Daily dose of hypocrisy
March 26, 2005 8:10 AM   Subscribe

On the role of government. The Houston Chronicle had a story (404 now) on then governor Bush's 1999 law giving hospitals the power to remove life support of the terminally ill. The decision hinges on the prognosis and, of course, the patient's ability to pay. The law recently gave power to the Texas Children's Hospital to remove the breathing tube of a 6-month old infant over his mother's wishes. What do people who support Bush's intervention in the Schiavo case think about Bush's Futile Care Law?
posted by jikel_morten (86 comments total)
 
The Christian Right are also capitalists as much if not more than they are Christians. I can guarantee you that if there wasn't a way to pay for Terry Schiavo's care that she would've been dead long ago and few on the right would've bat an eyelash. Keeping people alive in hospitals without taking money is socialism.
posted by Arch Stanton at 8:20 AM on March 26, 2005


The baby wore a cute blue outfit with a teddy bear covering his bottom. The 17-pound, 6-month-old boy wiggled with eyes open and smacked his lips, according to his mother.
- how to start an object news report.

and, yes. of course i'm outraged and shcoked at this new different level of hypocracy from the new right.
posted by es_de_bah at 8:26 AM on March 26, 2005


Interesting how an article on the Futile Care Law should have been removed, especially since it was up as recently as March 18th. I guess Texas does operate on the "you scratch my back and I'll scratch yours" premise.
posted by clevershark at 8:29 AM on March 26, 2005


The two Texas cases you've cited require a ventilator in order to breath; Terri Schiavo doesn't. I consider prolonging someone's life by breathing for them extraordinary means, and in these cases I can understand why the hospital wants to discontinue care. These people will never breathe again on their own, and in the case of the baby his lungs will never develop. Sad, but futile.

Terri Schiavo is being denied food and water, two things that are a basic human right. She can breath just fine on her own. If this was a question about turning off her ventilator then I'd totally side with the husband no matter how much money was involved, but instead it's a question of starving her to death.
posted by sbutler at 8:35 AM on March 26, 2005


I wish somebody would tell all those self-righteous, moralistic and oh so conscientous jerks demonstrating in front of the courts about this. But I guess there are no current news in the bible. Ahhgg.
posted by thehippe at 8:37 AM on March 26, 2005


Sbutler - I see where you're going with this... but how ironic that she wanted to starve to death 15 years ago - and now she's getting her wish.
posted by OhPuhLeez at 8:40 AM on March 26, 2005


sbutler - I see where you're going with this... but how ironic that she wanted to starve to death 15 years ago - and now she's getting her wish.

I doubt she wanted to starve to death, but yes, I see the irony in this situation.
posted by sbutler at 8:43 AM on March 26, 2005


Damn, saw the link showing the actual Texas Law posted all week. Now don't know where to find it now.
posted by thomcatspike at 8:44 AM on March 26, 2005


I linked to this story in a MeFi comment on the 21st, and that link is still working. Though the cases can't be directly compared, it does show the president's, ahm, flexibilty on the issue.
posted by jasonsmall at 8:50 AM on March 26, 2005


The husband signed over his powers over Terri's life and death to the courts years ago. The courts ordered the removal of the tube, not the husband.

This isn't about money, it is about Terri's expressed (though not written down) wishes. OF course the fact that she can pay for it means she is a good person and deserves to live.
posted by jmgorman at 8:50 AM on March 26, 2005


sbutler, if there was really any 'her' left, I'm sure her husband would want to keep her alive. But her brain mostly died and turned to liquid. There's no 'there' there. There's nothing left to suffer, just some automatic systems.

It's a bit like that airplane that crashed awhile back, where all the pilots and passengers had died of anoxia, but the plane flew on autopilot for a few hours more before actually falling out of the sky.

The tragedy happened when the people died. You're sort of mourning the autopilot.
posted by Malor at 8:50 AM on March 26, 2005


Malor: Why is it that just because her higher brain functions have stopped working that she should have to starve to death? Why does our legal system recognize that someone in Schiavo's condition can be purposely allowed to die without offering the solution of making that death humane, painless, and swift?

I would say there's also a tragedy in the way the plane goes down.
posted by jasonsmall at 8:57 AM on March 26, 2005


If I ever lose a limb, I want it hooked up to life support, so it can live the rest of it's happy life.
posted by iamck at 9:03 AM on March 26, 2005


These people will never breathe again on their own, and in the case of the baby his lungs will never develop. Sad, but futile.

Terri Schiavo is being denied food and water, two things that are a basic human right


that is a semantic argument if i every heard one.
terri schiavo could lay there till she dies of old age and never so much as order a baked potato, "sad but futile"

she is not being denied a thing, instead she is no longer being pumped day and night with food and water.

the only thing different about these to cases is, the little babe may have been sentient, which means he could feel the pain of his little life snuffed out. human rights???
posted by nola at 9:03 AM on March 26, 2005


Why is it that just because her higher brain functions have stopped working that she should have to starve to death? Why does our legal system recognize that someone in Schiavo's condition can be purposely allowed to die without offering the solution of making that death humane, painless, and swift?


there's something in the medical code of ethics that you can't do harm--giving her a shot or ending her life would do harm. (altho good, caring doctors do overprescribe morphine on purpose, quietly, all the time in cases like this, to kill hopeless patients, so it's up to the doctor--no doctor would do this knowing that the parents want her not to die, and especially after all the media attention)
posted by amberglow at 9:04 AM on March 26, 2005


sbutler- Terri Schiavo may be able to breathe, but she requires a feeding tube to eat, and has shown no signs of ever being capable to eat on her own again.

As well, I'd consider oxygen a far more fundamental right than food and water. Asphyxiation seems quite a bit more cruel than dehydration, although I forgot which previous Mefi thread cited the relative peace of a dehydration death. I'd say pulling Schiavo's tube is more humane and the right decision. I can definitely say if I couldn't feed myself and I was incapable of communication, I'd want to die pretty badly.

Or for anyone who wants some good old fashioned hyperbole fun- BUSH WANTS TO CHOKE BABIES TO DEATH!
posted by Saydur at 9:06 AM on March 26, 2005


Here is the cache of the article.
http://64.233.179.104/search?q=cache:PJdXVnLyr6sJ:www.chron.com/cs/CDA/ssistory.mpl/metropolitan/3073295+&hl=en&client=safari
posted by amboy00 at 9:19 AM on March 26, 2005


Despite this being a contrived FPP with poor links I think that the media, the right, the left and the general public are generally out of their depth forming definitive opinions in these types of cases. Noone other than those directly involved with the patients are adequately informed.

As a former front line health care worker it has been my experience that health care professionals are best placed to come to decisions. Now maybe it is easier down here with a quasi-socialistic healthcare system but I've always found Doctors, Nurses and others involved to be very caring, sensisitive, aware, empathetic, fully communicative, energetic and open when it comes to a decision whether or not to withdraw care. I have seen it withdrawn many many times and I never felt that it was the wrong decision.

Having said that, sbutler makes a good point about this matter being a standout because of the comparatively low level of care required. I've never seen anyone starved and when I first heard about the case, that was the thing that caused me concern. It was always my role to ensure patients were adequately hydrated for one - it really is a basic nursing requirement. I can't imagine how I'd feel caring for the lady during the final days - knowing that something very very simple that would ease discomfort (even if only some basic reactive tongue movement to dehydration etc - it's always difficult to predict how a person with severe brain damage 'feels') was not able to be employed. All this is swept up in the vagaries surrounding the relatives of course. I'm not drawing a conclusion here - I'm just saying that on the face of it, a feeding tube is pretty low-level stuff and many people have it over a long time period.

I didn't join (or read) the thread in AskMe about ensuring 'not for resuscitation' is written down for relatives in the case of grave health problems or the like. And that's the term I was used to: 'Not for resuscitation'. The Doctor would confer with relatives, advising diagnosis and more particularly, prognosis and recommendations would be made and usually accepted. But it is a bit more difficult these days, what with all manner of drug and machine that can bring people back, arrest decline, maintain people at many different levels of functioning - it is really difficult to know what is 'basic' or what is 'intervention' when a person's life quality is being judged/juggled. Ensuring one's future goes according to plan may really need a long contract with many specifics outlined, just in case. Saying that you don't want to be resuscitated really doesn't hold much water anymore IMHO. And I wonder what Terri had in mind when she allegedly told her husband of her wishes. (I say allegedly for no other reason than I've only heard it via hearsay - it is not sarcasm or meant to infer anything)

Anyway ... I've said a lot more than intended. The case is a political and legal football which is really sad. It's about a lady's life and all other angles are irrelevant to me.
[But this FPP is also a pretty sad case as well.]

(On preview....dehydration isn't a 'nice' way to go. Maybe easy in terms of less work, but 'nice' is never a word I'd use in that situation - it causes a lot of discomfort - of course here the argument is about what level of 'feeling' does the patient have.....I'm not there, I can't be sure)
posted by peacay at 9:25 AM on March 26, 2005


It's a bit like that airplane that crashed awhile back, I'd say pulling Schiavo's tube is more humane and the right decision.

For starters seems a lot of the facts people have about this case is incorrect. Then which side of the political fence people stand on is confusing. The case is not about opion; It’s abaout Who her Fiduciary is.
People have living wills for this type of situation.
posted by thomcatspike at 9:29 AM on March 26, 2005


What does this have to do with Terri Schiavo?
posted by bevets at 9:30 AM on March 26, 2005


Can someone explain to me why food and water or oxygen are considered "rights"? It's always struck me as an odd phrasing. They're necessary for all life on Earth, but have they been codified in our laws as rights?

peacay, we say DNR- Do Not Resuscitate up here.

and what discomfort is there when the patient can't feel it or be aware of it? Don't you need a functioning brain and nerve system to feel discomfort?
posted by amberglow at 9:31 AM on March 26, 2005


It's a bit like that airplane that crashed awhile back,
Whoops, ran two comments together. Above is the link on the plane crash.
posted by thomcatspike at 9:31 AM on March 26, 2005


I am soooo afraid to click a bevets.com link. Will I lose my evolutionary beliefs?
posted by peacay at 9:33 AM on March 26, 2005


It this another one of those feeding tube posts?
posted by odinsdream at 9:34 AM on March 26, 2005


bevets, that is wholly unsupported slander against the husband, who spent years at her side, and flew her all over for treatments--anything that might possibly work was tried. He was tirelessly aggressive in trying to help her. Read this USA Today article, and see that the Schindlers for years were close with him, and never ever even insinuated anything like the shit people are saying now.-- ... It wasn't always this way, according to a USA TODAY review of voluminous records in the Probate Division of Pinellas County Circuit Court in nearby Clearwater.

Those records show that Michael Schiavo and the Schindlers jointly supervised care for Terri after she collapsed. For the first 16 days and nights that she was hospitalized, Schiavo never left the hospital. Over the next few years, as she was moved from the hospital to a skilled nursing facility, to a nursing home, to Schiavo's home and finally back to a nursing home, Schiavo visited Terri daily.

They had met in a class at Bucks County Community College in Pennsylvania. They were engaged five months later and married on Nov. 10, 1984, in Huntingdon Valley, Pa. She was, he said, "sweet. Very personable. You would meet her and just be charmed by her. ... To me, she was everything."

Once Terri was unable to help herself, Michael became a demanding advocate.

John Pecarek, a court-appointed guardian for Terri, described her husband as "a nursing home administrator's nightmare," adding, "I believe that the ward (Terri) gets care and attention from the staff of Sabal Palms (nursing home) as a result of Mr. Schiavo's advocacy and defending on her behalf."

Mary Schindler testified that, while her daughter was at one nursing home, her relationship with her son-in-law was "very good. We did everything together. Wherever he went, I went." ...

posted by amberglow at 9:36 AM on March 26, 2005


What does this have to do with Terri Schiavo?

Who?
posted by Space Coyote at 9:40 AM on March 26, 2005


Despite this being a contrived FPP with poor links
posted by peacay at 9:25 AM PST on March 26 [!]


Sorry, I thought it was an interesting topic that the links supported. Granted, the links were hardly far-flung or remote, but I felt the issue was the meat in this case. My apologies if not up to snuff.
posted by jikel_morten at 9:40 AM on March 26, 2005


It's NFR here amberglow ;)
I know it's about neurofunctioning - but I'm not there I can't tell. You need to be at the bedside to know, irrespective of neurology reports - it is reactions and reflexes. I can only say it so many ways......I can't form an opinion about this without caring for her.

And I refer to Oxy/hydration/toileting/repositioning +/- food as basic needs. Rights are legal things. Needs are the stuff of all humanity.
posted by peacay at 9:40 AM on March 26, 2005


There is a lot of misconceptions about the use of feeding tubes. Using a feeding tube to prolong life has only been possible since the seventies-- it is a very precise medical intervention that is legally classified as an extraordinary measure. Which is what makes it perfectly legal to remove it. If Ms. Shiavo had been hospitalized prior to the seventies, she would undoubtedly be dead by now, just as my maternal grandfather died in 1952 in a psychiatric hospital when his brain tumor interfered with his ability to eat and drink.

Also the term "starved to death" is an emotional misstatement designed to mislead the general population. She will be dead of dehydration long before she starves to death. Her organs will begin to shut down and death will follow. Many terminally ill patients go through the same experience and it is considered a relatively painless death for people who have fully functioning brains. Ms. Schiavo won't feel a thing.
posted by Secret Life of Gravy at 9:41 AM on March 26, 2005


I am soooo afraid to click a bevets.com link. Will I lose my evolutionary beliefs?

no, but you'll always giggle a little when you see his name from now on.
posted by quonsar at 9:43 AM on March 26, 2005


jikel_morten......it's mostly to do with their being other current threads on the topic still going. The link about the child could have been better posted in a comment sent to those threads. The links are very old for a currently breaking story. And the link to the child story was, as noted above, quite editorialized - obviously there's enough members here who can insert their own opinions.
You've seen the guidelines ?? have you?? .."..most people haven't seen it before, there is something interesting about the content on the page..'
posted by peacay at 9:52 AM on March 26, 2005


Secret Life of Gravy.......point taken......starved is wrong....dehydration is right.

But I disagree about definitely stating that dying of dehydration is 'relatively painless'.....or at least it IS compared to some things. But it's not pleasant and can cause quite a bit of discomfort - I don't know about Mrs Schiavo but I'm sure as hell not going to definitively state Mrs Schiavo 'won't feel a thing'. That's ludicrously presumptuous. You gotta be there.
posted by peacay at 10:00 AM on March 26, 2005


jasonsmall: personally, I think laws against suicide are some of the worst on the books. If there is any single thing you own, it's your life, and you should be allowed to live it, or dispose of it, as you wish.

The fact that voluntary euthanasia is not allowed in this country is a terrible tragedy, IMO. But, like it or not, removal of the tube is really the only option.

My father died in a very similar fashion; he had esophageal cancer and eventually couldn't eat or drink anymore. They kept him on fluids but let him starve, at his request. It was an easy, gentle passing, and about as good as one could hope for under the circumstances.

Personally, I think that would be the best way to handle Terri's death, but given the level of media furor, and her stated wishes, I think her husband's decision is the right one... it's less comfortable, but it's much more certain that she will actually die before someone else invents some reason to intervene yet again.
posted by Malor at 10:01 AM on March 26, 2005


Sorry, I thought it was an interesting topic that the links supported. Granted, the links were hardly far-flung or remote, but I felt the issue was the meat in this case. My apologies if not up to snuff.

Here's my problems with your post:
  1. It doesn't cover anything new. The same issue has been rehashed through several threads over the last couple days. Framing it differently won't change the discussion.
  2. You don't seem interested in an honest answer to or discussion of your question. Instead, it appears you want to make fun of Bush/Schindler supporters by casting them as inconsistent. My Exhibit A is the title of this post.
The only reason I responded is because I'm a sucker. I don't expect this thread to survive Matt's morning coffee.
posted by sbutler at 10:01 AM on March 26, 2005


A feeding tube is life support under Florida law (my emphasis):
(10)  "Life-prolonging procedure" means any medical procedure, treatment, or intervention, including artificially provided sustenance and hydration, which sustains, restores, or supplants a spontaneous vital function.
dehydration isn't a 'nice' way to go. Maybe easy in terms of less work, but 'nice' is never a word I'd use in that situation - it causes a lot of discomfort

That's different than what doctors quoted in the Los Angeles Times say. In "one of the most detailed clinical accounts of starvation and dehydration,"
Instead of feeling pain, the patient experienced the sense of euphoria that accompanies a complete lack of food and water. She was cogent for weeks, chatting with her caregivers in the nursing home and writing letters to family and friends. As her organs failed, she slipped painlessly into a coma and died.
Also:
In a 2003 study published in the New England Journal of Medicine, 102 hospice nurses caring for terminally ill patients who refused food and drink described their patients' final days as peaceful, with less pain than those who elected to die through physician-assisted suicide.

The average rating given by the nurses for the patients' quality of death was eight on a scale in which nine represented a "very good death" and zero was a "very bad death."
I don't know about Mrs Schiavo but I'm sure as hell not going to definitively state Mrs Schiavo 'won't feel a thing'.
"What my patients have told me over the last 25 years is that when they stop eating and drinking, there's nothing unpleasant about it--in fact, it can be quite blissful and euphoric," said Dr. Perry G. Fine, vice president of medical affairs at the National Hospice and Palliative Care Organization in Arlington, Va. "It's a very smooth, graceful and elegant way to go."

"Her reflexes with respect to thirst or hunger are as broken as her ability to think thoughts or dream dreams or do anything a normal, healthy brain does," Fine said.

But even if her brain were functioning normally and she were aware of her condition, she still would not be conscious of pain, doctors say.
posted by kirkaracha at 10:16 AM on March 26, 2005


The two Texas cases you've cited require a ventilator in order to breath; Terri Schiavo doesn't. Oh, instead of a pump that moves gas, she requires a pump that moves semi-solid matter in order to live. That makes all the difference in the world..
posted by c13 at 10:17 AM on March 26, 2005


bevet...wow. quonsar's right.

I think this post was originally meant to bring the entire "Bush wants to choke babies" issue under a single heading.

I find the entire scenario of Bush's previous rulings on this issue fascinating. Flip-flop etc.

I hope that when I'm reduced to a quivering mass of nervous responses and drooling non-personhood, they'll give me the grape flavored tube goop. I like grape flavor.
posted by Baby_Balrog at 10:18 AM on March 26, 2005


Isn't the only reason the husband can pay for all this because he won a malpractice suit?

This issue is a Matrushka doll of irony.
posted by dirigibleman at 10:28 AM on March 26, 2005


This is no flip flop.
Baby was broke, Terri ain't.
Therefore, in our market, Terri should live.

I was most chilled by the hospital's interference of the press getting photos of the baby. Smart move on their part.

and as for Bevet's slander page:
thanks for the peek at the fuel source for these nutjobs.

one day, there will be a story out of florida that doesn't make me long for it to sink into the ocean.
posted by Busithoth at 10:36 AM on March 26, 2005


Oh, instead of a pump that moves gas, she requires a pump that moves semi-solid matter in order to live. That makes all the difference in the world..

Well, yes. In cases (1) and (2) their lungs no longer work, and in fact will never work (but I don't think that is relevant). As far as I've heard there's nothing mortally wrong with Terri's gastrointestinal system, she just can't swallow.

Let's suppose, for the sake of argument, that there is something wrong with her intestines and she isn't able to absorb nutrients. If they were keeping her alive with an IV, pumping the nutrients directly into her blood, then I wouldn't have a problem pulling the IV. Again, the difference is that in one case you are routing around an obstruction to sustain otherwise functioning organs, and in the other you are replacing the organs with machines.

Someone above called this a semantic argument. Maybe it is, and maybe it isn't, but the point is that a line needs to be drawn somewhere.

I'm not part of the Rush crowd, going around asking "why do Liberals want to kill Terri?!?!" I don't believe anyone wants to kill Terri, I simply think the conflict is over what constitutes alive and dead.

People who are against removing the feeding tube distinguish alive and dead based on a minimal set of biological criteria. If given basics such as food, water, and air can the body maintain itself? People who are for removing the feeding tube distinguish based on a certain level of conscience. Is Terri a rational being?

I forgot where I was going with this comment, but I think the latter definition invites a slippery slope.
posted by sbutler at 10:39 AM on March 26, 2005


oh, speaking of caring about people and hypocrisy: ... The reaction to Bush's silence was particularly bitter given his high-profile, late-night intervention on behalf of Terri Schiavo, the brain-damaged Florida woman caught in a legal battle over whether her feeding tube should be reinserted.

"The fact that Bush preempted his vacation to say something about Ms. Schiavo and here you have 10 native people gunned down and he can't take time to speak is very telling," ...

posted by amberglow at 10:41 AM on March 26, 2005


<sigh /> amberglow, you can do better than DU. Is there anything President Bush could have done to prevent the school shooting? No. Speaking about it wouldn't change what happened. However, signing the bill could have an effect.

Still, it wouldn't hurt for him to send him sympathy to the shooting victims. However, it isn't right to compare the two issues.
posted by sbutler at 10:48 AM on March 26, 2005




Someone above called this a semantic argument. Maybe it is, and maybe it isn't, but the point is that a line needs to be drawn somewhere.
It sure as hell is. What exactly does it mean that "the line has to be drawn somewhere"? What line? Drawn by whom? This person died 15 years ago, and her body has been artificially kept at a somewhat functional level ever since. If left to its own devices, this body will stop functioning. So where do *you* draw the line? At a system, organ, tissue or cellular level? Moreover, should we treat everyone else similarly? Because you can keep SOME part of EVERY person functioning almost indefinitely.
posted by c13 at 10:57 AM on March 26, 2005


kirkaracha ... that's a pretty good article. I accept that maybe I've overstated the case but I'm never going to be entirely convinced that every person dying from dehydration doesn't feel discomfort. That is just my bedside experience.
And without wanting to get into a fullblown argument about it - a newspaper article with arbitrarily obtained quotes/evidence is not a final answer - the final answer in anybody's health status comes from their carers. I'd be surprised if ALL the literature supported the positions they have asserted in the article. I'm just saying.....balance and all that.

But this case....Mrs Schiavo.....can't be argued via links and quotes. Is Dr Fine (from that article) her Doctor? I think it's pretty outrageous that he's commenting specifically at all, if not. And even if he is her Doctor (in which case I think he's a dickhead for revealing anything), does he do anything of a personal care nature or does he merely periodically assess her?
I am not advocating on Mrs Schiavo's behalf. I am not trying to say live or die. I'm just trying to maintain that this is not one of those things where nifty internet googlefu or posturing or reading or political views can address.
You need to be there with her to have a better idea.
posted by peacay at 10:58 AM on March 26, 2005


Why is it that just because her higher brain functions have stopped working that she should have to starve to death? Why does our legal system recognize that someone in Schiavo's condition can be purposely allowed to die without offering the solution of making that death humane, painless, and swift?

Yes, why must she starve?! The poor pro-lefe people are upset! It's horribe! It's inhumane! Its....oops...it's the result of them working their busy little pro-life butts to the bone to assure that physicians have no other option to end the life of someone suffering, or brain-dead.

Never mind.
posted by umberto at 11:02 AM on March 26, 2005


It sure as hell is. What exactly does it mean that "the line has to be drawn somewhere"? What line? Drawn by whom? This person died 15 years ago,

For starters, exactly the line that you've just drawn.
posted by sbutler at 11:04 AM on March 26, 2005


"Still, it wouldn't hurt for him to send him sympathy to the shooting victims. However, it isn't right to compare the two issues."
sbutler, your argument (?) confounds me.

Because the shooting happened, he should have stayed mum about it.
If having an 'effect' is your justification for Bush's groundbreaking interruption of his vacation-time to rush back and sign this bill, does this mean that if the President can't put his George Hancock on some piece of paper shoved in front of him, he should shut his trap, because it couldn't have an effect?
I'm not one to bemoan that the President needs to give pep talks to the people daily or anything, but a veritable massacre perpetuated on US soil might rise to the level of worthy of comment.
posted by Busithoth at 11:06 AM on March 26, 2005


People who are against removing the feeding tube distinguish alive and dead based on a minimal set of biological criteria. If given basics such as food, water, and air can the body maintain itself?

Nope. The people crassly using Terri for political gain believe in mysticism. In short, God gave Terri a soul, and as long as she breathes (or whatever irrational criteria they choose to pull out of the air), she is alive.

This issue is not about "right to die" or "culture of life." It's about crass opportunism. If Terri had a living will, she would be allowed to die, with absolutely no to-do. This is an infra-family dispute in a situation lacking a living will, with one side being cruelly taken advantage of by some crass, political opportunists.

By any rational measure, Terri is not alive, not any more than the average house-plant. Lacking a living will, it IS tough to decide what to do. BUT, her case has been impartially decided and reaffirmed 16 or more times now, by all manner of health care folks and judicial folks.

This is about political grandstanding, pure and simple, and nothing else. And the sad thing is that the grief-stricken and deluded parents that can't let go of the husk that was once Terri are being so cruelly taken advantage of.

What do people who support Bush's intervention in the Schiavo case think about Bush's Futile Care Law?

And as for this question in the FPP: the hard-core Bush-supporters I have run into think that it is all a liberal conspiracy. That law is really to PROTECT the family.

Really. That's what they think.
posted by teece at 11:11 AM on March 26, 2005


Ammm.. she's been on life support for 15 years.
Again, at what level would you say human life exists?
posted by c13 at 11:13 AM on March 26, 2005


This post has wandered all over the place, but the main, no, the only issue, is what Terri Schiavo wants. The courts have repeatedly held that she wants to be allowed to die. Now, if anyone knows of another way to resolve such disputes other than the court proceedings that have taken place, I've yet to hear about it. Otherwise, stick to the issue and show how someone in this mess has not received a full day in court.
posted by Mental Wimp at 11:57 AM on March 26, 2005


Mental Wimp, I think you've got the wrong post.
This was more about the Futile Care Law, no?
(not that it hasn't wandered all over the place)
posted by Busithoth at 12:03 PM on March 26, 2005


From this Orlando Sentinel article today.

Free reg or BugMeNot required.

Question: What is a "persistent vegetative state" and how is it diagnosed? Is it unusual for doctors to disagree?

Answer: People in a persistent vegetative state have lost all higher brain function, including the ability to think, experience emotions and understand the world around them. However, they continue to sleep and wake; open their eyes; breathe on the their own; and even make noises and facial expressions.

This is because their brain stems -- the portion of the brain that controls basic functions such as heartbeat and breathing -- continue to function.

Those suffering from this condition do not track objects with their eyes, blink on command or respond consistently to cues in the environment. When a patient fails tests over a period of time, doctors consider the condition "persistent."

There is no single test, such as a brain scan, that can peer inside the brain and absolutely determine a person's level of mental function. But doctors can diagnose the condition by testing a patient's ability to interact with his or her environment.

Doctors who have been appointed by Terri Schiavo's husband and the courts have determined that she is in a persistent vegetative state with no chance of recovery. Her parents and their physicians do not agree, maintaining that she is not vegetative and can recover.

Doctors who examine the same patient can reach different conclusions, but time is the best arbiter of diverging views, said Dr. Michael Pulley, an assistant professor of neurology at the University of Florida campus in Jacksonville.

"The way to resolve it is to see if there is any change [in the patient's ability to interact] over time," Pulley said, adding that improvements would be expected within the first weeks or months of the injury.

Terri Schiavo has been in this state for 15 years.

Q: Terri Schiavo appears to respond to her mother in a video released by the family. Her father said that she smiled Monday when he told her that her feeding tube could be re-inserted. Doesn't this show that she is not in a persistent vegetative state?

A: Terri Schiavo's parents say this is evidence that she is not in a vegetative state. Court-appointed physicians have not been able to document a consistent, predictable response from Terri that would indicate she is aware of her surroundings.

...

Q: Terri Schiavo's parents and a neurologist who examined her several years ago, Dr. William Hammesfahr, say the woman could get better with therapy. Would she be helped by rehabilitation?

A: Other doctors have concluded that she will not improve with rehabilitation, and previous attempts with therapy had no effect.

Terri underwent more than three years of rehabilitative therapy after her collapse in 1990, and her husband took her to a California center in late 1990 to have an experimental device implanted in her brain in hopes of stimulating activity.

Jay Wolfson, who reported to the court in December 2003, wrote: "In recent months, individuals have come forward indicating that therapies and treatments can literally regrow Theresa's brain tissue, restoring all or part of her functions. There is no scientifically valid, medically recognized evidence that this has been done or is possible, even in rats."

Q: Hammesfahr, the neurologist who examined Schiavo years ago at her parents' request, has said that Terri could eat and drink on her own if fed. Is this true?

A: Doctors performed "swallowing tests" on Terri in 1991, 1992 and 1993 and concluded that she "was not able to swallow without the risk of aspiration," which occurs when fluid or food is inhaled into the lungs.

Pulley, from the University of Florida, said that some patients in vegetative states can swallow, but this does not necessarily indicate higher thinking abilities because swallowing is a "reflexive" action.

posted by the_savage_mind at 1:17 PM on March 26, 2005


My wife works in the health care fileld so willing or not, i've been discussing this a great deal. The thing is, if you leave someone on a ventilator long enough, it's highly likely that they'll regain the ability to breathe on their own again. Then what?

Bottom line, the arguement between feeding tube and ventilator is irrelevant. The question is, machine help or not?

The Futile Care Law says the right to machine help depends on the prognosis and ability to pay. How is this not hypocrisy with respect to the Schiavo case?

Another quick observation, it's obvious that Bush hadn't perfected his Doubleplusungood speak yet. I'm surprised the Texas law wasn't named something like 'The Ease of Sufferring Law".
posted by underdog at 1:26 PM on March 26, 2005


But but her gallbladder wokrs fine!
posted by c13 at 1:27 PM on March 26, 2005


Food tubes!
posted by blacklite at 1:43 PM on March 26, 2005


sbutler. so if a person who is known to be conscious and can't be kept alive without medical intervention,we should pull the plug.

on the other hand someone who is in a "persistent vegetative state" and can't be keep alive without medical intervention, we should leave the plug in.

did i miss something? compare the cases and tell me why your point is not pedantic and the definition of semantic argument?
posted by nola at 2:11 PM on March 26, 2005


How about we take all of Terri's functioning organs and donate them to needy patients.

Then instead of lives saved vs. lives lost 1-0 or 0-1, we can have 6-1 or 8-1

High score! More life! Even her gall bladder can go!

:P
posted by anthill at 2:15 PM on March 26, 2005


What does this have to do with Terri Schaivo?

thehippe

I wish somebody would tell all those self-righteous, moralistic and oh so conscientous jerks demonstrating in front of the courts about this.

Here are some of those jerks

Baby_Balrog
I hope that when I'm reduced to a quivering mass of nervous responses and drooling non-personhood, they'll give me the grape flavored tube goop. I like grape flavor.

Saydur

I can definitely say if I couldn't feed myself and I was incapable of communication, I'd want to die pretty badly.


Maybe

Terri Schiavo may be able to breathe, but she requires a feeding tube to eat, and has shown no signs of ever being capable to eat on her own again.

teece

By any rational measure, Terri is not alive, not any more than the average house-plant.

They are truly withholding food from a person who is awake, alert, and can eat and swallow. ~ Dr. William Hammesfahr

To enter the room of Terri Schiavo is nothing like entering the room of a patient who is comatose or brain-dead or in some neurological sense no longer there. ~ Dr. William Polk Cheshire Jr.

As I looked at Terri, and she gazed directly back at me, I asked myself whether, if I were her attending physician, I could in good conscience withdraw her feeding and hydration," he wrote. "No, I could not. I could not withdraw life support if I were asked. I could not withhold life-sustaining nutrition and hydration from this beautiful lady whose face brightens in the presence of others. ~ Dr. William Polk Cheshire Jr.

On three or four occasions, I personally fed Terri small amounts of Jello which she was able to swallow and enjoyed immensely. ~ Heidi Law CNA

Secret Life of Gravy

She will be dead of dehydration long before she starves to death. Her organs will begin to shut down and death will follow. Many terminally ill patients go through the same experience and it is considered a relatively painless death for people who have fully functioning brains. Ms. Schiavo won't feel a thing.

kirkaracha

That's different than what doctors quoted in the Los Angeles Times say.

Instead of feeling pain, the patient experienced the sense of euphoria that accompanies a complete lack of food and water. She was cogent for weeks, chatting with her caregivers in the nursing home and writing letters to family and friends. As her organs failed, she slipped painlessly into a coma and died.

"What my patients have told me over the last 25 years is that when they stop eating and drinking, there's nothing unpleasant about it--in fact, it can be quite blissful and euphoric," said Dr. Perry G. Fine, vice president of medical affairs at the National Hospice and Palliative Care Organization in Arlington, Va. "It's a very smooth, graceful and elegant way to go."


A conscious [cognitively disabled] person would feel it just as you or I would. They will go into seizures. Their skin cracks, their tongue cracks, their lips crack. They may have nosebleeds because of the drying of the mucus membranes, and heaving and vomiting might ensue because of the drying out of the stomach lining. They feel the pangs of hunger and thirst. Imagine going one day without a glass of water! Death by dehydration takes ten to fourteen days. It is an extremely agonizing death. ~ Dr. William Burke

Unfortunately, having worked for 13 years in Africa, where the most common cause of death in children is dehydration from gastroenteritis, I have seen hundreds if not thousands of patients with dehydration and some of them so far gone, that despite resuscitation attempts, they died.

As dehydration begins, there is extreme thirst, dry mouth and thick saliva. The patient becomes dizzy, faint and unable to stand or sit; has severe cramping in the arms and legs as the sodium and potassium concentrations in the body goes up as fluids go down. In misery, the patient tries to cry but there are no tears. The patient experiences severe abdominal cramps, nausea and dry-heaving as the stomach and intestines dry out.
By now the skin and lips are cracking and the tongue is swollen. The nose may bleed as the mucous membranes dry out and break down. The skin loses elasticity, thins and wrinkles. The hands and feet become cold as the remaining fluids in the circulatory system are shunted to the vital organs in an attempt to stay alive. The person stops urinating and has severe headaches as their brain shrinks from lack of fluids. The patient becomes anxious but then gets progressively more lethargic.

Some patients have hallucinations and seizures as their body chemistry becomes even more imbalanced. This proceeds to coma before death occurs. The final event as the blood pressure becomes almost undetectable is a major heart arrhythmia that stops the heart from pumping. ~ Dr. David Stevens
posted by bevets at 5:38 PM on March 26, 2005


Bevets, you don't know shit.
posted by five fresh fish at 6:06 PM on March 26, 2005


Has anyone considered the fact that Jeb Bush will be out of the governor's chair (Florida) right about the time we're scheduled for another presidential election? Could this case be nothing more than political opportunity on his part? After all, it will look good to the pro-lifers in 3.5 more years...

And yes, I'm a (very jaded) Florida resident.
posted by Beansidhe at 7:14 PM on March 26, 2005


hey! guess who pulled the plug on his father?
... In 1988, however, there was no such fiery rhetoric as the congressman quietly joined the sad family consensus to let his father die.

"There was no point to even really talking about it," Maxine DeLay, the congressman's 81-year-old mother, recalled in an interview last week. "There was no way he (Charles) wanted to live like that. Tom knew, we all knew, his father wouldn't have wanted to live that way."

Doctors advised that he would "basically be a vegetable," said the congressman's aunt, JoAnne DeLay.

When the man's kidneys failed, the DeLay family decided against connecting him to a dialysis machine. "Extraordinary measures to prolong life were not initiated," said his medical report, citing "agreement with the family's wishes." His bedside chart carried the instruction: "Do Not Resuscitate."...



the Schindlers are now blaming Jeb for not acting--this is not a plus for him for 08--it's poisoning everyone involved actually.
posted by amberglow at 7:56 PM on March 26, 2005


and the NYT covers when families disagree with hospitals: ... Some are wary that doctors may be truncating treatment because of soaring medical costs, and Dr. Dianne Bartels, associate director of the Center for Bioethics at the University of Minnesota, said: "Sometimes there's also mistrust of the medical system. A doctor might have said, 'Your husband's never going to make it,' and he's already survived two or three times, so why should they believe the doctor?"

Thomas W. Mayo, an associate professor at Southern Methodist University law school and an author of the Texas law, cited another reason.

"There are more specialists with less contact with the family," Mr. Mayo said. "As patient volumes have increased and reimbursement rates cut to the bone, there's less incentive for everyone in the system to provide that. When a stranger says, 'Well, there's nothing we can do other than turn things off,' you're hearing that from someone you have no reason to believe other than he's wearing a white coat." ...

posted by amberglow at 8:21 PM on March 26, 2005


Media Matters has more on the recent articles praising Jeb and the people they quoted: ...The New York Times quoted University of South Florida professor Susan MacManus praising Bush without disclosing her ties to his administration. MacManus served on Bush's transition team on health care; was appointed by Bush to the Florida Elections Commission and served as an adviser to Bush as of August 2004. ...
posted by amberglow at 9:40 PM on March 26, 2005


just one more: a very interesting thing on the legal aspects of Congress' law, and how the family did not take advantage of them: ...It appears* that the law passed by Congress would have allowed the District Court to become the court of first instance, to become the original trier of fact (in other words, to discard wholesale the evidentiary and appeals process of the Florida courts and start all over again). But what the parents filed in the District Court was a claim that Schiavo's constitutional rights had been violated by flaws in the procedures of the state courts. And it was on this claim that the District Court (and then the Court of Appeals) — given the extensive trial court and appellate records — found that the plaintiffs were unlikely to prevail on the merits, and thus denied injunctive relief. ...
Having listened to and read much of what has been available on this case, I twigged to something the other day: that the Schindler lawyers had brought the wrong cause(s) of action. (Imagine how pleased I was with myself to hear David Boies voice exactly that opinion to Greta van Susteren on a Fox show night before last.) By not asking for a trial de novo, they themselves set up the situation where their petitions for injunctive relief would be denied, and denied, and denied again. According to the cited footnote, though they presented evidentiary materials they did not seek to argue them, but only tacked them on.

Was this faulty lawyering? Perhaps. Were it not for the fact that the right wing can command some pretty high-powered legal artillery, I might believe that.

I'm not usually a screamer, and I don't like to speculate without some factual backup, but in this instance I'm going to insert my own best guess as to another inference that can be drawn: that the right wing money and the right wing power driving the Schiavo Circus wanted only to prolong it long enough to give full voice to the Noise Machine, to set Terri up as a martyr (Pat Boone on tonight with Larry King Live even called her "America's Joan of Arc"), to milk it for all it's worth — without then having to continue paying for her care or otherwise remain involved with the "living" Terri once the ruckus dies down. It is entirely in their interest that Terri die once they have had their way with her. A martyr is a far more valuable commodity than a woman languishing in obscurity for months and years (and costing somebody a lot of money while she does so). ...

posted by amberglow at 10:04 PM on March 26, 2005


Metafilter: not for resuscitation.
posted by flabdablet at 8:50 AM on March 27, 2005


Creators of tube technique didn't foresee dilemma
The doctors who created the technique used to insert feeding tubes into patients said the procedure has gone far beyond its original purpose of helping infants and children who could not swallow. [Associated Press | March 27, 2005]
posted by ericb at 9:44 AM on March 27, 2005


all the psychos are calling for armed response --...After blathering some nonsense about the left's new "embrace" of federalism and dissing the judiciary as some outlaw radical regime living in the heart of our beautiful culture-of-life-infused nation, Coulter gets to the real point: calling for armed intervention. ...
posted by amberglow at 9:46 AM on March 27, 2005


great orcinus piece: 'Balance' and the tipping point
posted by amberglow at 5:47 AM on March 28, 2005


ericb - I read that article. I guess I didn't know Mrs Schiavo had an operative tube. My comments in this thread were related to the original nasogastric tubes, which are really basic things and employed by the million in many different situations. It may be that these are still regarded as 'extraordinary' under law but they are anything but, for workers in hospitals/health care factilities.
posted by peacay at 6:47 AM on March 28, 2005


I can guarantee you that if there wasn't a way to pay for Terry Schiavo's care

Who paid for the care? Insurance? Mom/Dad's pocket? The State?

One news report claimed Terry was bulemic. And her dietary habbit is what damaged her heart. So, under an ownership society, if you damage your body willingly, should you not pay?
posted by rough ashlar at 7:31 AM on March 28, 2005


It's been our money--Medicaid has been paying for all of it since the settlement money ran out (which was sometime in the 90s, i think). I know Jeb did something that allows her to stay in the hospice forever--there's a 6-month limit usually.
posted by amberglow at 8:23 AM on March 28, 2005


I apologize for this in advance, but as there is not dignity left in this topic.

This comic was mildly funny imo.
posted by edgeways at 12:13 PM on March 28, 2005


What the Repugs think of ownership societies, rough ashlar, is shown by their approach to drug laws.
posted by aeschenkarnos at 2:51 PM on March 28, 2005


Deathbed Conversion (Slate) ... Why the difference between then and now? Maybe because DeLay saw his father as a human being. He speaks of Schiavo as something more—and less. ...

This is what happens when you approach a tragedy as a politician rather than as a family member. You see quality of life as a slippery-slope abstraction, not as a reality affecting someone you love. You find it easy to impose a standard of documentation that would have forced your family to break the law. You second-guess a spouse in a way you would never second-guess your mother. ...

posted by amberglow at 5:36 PM on March 28, 2005


ugh--Fox has Hannity live at the Hospice.
posted by amberglow at 6:30 PM on March 28, 2005


Bevets, could you provide a reliable source for your quotes regarding the schiavo case? I see you provide one for the doctor that witnessed death by dehydration, but the rest you haven't. I googled some of the phrases myself, and I found them as quotes from heavily biased sites arguing against terri being taken off life support, but that's it. Is there a direct quote somewhere, or are these all word of mouth. The reason I ask is that you yourself have extolled the virtue of arguing using your opponent's words (like wringing a confession from a hostile witness was the comparison, I think) but here you only seem to have heresay from biased sources to back yourself up. That and the repeated opinion of one doctor whose integrity is questionable.

I smell more trolling.
posted by shmegegge at 7:15 PM on March 28, 2005


Gee, you think?
posted by five fresh fish at 8:44 PM on March 28, 2005


No, I stopped thinking long ago. At this point I'm actually in a persistent vegetative state, and my fingers keep striking the keyboard in a manner that resembles cognitive ability in form only.

Frankly, I wish I hadn't even posted that. I need to do a better job of keeping my troll-feeding level down.
posted by shmegegge at 10:32 PM on March 28, 2005


We'll have to pull your tube, you know.
posted by five fresh fish at 8:55 AM on March 29, 2005


List of Schiavo Donors Will Be Sold by Direct-Marketing Firm
"The parents of Terri Schiavo have authorized a conservative direct-mailing firm to sell a list of their financial supporters, making it likely that thousands of strangers moved by her plight will receive a steady stream of solicitations from anti-abortion and conservative groups....Privacy experts said the sale of the list was legal and even predictable, if ghoulish....Pamela Hennessy, an unpaid spokeswoman for the Schindlers, said she was initially appalled when she learned of the list's existence. 'It is possibly the most distasteful thing I have ever seen,' Ms. Hennessy said. 'Everybody is making a buck off of her.' Ms. Hennessy, who operates the Schindlers' Web site, www.terrisfight.org, said the family had not released any of the names or e-mail addresses gathered there. 'Obviously these people are enterprising, and they are taking advantage of this very desperate father,' she said." [New York Times | March 29, 2005]
posted by ericb at 9:52 AM on March 29, 2005


I'd laugh out loud, except that this means the evangel right has once again done a very smart job of subversively marketing directly to those people it has the best opportunity of brainwashing into its political organization.

Rational people will see this as dangerous. Religious rule is coming the the USA.
posted by five fresh fish at 10:08 PM on March 29, 2005


They're going back to court now
posted by amberglow at 10:11 PM on March 29, 2005


High Court to Schiavo's family: PWN3D.
posted by drezdn at 10:01 PM on March 30, 2005


she's dead.
posted by matteo at 6:55 AM on March 31, 2005


who?!
posted by Stauf at 9:02 PM on March 31, 2005


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