Pulling G-Tubes

webblarsk · Mar 20, 2005

In the LTC facilities I have worked in it is against regulations to pull a feeding tube. If the person is NPO and dosent have a feeding tube they cannot be in the nursing home. Is it different in different states.

kyjill · Mar 20, 2005

I'm surprised none of us has started to talk about this. I think it is horrid that Terry Schieble's parents are trying to get Congress involved in this case. The woman has been in a persistive vegetative state for 10 years!!! Her husband knows she wouldn't want to "live" this way...
The congressman leading the charge is just trying to divert attention away from himself since he has recently been found to be less than ethical in his career.
We've had a case where the family decided to take the G-Tube out. It was the most difficult decision they ever had to make. We supported them, of course, and the woman died in no pain with her family with her.
My Health Care Proxy paper is in an envelope on the refridgerator door along with a letter detailing my wishes. Living Wills are not valid in Massachusetts, but I'm hoping that if I should ever end up unable to speak for myself, the letter and my HCP, who is my husband (and who knows if he goes against my wishes I'll come back and haunt him), will be enough to prevent some right-to-life do-gooder from forcing me to have a GTube.

I would agree with you 100% if I truly belived that she was in a persistent vegetative state but I have viewed the footage of her interacting with and smiling at her mother and she appears very aware of her environment. How do we know that Terri can't eat? Her husband has never allowed a swallow study.

allnurses Guide · Mar 20, 2005

I'm surprised none of us has started to talk about this. I think it is horrid that Terry Schieble's parents are trying to get Congress involved in this case. The woman has been in a persistive vegetative state for 10 years!!! Her husband knows she wouldn't want to "live" this way...
The congressman leading the charge is just trying to divert attention away from himself since he has recently been found to be less than ethical in his career.
We've had a case where the family decided to take the G-Tube out. It was the most difficult decision they ever had to make. We supported them, of course, and the woman died in no pain with her family with her.
My Health Care Proxy paper is in an envelope on the refridgerator door along with a letter detailing my wishes. Living Wills are not valid in Massachusetts, but I'm hoping that if I should ever end up unable to speak for myself, the letter and my HCP, who is my husband (and who knows if he goes against my wishes I'll come back and haunt him), will be enough to prevent some right-to-life do-gooder from forcing me to have a GTube.

There are a couple of long threads in Current Events about this. I realize you won't be able to post but I think you can read them.

Terri Schiavo has been in whatever state she is in for about 15 years. There are evidently degrees of PVS .. if you watch the videos she does respond. She isn't brain dead nor in a coma.

Her parents are only availing themselves of what is their right as American citizens.

Her husband's motives are suspect.

Check out the other threads - lots of folks agree with you.

steph

allnurses Guide · Mar 20, 2005

Here is a concise timeline of events I found just in case you can't access Current Events.

Bioethics

What You Need to Know about Terri Schiavo

March 7, 2005

by Carrie Gordon Earll

Terri Schiavo's fight for life has been widely publicized in the media but do you know the facts?

Terri Schindler Schiavo is a 41-year old disabled Florida woman at the center of an on-going legal despite between her estranged husband, Michael, and her parents.

In 1990 at 26-years of age, Terri collapsed in her home when her heart temporarily stopped, cutting off oxygen to her brain and leaving her severely brain damaged.

Terri is not dying or terminally ill; she is not brain-dead or in a coma. She is an otherwise healthy mentally disabled woman. The diagnosis that she is in a "vegetative state" is disputed by many medical experts, including neurologists. Some neurologists believe it's possible that Terri is in a "minimally conscious state" (MCS)-- a neurological diagnostic criteria first defined in 2002. 1 Researchers are beginning to test this criteria against that of "persistent vegetative state" (PVS) with other patients. 2

Terri breathes on her own without the aid of a ventilator. Her only dependency is on a feeding tube into her stomach for liquids and nourishment. 3 She swallows her own saliva, a fact that leads some experts in speech pathology to believe that with sufficient time and therapy, she could regain her ability to swallow fluids by mouth. 4 As recently as 1997, nursing staff who cared for Terri testified that she could swallow fluids and Jello-O, follow people with her eyes and even speak. 5

An attorney for Terri's parents, Barbara Weller, has posted narratives on the Internet describing her recent visits with Terri. During these visits, Weller witnessed purposeful interaction between Terri, her parents and other visitors. 6

At the time of her collapse, Terri did not have a written advance medical directive. Since her disability, medical decisions have been made by her husband, Michael Schiavo.

Michael Schiavo won a medical malpractice case on Terri's behalf in 1992, pledging to use the money for Terri's rehabilitation and care for the rest of her natural life. 7 The court awarded more than $1 million: $300,000 directly to Michael for his loss and additionally, more than $700,000 for Terri's care. 8 Terri's parents, Bob and Mary Schindler, claim that prior to the settlement a neurologist recommended progressive therapy for Terri and that Michael agreed to provide such therapy, only to deny it and confine Terri to a nursing home after receiving the jury award. 9

It was after the settlement that Michael first claimed that Terri had previously stated that she didn't want to be kept alive by artificial means-a statement he never mentioned during the malpractice trial. 10

As guardian, Michael Schiavo controls the $700,000-plus trust fund awarded for Terri's care. 11 As of fall of 2003, Michael Schiavo's attorneys reported that the trust fund was down to $50,000, with more than $430,000 going to "pay for court costs associated with her husband's legal battle to remove his wife's feeding tube." 12 Meanwhile, Medicaid helps to pay Terri's $5,000-a-month nursing costs at a hospice in Pinellas Park, Florida. 13

Since 1995, Michael Schiavo has lived with a girlfriend, Jodi Centonze, with whom he has two children. 14 Michael remains legally married to Terri, as well as her guardian.

In 1998, Michael Schiavo petitioned the court to have Terri's feeding tube removed.

Terri's parents have offered to take care of Terri at their own expense, allowing Michael to keep all money remaining in the trust fund. To date, Michael Schiavo has refused, insisting that Terri die from dehydration.

Florida Sixth Judicial Circuit Judge George Greer has set Friday, March 18 at 1:00 p.m. EST as "date and time" certain to remove Terri's feeding tube-an act that will cause the painful death of an otherwise healthy disabled person whose body processes and benefits from the nutrients and fluids she receives daily.

TIMELINE: 15

On February 25, 1990, 26-year old Terri Schindler Schiavo collapsed in her home when her heart temporarily stopped, cutting off oxygen to her brain and leaving her severely brain damaged.

In November 1992, her husband, Michael, won a medical malpractice lawsuit after claiming that doctors failed to diagnose the chemical imbalance that caused the heart attack. The court awarded approximately $1 million in damages with $300,000 to Michael for his loss and another $700,000 to Michael for Terri's guardianship and care.

In July 1993, Terri's parents, Bob and Mary Schindler, petition the court to have Michael removed as Terri's guardian-a request that is denied in August 2001.

In May 1998, Michael Schiavo petitions the court to have Terri's feeding tube removed, claiming that Terri told him that she did not want life-sustaining intervention in the event of her incapacitation.

In February 2000, Florida Circuit Judge George W. Greer rules that the feeding tube can be removed.

After several court appeals, it is removed on April 24, 2001. Two days later, Florida Circuit Judge Frank Quesada orders doctors to reinsert Terri's feeding tube.

In October, 2001, the Florida 2nd District Court of Appeals indefinitely delays the removal of Terri's feeding tube pending the examination of Terri by five physicians: two selected by Michael, two by the Schindler's and one by the court. The two doctors selected by Terri's parents tell the court that she can recover; the remaining three stated that she is in a vegetative state with no hope of recovery. The following month, Judge Greer again orders the feeding tube to be removed again. More court appeals follow.

On October 15, 2003, Terri's feeding tube is removed for a second time.

October 20-21, 2003: the Florida State Legislature passed legislation (dubbed "Terri's Law") allowing Governor Jeb Bush to intervene, ordering the reinsertion of Terri's feeding tube-six days after it was removed.

May 6, 2004-January 24, 2005: Various courts, including the Florida Supreme Court, strike down "Terri's Law" as unconstitutional; the U.S. Supreme Court refuses to hear the case.

March 2005: Members of the U.S. Congress and the Florida State Legislature introduce legislation to intervene on behalf of Terri and other medically vulnerable patients.

LPN_mn · Mar 20, 2005

I don't understand how any of you can say what her husband has allowed and what he has not allowed. You are not there all you know is what you read and let me tell you the newspapers and her parents are not prayer books. I am so tired of people voicing negative opinions on something that they know nothing about. I haven't an opionion one way or the other because I am not close to the case and only know what I read in the paper, which by the way, I take with a grain of salt. I am going to say that I do not think congress should be getting involved in this matter. This is a private matter that the parents decided to take to the media hoping to gain sympathy and look what they have done. If I was the daughter I would be praying for death to take me so I could get out of this three ring circus that the family has created. I for one will be glad when Teri dies so that she will be out of her misery and maybe her parents can get on with their lives and quit abusing our court system.

steelcityrn, RN · Mar 20, 2005

Just so you know, because I didn't, that physicians and nurses have testified that terri makes those same smiles and responses even when she is alone. They have testified that is her behavior in a vegetative state. Im not really for the yanking of the tube now. I just feel that it would be like deciding to place a patient on a vent(A.L.S.), and then a few years later, deciding to pull it. It seems to me that once this is started, it should remain until death. She must be taken care of very well, because probably one of the few ways she may pass on her own now would probably be by pneumonia.

=kyjill]I would agree with you 100% if I truly belived that she was in a persistent vegetative state but I have viewed the footage of her interacting with and smiling at her mother and she appears very aware of her environment. How do we know that Terri can't eat? Her husband has never allowed a swallow study.

allnurses Guide · Mar 20, 2005

I don't understand how any of you can say what her husband has allowed and what he has not allowed. You are not there all you know is what you read and let me tell you the newspapers and her parents are not prayer books. I am so tired of people voicing negative opinions on something that they know nothing about. I haven't an opionion one way or the other because I am not close to the case and only know what I read in the paper, which by the way, I take with a grain of salt. I am going to say that I do not think congress should be getting involved in this matter. This is a private matter that the parents decided to take to the media hoping to gain sympathy and look what they have done. If I was the daughter I would be praying for death to take me so I could get out of this three ring circus that the family has created. I for one will be glad when Teri dies so that she will be out of her misery and maybe her parents can get on with their lives and quit abusing our court system.

You do have an opinion one way or another - you just stated it.

Nothing wrong with that.

The reason I've come to the conclusion I have is because leaving aside anything said in the media, I do not believe in the active taking of a disabled person's life just because I wouldn't want to end up that way.

And there is a disagreement over how disabled she is . . . some nurses/aides say she can swallow her own saliva and has eaten jello and drank fluids.

Since there is such a large discrepency between what the husband says and the parents say, I think it is a good idea to have some legal safeguard that wouldn't allow people to be killed easily.

If her parents get their day in court, what does it possibly hurt? Terri has already been disabled for 15 years.

We loudly protest about people on Death Row being put the death without due process and worry about innocent people being put to death. We worry more about criminals that we do about a disabled woman.

There are those who don't believe in capital punishment for convicted murderers/rapist/molesters . .I wonder how many of those people think it is ok to take a feeding tube away from a woman who is merely disabled?

steph