Artificial feeding-Terri Schiavo

Jenny99 · Mar 28, 2005

Jenny99 - Thank you for your encouraging thoughts. For a minute there I thought I was the bad guy. What can I say I'm a realistic person and sometime people need to be brought back to reality. Hope you have a great Easter.
Twinkle Toes.

You are very selcome. The only other thing I have to say is that if the parents have had no sense of reality throughout this whole thing - they better find reality pretty quick.

jenny99 :)

errn7 · Mar 28, 2005

I just wonder, how far this will go before it truly ends. Even when teri is gone, because of all this uproar and ignorance, there will be ultimately, changes made by our gov't officals to try and pry there way further into our private lives. The sad part of all this is...how many people in our hospitals where we work each day or even each hour are removed from life supporting medical devices, that prolong their lives. Wonder why you dont hear a thing about those people. They are humans just like teri. Just think of all the time and money that has spent spent by all these people and what it could have done if used wisely instead of trying to bring about one person's selfish wishes over another's. All that money spent on both the federal and state level's might have made a difference in helping to find a cure for spinal and head injury pts..........JMHO

humglum, BSN, RN · Mar 28, 2005

wait a minute- if she's on tube feeds, I can't see how her blood glucose levels have been stable. In the ICU where I work, patients on tube feeds are always on q6 hour glucose checks, and continuous tube feeds require q1 hour checks because of the tendency towards hypoglycemia.
i don't see how this argument can be true.

Exactly. All of our TF or HAL patients are on q6h fingersticks just because their blood sugars are so labile.

Chad_KY_SRNA · Mar 28, 2005

I heard on TV a minute ago that the families are fighting over whether or not to bury her or to creamate (SP) her. These people are obviously control freaks. I can't stand this anymore. Let the woman alone!

Tweety, BSN, RN · Mar 28, 2005

hum. so she would have wanted that treatment the first few years, but suddenly after he got that settlement he "remembered" that she'd rather be dead.
sounds real likely to me!

That's not what I'm saying. It took him that long to accept the fact that she was in the condition she claimed she didn't want to live in, and that there was nothing he or the medical establishment could do to change that. I think first he did what we all might do, make sure everything was done.

I doubt even me as a nurse, would from day #1 accept that it was a permanent condition. I've seen many cases where families initially were aggressive and then stopped because they knew it wasn't what their loved one's wanted.

Michael did not win a settlement and then say "o.k. gee, now I'm rich and she's got to go". That's a myth. Also remember during this time he was still getting along with the parents, they too were encouraging along the lines of aggressive treatment. I think during the lawsuit lawyers jaded him with their own greed, that he should continue to demand aggressive treatment and he bought into that. I'm not saying he's innocent. Sometime during the process, he could have stopped the insanity of his and his lawyers actions, if he truly loved her and made her "that promise".

Who is to say that during this time he wasn't full of guilt and agonizing over each and every decision every day to keep her alive despite his promise to her.

tvccrn, ASN, RN · Mar 28, 2005

I just wonder, how far this will go before it truly ends. Even when teri is gone, because of all this uproar and ignorance, there will be ultimately, changes made by our gov't officals to try and pry there way further into our private lives. The sad part of all this is...how many people in our hospitals where we work each day or even each hour are removed from life supporting medical devices, that prolong their lives. Wonder why you dont hear a thing about those people. They are humans just like teri. Just think of all the time and money that has spent spent by all these people and what it could have done if used wisely instead of trying to bring about one person's selfish wishes over another's. All that money spent on both the federal and state level's might have made a difference in helping to find a cure for spinal and head injury pts..........JMHO

The reason you don't hear about other people taken off life support is that the families of those people don't make a publice spectacle of it. These people have chosen to do this.

talaxandra · Mar 28, 2005

In the ICU where I work, patients on tube feeds are always on q6 hour glucose checks, and continuous tube feeds require q1 hour checks because of the tendency towards hypoglycemia.

Patients in ICU are generally more labile than patients who have been on parenteral feeds for a period of months or years.

Parenterally-fed patients are also more likely to run high than low.

All our patients are monitored 6/24 when feeding's initiated, but monitoring is then adjusted to individual patient need - on patients who've had stable serum glucose levels for a few weeks we drop it down to daily and then weekly for non-diabetics, daily to 6/24 for patients with diabetes, but rarely more often than that unless they've an acute illness on top of their chronic problem.

Tweety, BSN, RN · Mar 28, 2005

The reason you don't hear about other people taken off life support is that the families of those people don't make a publice spectacle of it. These people have chosen to do this.

Indeed the family was trying to drum up public sympathy and support. But also it's interesting how the media takes some cases and runs with it. Take the Laci murder trial. Lots of guys kills their wives, even when pregnant. What's so different about this. Also you see more about missing children from "nice" neighborhoods, than you do from the inner city. Anyway, that's a way off topic rant. :)

Peachy720 · Mar 28, 2005

I thought this was interesting, because I keep seeing people saying "Michael is truly the only one with Terri's best interests at heart," and so on.

If you read nothing else in this article, please read the last line. It is Michael's own words during a Larry King article.

"One of the glaring problems in the Schindler's battle on behalf of Terri is that liberal Florida Judge George W. Greer has ruled on the side of death again and again throughout this case. On February 25, he ordered that Terri's nutrition and hydration be discontinued March 18. In several decisions since that time he has also ruled that Terri cannot undergo more medical testing and cannot be fed by mouth -- this despite the fact that Terri can swallow and has been fed by mouth in the past.

Greer also denied a request by Florida's Department of Children and Families for a 60-day delay in the removal of the feeding tube so that the department could investigate allegations that Michael Schiavo has abused and neglected Terri.

Barbara Weller, an attorney with the Gibbs' Law Firm, which represents the Schindlers, told Florida Baptist Press that she understands the Schindler family's frustration with Greer. Weller informed the paper that none of the 33 medical professionals who have said Terri should be medically reevaluated have been paid, and that all of them initiated contact with the firm. "Any other judge in the nation would have ruled for us," Weller said. "So, from the legal side, we were very surprised."

The Schindler's attorneys have submitted affidavits from these doctors and medical professionals -- 15 who are board-certified neurologists -- contending that Terri's condition should be reevaluated.

"The important thing for people to understand is that she can eat and swallow right now," said Dr. William Hammesfahr, a neurologist who has examined Schiavo. He is in many of the videos circulated through the news media showing that Schiavo is at times responsive and seems to be aware.

A leading expert in the field of brain injury and stroke, Hammesfahr has asked to be allowed to work with Schiavo. Dr. Hammesfahr was nominated for the Nobel Prize in Medicine and Physiology in 1999 for his work in brain injury and stroke. He is a recognized expert in treating neurological disorders, having successfully treated thousands of patients using vasodilator therapy, which increases blood flow to the brain, potentially healing conditions previously thought to be untreatable.

"They are truly withholding food from a person who is awake, alert, and can eat and swallow," Hammesfahr said. After spending at least 10 hours with Schiavo several years ago, he told Judge Greer that he believes she can improve with therapy.

No Living Will

The issue that should chill the hearts of every American is that Terri Schiavo did not have a living will -- her desires are not known. Yet her husband has fought in courts for years to have the tube removed because, he said, she would not want to be kept alive artificially and she has no hope for recovery. But her parents contend that she responds to them and these 33 medical professionals agree that her condition could improve.

According to Andrew C. McCarthy of National Review Online, the legal question that is in front of the court in the federal appeal will be, 'Is Terri Schiavo in a persistent vegetative state (PVS)'.

He writes, "In 1990, in a case called Cruzan v. Missouri, the U.S. Supreme Court assumed that a competent person would have a constitutionally protected right to refuse lifesaving hydration and nutrition, and held that where a person (a) was actually in a persistent vegetative state (PVS) and (b) had actually evinced a desire not to be sustained in that state (i.e., a desire to die rather than be kept alive), the state was permitted-but not required-to allow her surrogates to discontinue sustenance."

The problem before the court is that at this moment, Terri Schiavo may be only days from starving to death. There is little time to prove whether Terri is truly in PVS as her husband claims, or is possibly able to receive rehabilitative care. And the lower court case screams of a biased judge who has not allowed her to be examined by unbiased medical professionals.

"Cruzan is distinguishable from Terri Schiavo's case in that there is powerful reason to doubt that Terri is in a PVS," McCarthy continues. "But, of course, Terri's case is not distinguishable unless the federal court is open to a full reconsideration of the factual determinations made by the Florida courts that Terri is in a PVS and that she asserted an informed desire to die."

Portions of the Transcripts from the Interview

LARRY KING: "Right now to Dunedin, Florida. Michael Schiavo is there. He is Terri Schiavo's husband. Also with him is George Felos, the attorney for Michael Schiavo. Fifteen years ago, of course you know the story, Terri Schiavo collapsed when her heart temporarily stopped beating and oxygen cut off resulted in Terri suffering severe brain damage. She is now 41-years-old being cared for in a Florida hospice, kept alive by a feeding tube. That tube was removed today. You were not there, Michael?"

MICHAEL SCHIAVO: "No, I wasn't, Larry."

KING: "Any reason?"

SCHIAVO: "I just didn't want to be in the room then."

KING: "And everyone keeps saying, Michael, I'll ask George in a minute, even if she said to you, I don't want to live like this, which is the reason you've been doing this, so what? If she's not in pain and the parents want her to be alive and you're no longer involved, so what? Why not keep her alive?"

SCHIAVO: "Because this is what Terri wanted. This is her wish. You know something, Larry, I feel like the government. What I'm here for tonight is I'm going to tell you -- I feel like the government has just trampled all over my personal life. It is uncomprehensible that a government can walk all over somebody's private judicial matter, because of their own personal feelings. You know, I should be sitting with my wife right now. You know, her tube was removed and I should be with her. But you know, I felt the need to speak out, because it is just horrible the way that this government is acting with this case."

... Later in the interview

KING: "Have you had any contact with the family today? This is a sad day all the way around, Michael. We know of your dispute."

SCHIAVO: "I've had no contact with them."

KING: "No contact at all?"

SCHIAVO: "No"

KING: "Do you understand how they feel?"

SCHIAVO: "Yes, I do. But this is not about them, it's about Terri. And I've also said that in court. We didn't know what Terri wanted, but this is what we want."

Larry King Live, CNN News, March 18, 2005.

(the interview goes on, but I think that's the meat of it)

Tweety, BSN, RN · Mar 28, 2005

All interesting stuff Terri, which is what makes this case disturbing.

It's a matter of opinion were Terri's best interests served in the end.

However, not just in this case, but anyone who removes a feeding from a person who has been in a condition such as Terri's in my opinion has their best interests at heart. That's just my personal belief and it's hard for me not to personalize it because I wouldn't want to live like that, no one I know wants to live like that, and I refuse under any circumnstances to allow my spouse or parents live like that.

Even if my spouse and I never had the talk and he were to get in a condition like that, then I would only have my own feelings and beliefs to go on, and I would pull the tube feeeding because it would be what I would want. I'm not going to allow my spouse live for years on end just because he never told me he woulld like to live like that rather than die. Does that make sense.

However, I support 100% families that choose to leave them in this condition and let a nursing home take care of them for 50 years if necessary, or let them take care of them at home. I also support 100% those that choose not to do that.

begalli · Mar 28, 2005

... Later in the interview
KING: "Have you had any contact with the family today? This is a sad day all the way around, Michael. We know of your dispute."
SCHIAVO: "I've had no contact with them."
KING: "No contact at all?"
SCHIAVO: "No"
KING: "Do you understand how they feel?"
SCHIAVO: "Yes, I do. But this is not about them, it's about Terri. And I've also said that in court. We didn't know what Terri wanted, but this is what we want."
Larry King Live, CNN News, March 18, 2005.

I think you may be taking this way out of context. The interview question that the bolded response from Michael Shiavo refers to is whether or not he's had contact with "the family." It appears that there's some agreement between Michael and the Schindler's that they not be in the same place at the same time and he's stating that he doesn't know how Terri would feel about this but it's what the family and Michael want.

I think that's pretty clear.

If you read earlier on in the interview Mr. Shiavo says this in response to who wanted what:

KING: "And everyone keeps saying, Michael, I'll ask George in a minute, even if she said to you, I don't want to live like this, which is the reason you've been doing this, so what? If she's not in pain and the parents want her to be alive and you're no longer involved, so what? Why not keep her alive?"
SCHIAVO: "Because this is what Terri wanted. This is her wish.

Antikigirl, ASN, RN · Mar 28, 2005

I also talked to my hubby about this situation, and basically I told him that if he put in a feeding tube to save my life...whether it was my wish or not, then you DON'T remove it or stop its use...it is too late by then! The feeding tube is a heroic measure to save a person, and once done you can't reverse it! I get to live that way...so be it..it was chosen for me, and I wouldn't be able to reverse the choice.

Oh man he threw a whopper of a scenero for me too! He said "okay say you are injured in a car accident and it perferated your spine and GI tract and so we had to put in a feeding tube...you are bed bound from here on out...you can breathe on your own, you can speak...all is well. BUT THEN you suffer a complication...you have a stroke that leaves you in a vegitative state. Would you want the discontinuation of the feeding tube at this point????"

OUCH! I thought of the money involved in my care, the turmoil my family members would go through either way...TOUCH CHOICE! I told him to do what is best for them at that point, but do it directly after the stroke not weeks or days later!!!! That if they wanted me to stay 'surviving' then so be it, but if they choose to let me go..do so very quickly after the stroke and not allow for nurishment at that time because in reality I wouldn't be able to feed myself anyway therefore more in the natural course of the situation. I reminded him to take each thing as it comes, each situation as its own situation...not in a chain. If I was to have a stroke without the car accident complication..what would he do??? He voted no feeding tube directly after...and I told him...then please do it that way then!

Very hard things to talk about...very hard indeed.

I still think that it is too late to be doing this to Terri, and I will always believe that. They saved her, and you can't reverse that fact. A choice was made 15 years ago...and that choice must stand. They chose life...