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...........

[Tweety, BSN, RN]

I think it does matter what the rest of us think. This decision will matter down the line, depending on how we see it.

I personally think, unlike my friend Tweety who said "I'm very confiident that we aren't heading towards a state of euthanizing handicapped persons" . . .that what we are looking at is euthanizing people who are no longer useful to us . . . and that definition can be quite broad depending on who you talk to.

The courts were never meant to be the last word in our society. There is a check and balance . . .

As a Christian, I believe that Terri Schiavo's soul inhabited her body until her death last week - I don't believe her soul left her when she became brain damaged.

I also don't understand blaming out of hand her parents for her bulemia . . .. people make choices as adults and blaming your bad childhood is a cop-out.

steph

Steph, I must not have read where someone said other's opinions don't matter. Of course they do.

I can't say that we are moving towards euthanasia any more than we were a few years ago before this case, because we've been pulling tube feedings, or gentlly allowing humans, including babies and children, who are breathing to finish a process of dying that may not have happened without interventions such as vents and tube feeds.

Did you feel this way before this one case? Because the people have been doing it for a while now. At least as long as I've been a nurse. If we're moving towards euthanasia, then we've been moving along years before.

The reason why I don't think so, is that while the majority of our society supported removing the tube, some powerful and a large group of people did not. This is not a mandate for rampant euthanasia. I do hope that we continue to have the choice to end treatment for persons in pvs.

We'll never know if Terri's soul was wanting relief 15 years ago or not. Or what God had in mind keeping her soul there that long. Or if we played God by putting the tube and prolonging her life, or if we played God by taking it out.

[LydiaNN]

I took it as she was talking symbolically, not literally.

I'd have to disagree, Tweety. I think symbolism is by its nature open to interpretation, but the definition of a term is much more basic. Bottom line, black and white, Terri Schiavo was alive. Why else worry about whether to "let her die"?

[Tweety, BSN, RN]

I'd have to disagree, Tweety. I think symbolism is by its nature open to interpretation, but the definition of a term is much more basic. Bottom line, black and white, Terri Schiavo was alive. Why else worry about whether to "let her die"?

I agree it's open to interpretation. It's a no brainer she was physically alive. Sorry for butting in. All I know is how I took this posters statement, and it made sense to me. The poster will have to explain what the meaning was.

[Tweety, BSN, RN]

The courts were never meant to be the last word in our society. There is a check and balance . . .

steph

And there are checks and balances in place to also not allow the people and the politicians to be the last word in our society as well. It seems to have worked nicely for a couple hundred years.

But it's flawed and I agree with you here, because as you know I'm certainly not happy with some of the courts/politicians/people's decisions.

[NRSKarenRN, BSN, RN]

busy with famly and just finished watching 14hours on tnt--very supportive of nursing but could have used better dialogue.

found these informative links:

while morphine is predominantly used for analgesia, it is also effective for the symptomatic relief of cough, dyspnoea and diarrhoea

http://www.medicineau.net.au/clinical/palliativecare/palliativec1258.html

[color=#0080c0]the fallacies of death causation in palliative care

http://www.mja.com.au/public/issues/feb17/ashby/ashby.html

[color=#336633]good outline: palliative care treatment

http://www.surgical-tutor.org.uk/default-home.htm?principles/oncology/palliative.htm~right

[color=#336633]the costs and benefits of hospice care

http://www.catholicdoctors.org.uk/cmq/may_1998/hospice_care.htm

[color=#336633]respect for life: a framework for the future

http://www.catholicdoctors.org.uk/cmq/2003/feb/respect_for_life_framework.htm

[LydiaNN]

I think it does matter what the rest of us think. This decision will matter down the line, depending on how we see it.

I personally think, unlike my friend Tweety who said "I'm very confiident that we aren't heading towards a state of euthanizing handicapped persons" . . .that what we are looking at is euthanizing people who are no longer useful to us . . . and that definition can be quite broad depending on who you talk to.

The courts were never meant to be the last word in our society. There is a check and balance . . .

As a Christian, I believe that Terri Schiavo's soul inhabited her body until her death last week - I don't believe her soul left her when she became brain damaged.

I also don't understand blaming out of hand her parents for her bulemia . . .. people make choices as adults and blaming your bad childhood is a cop-out.

steph

I totally agree with you about the bulimia. I think it is very interesting that she didn't develop it until after she was married. She weighed 150 pounds when she met Michael! We just don't have the information we need to draw any clear conclusion as to factors that may have contributed to Terri's bulimia, and blaming her parents absent that information is unfair.

[Stitchie]

Why is Roland "passionate" about this case? Perhaps for the same reasons all of us are: we view this as a very important, perhaps symbolic case about human life, and our care for that life. And for some, there is great concern that Terri Schiavo -- and others like her -- are being described using terms like "vegetable," "useless," etc., and we wonder if there are not parallells to times when other groups of people were described in similar terms, with horrendous consequences.

Terri Schiavo was alive. There were no extra-ordinary means being used to keep her alive. She was being fed, and given water. Her life included the time of her handicap, from 1990 to 2005. Life for Terri Schiavo didn't end in 1990. It ended this past Thursday. Let's remember that.

Jim Huffman, RN

Well, semantics aside, passionate in this sense means unwilling to consider other viewpoints as having any degree of validity.

I can see both sides of the argument and I agree that this is a complicated debate. If my personality ceased to exist (hence the 'left the building' reference, meant to inject a sense of irony in a sad situation) I would not want my body (building, temple, what have you) kept 'alive' under any circumstances. A feeding tube for a brain-damaged individual is extraordinary, and in the US it is used frequently because of the quest for research it can perhaps afford.

In no was, shape or form am I advocating eradicating damaged individuals. To make that insinuation is horrendous. I adopted two of them, twin girls, from Poland late last year. No one (meaning a Polish family of ordinary means) in that country would raise my beautiful, healthy, perfect daughters. The Poles don't have the resources we do.

In Poland my daughters were considered un-adoptable by a Polish family because one twin had a PDA repair (with a now perfect echo) and the other has some hip malformation and strabismus. The hip 'dysplasia' (which it really isn't, she just needs lower body strengthening) is fixing itself as she continues to be her active 17-month old self. The strabismus is now non-existent because of better nutrition and stimulation in a positive environment.

As far as bulimics being created by their parents, I have been educated on the process of creating 'perfection' in a teenager. I also have a teenage neice who informs me quite frequently on the pressure her friends' parents put these girls under to be perfect, and many of them end up with eating disorders. Control issues. Much as the Schindlers have shown control issues throughout this process.

By that arguement Carl Sagan would have been euthanized because of his own difficulities. The problem with absolutes, such as the horrifying Hitler comparison, is we gain perspective of 'normal'. Much as we gain perspective as 'fully alive'. And I would not want to be less than that, for many, many reasons.

I consider the Hitler comparison insulting in light of my own personal situation with my children, and I would ask that Roland consider an apology in light that everyone comes with a broad range of experiences, expectations and beliefs.

[sbic56, BSN, RN]

I took it as she was talking symbolically, not literally. Surely, this poster knows the difference between life and death. Again, it's a matter of opinion that just because a person is breathing are they really "living"?

That's right, Tweety...to me maintaining basic autonomic function is not synonomous with life.

I watched my mom die. Call me crazy, but I absolutely believe I felt her spirit as it left. That was quite some time before the breathing stopped. I believe that just as fervently as those who believe the soul leaves with the last breath. Thank goodness, she didn't linger in that state between life and death for more than a few days. I was just a kid when I watched my grandmother die at home and even then felt that her pale, still, barely breathing body was not really grandma, as she had already left. In '97, I felt a wonderful calm and feeling of peace on the highway to Massachusetts General, knowing dad was dying of a AAA as I drove along. I didn't know at the time what the feeling was for sure, but had a feeling. He died about 45 minutes before I got to the hospital. Those are my stories. We are all made up of a collection of beliefs that are formed by past experiences. Who is to say that one person is right, the other wrong? I think it is the not ever really being able to know for sure that makes people so uncomfortable.

[begalli]

...initially few suspected that foul play was involved (the bone scan done a year after her collapse didn't come to light until 2003).

The bone scan adds nothing to prove the notion of alleged abuse by Michael Shiavo.

...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....

Here's the Nuclear Imaging Report.

Here's the deposition given by the doc who signed that report.

Walker, MD from the deposition (page 29):

24 there is a list of probably 30 or 40 things that

25 could cause abnormal bone scans of this wide nature.

[Nurse Ratched, RN]

Folks, as this discussion has long since departed nursing as a subject, and Terri Schiavo is gone (rest in peace), the mods have decided that the thread is no longer appropriate for general nursing. New events in the story may be discussed in current events.

I go back a few pages to the quote where I wish we had closed...

In the meantime, we as nurses need to get back to doing what we do best--and that is healing the wounds of our people.