Terry Schiavo

[THE_DITCH_DOCTOR]

Are you sure you don't mean a PET scan Dixie? A PET scan measures uptake of marked glucose molecules to determine functioning of the brain. There is no reasonable excuse for conducting such a test when independent court appointed doctors have determined that she is not going to recover. Why spend thousands of dollars just to prove again what we already know?

[Ztenec]

Also Dixie, concerning your "let the patient decide" Umm this happened in 1990 so don't you think if should could just jump up and say hey guys I think I want to be alone she would have done so by now? :wink:

Anyway this is one of those threads I gotta stay away from because people are either for it or against it and nothing is going to change their minds.

[ed2brute]

Terri can't communicate any longer. She's not been able to for nearly 15 years. If she could advocate for herself this wouldn't be an issue. Plus her family disagrees over what she would want. That's what makes this so hard.

There are many, many mentally handicapped people in the world who function at a much higher level than Terri (e.g., Down's Syndrome) who have been ruled incompetent and have legal guardians.

[Guest]

Starving to death is certainly not a pleasant way to go, but I would rather do that than persist in that state. I am in some of your locals, and I will say it now. Mike, If you find me like that, leave me like that. Seeing some of the things that I have at my transport job, like 28 y.o. patients that had a subarachnoid bleed and now they just lay in bed, or the steady rotting away of digits and limbs associated with kidney dialysis pts. starving to death looks mighty good.

[9C1EMT]

I had to cast a no vote to the original question: is it congress' place to rule on this, or the President's, for that matter? NO NO NO NO! That is what our courts are for, and the matter should have ended there. I am glad that ed2brute was able to recall supreme court precedence on this matter, because apparently congress can't. I agree, starving to death is a horrible way to go, and I hate to say it but it is her own fault that she did not commit her wishes for long term care in the event of debilitation to legally binding paper. Now her family is split on deciding her fate for her...I couldn't imagine being in that predicament, and I would probably go insane if ever put there.

There have been and will likely be some more very interesting view points expressed on this, and despite the grim subject it has been a fine social learning experience reading this string.

[Dalgar]

Well for my two cents.

First of all since she is unable to give directives for herself it falls onto her legal gaurdian. He has made the choice for her based on her wishes. (So he says).

SHe did not have a living will (Thank god I do). Since when did the government have a right into our personal private lives. Sadly this is the real issue. Not whether Terry should die or not. It's about what the government feels it can do.

What really scares me is that twice now the government once at state level and now at federal scrammbled to pass a law saying they had a right.

With that. What is stop our government from making any kind of law they wish to control our life? When do we start seeing the government saying who can live and who can die?

When do we start seeing the government deciding who can get a transplant and who can't?

Thats the really scary part of all this.

[chipmunkemt_98]

Just to throw another stone in the pond. I am not saying whether this is the right decision in this case, but many patients who are on hospice CHOOSE to not eat or drink during what they know is their final days.

I have to disagree on this one. I went to hospice net to get this, but it is very informative. Having had to deal with hospice on a personal as well as a professional level, it hits the nail on the head on what I have had to deal with:

The Hospice Concept

Hospice is a concept of caring derived from medieval times, symbolizing a place where travelers, pilgrims and the sick, wounded or dying could find rest and comfort. The contemporary hospice offers a comprehensive program of care to patients and families facing a life threatening illness. Hospice is primarily a concept of care, not a specific place of care.

Hospice emphasizes palliative rather than curative treatment; quality rather than quantity of life. The dying are comforted. Professional medical care is given, and sophisticated symptom relief provided. The patient and family are both included in the care plan and emotional, spiritual and practical support is given based on the patient’s wishes and family’s needs. Trained volunteers can offer respite care for family members as well as meaningful support to the patient.

Hospice affirms life and regards dying as a normal process. Hospice neither hastens nor postpones death. Hospice provides personalized services and a caring community so that patients and families can attain the necessary preparation for a death that is satisfactory to them.

Those involved in the process of dying have a variety of physical, spiritual, emotional and social needs. The nature of dying is so unique that the goal of the hospice team is to be sensitive and responsive to the special requirements of each individual and family.

Hospice care is provided to patients who have a limited life expectancy. Although most hospice patients are cancer patients, hospices accept anyone regardless of age or type of illness. These patients have also made a decision to spend their last months at home or in a homelike setting.

______________________________

So, hospice care is generally for those who are terminally ill. Some of the illness' most patients suffer from usually range from cancer, ALS, MS, Alzheimer's, AIDS, etc. Hospice is usually set up to provide care plans for those who are not going to make it past the next year or so, but I have seen patients who have lasted much longer. The care plans are not based on a patient improving day by day, but to make each day they have more tolerable.

You DO NOT have to necessarily live in a hospice facility, but instead may live at home, in a nursing home, or even be in a hospital. Hospice DOESN'T mean DEATH, but does mean making foreseeable death more easy to deal.

By the way, one of my best friends has MS. She has been in a nursing home for several years. Hospice took over on her care over a year ago, and she shows no signs of dying right now. Hospice helps deal with day to day care plans, and they check on her daily. She receives nutrition via peg tube when she cannot eat. She has a daily regimen of ROM exercises to keep contractures minimal. It doesn't seem like someone who was "dying" would have this in a care plan, but it is provided. I know that one day, she may just stop breathing (from the MS) but until then, she is given care to make her comfortable and hospice doesn't push the death thing.

[paramedicmike]

So how does this affect the hospice patient's choice to stop eating or drinking? The passage you cited has no bearing on a patient's choice. A hospice patient can't be forced to eat (unless in the Terry Schiavo case where's she's a veggie and can't decide on her own in which case they're probably in a long term care facility and not necessarily under hospice care.). Hospice neither hastens nor postpones death. That's right. The *PATIENT* decides to stop eating to hasten death.

I have seen it before. A friend of mine had ALS. She decided that she was tired of fighting and stopped food or water. She was dead two days later.

I've seen terminal cancer and AIDS patients make this decision. Hospice care has nothing to do with the decision to stop eating.

EMSgirl's comments deal specifically with a hospice patient's right to chose. And she's right. Many patients who are under hospice care do decide to stop eating. It's not a comment on the care provided by hospice. It's not indicative of policies or procedures of the hospice care system. It's a personal choice by someone who is terminally ill, who has made peace with the fact that they're going to die, and who has decided that they're ready to go.

Be safe.

[chipmunkemt_98]

So how does this affect the hospice patient's choice to stop eating or drinking? The passage you cited has no bearing on a patient's choice. A hospice patient can't be forced to eat (unless in the Terry Schiavo case where's she's a veggie and can't decide on her own in which case they're probably in a long term care facility and not necessarily under hospice care.). Hospice neither hastens nor postpones death. That's right. The *PATIENT* decides to stop eating to hasten death.

I have seen it before. A friend of mine had ALS. She decided that she was tired of fighting and stopped food or water. She was dead two days later.

I've seen terminal cancer and AIDS patients make this decision. Hospice care has nothing to do with the decision to stop eating.

EMSgirl's comments deal specifically with a hospice patient's right to chose. And she's right. Many patients who are under hospice care do decide to stop eating. It's not a comment on the care provided by hospice. It's not indicative of policies or procedures of the hospice care system. It's a personal choice by someone who is terminally ill, who has made peace with the fact that they're going to die, and who has decided that they're ready to go.

Be safe.

Yes, this is true, some 'CHOOSE' their escape from the pain. What I was specifically saying is that hospice works with the patient and family to make the most comfortable choice in patient care during their last days. That Hospice DOES NOT MEAN DEATH SOON, but helps provide comfort and care geared for those who are terminally ill.

For a final note, Advanced Directives are a good idea for everyone, whether you are sick or not. Who knows what will happen tomorrow? With these set directives, your family and your healthcare providers will know exactly what you want done for you in case something happens.

As with Terry Schiavo, who really knows what she wanted?

[lil_animal_88]

This is a serious subject, that obviously hits home to all health care providers.

I absolutely think they should let the husband make this decision. In fact I think more people with incapacitated family members should be as strong as him and choose the same. People like her have no quality of life. And I might really tick some people off by saying this but, they are a huge burden on the health care system. In my opinion the family needs to quit being greedy about their own feelings for her, and start thinking about what Terri would want. It is a classic case of not letting go. This woman died a long time ago. She is merely existing and not living.

Honestly... maybe we need to have a poll here and see how many people would want to exist this way.

I think what really makes it hard for some is in this particular case this woman actually looks well cared for. What about all the people that we see in the extended care facilities? You know, the ones that lay in the same position all the time and have nothing but a tiles on the wall to stare at? The ones who have no family, no one to come and visit. No one to interact with but the staff. Every day of their life is exactly the same. And even if they can think for themselves, they have no way to express it.

This, if you want to call it lifestyle is the very same as the most cruel torture.

Nothing really brings the mood down in EMS like running a rescue on the same vegetated patient week after week. These people are suffering, always having complications varying from sepsis to pneumonia. Suffering from the pain of debriedment of that stage 5 decubitus ulcer. Not to mention the pain from the contracted arthritic joints.

I feel so strongly about this. I had my first cardiac arrest that i actually brought back a few weeks ago. This woman was a vent dependent, peg tube dependent AXOX1 p.t whom pulled her trachea out. Before the Nursing home staff realized that this had happened she was already arrested. No DNR papers so when we got there we had no choice but to work her. She was in asystole, but the down time was estimated to only be approx 8min. We did our usual CPR, ET, Epi, Atropine then some bi-carb and to our amazement we got a rhythm back with a pulse and somewhat of a blood pressure. So we transport her to the hospital. She lives. And returns to the Nursing home about a week later. For a few seconds after the call I was excited to have "saved" a life. I shortly realized after, we only prolonged her death.