State meddles in private tragedy?

[Gav]

So what do y'all think of this: US deadlock in right-to-die case.

Personally, I think it's a private matter between the family and medical personnel. This persistent vegatitive state isn't likely to get much better. I can see why the mum and dad would want to fight to keep her alive. What I don't understand is why the politicians have seen fit to get involved. I can also see a better way for her to die than to slowly starve to death ... I suppose that's as far as the doctors are allowed to go. You wouldn't keep a dog alive in this situation why a human?

[mrbiggs]

"I'm not touching that one with a 60 foot pole."

-South Park

[jeff]

"State meddles in private tragedy" summarizes it pretty well. The conservative party of "less government interference in private affairs" abandons its principles in order to serve the religious right.

The whole thing is a tragedy of course, but after 15 years of vegetative state there's not a hell of a lot of likelihood that this poor woman will regain consciousness. Her family is deluded in thinking she's responding to them - the parts of her brain that make a "mind" are no longer there, even if she sometimes reflexively responds to light stimulus.

Gav, I just checked with my wife (the surgeon). Deathly ill people who aren't fed (or refuse to be fed) don't suffer. In her case she'll probably enter renal failure (no hydration -> kidneys shut down) without experiencing discomfort (which can be managed with drugs in the general case anyway) and enter a coma that would lead to death. In her case, I think that's the merciful thing to happen.

God forbid I ever am in a vegetative state like her, but if I am, I don't want to be preserved in that state like a piece of meat. The merciful thing is to let her go.

All, merely my opinion...

[Maeve_Mari]

And to make it worse, she told her husband that if anything ever happened to her, that she didn't want to be left in that state either! The indignity of laying in a bed for all those years with doctors and politicians poking and prodding her!

I understand that it is a very fine line between life and quality of life, but her saddened family needs to understand that it is time to let go. Let her go, let their hearts grieve, and let her family move on.

This summary item is interesting too:
http://slate.msn.com/id/2115064/

[lochinvar]

There comes a time when "prolonging life" crosses over into "prolonging death". That is just what is happening here.

Let her go.

[Maeve_Mari]

Here's something interesting. I've wondered how doctors know when someone is going to be persistently vegetative versus when there is a slight chance of recovery:

Doctors work to understand vegetative states
By Rita Rubin, USA TODAY
A Scottish neurosurgeon who helped coin the term "persistent vegetative state" said Sunday that Terry Schiavo's parents' belief that their daughter can respond to them is "wishful thinking."
"We've all met families like this, and you can't do much about it," said Bryan Jennett, an emeritus professor at the University of Glasgow.

In 1972, Jennett and Fred Plum, now an emeritus professor of neurology at Cornell University, co-authored a paper for a British medical journal: Persistent Vegetative State After Brain Damage: A Syndrome in Search of a Name.

In a frequently broadcast videotape, Schiavo's eyes are open and she appears to be smiling. "A lot of these can be just reflex reactions," Jennett said.

Part of the problem, says Dartmouth neurology professor James Bernat, is that the average person is unfamiliar with the features of a persistent vegetative state. Bernat estimated that perhaps 10,000 Americans alive today are in a persistent vegetative state, mainly because of head injuries.

"Just looking at a videotape of someone propped up in bed, with their eyes blinking and so on, it looks like they're aware," Bernat, co-chairman of the Dartmouth-Hitchcock Medical Center, said Sunday.

Patients in a persistent vegetative state continue to have periods of being awake, but there is no presence of awareness, he said. Because their brain stem is still intact, people in a vegetative state can follow things with their eyes, but only slightly to the left or to the right, Bernat said.

"It's common for family members to make the claim that they believe the person is aware and knows they're there," Bernat said. In such cases, he said, a neurologist will examine the patient in the presence of the family members. "It does make sense to me that a person would respond more to a loved one than to a doctor," Bernat explained. "We want to give them every possible chance, every benefit of the doubt."

Neurologists check whether the patient looks into their eyes when spoken to, he said. "We move and we see if their eyes follow us. We ask them questions. We give them commands to do. We present pictures or photographs ... to see if there's any kind of reaction."

If a patient does appear to respond, he said, the neurologist will repeat the stimulation a number of times to make sure the response was not just a well-timed but random movement. To make a diagnosis of persistent vegetative state, Bernat said, "there really has to be zero evidence of any responsiveness that suggests awareness."

It's uncertain how long Schiavo can survive without a feeding tube, Bernat said. "Usually, it's in the one- to two-week range," he said. The timing depends on how well hydrated she was before the tube was removed and whether her doctors, concerned about potential suffering, are giving her painkillers in intravenous fluids.

[dunastor]

There are several problems with this case.

First, as Maeve_Mari posted, persistent vegetative state means that this is an end stage situation. There will never be any improvement.

Second, the matter of suffering. This is very difficult. As this person isn't aware, she also shouldn't be aware of any suffering. In the Netherlands unbearable suffering is one of the criteria in active ending of life.

NOTE: This case has nothing to do with euthanasia. In cases like these, providing support, fluids and food are medical actions. With a very poor prognosis it is medically pointless to prolong this state of being. Irregardless of any other person having guardianship over this person, doctors should already have retracted support in this case many years ago...

Third, and very important IMHO: Her husband is her legal guardian. He has the legal power to make decisions about withdrawing support from his wife. Her parents are out of any influence on this. I don't understand how people can have the idea the parents are entitled to any decision regarding life support in this matter, legally speaking.

[Purple Fencer]

Just let her go....she's not living....it could be argued she's really not even existing.

[esskreemr]

As or rather or not Schiavo's tube should be removed, that is a difficult decision. My mother has verbally expressed that she wouldn't want medical intervention if she was brain dead. I don't want medical intervention if found brain dead. I would hope my wished would be respected. Apparently they may not though.

This just goes to show you that even a living will (there was none apparently in this case) my not even be iron-clad.

It's also extraordinarily ironic and hypocritcal that Tom DeLay ( I can't stand the man) is the leading advocate.

A note on DeLay's voting record:

# Voted YES on making federal death penalty appeals harder. (Feb 1995)
# Voted NO on replacing death penalty with life imprisonment. (Apr 1994)

Quote about Shiavo case:
"We should investigate every avenue before we take the life of a living human being. That is the very least we can do."

[Philistine]

Originally Posted by dunastor

{snip}
Third, and very important IMHO: Her husband is her legal guardian. He has the legal power to make decisions about withdrawing support from his wife. Her parents are out of any influence on this. I don't understand how people can have the idea the parents are entitled to any decision regarding life support in this matter, legally speaking.

What happened was, the husband submitted the matter to the Court (in 1998) under a provision of Florida law which allows the Court to then make the determination.

The whole thing is a godawful mess. The attempt to federalize the case leaves me...speechless.

The only good thing that may ultimately come out of this, is it raises the issue in the public eye, and at the very least will get people to talk about how they wish to be treated in a similar circumstances, and hopefully will get people to write down their wishes.

--Philistine

[Maeve_Mari]

Okay, now this one gets me too. Here's some crack pot surgeon, publicly stating that he watched the video of Terry Schiavo for about an hour and has determined that all her doctors (from the last 15 years that she has been in a persistent vegetative state) are all wrong. He can see it from watching the video and knows that she, in fact, has responses to stimuli.

Yep. All those doctors and specialists are wrong. They don't see the great possibilities of rehabilitation if only they would provide her with a spoon and some therapy. And this from the next great Presidential Candidate for 2008! Maybe all these doctors and specialists are all in on some conspiracy to eliminate this woman!

Frist views video, disputes Schiavo diagnosis
Senator's comments raises eyebrows in medical, political circles

Bill Frist (R-Tenn.), a renowned heart surgeon before becoming Senate majority leader, went to the floor late Thursday night for the second time in 12 hours to argue that Florida doctors had erred in saying Terri Schiavo is in a "persistent vegetative state."

"I question it based on a review of the video footage which I spent an hour or so looking at last night in my office," he said in a lengthy speech in which he quoted medical texts and standards. "She certainly seems to respond to visual stimuli."

His comments raised eyebrows in medical and political circles alike. It is not every day that a high-profile physician relies on family videotapes to challenge the diagnosis of doctors who examined a severely brain-damaged patient in person. Democrats were quick to note that Frist was getting rave reviews from conservative activists who will play a major role in the 2008 presidential primaries he is weighing.

In addition to the speeches, Frist backed a Senate strategy that threatens criminal sanctions against anyone who keeps Schiavo from attending a Washington hearing next week, to which she and her husband Michael Schiavo were invited early yesterday.

"I suspect that Senator Frist has his eye more on the Iowa caucus than the Hippocratic Oath," said Marshall Wittmann, a senior fellow at the Democratic Leadership Council and former GOP Senate staffer. "This is clearly the politics of the Republican base."

Republican pollster Anthony Fabrizio said Frist will doubtlessly win applause from staunch opponents of euthanasia and abortion, but he may receive a cooler reception from advocates of states' rights and limited federal government. "If you want to confirm your bona fides" with the former group, Fabrizio said, "this is a good way to do it. But while you're pleasing one segment of the party, you may be setting yourself up for trouble with conservatives who say 'we don't want more federal control over this stuff.' "

Some medical professionals questioned the appropriateness of Frist challenging court-approved doctors who have treated Schiavo. Laurie Zoloth, director of bioethics for the Center for Genetic Medicine at Northwestern University, said she was surprised to hear Frist weigh in, given that he has not examined Schiavo. "It is extremely unusual -- and by a non-neurologist, I might add," Zoloth said in an interview.

Were Frist rendering an official medical judgment, she said, relying on an "amateur video" could raise liability issues. After 15 years, "there should be no confusion about the medical data, and that's what was so surprising to me about Dr. Frist disagreeing about her medical status," Zoloth said.

It is not the first time that Frist has created a stir in medical and political circles. In December, on ABC's "This Week With George Stephanopoulos," he repeatedly declined to say whether he thought HIV-AIDS could be transmitted through tears or sweat. A much-disputed federal education program championed by some conservative groups had suggested that such transmissions occur. After numerous challenges by Stephanopoulos, Frist said that "it would be very hard" for someone to contract AIDS via tears or sweat. The Web site of the Centers for Disease Control and Prevention says: "Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV."

Frist's aides say political considerations played no role in his actions regarding Schiavo. "His interest in this was sparked solely as a medical and human rights matter," said Eric M. Ueland, his chief of staff. "It's time for people to take off the 2008 rose-colored glasses and see Bill Frist for who he really is."

Conservative activist Gary Bauer, who made a 2000 presidential bid, praised Frist's role in the Schiavo case and said he would be surprised if conservatives of any stripe take offense. "I don't think there's any danger on the limited-role-of-federal-government argument," Bauer said, "because protecting life is an issue that transcends federalism." Still Bauer said, Frist's intervention carries political risks because "the general public has been told she's in a vegetative state," and voters may view his actions as inappropriate meddling. "But I think he and others have been so courageous about this" that people will see them as "willing to go to the mat for one handicapped individual in Florida."

Democratic strategist Jim Jordan offered a much stronger assessment. "It's quackery," he said. "It'd be hilarious if it weren't so grotesque, how his presidential ambitions and pandering to the right wing is clashing with his life's work."

http://www.msnbc.msn.com/id/7235267/

[Bayou Bum]

I can't stand the way the republican party is so anal over our morality and their view of life. The want to keep everything alive, except criminals, animals and forests no matter what the costs. I suppose if she were on death row, they would be fighting to keep her alive until the date of her execution. What a dilemma it would be for them to have a pregnant woman in a vegetative state on death row, plus a voting democrat with the last name of Kennedy.

I'm just glad that our country is in such fine shape that congress has nothing better to do than spend their time on this or steroid use in baseball!

[Maeve_Mari]

I'd want to add that this is not a neglected case either. The state of Florida has been grappling with this for ten years - fifteen years! Legislation has come and gone and the State Supreme Court has ruled on this, and our U.S. Supreme Court decided that the state had done a sufficient job interpreting the law that it declined the occasion to hear the case themselves.

So taking this time from the important issues that Congress has before them - namely their Easter Break - is really intrusive and inappropriate!

[gojujay]

You can always count on the parties to pander to their constituents no matter how it tramples on States rights. Keep the Feds out of peoples lives.

That said, the family is making all sorts of allegations about the judge and conflict of interest, Michael Schiavo and HIS conflicts of interest. I wonder if there is anything REALLY to it, or is it just a desperate family grasping at straws...

I've talked to my wife, if all I need is a feeding tube, you never know... Where there's life, there's hope. A respirator and unconcious is a little different.

[jeff]

The reason she needs a feeding tube, poor thing, is that she's not conscious/present enough to eat (chew, swallow) on her own, not that she's compos mentis and has a problem with her throat. All that's left is lower-order brain function like reflexes, not the part that makes a person into a person. What a pity.

[keith]

here is a fun quote from the cnn coverage;

Florida Gov. Jeb Bush, the president's brother, issued a statement shortly after the House vote: "I thank the Congress for its swift action allowing Terri's parents to seek a federal review of this case. Certainly, an incapacitated person deserves at least the same protection afforded criminals sentenced to death."

isn't the GoP pushing to limit federal appeals for state death penalty verdicts?

..... or am I just not with the programme?

[jeff]

Originally Posted by gojujay

I've talked to my wife, ...

I forgot to mention - advice for all of us: don't just talk to your spouse - that's just not good enough (that's where the Schiavos got their trouble).

Get in writing an "advance directive" or "living will", and appoint who can serve as your "medical proxy" in case you're unable to speak for yourself and express your will.

I'm not kidding.

[L.O.A.S.]

Originally Posted by Gav

Personally, I think it's a private matter between the family and medical personnel.

It should be, the question is which family member should have power to make that decision. On one hand there is her loving parents who want to keep her alive. On the other is her husband who wants her dead.

Originally Posted by Gav

I can also see a better way for her to die than to slowly starve to death ... I suppose that's as far as the doctors are allowed to go. You wouldn't keep a dog alive in this situation why a human?

Funny should should say this. Would you be jailed for starving your dog?

[L.O.A.S.]

Originally Posted by jeff

Gav, I just checked with my wife (the surgeon). Deathly ill people who aren't fed (or refuse to be fed) don't suffer.

You mean to say that starvation doesn't hurt? I can't imagine that it would be a pleasant feeling ( I get grouchy if not fed at least once a day). I am not disputing your wife's claim about deathly ill people (which Terri is not), although I would say that when my back is really bothering me, I don't feel the ache in my knees.