures and what we don't want to live like. My parents know now how I feel, but no one was in the room when we had these discussions so who's to say that Terri and Michael didn't have these discussions? We need to leave Terri alone and let her die with dignity and not a three ring circus.

i so agree. that she is all over the news in her state has been my biggest source of disgust about this whole thing. and thankyou, i was wondering if anybody else knew anything about eating disorders and saw the irony of her parents wanting to force feed her. people who have eating disorders feel usually that there is nothing to control in their lives so resort to starving themselves. they have body issues that are severe. i cannot imagine that someone with body issues would want to be on the news in the state that she is in or at all. politicians using her situation to push their agendas. its gross.

[NoCrumping]

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?

Please excuse my ignorance, and please someone educate me on this.

If a person is breathing on her own, how can one even request to end the life, even if it is a non productive one? I know there are living wills with the "be kept alive by artificial means" clauses, but I thought that was just at the time of considering treatment, like for the feeding tube. I didnt think you could change your mind 14 years later. Has this been done before? Is the controversy just that there are opposing sides? ( parents and husband) I am not understanding the situation.

[BlanckOne]

Are any of you aware that he had been awarded quite a sum of money after her incident because he told the courts that he would need it to care for her the rest of her life? He told the courts that he was going to quit his job and spend the rest of his life caring for her, that he would stand by her the rest of her life.

According to the Orlando Sentinel this past week those awards are not going to pay for her care...her bill is being picked up by the generous tax payers of this state of Florida!

I never saw mention throughout this thread, but this has been in our news for years. The last couple years it has gotten ugly In the beginning of this fight, the family of Teri, I believe it was her sister, stated that Teri was actually starting to fear him and ready to leave. The marriage had soured, he was calling names, she became anorexic because the badgering of her gain of weight! The previous reports had questioned the possibility of previous injuries not reported or treated while they were together. :angryfire The first court fights had clinical people from the nursing facility testify that the "spouse" would bar any type of mental stimulation(no talking in her room, no TV, drawn blinds, no radio, etc), antibotics, or physical therapy for her, he did yell and swear at caretakers, ban family members. The lawsuits had been won, but the money wasn't being used for her improvements.

My biggest confusion is how any WOMAN/MAN can live with someone willing to do this to their current partner? Why not just divorce and move on? How do they explain to their kids what they are hearing from the other kids, neighbors, etc? How can they justify to those kids that Dad is married to someone else, they are waiting for her to die so they can get the money to marry???? He is entitled to look for love elsewhere, but that means the current relationship is over. According to him, Teri is not the person he married anyway, so just leave and let the parents take over. Why is it ok to withdraw nutrition and fluids from diabled adults but NO ONE would ever step over the line and suggest the same for a minor!! In my eyes every human has a god given right to food and water, however it is delivered! It is not the same with ventilators, etc.

If it walks like a duck, it talks like a duck........it is a d***!

[caroladybelle, BSN, RN]

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.

This is a rather inappropriate thing to say to anyone on this BB.

While one may not approve of what a certain poster has to say, unless you know someone's credentials, one should not make such baseless assumptions.

[Tweety, BSN, RN]

This reminded me of one of my math prof. He said sometimes he think "1", say "2", and write down "3" in class.

-Dan

:rotfl: :rotfl:

I did that on a recent chemistry test. Thinking to myself something like "8.13" and writing 7.86 or something silly. Glad I'm not the only one.

[Tweety, BSN, RN]

Please excuse my ignorance, and please someone educate me on this.

If a person is breathing on her own, how can one even request to end the life, even if it is a non productive one?.

That's one of the main focuses of the debate. Many people vote for, if they are breathing, that's life, don't mess with it. Other people look at quality of life and suffering. Some say breating is a quality life, some say it's suffering. There is no answer, people are all over the place in where they stand.

While I can't "understand" certain beliefs either, I just have to remember to be respectful that it's their right to feel that way.

I know there are living wills with the "be kept alive by artificial means" clauses, but I thought that was just at the time of considering treatment, like for the feeding tube. I didnt think you could change your mind 14 years later. Has this been done before? Is the controversy just that there are opposing sides? ( parents and husband) I am not understanding the situation.

People change their minds in health care and treatment all the time. There is precident for putting in a feeding tube, then pulling it later. In fact this has worked in his favor, as there is legal precident, and to deny him would say those other spouses who have faced the same decision and pulled tubes weren't legally doing so, and allow families or other people to challenge them.

I've seen families/spouses change treatment plans frequently, rescind DNRs, make them a DNR, pull the vent, don't pull the vent. It's an agonizing decision and one can see why one would change his mind. I can't judge the timeframe, maybe after many years of futile treatment without improvement in quality of life people change their mind.

Should they be allowed to do that? Good question. I say yes.

[caroladybelle, BSN, RN]

______________

She has had no MRI. Wouldnt the husband want the most up to date information.

Since this case, I am questioning whether I need to be a nurse because I dont believe in the murder of he handicapped. Nothing that I read about nursing told me that I needed to be pro-euthanasia.

Yest. I talked with my favorite teacher about changing my major to chemistry. At least I can make drugs to help people live.

MRIs only guage structures, not brain function. Therefore an MRI is not going tell whether she has improved functioning.

No one requires you to be pro-euthanasia as a nurse. You are expected to respect your patient's dignity, concerns and integrity as an individual. If you are unable to respect their wishes in regard to their body and care, you recuse yourself from their care, and find someone that can treat them.

And chemists are hardly saints in the ethics forum, either.

[danu3]

i have read in some articles she has fluid instead of a cerebral cortex. is that not true? ...

I posted this before. But here it is:

http://www.miami.edu/ethics2/schiavo/CT%20scan.png

This is a CAT scan of Terry's brain (not sure when it was taken, don't think it is recent). It is from a reputable site (University of Miami).

You don't need to be an expert to see that she has this huge ventricle in her brain (the big blue blob in the middle). If you look closely, the same shade of blue in the ventricle are also all over the brain (especially toward to top part of the brain). You do see the white stuff (I pressume those are brain tissue) sort of are here and there however mixed in with the deep blue (the ventricle color).

So as for your question, technically according to this scan, you do not have liquid instead of a cortex because you can see the brain tissue (assuming I am interpreting it right given that I have no idea how to interpret a CAT scan, I am just doing educated guesses here). However, you can see there is quite a bit of damage all over the brain (especially in the middle and up on top).

Obviously with that much structural damage, it is going to adversly affect function also (as we all learn in A&P).

-Dan