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...........

[deanpicu]

Ya but even the original court documents state that Mary Shindler testified that she was present when Terri uttered those words with the rest of the Shiavo's, the question since has not been whether she said that or not, but how much importance that statement has when parents want something other than those wishes.

This would certainly be true if it were verifiable that this was indeed her wish. Unfortunately, that has yet to be proven the case. And therein lies the dilemma.

[bugsbee]

Again I know very few nurses that would put their license on the line and say such. If it was true their would be several that would come together i ncluding doctors ect. This is another ploy from the parents to go to any extreme to discredit their son in law. And all they are doing is taking away their daughters dignity and her privacy. The courts have seen all testimony and have left the decision to the husband. So the few who come forth are last ditch efforts to try and help the parents win..

[jnette, ASN, EMT-I]

Ya but even the original court documents state that Mary Shindler testified that she was present when Terri uttered those words with the rest of the Shiavo's, the question since has not been whether she said that or not, but how much importance that statement has when parents want something other than those wishes.

Okay, then I concede. I was not aware that she had actually verbalized any wishes to that effect.. verbally or in writing. All I had heard was the husband's declaration that they had "discussed" these matters a time or two in the past, (prior to her incident) but nothing more specific or relating to her situation after the incident.

If she did in fact make it clear that this was her wish, then it should be honored... and the tube should NEVER have been placed to begin with.

[steelcityrn, RN]

Seems horribly sad that the parents can't except their dgt's wishes, she has been without food and water now over a week. Its just a total mess.

[shadowflightnurse]

Have to agree with Asher on the last statement. I absolutely do not want the government deciding on my medical care. Suppose you were diagnosed with ______ (fill in blank with terminal condition of your choice). After all the consults and medical advice, you decide to forego any treatment and let nature take its course. But good old Uncle Sam steps in and decides that you will go through every treatment, surgery, etc prescribed by a doctor. I'm not saying I agree with the husband or that he is without fault, but he is her next of kin. My wife and I have discussed this and similar circumstances. She knows what I would or would not want and I know what her wishes are. Even though we have not drafted a living will or advanced directives, we do know what we want. I hope the Shiavo case causes more people to discuss their wishes with their family-not just their spouse-and draft libving will/advanced directives.

[danu3]

About the 2 CNAs and the RN who gave the affidavits, it just dawn on me that means there are foul play involve regardless whether the affidavits are true or not.

If they are true, then the husband is highly highly suspect and maybe an in depth investigation into the husband is in order as foul play is suspected. If the affidavits are false, then there are also foul play involve, this time on the people who gave the affidavits. I mean, if it is false, isn't that slander at the least. That kind of affidavits could potentially get an innocient person in jail.

I suppose there is a third alternatives, there are some major miscommuncations between the husband and the people who gave the affidavits.

-Dan

[danu3]

This is getting confusing with everyone having their own sources of information. Can we give our source of information so that those of us who can't sleep can check them out personally and decide the quality of the sources ourselves?

I'll start. My major sources are (I try to list only sources as close to the "horse's mouth" as possible)

• http://www.terrisfight.net
  Parents' web site. Give their point of view. Good site to understand how the parents feel and what they believe.
  
• http://www.miami.edu/ethics2/schiavo/wolfson%27s%20report.pdf
  The Wolfson's report commision by Gov Bush. This is probably the most neutral document (and it even has some compassion for both sides) I personal could find. Also give very good history as to what happened. About 40 pages but worth reading every single page including the small footnotes.
  
• http://www.miami.edu/ethics2/schiavo/Schiavo_links.htm
  University miami. Has links to both sides. A neutral site as far as I can tell and I feel it is reputable.
  
• http://www.miami.edu/ethics2/schiavo/CT%20scan.png
  Terri brain's CAT scan (an old one)
  
• http://www.miami.edu/ethics2/schiavo/timeline.htm
  Detail timeline (timeline is also in the Wolfson's report)
  

I don't know of any web site by the husband.

-Dan

ps. I wonder what the silent parties are thinking (beside Terry)? Parties like the current hospice nurses, doctors, social workers, and other hospital staff. Parties like the husband's girlfriend and their kids.

[ktwlpn, LPN]

....I hope you all get those Advance Directives written-talk with your friends and families..As I said earlier-death is the last trip we take and we should make sure our loved ones have our intinerary. ...I am in awe of this thread and impressed that it has remained civil for this long.... My thoughts and prayers go out to all------not just the 2 families that are front and center in this debate but everyone that is struggling with the loss of a loved one....I hope this case does to bring a continued awareness to the importance of Living wills and and a more openess with death and end of life issues..Much of our society has hidden,denied or attempted to pretty it up for too long.It is a natural part of life.What is becoming un-natural is our ability to sustain the body...Should we do so just because we can? What happens when the healthcare system collapses from the strain? We have to face that there are going to HAVE to be limits set eventually-Our resources ARE finite.........That's it for me tonite.................................A final note----Peace and love to all......

[leslie :-D]

Seems horribly sad that the parents can't except their dgt's wishes, she has been without food and water now over a week. Its just a total mess.

Gosh, all the ambivalent feelings, especially with this case being so ambiguous and so many questions unanswered. It took 15 yrs to come to this decision? IF she is in a pvs, then i don't feel as badly, as she would be totally unaware of what is happening. It it's not a pvs and she's aware of her environment, then words cannot express my grief for her.

Yet I can assure you that with hospice involved, Terri is not suffering as I am confident she is receiving the appropriate meds to keep her comfortable; combined with the nurses who are giving keeping her comfortable to the best of their ability.

Yet i just can't help but think there's an element of impropriety in this case. Too many secrets.

leslie

[Tweety, BSN, RN]

Dan, most of the information I've been getting is from the reports in the newspaper here where Terri lives. St. Pete Times. http://www.sptimes.com

Lately however, I've not been reading much, but nothing new has come to light.

[LydiaNN]

It sounds as though her parents are done filing appeals now. I can't help but think this is a good thing, as Terri will be dying and this way all the energies can be focused on the time she has left.

[anubis9727]

OK-so the bottom line here is #1-is artificial feeding "heroic measures"? It does not matter what we think of the husband,the parents or her quality of life.......By law-does this man who IS legally her husband have the right to make this decision? Apparently so-there is not enough evidence to charge the husband with any criminal act (many suspect him of causing her collapse) Can those of you who do not consider tube feeding a heroic measure tell me why you feel this way?

Which justification for feeding Terri would you like? If we accept for just one moment that Terri is minimally responsive, not unlike an infant, then it becomes socially and morally reprehensible not to provide her with nutrition and hydration. How about religious? "do unto others as you would have them do unto you" Also I am not aware of many good practicing Catholics who would be okay with not feeding someone who was in need. Let's try psychological- According to Maslow's "Hierarchy of Needs", food and drink are one of our basic physiological needs. Without it we not only die, we are unable to develop further as human beings. Therefore, logic dictates that even though Terri may be unable to express it, There is no way she can be "at peace" because her basic needs are not being met. And lets face it, her basic needs may be all Terri is still capable of perceiving. On another note, I find all these pundits, no matter how many degrees they have, annoying when they speak with such absolute certainty about what Terri is or is not capable of perceiving. When we are talking about the human brain, the single most advanced piece of hardware that either Darwin or God (take your pick) could conceive of, how can any of us truly be certain?

"why is it when you talk to God you're praying, but when he talks to you you're crazy? - tv show, "touched by an angel"