Terri Schiavo's: Judge denies request to reinsert feeding tube

[4dmin]

http://www.msnbc.msn.com/id/7254897/?GT1=6305

^ what do you guys think about this case???

[A.P. Photography]

It never should have gone to where it is now. This is something the family should deceide and if the husband request it then all parties should honor it. I mean after 15 yrs in a vegitative state with no signs of recovery it is time to let her go. If you look at it from a religous stand point, the Bible says that a man and woman will leave their parents and join to become one. Meaning that they become responsible for each other, not mommy and daddy step in and try to make the deceisions based on what they feel is best. If their faith was strong like they claim it to be she would be walking around normal or they would be at peace with letting her go which with the escalation of this case it seems that thier faith is not where it should be.

[Jaimecbr900]

^^^^Hey, you stealing my lines?????? ;) :D

Paul, why don't you cut and paste the other post over to this one?

I was hoping for a little more lively debate.

[A.P. Photography]

^^^^Hey, you stealing my lines?????? ;) :D

.
Or are stealing my lines? :p
Guess we have the same views on some things

[Redneckshenanigans]

personally, i would just let her go. from what the doctors know she isnt even aware of where she is or what is going on. more than likely its jus a reaction for her eyes to be open because her brain is still alive, jus severely damaged. if it was someone in my family i would have ended it all a long time ago. plus if i ever have something happen to me where i end up in a veg. state i hope someone will pull the plug on me!

[seksicarlovinchick]

see, the thing is that her parents just want to take care of her, people have offered this guy money ya know, like millions of dollars, but at this point it's just a control issue I think. Granted, she died a long time ago, apparently she was bulimic (sp?) and stuff, but still if the parents want to take care of her why not, it's better than letting her starve to death. it takes the human body about 2 weeks to die without food or water...um cruel and unusual punishment if you ask me

[A.P. Photography]

How ever cruel and unusual is seems, her parents keeping her alive is a lot worse IMHO. She is being kept alive here in this world when she could be happy in free if she passes away. It is really the lesser of two evils.

[seksicarlovinchick]

Well, i guess it's easy to pass judgement when one isn't in the situation, i'm just glad it's ot a decision I have to make

[Jaimecbr900]

see, the thing is that her parents just want to take care of her, people have offered this guy money ya know, like millions of dollars, but at this point it's just a control issue I think. Granted, she died a long time ago, apparently she was bulimic (sp?) and stuff, but still if the parents want to take care of her why not, it's better than letting her starve to death. it takes the human body about 2 weeks to die without food or water...um cruel and unusual punishment if you ask me

Control issue from whom? The parents or the husband?

What people don't want to understand is that the parents aren't gonna be "taking care of her". Tax payers and a hospital will be. She is in a veg state. She will never wake up and walk and talk and take care of herself. She is simply laying there. Would YOU want to lay in the same fetal position for 15 yrs? Is that considered a good life to live?

She's not simply mentally retarded or physically challenged. She's been deemed to be "brain dead". That is a far cry from killing someone. It's hard to kill something that's already dead.

I can tell you from experience that letting someone go and pass it's very difficult. I can also tell you from experience that sometimes it's better to let someone go than to keep them around. Doing so is selfish IMO.

[seksicarlovinchick]

Like I said, it's easy to judge, i don't pretend to know everything, and i admit that I am probably wrong, but in my own nieve mind, killing is killing...it's a control issue for all parties involved, although the parents just want the best for their daughter...the thing is, you never know, what if the chance exists that she could wake up ay know, I'm just saying, I think it's wrong to just let her sit there and starve, it's slow and painful...however, there is the whole idea of putting things in god's hands...so it's a hard decision to make, and I can see both sides of the argument

[A.P. Photography]

..however, there is the whole idea of putting things in god's hands...so it's a hard decision to make, and I can see both sides of the argument
You just answered your own question as to what to do. If it was put in God's hands and the family believed there is no doubt she would be walking around and talking now. The hardest thing you have to do is give it over to God and trust in him, the parents are wanting what they want and not what God wants. God creates life and takes it away, man accepts life and tries to play god with machines to keep people alive. Look at it like this, if you are a christian, the body sustains trauma to the point of no recovery and the spirit goes on to be with Christ. The human body has now become the same thing as a car, it is running (breathing) but cannot think for itself (braindead) and will continue to run as long as you put gas in it (feeding tube). Now how is that a loving thing to do, holding onto a persons body to relieve nothing but past memories. It is hard on everyone involved and now it has become a media mockery because of the selfishness of the parents.

[Jaimecbr900]

Like I said, it's easy to judge, i don't pretend to know everything, and i admit that I am probably wrong, but in my own nieve mind, killing is killing...

She's only "alive" in technical terms. She in fact died years ago. Her body is all that is left. This is why it's a selfish thing to do. If she were to ever be able to even just so much as speak, then it would be different. But to simply just lie there until the rest of your body catches up to the brain? That's what's torture IMO.


it's a control issue for all parties involved, although the parents just want the best for their daughter...

That's a matter of opinion. Her parents are holding on to memories and trying to manifest that thru a lifeless body. When the brain went, it took with it all remnants of who the person ever was. The parents are just not understanding that.



the thing is, you never know, what if the chance exists that she could wake up ay know, I'm just saying, I think it's wrong to just let her sit there and starve, it's slow and painful...however, there is the whole idea of putting things in god's hands...so it's a hard decision to make, and I can see both sides of the argument

Well, we actually do know. Doctors do have a very good idea of what her prognosis is. If I'm not mistaken, it's actually the same prognosis they gave her 15 yrs ago. Classifying someone "brain dead" is not as simple as it seems. After 15 yrs, there is a super high degree of certainty as to what is going to happen in the next 15 yrs.

I just think it's selfish of the parents to want to keep her like that when only God can help her at this point. I'm a Christian and believe in divine intervention, but I also look at things logically. Maybe it's the parents and a machine hindering God's purpose, instead of the other way around.

[Julio]

let her go.

[uncle_el]

this case is very sad, on both parts. the parents seem to be out of touch with reality, and the doctor(s) there seem not to be able to get across the truth to the parents.

if you've never seen someone with a significant brain injury, it all just sounds like words. you believe what people tell you, because you have nothing to compare it to.




here's a paper i wrote on diagnosing brain death about a year and a half ago...



Mr. JF is a 57 year old man with a past medical history of hypertension who was found unresponsive by a family member. Emergency Medical Services found the patient to be unresponsive and hypertensive. Upon arrival to the Emergency Room at Grady Memorial Hospital, the patient was in respiratory distress. He was a very difficult intubation, and a tracheal tube for breathing was eventually placed. On Computed Tomography (CT) of the head, he was found to have bilateral posterior cerebellar artery (PCA) infarcts and uncal herniation.


Whether as a physician in the emergency room, in the trauma bay, in the medical intensive care unit, or on the neurology service, we already have or will encounter a situation such as this at some point during our careers. Many difficult decisions need to be made immediately, and others will need to be made over the next few hours and days. As with many patients, these decisions will be critical to the patient’s prognosis for survival, the family’s perception of the patient’s prognosis, as well as their perception of the care given to the patient. The comatose state, vegetative state, and brain death are issues that are discussed by those outside of medicine. These topics have quite a bit of confusion among the general public, and it is quite apparent in the with the Terri Schindler-Schiavo case.




According to www.terrisfight.org, Ms. Schindler-Schiavo “is in a locked-in state”. Furthermore “though she is responsive to stimuli, interacts with her environment and her loved ones and is capable of communicating in limited ways, she is a disabled and vulnerable adult - requiring protection, therapy and the route to recovery.”1

Her case has spawned debate on television, on Internet forums, and even a new “Terri’s Law”- the term given to the decision of Florida governor Jeb Bush to restore tube feedings to Ms. Schindler-Schiavo. It is important for us as physicians to dispel any misconceptions our patients’ families may have. It is also important for us to respect and honor the decisions of our patients’ families.




Brain Death, a definition:

The levels of consciousness can be thought of as a continuum: from alert, oriented, and active in a meaningful way with other individuals to absolute absence of alertness, orientation, or activity.

Coma, from the Greek word “koma”, literally means deep sleep 1. The comatose state is one of pathologic unconsciousness. The comatose patient is unaware of his/her surroundings, and is unable to be aroused. There are many anatomical and metabolic reasons for a person to be in a coma, which are outside the scope of this paper. However, all of the different reasons for coma affect the cerebral cortex and/or the reticular activating system. The cerebral cortex, which is composed of the right and left hemispheres, controls voluntary movement and sensation. It is also responsible for thought, reasoning, and memory. The reticular activating system is not located in a particular area of the brain, but rather it is a collection of different portions of the brain, including the thalamus, brainstem, and medulla. Together, the cerebral cortex and the reticular activating system are responsible for consciousness.2, 3

A comatose patient may or may not make a meaningful recovery. One comatose patient may regain consciousness, as well as regain all abilities present prior to the coma, whereas another comatose patient may regain consciousness, but with impairment of some or all abilities. Yet another comatose patient may remain in a coma. This third scenario is termed a persistent vegetative state. A persistent vegetative state is also characterized by unawareness, but patients have normal sleep-wake cycles and are arousable. A fourth comatose patient may progress to brain death.

Brain death can be defined as “an unresponsiveness and lack of receptivity, the absence of movement, and breathing, the absence of brain-stem reflexes, and coma whose cause has been identified”4. In the brain dead state, a patient is completely relying upon medical interventions to keep the heart beating and the lungs respiring.




Mimickers of brain death: hypothermia, drug intoxication, “locked in” syndrome.

There is an old saying that a dead body must be a warm body. Hypothermia is a condition that occurs when body temperature falls below 35 degrees Celsius. It may occur when a person is subjected to extremely cold temperatures, or if there is a pathological condition affecting the temperature regulating portion of the brain, found in the hypothalamus. As the core temperature of the body drops below 35 degrees Celsius, coordination will begin to be lost. The skin may become pale, muscles may become rigid, and shivering may occur in an attempt to maintain and perhaps raise core temperature. Heart rate, respiratory rate, and blood pressure may begin to rise in this early stage of hypothermia. As the core temperature continues to drop, speech may become slurred and confusion may begin to set in. As the core temperature of the body drops below 32 degrees Celsius, the response to light is lost (i.e. no pupillary response). Although they rose in the early stage of hypothermia, heart rate, respiratory rate, and blood pressure will begin to plummet once core temperature falls below 32 degrees Celsius. As the core temperature drops below 28 degrees Celsius, brain-stem reflexes are lost. It is imperative to remember that people can survive the extreme cold, and all of these deficits are potentially reversible.5

http://www.rendlake.com/images/hypothermia-chart.gif


A chart used by EMS.

Somewhere between twenty-five to forty percent of hospital admissions are related to substance abuse and its sequelae, and ten to sixteen percent of outpatients seen in primary care practice are suffering from addiction related problems. Roughly ten percent of Americans, report misuse of sedatives in their lifetime. Approximately five to ten of primary care patients meet clinical criteria for major depression. Approximately ten percent meet criteria for minor depression. Antidepressant has increased dramatically within the last ten years with the advent of selective serotonin reuptake inhibitors (SSRIs), the television commercials and advertisements of pharmaceutical companies, leading to the increased awareness and recognition of depression by the general public. Sixty-two percent of Americans age eighteen and over have had alcohol in the past year. Thirty-two percent of those had five or more drinks on the same occasion at least once in the past year. Needless to say, sedatives, antidepressants, and alcohol are commonly used, misused, and abused in today’s American society. When used in combination, the effects can be deleterious, even fatal. Barbiturates, other sedatives, antidepressants, even alcohol can mimic brain death when present at extreme or toxic levels. However, certain portions of brain-stem function remain intact, such as the pupillary response to light.6, 7, 8, 9, 10, 11, 12, 13


Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy of unknown origin, characterized by progressive muscle weakness and areflexia. It appears that GBS, also known as ascending paralysis, was first described by James Wardrop in 1834. It was more fully described by Jean Baptiste Octave Landry de Thézillat in 1859, and for a time was known as Landry’s ascending paralysis. In 1916, the landmark study was undertaken by Guillain, Barré, and Strohl. The name "Guillain-Barré Syndrome" was first used in 1927 and persists to this day. GBS occurs in both men and women, affecting people of all ages. It has an annual incidence of 0.6 to 2.4 cases per 100,000; and is now the most common cause of acute flaccid paralysis in healthy people. 14, 15, 16, 17



Though spontaneous remission is the typical outcome, GBS can progress to involve cranial and peripheral nerves, resulting in a “Locked-In Syndrome” (LIS). The term LIS was introduced by Plum and Posner in 1966 and is used to define a clinical picture characterized by a total paralysis of voluntary motor functions with preservation of vertical eye movements combined with synergetic elevation of the upper eyelids when looking upwards. This syndrome is usually associated with a bilateral ventral pontine lesion.18, 19, 20

Brain death is a completely irreversible condition, whereas hypothermia, drug intoxication, and locked-in syndrome are potentially reversible.







Determination of brain death:

One must use his/her clinical neurological skills to find and document coma, the complete absence of brain-stem reflexes, and apnea. The clinical criteria consist of: coma, absence of motor responses to pain, absence of pupillary responses to light, absence of corneal reflexes, absence of caloric responses, absence of gag reflex, absence of coughing in response to tracheal suctioning, absence of sucking and rooting reflexes, and absence of respiratory drive at a PaCO2 that is 60 mm Hg or 20 mm Hg above normal base-line values (i.e. failed apnea test). 21

http://content.nejm.org/content/vol344/issue16/images/large/06t1.jpeg

A physician should refer to the rules, regulations, and criteria of the particular hospital in order to establish brain death in a patient. It is of note, “that it is not the physician’s role to diagnosis death, but rather to diagnose life.”22


What to do if uncertainty remains about brain death?

If uncertainy remains, so-called confirmatory tests can be ordered: electroencephalography (EEG), transcranial Doppler ultrasonography, cerebral angiography, and/or cerebral scintigraphy. None of these technological modalities should be used alone in determining brain death, but rather their interpretation should be combined with the objective findings of the physical exam.

An EEG is a non-invasive procedure in which electrodes are placed on the head of the patient. The electrical output and activity of the brain is recorded and read on a monitor. In brain death, a lack of reactivity to stimuli needs to be demonstrated on EEG.23

Transcranial Doppler ultrasonography is another non-invasive procedure. However, this modality uses sound waves to detect direction, velocity, and direction of blood flow.

A cerebral angiography test is an invasive procedure where a radiopaque substance is injected into the arteries so that the blood vessels will be prominent on X-ray. In brain death, no filling of the cerebrum should be detected in the carotid or vertebral arteries on cerebral angiography.24

Cerebral scintigraphy uses a radionucleotide, generally technetium bound to another molecule, to determine perfusion of the cerebral perfusion. There should be absence of cerebral and brain stem activity on cerebral scintigraphy in order for brain death to be determined.


Conclusion:

The subject of brain death is a hot button issue in today’s society. Care should be taken by the physicians, and the rest of the health care team in establishing brain death. The cause of the patient’s coma must first be determined. Mimickers of brain death need to be ruled out. A careful physical and neurological exam will lead the physician to diagnose life, or determine a state of brain death. If the objective physical exam does not fit all clinical criteria of brain death, there are a number of confirmatory tests which can be done. The results of any test performed should be used in conjunction with the physical exam. In the end, it is important for the physicians: 1. to answer any questions of the patient’s family, 2. to dispel any misconceptions about the patient’s condition, and 3. to honor the decisions of the family, even if it goes against what the physicians would choose to do.



Upon neurological exam, Mr. JF was found to have absence of all brain stem reflexes. He failed the apnea test. However, he did have a reproducible triple reflex with plantar stimulation. An EEG was obtained, which was found to be severely abnormal, but not isoelectric. The medical ICU team was informed of the findings. The family, taking everything into account, decided to withdraw care.







in my mind, this is one of the most important pieces:
http://content.nejm.org/content/vol344/issue16/images/large/06t1.jpeg


beyond that, as i said above, there are other tests that can be done:
eeg to show if there's any brainwaves...
mri to see if there's any metabolism
ultrasound
cerebral scintigraphy to see if there's any blood flow...

i just wonder in terri schiavo's case whether or not any of this has been done. i imagine that it has, but we never hear about it.

also, as i said earlier, if you've never seen someone with a significant head injury; never seen someone comatose... never seen someone brain dead, you have no idea what the experience is like.

for instance, you can pinprick the bottom of someone's foot. if you or i had our foot pricked by a pin, we would move our foot away from it (and maybe even hit the person, lol). someone who's brain dead may not move, or the foot may move towards the stimulus... the movement doesn't mean the person is aware of it.

also, reflexes may be intact, but that doesn't mean anything, as we do not control our reflexes- it's simply an electrical relay between the neurons of the foot and the spinal cord... the brain isn't involved. but if a layperson came in during that exam, he or she might think the person moves on his/her own.







just one medical student's opinion...

[seksicarlovinchick]

I just think it's very sad, like i said, i see both sides, just sad.

[SL65AMG]

pull the damn plug.....(already been done).... and LEAVE IT OUT!!!!

[Miranda]

You know.. there is a HUGE difference between saying that someone should be pulled off of life support and saying that someone's feeding tube should be removed!

She is being starved. If any of us was denied food or water, we would die too. I think that the distinction is not being made as it should be. I feel terrible for her family (if they were willing to take on the financial responsibility for her care from here on out).

More later.. COPS is on!


~ Miranda

[BTLFED]

Holy fuck I am not getting into this thread.

[Jaimecbr900]

You know.. there is a HUGE difference between saying that someone should be pulled off of life support and saying that someone's feeding tube should be removed!

She is being starved. If any of us was denied food or water, we would die too. I think that the distinction is not being made as it should be. I feel terrible for her family (if they were willing to take on the financial responsibility for her care from here on out).

More later.. COPS is on!


~ Miranda

Actually, if you wanna be technicall her feeding tube is in fact her life support. Again, simply being a hunk of meat breathing does not a equate to being alive. If you think so, I challenge you too to go to your nearest hospital and volunteer your time to see what it's like in reality. I have and KNOW what it's like. My wife's uncle was also an extended care patient until his death last year. I was literally standing there when he took his last breath. HE told me himself when he could speak and was in BETTER shape than he was the last few MONTHS that he wanted to be let die in peace. We even paid an attorney to come and draw up the paper work for the living will at their home for that reason. He even had "no recusitation orders".

So until some of you clean up a bed sore or listen to miserably uncomfortable person TELL you with their own mouth just how miserable being bedridden is.....don't think for a second YOU know how it really is. People need to be allowed to rest. This lady needs to be allowed to rest.

I know most of you here are not religious. And everyone knows that I am. One thing that hasn't been noticed in either of these two discussions is the irony of WHEN this is all coming to a head....Easter. For those that don't know, Easter is the celebration of Jesus' resurrection. Anyone see the symbolism there? Maybe it's coincidence, but maybe not. If she was a believer, she is guaranteed a better place upon death. Now, why would you KEEP someone you love FROM that? Yet, some of you wanna say her parent's aren't being selfish? Ironic isn't it? Think about it.

[A.P. Photography]

Here again Jaime answers before I can get a word in. :goodjob:



(if they were willing to take on the financial responsibility for her care from here on out).

Thats just it, the tax payers have been footing most if not all of the bills for her to be kept alive. The family has not even really had to contribute so the finaicial burden is not really on them but the taxpayers.

Like Jaime said, this time of year is very surreal. IF they are believers then they know where she is going, why would you want to deny her that? To me that is more cruel and inhumane that wanting to keep her here on the feeding tube.

[Miranda]

A very good friend of mine is in a coma right now (and has been for almost a month) that he will likely never come out of. Having visited him on multiple occasions, I can assure you that I know what it is like.

But no, life support is your breathing system. It is the system that monitors and, if necessary, supplies the essential amount of oxygen getting into your body. Many people have gone off of life support while in comas (keeping a feeding tube). This woman is not in a coma. She is in a completely different state. If this woman is allowed to die this way, it's only a matter of time before other cases of retardation (whether more or less severe) are treated the same.
As for religion, I believe I can speak to a possible motivation for her family's desires (beyond not wanting to lose their child). As I said before, she's not on life support (as in, she is breathing on her own). Denying her a feeding tube (food) is something that some people view as murder. I can see both sides of the coin, so I'm not going to give an opinion. But the fact of the matter is that her situation is a very hairy one. If she were incapable of breathing on her own, then yes.. I can understand the motivation of ending her suffering.
The fact of the matter, however, is that denying a feeding tube goes way beyond the scope of any state or proposed right-to-die laws. Even in Oregon, the only state that actually allows assisted suicide, the paperwork is very rigid (requiring special counseling with the patient and the patient's complete and utter rational desire to exercise the law). This woman has never been counseled. She has never written any kind of order to do something so drastic in the event of this kind of situation. Who is to say what this woman wanted? I cannot. Her husband's motives may be questionable. Her family's motives may be questionable. If I were the ruling party in this situation, I would have aired on the side of caution. You open a lot of scary doors when you make this kind of decision. My fear is more for future abuses of this case's rulings rather than this case itself. I have the utmost compassion for everyone involved here, but I cannot say that I agree with her fate.

The only other thing I have to say is this... don't be so quick to make assumptions about people. Just because I don't openly share my stories or my past doesn't mean I have no idea what this is like. As I said before, a friend of mine is in a similar boat. I watched my grandmother die as well. My father is a doctor, my mother is a nurse, and I am a pharmacy technician. I am surrounded with stuff like this every day. It broke my heart every time I visited one of my dad's PICU (Pediatric Intensive Care Unit) patients when I was a little girl. She was in a car accident and wound up just like this woman. As far as I know, her family is still caring for her. :(

~ Miranda


Actually, if you wanna be technicall her feeding tube is in fact her life support. Again, simply being a hunk of meat breathing does not a equate to being alive. If you think so, I challenge you too to go to your nearest hospital and volunteer your time to see what it's like in reality. I have and KNOW what it's like. My wife's uncle was also an extended care patient until his death last year. I was literally standing there when he took his last breath. HE told me himself when he could speak and was in BETTER shape than he was the last few MONTHS that he wanted to be let die in peace. We even paid an attorney to come and draw up the paper work for the living will at their home for that reason. He even had "no recusitation orders".

So until some of you clean up a bed sore or listen to miserably uncomfortable person TELL you with their own mouth just how miserable being bedridden is.....don't think for a second YOU know how it really is. People need to be allowed to rest. This lady needs to be allowed to rest.

I know most of you here are not religious. And everyone knows that I am. One thing that hasn't been noticed in either of these two discussions is the irony of WHEN this is all coming to a head....Easter. For those that don't know, Easter is the celebration of Jesus' resurrection. Anyone see the symbolism there? Maybe it's coincidence, but maybe not. If she was a believer, she is guaranteed a better place upon death. Now, why would you KEEP someone you love FROM that? Yet, some of you wanna say her parent's aren't being selfish? Ironic isn't it? Think about it.

[blacknight03]

Howard Stern say that mouth has to be good for something :idb: but thats even low for me...

[4dmin]

The fact of the matter, however, is that denying a feeding tube goes way beyond the scope of any state or proposed right-to-die laws. Even in Oregon, the only state that actually allows assisted suicide, the paperwork is very rigid (requiring special counseling with the patient and the patient's complete and utter rational desire to exercise the law). This woman has never been counseled.please explain how you would counsel a brain dead woman??? sorry but you could walk in the room call her name and she would still be sitting there drooling staring off into space... its the reality she is living. we are not talking a woman who this just happened too but she has been in this state for 15 years and 4 doctors have all came to the same conclusion; as well as the court systems. beyond that the parents gave their daughter away when she married the dude, so he should be the one to make the decisions on her life. its not like he was some guy who was cheating around on her and then suddenly won a settlement and wants to kill her. She put herself in this position... The parents need to just let go, people die its life. And even if your a GOD fearing person, GOD never meant for people to live on machines

[A.P. Photography]

. And even if your a GOD fearing person, GOD never meant for people to live on machines
Exactly

[blacknight03]

same here

[Jaimecbr900]

A very good friend of mine is in a coma right now (and has been for almost a month) that he will likely never come out of. Having visited him on multiple occasions, I can assure you that I know what it is like.

First, I'm sorry about your friend and his condition.

Second, you are wrong. It is FAR FAR different to be in a coma for a month than to be BEDRIDDEN for any length of time. My wife's uncle was bedridden for the final year of his life. He himself told all of us, when he still speak, that he didn't want to live like that anymore. THAT wasn't even when he was at his worst.

So even though I don't know you, I still stand by my statement that too many people that want to keep this woman alive have no clue what being in a bed for 15yrs is remotely like. If they did, they certainly would agree that's no way to live even if you can't feel anything.


But no, life support is your breathing system. It is the system that monitors and, if necessary, supplies the essential amount of oxygen getting into your body. Many people have gone off of life support while in comas (keeping a feeding tube). This woman is not in a coma. She is in a completely different state. If this woman is allowed to die this way, it's only a matter of time before other cases of retardation (whether more or less severe) are treated the same.


Again, you're actually not totally correct there. As I stated above, technically her feeding tube is in fact her life support since she breathes on her own. The only other thing to keep her from dying on her own is food/water, hence the feeding tube. By definition then:

Source: Merriam-Webster Medical Dictionary, © 2002 Merriam-Webster, Inc.


life support

n 1: equipment that makes life possible in otherwise deadly environmental conditions; "the astronauts relied on their life-support systems" [syn: life-support system] 2: medical equipment that assists or replaces important bodily functions and so enables a patient to live who otherwise might not survive; "the patient is on life support" [syn: life-support system]

Function: noun
: equipment, material, and treatment needed to keep a seriously ill or injured patient alive <research shows that if basic life support is used on serious trauma victims within four minutes and advanced life support within eight, nearly 50% of them survive —Nancy Gibbs et al> <was on full life support for three weeks —Richard Hoffer>

So as you can see, equipment is NOT the ONLY means of life support. Again, that's what I was trying to tell you before.


If she were incapable of breathing on her own, then yes.. I can understand the motivation of ending her suffering.

Again, I disagree with you. Not being able to breathe on their own is NOT the only sign of "suffering". Even when people can breathe on their own they can suffer. This is why I keep telling people like you to go visit a hospital and see for yourself what kind of "life" people that are permanently bedridden have BEFORE you pound on your chests and say it is a life.



The fact of the matter, however, is that denying a feeding tube goes way beyond the scope of any state or proposed right-to-die laws. Even in Oregon, the only state that actually allows assisted suicide, the paperwork is very rigid (requiring special counseling with the patient and the patient's complete and utter rational desire to exercise the law). This woman has never been counseled. She has never written any kind of order to do something so drastic in the event of this kind of situation. Who is to say what this woman wanted? I cannot. Her husband's motives may be questionable. Her family's motives may be questionable. If I were the ruling party in this situation, I would have aired on the side of caution. You open a lot of scary doors when you make this kind of decision. My fear is more for future abuses of this case's rulings rather than this case itself. I have the utmost compassion for everyone involved here, but I cannot say that I agree with her fate.

How is gov't intervention into your last desires something that ANYONE would want? In other words, how can you say that allowing her to die on her own and due to her own wishes something that would infringe on our rights. THAT is what our rights SHOULD BE. So, bringing the courts/gov't into it only went in the other direction. Had the courts decided to keep her alive while they do their red tape fact finding for 50 yrs, THAT would've opened up the court system to a million cases a year where 2 people wanted to fight over keeping 1 person alive or letting them die. THAT to me would be far more destructive and counterproductive than deciding that it is in fact OUR choice to die instead of the gov't's.

I don't follow your logic at all. Please explain.


The only other thing I have to say is this... don't be so quick to make assumptions about people. Just because I don't openly share my stories or my past doesn't mean I have no idea what this is like. As I said before, a friend of mine is in a similar boat. I watched my grandmother die as well. My father is a doctor, my mother is a nurse, and I am a pharmacy technician. I am surrounded with stuff like this every day. It broke my heart every time I visited one of my dad's PICU (Pediatric Intensive Care Unit) patients when I was a little girl. She was in a car accident and wound up just like this woman. As far as I know, her family is still caring for her. :(

~ Miranda

I'm not making assumptions, just voicing my opinions. Your father may know what it's like, your mother may know what it's like, but I still don't think you fully do. We don't let animals suffer. We put them down when medical options are exhausted. Why do we treat humans worse? Why prolong the inevitable? Again, I have been looking but have yet to be shown a single reason for this woman to remain a vegetable for 15 more years. Not one. I welcome anyone to find one. If there is none, then a compassionate human being says let the woman die in peace.

[Jaimecbr900]

One more thing:

This is not even about the money for me. As a tax payer, I'd rather see my tax dollars spent on medical care than to give it to the millions of other ingrates that are nothing but lazy. That's a whole other subject there.

To me, it's about what's right for this lady. If she'd only been afflicted for a year or even 2 and not all the tests had been performed to determine her brain activity, I would feel different. IF only 1 doctor had said she was brain dead and NOT 4, I would feel different. IF the husband would have said she wanted to be kept alive and the parents were fighting it, I would feel different.

As it stands, I honestly feel she should be allowed to finally go home.

[Dragonfly5338]

I just think they should end her life quickly and painlessly, not letting her starve without food or water for 11 days so far.

We can do the humane thing with our pets to end their suffering, but not the people that we care about most. I don't get it.

[4dmin]

^ agree i think its amazing we have the death penalty but no assisted suicide

[Miranda]

blah blah blah... words words words...


Food is not a bodily function. It is not something the body produces on its own. Your definition is a little off. And like you and some others have said... you don't simply starve a person or an animal to put it out of its misery. That is the farthest from humane.

Also, government's role in assisted suicide has nothing to do with each person's wishes. It has everything to do with doctors' rights and responsibilities as it pertains to their patients. Next, you miss my point about HER wishes. I'm not saying that someone should go ask her if she wants this (obviously that's not an option). What I am saying is that no law in this country has provisions for this kind of situation. All assisted suicide laws deal DIRECTLY and ONLY with the PATIENT's wishes. This case is far beyond that scope. Because there is no evidence that she (during her lucid life) ever made any provisions in the event of this kind of situation, there's no way to tell what she would have wanted. And, if there is a chance that she would have wanted to be cared for (or even did not want to die), then this present course of action is not correct. As it stands, there are no laws in the state of Florida which allow medical practitioners to assist in the denial of food and water as a means of assisted suicide.

If you really want to believe that I am ignorant of this type of suffering, then that's fine. This isn't a discussion about IA members' experience with this kind of situation. But if you want to start a discussion about our own experiences with this kind of thing, then I would be more than happy to tell you all about my experiences with a girl named Missy. ;)

~ Miranda

[Jaimecbr900]

Food is not a bodily function. It is not something the body produces on its own. Your definition is a little off. And like you and some others have said... you don't simply starve a person or an animal to put it out of its misery. That is the farthest from humane.

You need to read the definition of "life support" again is what you need to do. If you have a problem with the definition, argue it with WEBSTER and not me. :rolleyes:



Also, government's role in assisted suicide has nothing to do with each person's wishes.

Actually, you're right. The gov't should stay out of it.



It has everything to do with doctors' rights and responsibilities as it pertains to their patients.

Really? Go ask your dad if he is willing to go to jail over his "beliefs" and exercising those beliefs to supercede the wishes of the patient. All the bleeding hearts are trying to make this political when IT ISN'T. IT'S ABOUT WHAT THE WOMAN WANTED AND WHAT'S BEST FOR HER. It's ridiculous how everybody is trying to shift the spotlight to try and NOT face reality. Reality is for 15 yrs the lady has gotten no better. She is a vegetable. All forms of treatment and test have been exhausted. WHAT ELSE DO YOU WANT? Bottomline, it's simply selfish for people to want her around for their own pleasure because we all know SHE is getting none.



Next, you miss my point about HER wishes. I'm not saying that someone should go ask her if she wants this (obviously that's not an option). What I am saying is that no law in this country has provisions for this kind of situation. All assisted suicide laws deal DIRECTLY and ONLY with the PATIENT's wishes. This case is far beyond that scope. Because there is no evidence that she (during her lucid life) ever made any provisions in the event of this kind of situation, there's no way to tell what she would have wanted.

That depends on which side you believe. Her husband clearly said she told him her wishes. Do her parents have any "proof" either????? NO. Why does that make them any more rightful to do anything with her? Everybody wants to point the finger at the husband as the bad guy, but nobody has even bothered to question the parent's motives. Show me one single shred of evidence that points towards HER saying while she was "lucid" that SHE wanted to live hooked up to a machine for 50 yrs w/o a chance for recovery????? I have yet to meet that person that wants that, so why would she be any different?



If you really want to believe that I am ignorant of this type of suffering, then that's fine. This isn't a discussion about IA members' experience with this kind of situation. But if you want to start a discussion about our own experiences with this kind of thing, then I would be more than happy to tell you all about my experiences with a girl named Missy. ;)

~ Miranda

Judging by your smart ass response to my rebuttal, ignorance is not the trait you should be concerned about IMO. :rolleyes: So if you want me to respond to you respectfully from here on out, then you'd better learn how to make your point with sentences that are more intelligent than blah blah words words...... :rolleyes:

[Miranda]

Hey, don't take any offense to my quote. There's no point in quoting back every little thing you say. But if it makes you feel better, here you go... I quoted everything.


As for the definition of life support.. The legal definitions of life support are not based on Webster's Dictionary. As a matter of fact, Websters and the constitution have little to nothing to do with one another. Life support is respiratory and vascular (you know, ventilators n stuff), not feeding tubes. I have to eat, but that doesn't mean that I'm on life support.

The government HAS to be part of this process. The law's involvement is primarily to shield doctors from any malpractice suites or criminal charges. Even if patients want to die, there are often other family members who don't agree. If a doctor assisted a patient in suicide without the provisions of said laws, then he or she would be completely open to suit and/or jailtime. As for my dad, he believes that the denial of nutrition is cruel, and he would not feel comfortable taking any part in the execution of this ruling.

As for what she wanted, in the state of Florida, provisions calling for ANY kind of withdrawal of care require WRITTEN and notarized consent from the patient. Regardless of what she may or may not have said to her husband (who may or may not have been a major cause of her state - do remember, she became vegitative as a result of extreme bulemia), since it wasn't in writing, it was not legally valid.

Another concern that I have with this is that there is no hard and fast definition of brain death. I have read several reports of coma patients who have come out of comas and have remembered what people said to them when visiting. Because of this, there's no way to say for sure whether or not she is comprehending what's around her. She may very well be able to take all of her surroundings in, but is unable to respond. There have been medical studies chronicling cases of patients who have suddenly come out of the most bizarre of conditions and have been completely capable of relating their experiences during their care.

And while I would agree with Val that this isn't humane and she should be essentially put to sleep, that WOULD be illegal in Florida. That's why they're denying her food and water. She will die of dehydration.

~ Miranda


You need to read the definition of "life support" again is what you need to do. If you have a problem with the definition, argue it with WEBSTER and not me. :rolleyes:




Actually, you're right. The gov't should stay out of it.




Really? Go ask your dad if he is willing to go to jail over his "beliefs" and exercising those beliefs to supercede the wishes of the patient. All the bleeding hearts are trying to make this political when IT ISN'T. IT'S ABOUT WHAT THE WOMAN WANTED AND WHAT'S BEST FOR HER. It's ridiculous how everybody is trying to shift the spotlight to try and NOT face reality. Reality is for 15 yrs the lady has gotten no better. She is a vegetable. All forms of treatment and test have been exhausted. WHAT ELSE DO YOU WANT? Bottomline, it's simply selfish for people to want her around for their own pleasure because we all know SHE is getting none.




That depends on which side you believe. Her husband clearly said she told him her wishes. Do her parents have any "proof" either????? NO. Why does that make them any more rightful to do anything with her? Everybody wants to point the finger at the husband as the bad guy, but nobody has even bothered to question the parent's motives. Show me one single shred of evidence that points towards HER saying while she was "lucid" that SHE wanted to live hooked up to a machine for 50 yrs w/o a chance for recovery????? I have yet to meet that person that wants that, so why would she be any different?




Judging by your smart ass response to my rebuttal, ignorance is not the trait you should be concerned about IMO. :rolleyes: So what if you want me to respond to you respectfully from here on out, then you'd better learn how to make your point with sentences that are more intelligent than blah blah words words...... :rolleyes:

[Jaimecbr900]

As for the definition of life support.. The legal definitions of life support are not based on Webster's Dictionary. As a matter of fact, Websters and the constitution have little to nothing to do with one another. Life support is respiratory and vascular (you know, ventilators n stuff), not feeding tubes. I have to eat, but that doesn't mean that I'm on life support.

Constitution? I've read the constitution and nowhere does it address "life support" and the "right" or no to it. Where are you referring to?



The government HAS to be part of this process. The law's involvement is primarily to shield doctors from any malpractice suites or criminal charges.

That's fine, but in this case that's NOT why the gov't stepped in. They stepped to grand stand and because the parents filed a lawsuit. In either case, the gov't has laws on the books already regarding living wills and how to contest them. That has nothing to do with doctors. The parents KNEW that the husband wanted to do this for quite a while now. They tried to contest the LAWS and they lost. They then took it to the media to find allies. All the while they made it about them instead of the daughter they so proclaim to love. Ironic isn't it?


Even if patients want to die, there are often other family members who don't agree.

That's the point.....it's NOT UP TO THEM. Are we going to always sit around and let everyone manipulate everything? There has to be a point where both laws and common sense kick in.



Regardless of what she may or may not have said to her husband (who may or may not have been a major cause of her state - do remember, she became vegitative as a result of extreme bulemia), since it wasn't in writing, it was not legally valid.


Typical female response to bulemia. Why is it someone else's fault? Do you think her husband MADE her do it? I guess it's easier to blame others than to take responsability for your own faults.


Another concern that I have with this is that there is no hard and fast definition of brain death. I have read several reports of coma patients who have come out of comas and have remembered what people said to them when visiting. Because of this, there's no way to say for sure whether or not she is comprehending what's around her. She may very well be able to take all of her surroundings in, but is unable to respond. There have been medical studies chronicling cases of patients who have suddenly come out of the most bizarre of conditions and have been completely capable of relating their experiences during their care.


Site a single case of someone EVER progressing after 15 yrs of persistent vegetative state.

The question comes in to the point of why are we fighting to prolong, NOT PREVENT, the inevitable? I'm sure you can bring a doctor from Antartica that says he MAY be able to cure her with some dancing and snow cones. Are we to say..."hey, this guy MAY be able to do it, so let's give him a shot. Who cares if that means keeping this body around for another 15yrs... What the hell!!!". It's simply ridiculous. There has to be a point at which someone has to step in and say enough is enough. 15yrs worth of trying is far more than 50% of the millions of marriages even try.

BTW, It was reported the other day that the father said Mrs. Schiavo TOLD him via "mouthing" that she "wanted to live". Isn't that perfect timing? 15yrs of silence and suddenly at the 11th hour she "mouths" something ONLY to the father. Even if that were true, which I don't believe, why wouldn't she have said she was hungry or thirsty too? My point? As sad as it is, she hasn't changed one bit since they removed the feeding tube 11 days ago. This again goes to further prove that she is in fact "brain dead". Wouldn't you say?


And while I would agree with Val that this isn't humane and she should be essentially put to sleep, that WOULD be illegal in Florida. That's why they're denying her food and water. She will die of dehydration.

~ Miranda


It is extremely sad that it went down the way it did. I totally agree. The blame for that is our crappy laws that don't allow people to choose their own way to go. One day the gov't will quit wasting all their resources on trying to get even further into everyone's business and letting people live by their own decisions.

One big silver lining here is that I'm certain that millions of people that didn't have a living will before......I bet do now. ;)