Artificial feeding-Terri Schiavo

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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...........

Ah, those of silver-tongue (Felos).

I'm sorry, but Terri Schiavo has been a victim of hospice abuse.

You are supposed to be terminally-ill (to die within 6 mos) in order to obtain hospice services, and she was not. :angryfire

Folks may want to consider this article of an RN, albeit a Catholic RN, about

euthanasia in this country:

http://www.catholictradition.org/targeted.htm

It's easy to think of withdrawing support when we decide someone no longer has a "quality of life"; the only question is--what might it take for someone to decide that that person is us, say, when we have been over-medicated?

NurseFirst

Nevermind. Keep my opinion to myself

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Terri was not in hospice until they pulled the tube the first time, at which time she became a hospice patient and was moved to this facility.

After they reinserted the tube, hospice tried to place her back in a nursing home and no one would take her. So they kept her for the duration. It wasn't that hospice was abusing her by keeping her as a hospice patient, the case managers and social workers for hospice had a difficult time placing her during the time her feeding was back in.

Thank you Tweety!

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Roland

I have a problem with Terri being in hospice for so long too. I understand she had medicaid so we as tax payers paid the bill as well. I always thought hospice was for the terminally ill patients with 6 to 12 months to live. But yet both sides had money for litigation which I'm sure was not cheap.

Terri probably would have had Medicare/Disability. Medicare has a hospice benefit which probably would have taken care of the hospice bill. The hospice I work for accepts Medicare payments, insurance payments or if the patient is unable to pay then we absorb the bill. It is a Federal law that if the patient cannot pay the bill than the hospice absorbs the bill. This is where donations come into effect.

I am going from the hospice I have worked for which is not a inpatient facility so I could be completly off. But I wanted to share what I know about the hospice benefit.

Also with hospice, yes the patient must have a terminal diagnosis. But must be recertified every 90 days for the first 2 benefit periods and than every 60 days after that. If the hospice can show that patient is still terminal and isn't going to get better that they can be recertified. There have been patients on hospice for 2-3 years. With her husband being in charge and stopping all the treatments, (ie: not treating infections, not seeking therapy) the doctor probably continued to recertify her.

Hope I have made some sense and am not just rambling. :uhoh21:

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I thought I read that Medicaid was paying for her daily expenses.

So many things to search through though to find that link . .. . I'm getting a bit fried on this sad subject.

steph

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I thought I read that Medicaid was paying for her daily expenses.

So many things to search through though to find that link . .. . I'm getting a bit fried on this sad subject.

steph

Medicaid could have been paying for the daily expenses. Like I said it may be different with a inpatient hospice.

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I thought I read that Medicaid was paying for her daily expenses.

So many things to search through though to find that link . .. . I'm getting a bit fried on this sad subject.

steph

I found a site, you are right. Medicaid was paying the expenses. Which proves to me inpatient hospices are a little different than I am used to. :uhoh21: Guess I should keep my mouth shut!

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I found a site, you are right. Medicaid was paying the expenses. Which proves to me inpatient hospices are a little different than I am used to. :uhoh21: Guess I should keep my mouth shut!

No, don't keep your mouth shut . . . we all make mistakes. The problem comes when we don't admit it. :)

steph

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Specializes in LTC,Hospice/palliative care,acute care.
(the bone scan done a year after her collapse didn't come to light until 2003). .
correct-and the apparent injuries could be attributed to vigorous CPR-she coded numeorus times in the ambulance the night she collapsed.She also had a car accident sometime prior to her collapse..Bone mass is lost at a rapid rate during the first year of immobilization-vigorous physical therapy can cause injury.She also had an eating disorder-that can also cause bone loss....Dr Michael Baden made alot of misleading remarks in interviews regarding this matter-and the skilled interviewer Gretta Van Susteren called him on it-I'll have to link the info....If it can be proven that her husband did NOT cause her any harm would the preponderance of the evidence then convince you that she DID say she never "wanted to live that way? SHe was close to my age-we are in highschool when Karen Quinlan collapsed-I am sure she must have known about that...We all talked about her.Also her elderly grandmother was on a ventilator before her death (tells you a little more about the parents,IMHO) That is the context of the alleged conversations. Why is this scenario so difficult for some to belive?
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Specializes in Critical Care/ICU.

After they reinserted the tube, hospice tried to place her back in a nursing home and no one would take her. So they kept her for the duration. It wasn't that hospice was abusing her by keeping her as a hospice patient, the case managers and social workers for hospice had a difficult time placing her during the time her feeding was back in.

I can completely understand this.

Back in August of 2004 we had an admit to our ICU. It was a 19 year old young man with Deuchene's (sp?) Muscluar Dystrophy. He had pneumonia with a complete respiratory shut down. He was very sick and intubated for a long time. The docs finally decided to trach and tube him. His body is completely contorted but his mind completely intact. He's quite intelligent actually and a bit manipulative.

Long story short, it is now April. This young man, who is vent dependent and certainly NOT requiring ICU care or even hospital care, is now a lifetime resident of our ICU. At this point he will be with us until he dies. For the most part during the day every day, his family gives care - suctioning, bathing, etc. The nurse gives meds...that's it. We were told last week to go ahead a sign up for our shifts with him because everyone will take turns being assigned to him.

He's a 1:1 in a contact isolation private room because he had MRSA and is a carrier. It's ridiculous.

Without the entire family up and moving several hundred miles away, there is absolutely no where that can take him on the vent and we even had one local LTC place go through a Medicare audit just so that they could take him on the vent....didn't work. It was very nice of them to try....they didn't have to. He can't go home because there is no way that the family, who is 200% supportive of this young man, can afford the costly home care.

Medicaid or Medicare (I don't which one) IS paying for everything but $400/day for his care in our ICU. I'm not sure what or even if the family is paying anything for his private room in the ICU. If he were to go home, where he and his family want to be, it would cost the family about $5,000/month.

This is so damn bass ackwards.

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Specializes in Med-Surg.
That "quality of life" comment scares me. I don't believe in gauging what a person's life is worth by the so-called "quality" of that life.

steph

That's understandable. But personally I can and do decide what is a quality, when it comes to my loved ones. To me a pvs with no response is not a quality life. When it comes to others, I let those loved ones decide. Many feel that if a person is breathing then it's a quality life. That's o.k., they aren't married to me, nor my parent's child.

But I also must point out there is a difference between "worth" and "quality". Every life has worth, but not every worthy life has quality. I know I'm not explaining it very well at all. But because I decide to remove a feeding from a loved one, I'm not saying their life has no worth. If that's how you look at it that's o.k., but I don't. :)

I seriously doubt we're entering into an era where handicapped persons are in jeopordy, but I may be wrong, we'll have to see. Fortunately Florida law is pretty specific about who can have life support and feedings removed. Mr. Shaivo didn't violate that law, nor were any laws rewritten. Don't know what it's like in California, but I don't think euthanasia is legal yet. And I doubt this case has any way, shape, or form advanced the cause for euthanasia. In fact it may have hurt their cause more than helped. And isn't assisted suicide still illegal as well? So I'm not worried.

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Specializes in Med-Surg.

begalli, I can tell you story after story of cases like yours, but don't get me started. It's total insanity.

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Specializes in Med-Surg.
I haven't seen anyone suggest that the healthcare standards in Florida are lower than they are anywhere else. It is certainly not what I was getting at when I said it is too bad they didn't choose to let Cyril Wecht observe the autopsy. Sometimes my preference to be concise works against me, if I don't elaborate enough to make my point. What I was getting at is that I would have allowed an observer, not as a suggestion that I thought the FL authorities were incapable of doing their job, but as a preventive measure so that the Schindlers wouldn't have yet another thing to question. Yes, I did say that I trust Dr. Wecht implicitly, but only because of my familiarity with the quality of his work, not because he's from Pittsburgh and only people from Pittsburgh (or anywhere else) should be trusted.

Teapot, I certainly didn't mean to imply that when I said "someone up North" (don't know where that came from), that you or anyone else was criticizing the South.

But I have to believe, I mean I really have to believe, that our ME is on the up and up, legit and competent. I can't fathom anything else, it's too frightening.

I do not have a problem with a witness or even a second opinion, but I have a problem with that expert being hand picked by the Schindlers, no matter how good he/she is. No offense intended to the guy from "up north". :)

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