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Mae Magouirk Update - The Contrarian Edition

Update: No matter the arguments, Mae is out of the hospice and on her way to UAB. I spoke to Ken for about 12 seconds and he promised an update when it was available.

Multiple people have made the argument that this case just doesn't add up. That we don't know all the facts. So, I'm presenting the contrarian arguments as best I can find them. (WIth my opinion of course.)

The Commissar, emailed the hospice where Mae Magouirk was admitted and they emailed back a reply I had seen elsewhere. I had not run it before mostly because I did not realize it was complete. The Commissar says that this is the full reply and for the sake of discussion, I'll keep the Commissar's bolding.

Federal (HIPAA) regulations prohibit us from speaking publicly about the treatment or records related to individual patients. However, we can say that we do not deny nutrition or hydration to any patient.

The staff of West Georgia Hospice/Hospice LaGrange provides compassionate and quality care to each of its patients, which includes offering food and water at frequent intervals.

Perhaps I lived too long in the Bill Clinton "non denial denial" era but that seems like completely worthless legal doublespeak to me. What is most telling is that they have steadfastly refused to confirm or deny repeated inquiries as to whether Magouirk is on a feeding tube.

They say they can't because of patient confidentiality. OK, fair enough. But certainly the granddaughter can give them the right to make a statement. Hospitals make statements to the media every day. All they need is permission from the guardian. In this case, the granddaughter, Beth Gaddy. Apparently Gaddy has not given them permission. Further, Gaddy has refused to talk to the media herself. This is itself probably significant.

But let's look at the bolded sections of the statement:

we can say that we do not deny nutrition or hydration to any patient
OK, but if there is on order on the chart, do they remove feeding tubes? I think we all know the obvious answer. It's a well crafted line from an attorney who gets paid well to say nothing.

which includes offering food and water at frequent intervals
OFFERING food and water to someone who requires a feeding tube? Come on. If you want to believe that statement means something to anyone other than the lawyer who wrote it, OK, more power to ya. I don't think it's worth the paper it's printed on.-- And it was emailed.

The other bit of "contrarian" news I have concerns the judge. From NBC News11

Mullinax says Gaddy has withheld nourishment and fought further treatment saying Magouirk needed to be with Jesus. He also charged that the judge went along though Magouirk was hardly comatose. ...

Judge Boyd called Mullinax's charges completely false and said all relatives agreed to let three doctors decide what was next for Magouirk. He said that everyone was happy with the compromise.

"They were hugging necks, and, as far as I knew, the family was fine," the judge said.

I've read this quote 6 or 7 times and I'm not sure what exactly the judge is denying. Nobody disputes that a 3 Doc panel is still(!) deciding what care this woman should receive. Ken and his side of the family have said that many times. And it is quite possible that almost a week ago all sides did agree... But the report was due on Monday. We are approaching a week. As I understand the problem, Ken and his side of the family are concerned that she is not receiving nourishment during this time.

POTENTIALLY the judge is saying that she IS on the feeding tube and/or receiving adequate nourishment.... But that's not what it sound like when he talks about the family agreeing and "hugging necks."

As I understand the issue the problem Ken and his side of the family are having is that while the Docs take almost a week to decide what to do with the woman, she is not being fed. (and was not being fed prior to that) IF that is NOT the case, then Ken will look foolish indeed. It is possible this is a hoax but the odds seem long.

The answer I want is simply whether this woman is being fed while the doctors contemplate their collective navels. [How long does it take to make a diagnosis on one patient?] Ken and his side of the family say she is not. Nobody on the other side will give a definitive statement. I've taken some flack for believing Ken. At this point, absent a simple denial, it seems the most plausible.

For better or worse, I've given you both sides (with my current opinion) you can draw your conclusions who is telling the truth.

BTW- There was a far more compelling "contrarian argument" I saw but can not verify. Supposedly, the judge ordered Magouirk be fed. If this was the case, either Ken's story falls apart or somebody is in big, big trouble. Unfortunately, the person who cited the ruling provided no link and not even a direct quote to google.

If one of my hyper-informed readers knows anything about this, I'd appreciate a link in the comments. I'll promote it to the front page. That would be for more impressive than the stuff quoted above. I'll be checking comments every hour or so.


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Listed below are links to weblogs that reference Mae Magouirk Update - The Contrarian Edition:

» The Politburo Diktat linked with Statement from Hospice LaGrange

» MY Vast Right Wing Conspiracy linked with Mae Magouirk out of hospice; at UAB Medical Center

» The Original Musings linked with Update: Mae's out of the hospice

» MY Vast Right Wing Conspiracy linked with Mae Magouirk WTF

» BIRD linked with EVIL DOESN'T TAKE A HOLIDAY

» Murdoc Online linked with UPDATE: The Shiavo Slippery Slope?

» JackLewis.net linked with Mae Magouirk: updated timeline and commentary

Comments (31)

Apparantly she is on her wa... (Below threshold)
Just Me:

Apparantly she is on her way to UAB, and is receiving fluids and nourishment by IV (although it wasn't clear if she had already been receiving that nourishment).

http://www.blogsforterri.com/archives/2005/04/breaking_news_m_1.php

Oh, but I will add, that I ... (Below threshold)
Just Me:

Oh, but I will add, that I do not understand why she wasn't being fed while the decision was made.

That to me is a no brainer.

Reading around the blogs, I... (Below threshold)

Reading around the blogs, I see quite a few people coming up with the story that there never was a feeding tube involved.

There's this statement from a pastor who looked into the situation today:

"The details are many, but in short, the grandmother is not being denied anything, but refuses herself to eat (there never was a feeding tube). POA arrangements were made while the court was on break by the family among themselves. The judge was not in the room when the family agreed among themselves to give custody to the granddaughter."

Relevant link here: http://stopthebleating.typepad.com/stop_the_bleating/2005/04/wtf.html

If one of my hyper-infor... (Below threshold)
julie:

If one of my hyper-informed readers knows anything about this, I'd appreciate a link in the comments.

Paul: I saw something that could have been interpreted as such very early this am on worldnet. However, it had legal loopholes big enough to drive a mack truck through.

Michelle from what I have r... (Below threshold)
Just Me:

Michelle from what I have read, it sounds like the grandaughter may have been opting not to have a feeding tube put in, and that either they weren't providing nourishment through an IV or temporary nose tube (same concept as a feeding tube, but the tube is run through the nose instead of being surgically placed in the stomach), and what they were giving her was not adequate.

I am guessing they weren't giving her a nasal feeding tube, and the other methods weren't enough.

I am sure more information will come out, but I have to agree with Paul, there is something wrong, when you aren't adequately nourishing a person while you are deciding whether or not you are going to let the grandaughter kill her.

I did not find the direct l... (Below threshold)
julie:

I did not find the direct link to the comment by the pastor. Again, to me he is an unverifiable source. If he looked into the situation today, it would appear that he was not a percipient witness to what he is relating. Additionally, he states:

Mae refuses herself to eat (there never was a feeding tube).

Now what does that really mean? That she didn't have a feeding tube through her abd like Schiavo? Correct. However, she did/does have a ng (nasal-gastric) tube. Sometimes they connect it to suction. Sometimes they insert a larger one for nutrition. But tell me, how many of you would be interested in eating if you had a big fat tube threaded up your nose and down the back of your throat, pass your esophageal flap, and into your stomach? Still want dinner??

I can't understand why some... (Below threshold)
Beth:

I can't understand why some are so anxious to debunk the story, except that the concept of killing off Granny because she's old and sick is so unacceptable it's hard for them to believe it.

I'd like to see more evidence (IOW, more than conjecture and suspicion) that proves this story false before I'll go along with that side of it.

Here's the <a href="http://... (Below threshold)
Beth:

Here's the link to the guy who had the email from the pastor Michele mentioned:

Burton Terrace

Old people often refuse to ... (Below threshold)
Paul:

Old people often refuse to eat, choosing to end their life when they want... But in this case she was on so much pain med, I'm not sure she had the ability to eat enough to sustain her... I dunno, probably irrelevant now.

Sounds to me like maybe the... (Below threshold)

Sounds to me like maybe there was a disagreement about whether she needed a feeding tube or not. Have you seen this thread from someone who talked with the judge? http://cait-sozblogs.blogspirit.com/archive/2005/04/10/mcgouirk_judge_is_pro-life.html

Dammit, now this story is g... (Below threshold)
Les Nessman:

Dammit, now this story is going to go away.
I barely had a chance to gossip and I didn't get to falsely accuse anyone of anything.

Oh well; next time.

Paul:But in thi... (Below threshold)
julie:

Paul:

But in this case she was on so much pain med, I'm not sure she had the ability to eat enough to sustain her... I dunno, probably irrelevant now.

Oh, I don't know about that. Maybe, the pain meds made her too nauseated to eat. Maybe, Michele would know something about that?

Hey, ask Ken if this is Mrs. Magouirk's first helicopter ride for me. Thanks.

Let me throw out a theory t... (Below threshold)
TomT:

Let me throw out a theory that might explain the contradictory statements from various sources (assuming that everyone is being mostly honest but not necessarily complete)...

Aunt Mae is rushed to the hospital in LaGrange with symptoms of a heart attack, the doctors find the aortic dissection and advise that most of the time, it will rupture into an aneurysm causing rapid death, and surgery is not an option. They recommend hospice, but due to the sedating medication needed to keep her blood pressure down, Mae can't consent. Beth says, that's ok, I have power of attorney, so Mae is moved to the hospice.

When Mae's brother Ken finds out, he realizes that while Podunk General can't treat an aortic dissection, UAB can, and he wants her moved. Beth goes to the judge and claims Mae is no longer competent (she does have financial power of attorney, maybe Mae was getting a bit daft), and gets appointed as guardian. She accepts the diagnosis of the LaGrange doctors and doesn't want to risk Mae dying in a needless helicopter ride, while Ken wants a second opinion. The judge grants a new medical evaluation in an order affirming Beth's guardianship and requiring Mae to be properly cared for.

I think Mae was at least partly conscious some of the time and refused to eat and drink. Ths hospice "offered" food, but Mae didn't take it. Here's where it gets tricky. If Mae is competent, she can decide to refuse treatment and nutrition. But, Beth seems to have had her declared incompetent (why else would there need to be a guardian for a lucid person), in which case the living will should kick in. It sounds like there never was a feeding tube, but there should have been--Mae's competently expressed written wishes should have been followed by her guardian after she was declared incompetent.

When and if she is lucid enough to pass a competency evaluation by UAB's psych consult and ethics officer, she could certainly revoke her living will and choose another course of treatment for herself. For now, she is being treated as she requested in her living will.

I don't care about individu... (Below threshold)

I don't care about individual cases involving forced euthanaisia. These are just the tip of the ice berg.

According the the Hospice Patient Alliance there are literally thousands of these cases every year.

What has happened is that the medical community, using the rationale of medical ethicists, the legal maneuverings of lawyers, the acquiesance of judges, and the support of a large segment of people who believe one can glean eternal truth from empiricle observation, have altered the very definition of human life itself.

This one thing is more important than all the Terri Schiavos or Mae Magouriks you can find.

julie...depends upon which ... (Below threshold)
-S-:

julie...depends upon which "pain meds" she's been given.

If morphine/opiates, then she'd be constipated (they reduce the peristaltic function rate, thus, you get constipated when you take opiates).

If hydrocodone/codeines, they aren't necessarily make anyone nauseaous, unless there's, perhaps, no fluid present to assist digestion and/or the stomach itself is structurally compromised, things of that nature.

rather..."they don't necess... (Below threshold)
-S-:

rather..."they don't necessarily make anyone nauseous..."

What Superhawk wrote (^^).<... (Below threshold)
-S-:

What Superhawk wrote (^^).

Particularly..."What has happened is that the medical community, using the rationale of medical ethicists, the legal maneuverings of lawyers, the acquiesance of judges, and the support of a large segment of people who believe one can glean eternal truth from empiricle observation, have altered the very definition of human life itself...This one thing is more important than all the Terri Schiavos or Mae Magouriks..."


It's the New Age dadaists now surfacing in "aged, learned" professions in our societies. I write societies because they've negatively impacted many European socieities already with a very wasteful approach to and about human life, based upon The War of the Wills.

Literally, it's a case of willfulness now being trumped as triumphant; the word-play I used, above paragraph ("The War of the Wills") is Hitler-esque literature...interesting that it now blossoms in, yet again, parts of Europe, spilling out elsewhere as "New Age" and liberalism, complete with all manner of hocus-pocus determination (Felos is an excellent example of these).

S: Tell that to Michele, no... (Below threshold)
julie:

S: Tell that to Michele, not me. She's the one with c/o nausea.

TomT, and/or others...what ... (Below threshold)
-S-:

TomT, and/or others...what would have resulted if there existed no power of attorney on Mae's behalf? Would the hospital therefore assume that position on her behalf? And be required to keep her alive, to provide treatment? And would that include moving Mae to whatever facility could provide treatment if the receiving facility could not?

Seems that the whole chain of conflicting, confusing events began with the Beth stepping up as holding "power of attorney" - and that "power of attorney" doesn't seem to be wholly regulated as to what that "power" can and cannot do on someone else's behalf.

O.K., to michelle, then...w... (Below threshold)
-S-:

O.K., to michelle, then...what I wrote, earlier.

If what you mean by "c/o nausea" is nausea as a result of taking codeine/opiates (???), then I'm thinking that it's a simple case of (1.) taking the meds with food, and, (2.) making sure that you also take in enough liquid while taking the meds and the food.

Constipation can also cause nausea...you need to take care of the whole process (stool softeners instead of laxatives, however, are best), but most of all, MORE LIQUID INTAKE helps wonders with ongoing nausea and constipation. And that means water, not sodas, but water. Eight or more glasses a day, a lot of water, just water...works wonders on your digestive system.

Ohterwise, if you're alread... (Below threshold)
-S-:

Ohterwise, if you're already doing all of that (lots of water, taking the meds with food, using a stool softener) and you're still plagued with nausea, there's reason to ask the doctor who is prescribing the pain meds to take a closer look.

-S-,According to the... (Below threshold)
TomT:

-S-,
According to the first stories on BlogsForTerri, Georgia law desingates a hierarchy of who can speak for the patient if there is no specific designation. Mae Magouirk's brother and sister rank higher than her granddaughter. What should have happened is that Mae would have remained in LaGrange hospital and they would be obligated to provide such treatment as their doctors deemed medically appropriate. Once the brother or sister was contacted, he/she would make the decision to transfer to hospice, or in this case, to transfer to UAB for more aggressive care.

It appears the granddaughter assumed her power of attorney covered medical care (it did not) and LaGrange hospital did not verify, so Mae was inappropriately transferred to hospice.

It also appears, from comments elsewhere, that the hospice did check the POA, found that it was insufficient, and sent Beth Gaddy to the probate judge.

Based on all the little bits of info on different blogs, and assuming they are accurate, and also assuming everyone involved was acting with good intentions, I think the only real fault here lies with LaGrange hospital. They apparently diagnosed Mae's dissection as terminal without considering the possibility that another hospital might be better able to treat it, and did not properly review Beth's power of attorney document. If they had properly contacted the brother and sister, the brother and sister would have requested a transfer to UAB, which it seems would have been granted, and everything that followed would never have happened.

I began reading about this ... (Below threshold)
Pattie7242:

I began reading about this yesterday and have decided that I will be adding an article to my living will, I choose to die in my own bed, I am NEVER to be taken to a "hospice". I do not want to be sent to a "killing house" under any circumstances. There are still questions in my mind such as why this woman was ever sent to a hospice to begin with if she was not dying. It would not matter to me what ANY of her relatives wanted, it is her living will that should apply. IMHO

Forget it, S. It was sort o... (Below threshold)
julie:

Forget it, S. It was sort of an inside joke. Not to be taken seriously.

The judge's comment about b... (Below threshold)
Anna Nordin:

The judge's comment about both sides 'hugging necks' to me is vague. It could mean that they are in agreement or they are trying to strangle each other.

O.K., julie. I sorta' foun... (Below threshold)
-S-:

O.K., julie. I sorta' found a tad of wry humor in the original statement, just writing here more for the average reader than to or about you, specifically, and/or michelle. The comments were academic, not personal, not in retort or response or counter nor in anything related, just writing as to the issue of ANYone experiencing nausea as a result of taking "pain medication" (which is a huge area in and of itself, approaching infinity in possibilities)...

I appear to have missed completely whatever the joke was, however. But it's not like I was trying to find it, is my point.

Tom T: "According to the... (Below threshold)

Tom T: "According to the first stories on BlogsForTerri, Georgia law desingates a hierarchy of who can speak for the patient if there is no specific designation. Mae Magouirk's brother and sister rank higher than her granddaughter."

Then BlogsForTerri was/is wrong. Georgia Code Section 29-5-2 is here. The preference order for guardianship of an incapacitated adult in the absense of a (1) prior nomination by the incapacitated adult is: (2) spouse, (3) adult child, (4) parent.
Then comes:
"(5) A guardian of a minor child, upon the child´s reaching majority, in the event he is then adjudicated as incapacitated within the meaning of this chapter; a guardian of the person in the event of an application for guardian of the property or a guardian of the property in the event of an application for guardian of the person;
(6) A relative or other person who has provided care for the incapacitated person and with whom the incapacitated person has resided for a significant period prior to the time of application; and
(7) Other persons, such as relatives; persons nominated by a spouse, adult child, parent, or guardian; or private persons providing income or other care to the incapacitated person...
"

There is nothing in the law that puts siblings ahead of granddchildren in the hierarchy, they both count as "relatives." So, if the grandaughter did have a financial power of attorney ("guardian of the property"), she would be of higher preference under the statute (5) than siblings, nephews or cousins.

The judge's comment abou... (Below threshold)

The judge's comment about both sides 'hugging necks' to me is vague.

Anna,

"Hugging necks" is an expression used by "southerners", basically just means that were hugging.

Prolonging suffering, one p... (Below threshold)
old lady:

Prolonging suffering, one person at a time. Who gives you the right? It's all about you, isn't it. Butt out.

If you ever show up at my door when I've decided I've had enough, I'll shoot you.

Just because you're not vegetative doesn't mean life is still worth living. I'll go when I''m ready, without your forced intervention.

Dying is a process. Don't interrupt me. I don't want to have to start all over at the beginning again.

"they were hugging necks" -... (Below threshold)
rhodeymark:

"they were hugging necks" - thanks John for straightening that one out. I thought it was an adjective.

A Financial POA is NOT a Cu... (Below threshold)
FLCricket:

A Financial POA is NOT a Custodianship! The granddaughter was without question NOT the Guardian and therefore, not the one to determine any medical action. Furthermore, the living will was still ignored. Finally, there never was an NG tube. UAB's Kirkland Clinic inserted the first one. If you've ever been on a Morphine drip you'll know that you just don't have the will power to do much, let alone try and eat or drink. And let's face it, ice chips and jello...not exactly what I would call sustanance.

A lesson for all of us here, make a Living Will NOW and choose your Financial POA and your Custodian POA but don't make them the same person, and be sure to name them as such in your Living Will. This should reduce anxiety and any questions the family, Medical Facility and any subsequent legal authority may have on your wishes. However, the fact remains, if you're incapacitated in any way someone is going to find a way to take advantage of you. Thus is the fact that evil still pervades our society.




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