So where do people stand on the Schiavo feeding tube? The parents and sibs want it left in and believe their faily member can interact with them, and beg the husband to divorce her and leave her alone (he's got a girlfriend and kids with her). He says she told him he didn't want this, and court appointed docs say her prognosis for mentating again is 0%. The tube's been out and back in several times, and now its out. Jeb blocked them once and was overruled... now Congress is trying their hand at medical ethics. My view is, people have a right to refuse any treatment, and when she was of sound mind and body, she, to our best knowledge, said this was not for her. Not do I want to pay into an insurance program that will fund perpetual care of the hopelessly neurologically damaged--I want funds spent on me while I'm alive, and me.
Wherever you stand, you have to wonder... what could we have done with the $ spent thusfar wrangling over the future of one woman who is unaware of her situation and can't benefit from anything we do for her, and what could congress have done for healthcare if they thought about the country instead of poking their heads into symbolic cases.
More to the point, I believe there are some hungry, unvaccinated children out there if anyone has a few million dollars to burn.
Feeding tubes and priorities
-
RACastanet
- Posts: 3744
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA
I completely agree that the government has overstepped it's bounds on this one and that it shows the need for a living will...
HOWEVER, what troubles me is the fact that hubby won't divorce her (even though the family has asked him to and he's been living with his girlfriend and has children with her) and (mostly) the fact that hubby stands to gain about $1,000,000 from her life insurance when she dies. A fact that he tried to hide from the family, but they found out through a PI. Hmmmmmm...
HOWEVER, what troubles me is the fact that hubby won't divorce her (even though the family has asked him to and he's been living with his girlfriend and has children with her) and (mostly) the fact that hubby stands to gain about $1,000,000 from her life insurance when she dies. A fact that he tried to hide from the family, but they found out through a PI. Hmmmmmm...
-
gmattson
- Site Admin
- Posts: 6069
- Joined: Wed Sep 16, 1998 6:01 am
- Location: Lake Mary, Florida
- Contact:
Panther point..
That bothers me too Panther. Can a lawyer tell us at what point she is considered legally dead and can collect the insurance?
Is he afraid that she may one day wake up and inform the world that her husband killed her?
The religious lobbying groups may be trying to tie this case into the abortion issue. If they can get the government to intervene based on a new definition of "life", it may carry over to new "right to life" for fetuses.
Is he afraid that she may one day wake up and inform the world that her husband killed her?
The religious lobbying groups may be trying to tie this case into the abortion issue. If they can get the government to intervene based on a new definition of "life", it may carry over to new "right to life" for fetuses.
GEM
"Do or do not. there is no try!"
"Do or do not. there is no try!"
-
Gene DeMambro
- Posts: 1684
- Joined: Sat Dec 12, 1998 6:01 am
- Location: Weymouth, MA US of A
The husband claims he won't get any money upon his wife's death, and whatever money he did get when he won his malpractice suit went for his wife's care. He's also been offered millions to just walk away from the whole thing.
Maybe her parents/siblings and her husband are being self-serving in all of this. Discount his statements regarding him not getting any money from her death. Ignore the family's assertions to the contrary. Doctors, medicos and everyone without stake in this have all said that she has no upper brain function, and her case is hopeless.
State courts, state appeals and supreme courts, federal courts, federal appeals and supreme courts have all ruled the same way, by and large. And now Congress passed an eleventh-hour law, just to rehash the same things that have been picked over for the last decade?
Rich is right: get a damn living will.
Gene
Maybe her parents/siblings and her husband are being self-serving in all of this. Discount his statements regarding him not getting any money from her death. Ignore the family's assertions to the contrary. Doctors, medicos and everyone without stake in this have all said that she has no upper brain function, and her case is hopeless.
State courts, state appeals and supreme courts, federal courts, federal appeals and supreme courts have all ruled the same way, by and large. And now Congress passed an eleventh-hour law, just to rehash the same things that have been picked over for the last decade?
Rich is right: get a damn living will.
Gene
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
This case is a classic example of why I hold no allegience to either major party.
Where do the Republicans - advocators of "state's rights" - get off allowing the federal government to stick its nose into business already rigorously decided on by a state? I'll tell you where... This is basically W paying homage to a political group (Evangelicals) who helped get him in office.
GW disappoints me here. Generally he acts on principle. He got this one wrong. But he knew it would play well in the bible belt.
The moral of the story here is to make a living will. This way, there wouldn't have been any doubt, and we can forget about the typical B.S. concerning who gets what when the corpse goes into rigor mortis.
- Bill
Where do the Republicans - advocators of "state's rights" - get off allowing the federal government to stick its nose into business already rigorously decided on by a state? I'll tell you where... This is basically W paying homage to a political group (Evangelicals) who helped get him in office.
GW disappoints me here. Generally he acts on principle. He got this one wrong. But he knew it would play well in the bible belt.
The moral of the story here is to make a living will. This way, there wouldn't have been any doubt, and we can forget about the typical B.S. concerning who gets what when the corpse goes into rigor mortis.
- Bill
So the doctors say no brain function that they can tell ... Medicine is still a practice, right?
Everyone is talking about "the right to die" and yet shouldn't the issue be more about the sanctity of life? Yet depending on which polls you want to listen ~60% of the country thinks we should starve this person to death. Somehow because she can't contribute any measurable meaning to society her llife can be judged to be worthless. I challenge anyone to go 3 days without food and water and then, come back and pull the feeding tube out themselves.
Everyone is talking about "the right to die" and yet shouldn't the issue be more about the sanctity of life? Yet depending on which polls you want to listen ~60% of the country thinks we should starve this person to death. Somehow because she can't contribute any measurable meaning to society her llife can be judged to be worthless. I challenge anyone to go 3 days without food and water and then, come back and pull the feeding tube out themselves.
... small is the gate and narrow the road that leads to life, and only a few find it. Mttw 7:14
-
gmattson
- Site Admin
- Posts: 6069
- Joined: Wed Sep 16, 1998 6:01 am
- Location: Lake Mary, Florida
- Contact:
I had a very good friend
who was dying of cancer. He reached a point where he decided it was time to go.
He was being cared for in a hospice at the time of this decision. He received guidance on how to legally end it all by starving himself.
He spent the last two weeks at home with wife and family, taking just enough water to wet his lips. I saw him a couple days before the end. He was still on morphine, so the pain and suffering wasn't there and he was quite animated and alert. He said after a short while he lost any craving for food and water. One by one his organs shut down and he passed on peacefully.
It is interesting that we put our beloved pets down when we know the end in inevidable, yet we prolong human life way beyond what is either humane or logical.
Some things just don't make any sense.
He was being cared for in a hospice at the time of this decision. He received guidance on how to legally end it all by starving himself.
He spent the last two weeks at home with wife and family, taking just enough water to wet his lips. I saw him a couple days before the end. He was still on morphine, so the pain and suffering wasn't there and he was quite animated and alert. He said after a short while he lost any craving for food and water. One by one his organs shut down and he passed on peacefully.
It is interesting that we put our beloved pets down when we know the end in inevidable, yet we prolong human life way beyond what is either humane or logical.
Some things just don't make any sense.
GEM
"Do or do not. there is no try!"
"Do or do not. there is no try!"
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Actually it isn't. Even the Catholic Church stipulates that no extraordinary means are required to maintain a life. Given that this conscious-free corpse cannot function without extraordinary means (a feeding tube), then this qualifies.sarosenc wrote: Everyone is talking about "the right to die" and yet shouldn't the issue be more about the sanctity of life?
Be careful what you wish for. Medicine is getting better and better at extending "life", while the cost of healthcare is outpacing the GDP. If you mandate extraordinary means to keep brain-dead corpses "alive" by artificial means, then pretty soon you run out of money to care for the conscious. And that would be unethical. No matter how you look at this, it's a no-brainer (pun intended).
The only real issue here is the wishes of the brain-dead woman vs. who has a right to express those wishes when the woman failed to create a living will. And that can be a messy business when parties don't agree. The only reasonable way to settle that is through the courts, and they have done their job.
Attention-seeking politicians need to butt out.
- Bill
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
That's what morphine is for, my friend. There is absolutely no need for there to be any pain. That would be unethical, as you have suggested.sarosenc wrote: I challenge anyone to go 3 days without food and water and then, come back and pull the feeding tube out themselves.
Pain management is itself a specialty these days. And folks dealing with end-of-life pain have every right to use the most powerful pain relievers available. Addiction and abuse aren't issues here, so long as they are prescribed by a properly qualified specialist.
- Bill
Last edited by Bill Glasheen on Wed Mar 23, 2005 1:01 am, edited 1 time in total.
-
Mark Weitz
- Posts: 397
- Joined: Fri Feb 27, 2004 4:27 pm
- Location: Toronto, Canada
IJ said,
Bill, it seems both Catholicism and the more traditional texts in Judaism would agree with you. Among the Jewish orthodox, no life is to be willfully extinguished "by even a breath". At the same time, no meaningless, ineffectual treatment need be continued and allowing nature, and/or the will of God, to take its course is perfectly acceptable and considered ethically sound, especially in cases as severe and irreversible as this.
No one is suggesting her life is worthless and this in no way creates an open season on disabled people. And I do not see what is morally superior or dignified about preserving her life in such a state, and apparently neither does she.My view is, people have a right to refuse any treatment, and when she was of sound mind and body, she, to our best knowledge, said this was not for her./quote]
I agree though the big problem, which is why a living will is so important, is that it was expressed verbally and not written down. We only have the husband's word and, I believe the husband's sister.
If US fed or state law is similar to Canada's on treatment decisions, then I can understand his interest in not divorcing her before she dies. In most Canadian provinces, treatment decisions, in the absence of of a living will, automatically goes to the spouse. There's a hierarch of substitute decision makers (SDM) that is enshrined in law precisely to avoid these matters having to go outside the health care system. Perhaps as her spouse, he is in a much more powerful legal position to assert his role as SDM.
Bill said,
100% agreement there. It's outrageously and transparently self-serving but of course they get to wrap themselves in their moral argument about how much they support life. Nothing like boost from your constituents while your on the road to the mid-terms.Where do the Republicans - advocators of "state's rights" - get off allowing the federal government to stick its nose into business already rigorously decided on by a state? I'll tell you where... This is basically W paying homage to a political group (Evangelicals) who helped get him in office.
Sarosenc said,
Everyone is talking about "the right to die" and yet shouldn't the issue be more about the sanctity of life?/quote]
Life is sacred but I feel it's important to draw a distinction between biologically existing and actually being able to live in a manner in which she is aware. Apparently, the part of her brain responsible for thought is liquid, she has no thinking, no cognition whatsoever. Looking at her lying there in such a ghoulish state, do you really feel that this is living, that your preserving something other than respiration and a heart beat? Of course she's a human being and deserves the full protection of the society she lives in but the decision to not exist under such horrific conditions was apparently made by her prior to her heart attack (if we can believe her husband though I haven't heard any evidence of his being an untrustworthy witness to her verbally expressed treatment decisions).
Somehow because she can't contribute any measurable meaning to society her llife can be judged to be worthless.
Bill, it seems both Catholicism and the more traditional texts in Judaism would agree with you. Among the Jewish orthodox, no life is to be willfully extinguished "by even a breath". At the same time, no meaningless, ineffectual treatment need be continued and allowing nature, and/or the will of God, to take its course is perfectly acceptable and considered ethically sound, especially in cases as severe and irreversible as this.
With apologies to the ancient (no offense intended) moral philosophies of some orthodox religions, they do not apply. Their codes of morality applied to/ were created for a world in which advanced medicine did not exist. They NEVER had to face a patient who was being tortured on a ventilator with no chance of recovery or left a vegetable on artificial nutrition for decades and they did NOT specify that was a goal. They need a fresh look at "life;" the boundary between it and death has become much more gray since BC. And while I am ALL for prolonging and improving life, I have, based on coming up 6 years of clinical experience, lost all taste for prolonging dying.
Just today a critically ill and fragile woman who we've been trying to reach family on for two days had a bloody, awful, painful "code blue" and went to the ICU where she will certainly die regardless of our best efforts, because her family didn't return our calls or take off work to come discuss her "code status" as requested. (She was not able to specify wishes). I suffered because it's painful to order painful and hopeless procedures on the dying--but trust me, she suffered a lot more.
As for "starving" this woman, we would be doing no such thing. Extraordinary measures are optional. They can be declined. They can also be discontinued. Just as with a ventilatory or powerful drugs or dialysis or implanted defibrillators, artificial feeds can be ethically stopped. We are not "starving" her, we are ceasing to artificially sustain her. This is no ethically different from not instituting tube feeds in someone who declined them.
Perhaps more importantly, our human experience without 3 days of food is irrelevant. Our experiences depend on cortical functioning, which she lacks. She will not experience thirst or pain. Most dying people reach a point at which these sensations pass EVEN if brain function persists. They simply no longer wish to eat; their bodies know they are dying.
Here's a thought: this DOES show to the nation how important a living will (and telling your next of kin your wishes) are. But could there be something wrong with a system that keeps hopeless cases alive as a default position while the needy go unserved? TODAY, I have two patients I am sending out on the street without dialysis (ages 42 and 39). They will come back to the ER and rececive dialysis on a compassionate basis from the hospital, unreimbursed, but less than optimal, and with less than optimal supplies of meds and followup with doctors. And they have the *capacity* to suffer from lack of care.
Just today a critically ill and fragile woman who we've been trying to reach family on for two days had a bloody, awful, painful "code blue" and went to the ICU where she will certainly die regardless of our best efforts, because her family didn't return our calls or take off work to come discuss her "code status" as requested. (She was not able to specify wishes). I suffered because it's painful to order painful and hopeless procedures on the dying--but trust me, she suffered a lot more.
As for "starving" this woman, we would be doing no such thing. Extraordinary measures are optional. They can be declined. They can also be discontinued. Just as with a ventilatory or powerful drugs or dialysis or implanted defibrillators, artificial feeds can be ethically stopped. We are not "starving" her, we are ceasing to artificially sustain her. This is no ethically different from not instituting tube feeds in someone who declined them.
Perhaps more importantly, our human experience without 3 days of food is irrelevant. Our experiences depend on cortical functioning, which she lacks. She will not experience thirst or pain. Most dying people reach a point at which these sensations pass EVEN if brain function persists. They simply no longer wish to eat; their bodies know they are dying.
Here's a thought: this DOES show to the nation how important a living will (and telling your next of kin your wishes) are. But could there be something wrong with a system that keeps hopeless cases alive as a default position while the needy go unserved? TODAY, I have two patients I am sending out on the street without dialysis (ages 42 and 39). They will come back to the ER and rececive dialysis on a compassionate basis from the hospital, unreimbursed, but less than optimal, and with less than optimal supplies of meds and followup with doctors. And they have the *capacity* to suffer from lack of care.
--Ian
-
Mark Weitz
- Posts: 397
- Joined: Fri Feb 27, 2004 4:27 pm
- Location: Toronto, Canada
IJ, I agree with much of what you say except,
The technology has certainly evolved to a point not conceived by our ancestors but much of health care consent and capacity law here draws heavily from religioius thought. Orthodoxy certainly does not have all the ethical answers but it does inform much of how both medical professionals and patients approach end-of-life care. And this is precisely what we see in cases where people, either stated in their living wills and POAs or in-hospital treatment decisions, choose to forgo the heroics of medical technology and let life take its course, right? This is an ethical approach that is quite old, relevant to today, and practiced daily by those who choose to meet their death in the manner described by George earlier in this thread and as my mother did when she passed from cancer years ago.
One of the cases you describe, IJ, where family can't be contacted is as much about communication as it is about the technology available to preserve a living corpse, but again you stated that extraordinary means or heroics are in such cases optional, again drawing on an "ancient" belief that it is ethical sound to allow natural passing. What would be new to the ancients is the technology but much of their ethical thinking remains relevant today.
Mark
They absolutely do apply both in the spirit and letter of the law, at least in my province of Ontario, and in many health care settings where different religious populations frequent, such as the Mt. Sinai Hospital (predominantly Jewish) and Scarborough Grace (predominantly Catholic). BTW, I am not an observant Jew and was raised by agnostics so I don't have a personal investment here.With apologies to the ancient (no offense intended) moral philosophies of some orthodox religions, they do not apply. Their codes of morality applied to/ were created for a world in which advanced medicine did not exist.
The technology has certainly evolved to a point not conceived by our ancestors but much of health care consent and capacity law here draws heavily from religioius thought. Orthodoxy certainly does not have all the ethical answers but it does inform much of how both medical professionals and patients approach end-of-life care. And this is precisely what we see in cases where people, either stated in their living wills and POAs or in-hospital treatment decisions, choose to forgo the heroics of medical technology and let life take its course, right? This is an ethical approach that is quite old, relevant to today, and practiced daily by those who choose to meet their death in the manner described by George earlier in this thread and as my mother did when she passed from cancer years ago.
One of the cases you describe, IJ, where family can't be contacted is as much about communication as it is about the technology available to preserve a living corpse, but again you stated that extraordinary means or heroics are in such cases optional, again drawing on an "ancient" belief that it is ethical sound to allow natural passing. What would be new to the ancients is the technology but much of their ethical thinking remains relevant today.
Mark
IJ - I greatly respect your talents and efforts as a healer and your concern for your patients, even across this electronic medium, rings true. But I disagree with your comments on moral philosphy being outdated by scientific advances. I have seen first hand what starving/dehydrating to death looks like.
First was my wife's grandmother whose cancer surgery took part of her stomach and eventually she was no longer able to eat, that was five years ago.
The second, just this last summer was my own father who was diagnosed on June 1st with a very aggressive form of stomach cancer. The tumor that had grown inside of his stomach was the size of a football and completely blocked off the esophagus. A feeding tube was inserted to supply his nurishment. Surgery was not possible because of the danger to his aorta, chemo would have given him 6 weeks to 3 months in agony, he chose to die well on his own terms ... and he succumbed on August 27 less than 3 months after diagnosis. My father had been an active and healthy 190lbs in June, he was less than 120lbs when I picked up his corpse from the floor of the bathroom so the hospice nurses could clean him up.
You say it is more humane to end a life of suffering, but I gather from your posts that your philosphy is that all you have is this life. It doesn't make sense that you would want to take from someone else the only thing they have. I am not judging only trying to see from your perspective.
I just think that we rush to judgement and find it all to easy to make moral responsibility the legal responsibility of the judiciary, backed up by science that doesn't explain the mystery of life. The immensity of what science has brought to us about life should cause us to stand in awe, yet instead it seems to leave us with a bored arrogance bordering on contempt.
First was my wife's grandmother whose cancer surgery took part of her stomach and eventually she was no longer able to eat, that was five years ago.
The second, just this last summer was my own father who was diagnosed on June 1st with a very aggressive form of stomach cancer. The tumor that had grown inside of his stomach was the size of a football and completely blocked off the esophagus. A feeding tube was inserted to supply his nurishment. Surgery was not possible because of the danger to his aorta, chemo would have given him 6 weeks to 3 months in agony, he chose to die well on his own terms ... and he succumbed on August 27 less than 3 months after diagnosis. My father had been an active and healthy 190lbs in June, he was less than 120lbs when I picked up his corpse from the floor of the bathroom so the hospice nurses could clean him up.
You say it is more humane to end a life of suffering, but I gather from your posts that your philosphy is that all you have is this life. It doesn't make sense that you would want to take from someone else the only thing they have. I am not judging only trying to see from your perspective.
I just think that we rush to judgement and find it all to easy to make moral responsibility the legal responsibility of the judiciary, backed up by science that doesn't explain the mystery of life. The immensity of what science has brought to us about life should cause us to stand in awe, yet instead it seems to leave us with a bored arrogance bordering on contempt.
... small is the gate and narrow the road that leads to life, and only a few find it. Mttw 7:14
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Hmm... Much to ponder.
The answers here are not in science, nor are they in the judiciary, nor are they served to us by politicians. These are but tools that we have honed over time to serve us during our time on this earth.
One thing that amazes me is the fact that few people on this earth really accept the finite nature of their stay here. Don't get me wrong - I want a good long life if I can help it. But quality is important.
Death is a fact of life that we cannot avoid. The only issues here are when and how, and what are lives will be like before we pass away. In order to get our arms around all that, it behooves us to find purpose for our very brief existence here. For some who define their existence by what transpires on this earth, they embrace life and the legacy that they leave behind. For those whose purpose is significantly driven by the concept of a divine entity and an afterlife, this is but a temporary stay on a longer, more meaningful journey.
It's cavalier to curse at science, the judiciary, arguing relatives, politicians, and what not. But what really matters starts while we are active and thinking. And it ends only partially when we pass away. Maybe we left children here to carry on. Maybe we left a legacy of our acts to live on. Maybe our spirits venture elsewhere. One way or another, that IMO is what really matters when it's time to accept our fate.
People die every day. We hide it as if it's something that shouldn't happen. We are angry at those associated with it. We try to find meaning in acts towards the end that mean little in terms of defining our net existence. Why??? What is so wrong and bad about something that is inevitable? What is wrong with embracing death and life at the same time as two parts of a whole that must coexist?
I could go on and on... I will, but in pieces and parts here and there.
There is something quite empowering about facing The Grim Reaper without fear. And I say this both from the perspective of the person about to pass away, as well as from that of those associated with the end of someone else's life. It deserves attention. It deserves acknowledgement, It demands the best of what makes us human. And in our passing, we ironically define who we were while we were alive.
How will you be remembered when you face that? How will you be judged? What impact will you have on others as that great battle is waged and the transformation ensues?
- Bill
The answers here are not in science, nor are they in the judiciary, nor are they served to us by politicians. These are but tools that we have honed over time to serve us during our time on this earth.
One thing that amazes me is the fact that few people on this earth really accept the finite nature of their stay here. Don't get me wrong - I want a good long life if I can help it. But quality is important.
Death is a fact of life that we cannot avoid. The only issues here are when and how, and what are lives will be like before we pass away. In order to get our arms around all that, it behooves us to find purpose for our very brief existence here. For some who define their existence by what transpires on this earth, they embrace life and the legacy that they leave behind. For those whose purpose is significantly driven by the concept of a divine entity and an afterlife, this is but a temporary stay on a longer, more meaningful journey.
It's cavalier to curse at science, the judiciary, arguing relatives, politicians, and what not. But what really matters starts while we are active and thinking. And it ends only partially when we pass away. Maybe we left children here to carry on. Maybe we left a legacy of our acts to live on. Maybe our spirits venture elsewhere. One way or another, that IMO is what really matters when it's time to accept our fate.
People die every day. We hide it as if it's something that shouldn't happen. We are angry at those associated with it. We try to find meaning in acts towards the end that mean little in terms of defining our net existence. Why??? What is so wrong and bad about something that is inevitable? What is wrong with embracing death and life at the same time as two parts of a whole that must coexist?
I could go on and on... I will, but in pieces and parts here and there.
There is something quite empowering about facing The Grim Reaper without fear. And I say this both from the perspective of the person about to pass away, as well as from that of those associated with the end of someone else's life. It deserves attention. It deserves acknowledgement, It demands the best of what makes us human. And in our passing, we ironically define who we were while we were alive.
How will you be remembered when you face that? How will you be judged? What impact will you have on others as that great battle is waged and the transformation ensues?
- Bill
