Terri Schiavo’s family’s quest to head off the court-ordered starvation set to begin Friday at 1:00 p.m is out of judicial options.
TAMPA, Fla. (AP) – A state appeals court Wednesday refused to block the removal of Terri Schiavo’s feeding tube later this week in the long-running right-to-die battle between the woman’s husband and her parents.
The 2nd District Court of Appeal in Lakeland turned down a request from Bob and Mary Schindler for a delay while they pursue further appeals, and for a new trial on their daughter’s fate.
Schiavo, 41, suffered severe brain damage in 1990 when her heart stopped beating, and court-appointed doctors say she is in a persistent vegetative state.
Her husband, Michael Schiavo, has said she told him she would not want to be kept alive artificially. Her parents dispute that, and say she could get better.Terri’s husband Michael Schiavo recently turned down a $1 million offer to let his wife’s parents decide her medical treatment.
The Florida Legislature and Congress are both moving through bills that would block the feeding tube removal, but the court has already struck down Terri’s Law in Florida which rescued her from an earlier death-by-starvation order.
If we are agreed that no one knows Terri’s wishes and also agreed to the fact that she is being executed by the courts, then it follows that it is the courts that are forcing their tyranny on us.
OK, who wants to argue that? Bill?
“I’ve seen much worse in my current job *&* others, so emotion-based meandering attempts to bait me don’t really have much of an impact, either in terms of rousing emotions *or* impressing me intellectually. To balance the scales, tell you what — let me make you make you a counter-offer. }:) I’ll show up to do that, & you show up to take Terri’s place ad infinitum in mindless-existence-land in case Dubya’s ill-conceived attempt at bypassing the law makes it to his desk. … Yeah, somehow I didn’t *think* that would be a really enticing proposal.”
You DO realize that this is a Florida law that they are trying to pass, and that George W. Bush is NOT the Governor of Florida, right? I don’t believe for a second that you know a single thing that you’re talking about, and you’re just being a troll for the sake of being a troll.
The facts boil down to this – Terri Schiavo has not received a single MRI or PET scan since her admittance to a hospital, which would get to the core of these problems straight away. She is NOT braindead, she has displayed signs of consciousness and, had her husband allowed speech thereapy, she’d speak more than the few words she does now. She is not kept alive by anything else, save for that feeding tube, because she does not need other equipment. Michael Schiavo was the sole person present when Terri lost consciousness, the sole person to call a hospital, and the SOLE beneficiary of the $1.6M malpractice settlement. You TELL ME how this isn’t at all suspicious, and that she doesn’t deserve a chance at treatment and continuing living.
Michael Schiavo’s entire case rests on HEARSAY which, last I checked, wasn’t all that useful in a court case. He is the ONLY person who makes this claim that Terri doesn’t want to be kept alive the way she is now, and naturally doesn’t have corraborating evidence except his own word. No written documents, nothing. It blows my mind that this judge ignores the patently obvious – Michael is NOT looking out for the best interests of his wife – and just rubber stamps what he wants.
The legislation that they are trying to pass in Florida, and get to Governor Jeb (see that, Bill? J-E-B) Bush’s desk is designed to be in compliance to the court’s original complaint about the first “Terri’s Law”. This time, it should survive judicial review and Terri and others will not be prey to overzealous spouses like Michael Schiavo.
Bill at the age you were reading your comics I was reading The Seven Pillars of Wisdom, Mark Twain, a fair amount of world history (pre-liberal revision), several US Army TMs, and even Mein Kampf.
I like the funny papers too but there are more informitive writings in the world. Sadly it seems you are incapable of even absorbing the lessons from the good, fictional people of Dogpatch.
I was fortunate enough to have people around me that encouraged me to think for myself rather than repete what ever the line of the day was.
There were your ilk around too. Petty little people who had to strut and crow to try to appear to themselves and others like a creature of some importance.
So puff out your chest and tell us all how much better you are than us mere mortals Billy boy (or is it bully boy?). We’re all just so impressed.
AD:
There was some question as to whether or not chemical/other aid could be provided for Mrs. Schiavo’s sedation/pain relief.
Because she will not have an IV, because they will give her anything by mouth, because she has poor muscle mass, because her circulation will be compromised, there is no way she can be administered any type of pain medication effectively. She needs an IV.
I suspect Shiavo will be provided with whatever medication she needs such that pain will not be an issue.
If a pain med is not delivered in an effective manner it’s worthless. Plus, she can’t communicate that she is in pain. As she becomes weaker from starvation and dehydration any objective signs of pain may not be observable.
458.326 (3) and (4)
Which means they will administer no pain meds if her respiration is 12 or below regardless of any pain she may experience.
458.326 (1) For the purposes of this section, the term “intractable pain” means pain for which, in the generally accepted course of medical practice, the cause cannot be removed and otherwise treated.
Except her pain can be removed and otherwise treated by IV and food.
I never heard of any state pain care policy. I looked it up and it was enacted in Calif in 2005. Problem again is with the definition of intractable – her pain is not intractable.
Make that:
because they will NOT give her anything by mouth
And if they did administer pain med by mouth, it would be difficult to get it down her, keep it down her, and for her body to absorb it effectively.
Please leave bill-infopro alone. He is not worth the time to argue with.The case is a no brainer.He’s old enough to know better.So is Judge Greer and Terri’s husband and their ilk( insert bill, others,etc).What intrigues me is Judge Greer’s motive in all this.Besides political dumbassery, or just dumbassery(You choose).Anyone have a clue about him? bill, go away, ive read your ilks view.
>:-)
Greer is not a unique case. It seems all too common these days that courts choose favor the guardian over the ward. Basicly what it comes down to is money and greed.
As the baby boomers age there will be more and more people needing health care and services. With less people paying into the system profits drop.
T-4 and the Holocaust had their roots in the euthanasia of the elderly and disabled in Germany towards the end of WWI. There was a system in place to “educate” the german people about the kindness of removing the burden of life from the disabled.
The problem is progressive. If you know what to look for it is easy to see the subtle and not so subtle “lessons” in todays culture.
TS-S is one very visable victim of the move towards medical killing but there are thousands of victims every year that you never hear about.
G. wrote:
What intrigues me is Judge Greer’s motive in all this.Besides political dumbassery, or just dumbassery(You choose).Anyone have a clue about him?
He has some nebulous ties to the Hospice of Florida Suncoast, the organization that runs the hospice where Terri is interred.
George Felos, Michael Schiavo’s lawyer and all-around New Age Death Cult kook, was a chairman of the board of the Hospice of Florida Suncoast.
I’m pretty sure Felos is going to write and sell another book about his latest wonderful, spiritual woman-killing journey. What compensation Greer is getting for this, Satan only knows. Maybe setting judicial precedent to funnel more goverment money into the Tiergartenstrasse known as the Hospice of Florida Suncoast.
She is going to go through what my dad went throught, but in his case it was his written wish.
My questions about this topic are simple:
1. Is it morally acceptable to honor someone’s PVS instructions?
2. Did she leave PVS instructions with her husband. Obviously nobody can know this [lesson, do this in writing unless you want to put your spouse through years of hell.]
3. Is she in a vegetative state or not?
The first question is the most interesting to me. Other than that, this is hardly an important case in the pro-life movement. The second question is unknowable, while the 3rd has been concluded by the courts on the evidenc of medical professoinal.
What are PVS instructions?
What, for that matter, is PVS?
What is human life? What is thought?
We can measure certain things, but we still cannot understand the answer to the above questions. Here, even the golden rule fails us because we do not know what one would want or even if it is possible to want.
The only reason for killing a person in this condition is to relieve oneself of the burden of caring for them. Is there anything redeeming about such a sacrifice?
Here is the thing. We don’t even know why it is that we have free will. Yet we do. It is totally inexpicible given a mechanistic view of biology. There must be some extradimensional nature to ourselves. Something in addition to a pure physical existence.
So, given that. You have a decision that no mere mortal can answer with any exactitude. However, be reminded that the only reason for killing a person in this condition is to relieve us (not them) of a burden.
Persistent Vegetative State.
To me, the most interesting aspect of this debate is whether or not it is moral to honor someone’s instuctions upon reaching a vegetative state. Obvously, if you don’t want to live like Terri Shaivo, you should put that request in writing. But if you do, is it a moral request? It is an important point in this case because the husband claims she gave those instructions orally. We don’t know if that is true or not, but that is irrelevant to this question.
So the reason might NOT be to relieve oneself of a buden, since it could easily be to honor the request of a wife at what has amounted to great personal hardship. We simply cannot know whether the motivation is greed or heroism.
If the request were in writing, does that change anything? That is my question. And if the request was oral instead, does that change anything morally for the husband?
I maintain that Terri is indeed not in a persistent vegetative state, and cannot be proven as such because Michael Schiavo has forbidden any of the brain scans to prove that she is in such a state (Red Flag #1). He has been obstructing any form of examination (Red Flag #2) for as long as Terri has been this way. What makes this very weird is moving Terri from the hospital, where she can get treatment, to a hospice, where people go to (usually) die in comfort and then putting her on Medicaid. It’s just a little too bizarre that he is behaving this way, and Judge Greer’s rampant insistence that the law be followed to the letter in terms of keeping the spouse in charge of care, when there is clear conflicts of interest all over the place (Greer’s own stake in Terri’s hospice, Micheal’s lawyer’s stake, Michael’s stone-walling and the gains he stands to make from Terri’s death, the fact that Michael HAS ANOTHER WOMAN AND CHILDREN, just to name a few).
It’s just mind-bending.
McCain-I would say if a person informed themselves and left instructions regarding ventilators, feeding tubes and other means of support in writing in the case of PVS, then it probably isn’t immoral to honor those wishes. Although, I think it is probably immoral to starve/dehydrate somebody to death, but then that would require the active killing of the person with drugs, which may cross the line into immorality.
Hard questions to debate, but in this case I think it is immoral, since we don’t have any clear instructions in this case. The Florida law may in the end be too late to save Terri, but I think in the case of having a feeding tube removed, that it is not unreasonable to require written instructions.
Venilators are not the same as feeding tubes. Turn off a venilator, and death comes pretty quick, and without days of pain. Shutting off a feeding tube is going to involved a long drawn out death, that comes with quite a bit of pain, which is difficult to manage (given that oral and IV meds are out).
People make these off hand remarks while watching a movie, “Oh, i don’t want to live that way! Just pull the plug.” And that is suppose to suffice as informed consent. If I were in that situation, I would want at a minimum an IV.
Also, it was more than likely they were watching a movie about a ventilator, ventilators and feeding tubes are not the same thing, and when people do living wills regarding what treatments they do and don’t want and under what circumstances they want intervention to stop, feeding tubes and ventilators are handles seperately.
It is difficult to infer that a person who mayhave said they didn’t want a ventilator also meant they didn’t want a feeding tube and wanted to starve and dehydrate to death.
RE: julie’s post (March 17, 2005 10:52 PM) and pain relief / legal statutes
Because she will not have an IV, because they will give her anything by mouth, because she has poor muscle mass, because her circulation will be compromised, there is no way she can be administered any type of pain medication effectively. She needs an IV.
This is known? I understand they will not provide nutrient or fluid for sustaining life, whether via IV, per oral, or through osmosis, but has it been declared that no IV for pain is to be allowed? Her circulation will be progressively compromised but it will continue until she dies. To that end some medication will reach important, and not so important, nerve centers to ameliorate pain.
If a pain med is not delivered in an effective manner it’s worthless. Plus, she can’t communicate that she is in pain. As she becomes weaker from starvation and dehydration any objective signs of pain may not be observable.
It may not be perfect but it is not worthless. Now, I’m not an anesthesiologist or neurologist, so it would be difficult for me to say to what extent compound X need be present in neuromuscular synapses to be efficacious. However, I feel pretty confident that experts could administer an appropriate amount to ameliorate her pain. Yes, both subjectively and objectively observable signs of pain will fluctuate with her condition, but there are known schedules of medication dosage to approximate what a certain body mass in a certain condition will require. As I said, would it be perfect? Of course not, but this is better than nothing and will ease pain.
458.326 (3) and (4) Which means they will administer no pain meds if her respiration is 12 or below regardless of any pain she may experience.
It doesn’t say that at all. The disclaimer “in accordance with that level of care, skill, and treatment recognized by a reasonably prudent physician under similar conditions and circumstances” provides every bit of wiggle room required by the attending physician to administer ad libitum. A physician may not intentionally apply medication to euthanize but may provide medication as s/he sees fit to relieve the patient without fear of criminal prosecution. The limitations to drug therapy are limited primarily because of concomitant addiction which does not apply in the Schiavo case. (It is not the termination of life that scares these doctors, it is the fear of criminal prosecution, and that is a main reason why this legislation takes so long to codify.)
458.326 … “intractable pain” means pain for which, in the generally accepted course of medical practice, the cause cannot be removed and otherwise treated.
Except her pain can be removed and otherwise treated by IV and food.
We all understand this to be an exceptional case where the option of IV/oral administration of nutrient will not be allowed. I don’t believe pain relief regimes will be forbidden due to the extenuating circumstances.
Problem again is with the definition of intractable – her pain is not intractable.
I’ll repeat my previous allowance. While normal sustenance will be forbidden and the law currently prohibits that intervention, physicians will be allowed to treat the “intractable pain”.
If it is proven to me that pain relief via IV is forbidden, I’ll reconsider some of my response. My ultimate position remains, admittedly, pretty fixed, but I am always receptive to new infromation.
If her “guardian” would not spring for the price of a toothbrush, why does anyone think he will authorize payment for a bunch of expensive pain medication? Nothing in the court’s order requiring a painless murder. Nah….she’s PVS, won’t feel a thing, right?
RE: Old Coot’s post (March 18, 2005 10:55 AM)
…authorize payment for a bunch of expensive pain medication? Nothing in the court’s order requiring a painless murder. Nah….she’s PVS, won’t feel a thing, right?
Who is saying PVS and pain sensation are synonymous? One is a higher order neurological condition and the other is of more basic and distributed composition… quite different indeed.
I doubt the authorization of payment will be a limitation. Someone will intervene and recognize pain is present. Someone, maybe not the same entity, will authorize introduction of pain relief. Remuneration will not be the primary concern at that point… it will be to remove acute/acutely chronic pain. Compensation will be addressed at a future date and will be supplied by the “guardian”, the guardian’s parents, a kind benefactor, or the hospital’s taxing district or other universally shared and funded resource pool. Hospitals are not coin-operated entities where one must provide exact change at point-of-sale or nothing gets done. Does the “guardian” have to OK every single hospital function? I doubt it even though the pain relief issue is not trivial.
AnonymousDrivel: Well said. I hope you are correct. My (perhaps poorly written) sarcasm is just my way of venting. There is testimony from some of her former caregivers that they were forbidden (by her husband-guardian) to clean her teeth, forbidden to place padding in her hands to prevent painful muscle contractions, etc. We may never know the truth.
Plainly spoken, I don’t want to be a part of her murder, but if it must happen, it should be done quickly and as painlessly as possible….which IMHO precludes death by thirst/starvation.
RE: Old Coot’s post (March 18, 2005 11:44 AM)
There is testimony from some of her former caregivers that they were forbidden (by her husband-guardian) to clean her teeth, forbidden to place padding in her hands to prevent painful muscle contractions, etc. We may never know the truth.
Hmm. “Never know[ing] the truth” are probably the most appropriate operative words. I’ve not read all the testimony but somehow I think a great deal of context is in order. Some of that testimony sounds suspicious though, again I admit, I’ve not read every word of this multiyear saga. Perhaps the actions were as exact and unsavory as detailed.
…but if it must happen, it should be done quickly and as painlessly as possible… which IMHO precludes death by thirst/starvation.
I think that would be a humane response. I’d prefer that quicker / less painful options be allowed. Florida, however, does not offer such an option so a moot point for now.
McCain,
How can we honor a commitment to a person when we don’t know what they want?
A person could say, “If I ever get like that, I don’t want to live”. But when they get “like that” they understand that “that” is not what they thought. There will be some uncertainty involved. They only one who knows for sure how they will feel at an instant in the future is the person once they have reached that instant. Once the instant is over, they may feel different.
You cannot honor a commitment to someone who doesn’t know what they are saying. The only interpretation we can give such statememnts is that the person would wish to avoid the situation if they could. That doesn’t tell us anything.
There is no dignity in suicide that requires the corruption of others. In fact, there is no dignity in suicide.
But when they get “like that” they understand that “that” is not what they thought. There will be some uncertainty involved.
So would you object to it if that someone put it in writing in a living will? If someone expressed that in this exact situation, they would not want to live? They couldn’t have forseen exactly what it would be like, but those are still their wishes. Should they not be honored?
Mantis,
You understand that the whole premise is ill-posed. So what you are really asking is whether or not I would step in and assume some authority over your life in terminating it.
Personally, I would not feel comfortable with such a decision. It is one thing to say, “Don’t do anything extraordinary and futile to save me”; it’s another thing to say, “kill me”.
The general rule should always be, “Don’t kill”. Our society believes that eating, sleeping, etc. are normal functions that each person has an inherent right. Look at our definition of torture.
However, no one will stop you if you say, “don’t feed me”. We have to know that it is your choice and yours alone and that you have the demonstrated capacity for understanding the choice at hand. The choice must be well-considered and rational.
What if there is uncertainty? In that case, we can only do what we would be absolutely certain that you would want up to the limits of common decency. If we would not treat a terrorist in a certain way, we ought not to treat an innocent person in that way either.
We cannot take full responsibility for your incapacitation. Before you become incapacitated it is your responsibility to make your own arrangements and provide your own safeguards. If you fall into our hands, you should expect that we will treat you in the same manner no worse than how we treat terrorists.
Today, our standard is that we will respect living wills that call for “no hydration” under certain circumstances. You’ve been given fair warning. We even have forms.
Just Me made the comment that:
“‘What is also correct, & in not merely a technical but an even larger (as in, practical upshot) sense, is that the USSC refused to hear Jeb’s appeal. That is only done in cases where the court deems an appeal has no merit.’
“Actually, you can’t say the court ruled definitively in favor of the original court, sometimes the SCOTUS just chooses not to take a case, because they don’t want to hear it, and at a later date they could take up a similar case and rule the other way. A refusal to hear a case doesn’t mean anything about the merits of the case, it just means the court doesn’t want to take it.”
And of course if one pays close attention, I didn’t say that the USSC “ruled in favor of the original court.” What I said was that they refused to hear the appeal, which carries the standard connotation that they feel the appeal has no merit (or that the appellant has no standing, which is for all practical purposes the same thing). The practical upshot of either the former *or* the latter is identical. 😉
Old Coot’s stab at painting me as a troll I actually found quite amusing, considering the increasingly vituperative remarks that have become standard in this thread for those who seem to feel I have an ideological axe to grind on this issue. [Isn’t it interesting how for many people, the closer a deadline for an issue gets & the more emotion they have invested in it, the more strident & emotionally antsy their remarks become? 🙂 Yet another advantage of looking at issues from a strictly objective POV — one doesn’t fall into the trap of hitching an emotionally intense wagon to a falling star. :)]
Now poor Paul, on the other hand, asks me to fall into the obvious trap of agreeing to a false premise: “If we are agreed that no one knows Terri’s wishes and also agreed to the fact that she is being executed by the courts….” Since we *aren’t* agreed to that, the supposition the premise is based on is moot as well, QED, i.e., to wit, to woo, & ipso facto id est factotum.
College Pundit, of course, would like me to think I’m confused: “‘…in case Dubya’s ill-conceived attempt at bypassing the law makes it to his desk. … Yeah, somehow I didn’t *think* that would be a really enticing proposal.’
“You DO realize that this is a Florida law that they are trying to pass, and that George W. Bush is NOT the Governor of Florida, right?” Had CP been watching the news instead of the thread, he’d have known that I of course *was* in fact referring to the attempt being made to craft a federal law, since the attempt by the FL legislature had been defeated somewhat earlier by the state senate’s refusal somewhat earlier to go along with the house’s “irrational exuberance.” Or maybe CP just wasn’t aware that Dubya & Congress were trying to weigh into the matter as well. }:) And of course again the dreaded T-word makes its appearance, not to mention what in the ’50s was called the “big lie technique” (If you say something long enough, & loud enough, & often enough, people will start to take it as the truth.) “Michael Schiavo’s entire case rests on HEARSAY which, last I checked, wasn’t all that useful in a court case.” It would appear that CP needs to check into the source documentation on the various Schiavo court cases as well as the news. 🙂 God, this is getting to be like shooting fish in a barrel — Oh, well; one plays the hand one’s dealt, I guess.
Now Been There, OTOH, is actually a little more muscular, but he made the assumption that all I read was the comics. Second of all, for his era & mine, what we were reading then doesn’t really play into our abilities now, but for the record, at the same time I was reading the comics I mentioned, in addition to Twain & Hitler just like he was, I was also reading Scott (as in, “Ivanhoe”) Spenser, Dickens, Bacon, Faulkner, Steinbeck, & a few other “light classics.” But then there come those darned not-so-veiled insults again: “Petty little people who had to strut and crow…” If I either took things personally or had a thin skin I might have been affected by that. Thankfully, though, neither’s the case, so….
One thing that really *does* amuse me is the confab going on here & elsewhere about whether Michael will spring for an pain meds/whatever. Apparently folks have been so busy reading the blogs that they weren’t aware that the settlement trust fund money was all but exhausted quite some time ago, & that Terri is receiving care because she’s on the hospice’s indigent list. One wonders if people even bother to check their facts at all any more….
This is known? I understand they will not provide nutrient or fluid for sustaining life, whether via IV, per oral, or through osmosis, but has it been declared that no IV for pain is to be allowed?
No iv means no iv, not no iv except for pain meds. Are they going to start and stop iv’s just to give her pain meds q x d? prn? No. If she isn’t going to be hydrated, I don’t’ see how a heplok will even work.
Her circulation will be progressively compromised but it will continue until she dies.
Her heart may pump, but her veins will collapse and it will be close to impossible to start an iv, it will compromise the effectiveness of the absorption of IM drugs. Sometimes, circulation can completely shut down to your lower body.
To that end some medication will reach important, and not so important, nerve centers to ameliorate pain.
For the sake of argument, assuming that is true, it’s not good enough. You’re having 4 impacted wisdom teeth pulled and I provide you with aspirin. Some med will reach important, and not so important, nerve centers but do you want to argue that is adequate? And let’s say, you throw up the 2 aspirin I give you. Hey, I gave it to you! That the route was ineffective is not my problem!
It may not be perfect but it is not worthless.
Not good enough. It’s not humane.
Now, I’m not an anesthesiologist or neurologist, so it would be difficult for me to say to what extent compound X need be present in neuromuscular synapses to be efficacious. However, I feel pretty confident that experts could administer an appropriate amount to ameliorate her pain.
Boy, are you in for a rude awakening if you or a love one ever become seriously ill. Only recently has pain management been recognized as important. As I already indicated there are all sorts of problems regarding managing pain for her.
Yes, both subjectively and objectively observable signs of pain will fluctuate with her condition, but there are known schedules of medication dosage to approximate what a certain body mass in a certain condition will require. As I said, would it be perfect? Of course not, but this is better than nothing and will ease pain.
Not good enough. It’s not humane.
458.326 (3) and (4) Which means they will administer no pain meds if her respiration is 12 or below regardless of any pain she may experience.
It doesn’t say that at all. The disclaimer “in accordance with that level of care, skill, and treatment recognized by a reasonably prudent physician under similar conditions and circumstances” provides every bit of wiggle room required by the attending physician to administer ad libitum.
The disclaimer is routine malpractice/negligence language. The standards of care is that you do not further depress a patient’s respiratory rate if it is 12 or below by giving pain meds. There may be some slight variation in that rate but not by much.
A physician may not intentionally apply medication to euthanize but may provide medication as s/he sees fit to relieve the patient without fear of criminal prosecution.
How is giving a drug that depresses the respiratory center of your brain when your respirations are already so low the drug would be contraindicated because it could kill a patient, not euthanasia? It’s certainly not within any standard of care.
458.326 … “intractable pain” means pain for which, in the generally accepted course of medical practice, the cause cannot be removed and otherwise treated.
Except her pain can be removed and otherwise treated by IV and food.
We all understand this to be an exceptional case where the option of IV/oral administration of nutrient will not be allowed. I don’t believe pain relief regimes will be forbidden due to the extenuating circumstances.
Never said they would be. I said she would not be adequately medicated and gave a number of reasons why and why this was inhumane. This type of treatment would not suffice for someone dying without a mandated court order. Their pain would be adequately treated. People are trying to sell what happens in that there will be minimal discomfort. Bullshit.
You are arguing special license to give pain meds because of intractable pain. Her pain is not intractable under the definition . Because a court won’t allow an IV does not change the statutory definition of intractable pain.
I’ll repeat my previous allowance. While normal sustenance will be forbidden and the law currently prohibits that intervention, physicians will be allowed to treat the “intractable pain”.
They will not be allowed to treat her pain in the most effective manner. Why do you think they won’t give her an IV? If you don’t feed her or give her antibiotics if she gets ill she is still going to die soon anyway. Palliative care generally includes hydration because to do otherwise is unnecessarily painful. So, why won’t they give her an IV and allow her to be properly medicated?
If it is proven to me that pain relief via IV is forbidden, I’ll reconsider some of my response. My ultimate position remains, admittedly, pretty fixed, but I am always receptive to new information.
It’s not my job to convince you of anything.
Interesting how the clamor has died down now that the tube has been removed. 🙂 (And yes, folks, no fooling, it actually has been.) Maybe some folks are in shock, or maybe it’s just anti-climactic, or maybe who knows what…. Now might be a good time to broaden the focus (It’s become a little tunnel-visionized what with all the volume.) & reflect on bioethics for a few minutes. Here’s an article that should provide a good bit of food for thought for those who’re actually *honestly* intellectually involved in this. The term “slippery slope” comes to mind, although not for the reason some here might think. };)
http://www.msnbc.msn.com/id/7231440
Bill,
It is an argument, not a premise. If you don;t agree to an obvious truth statement, then we all expect you to explain. Otherwise, I will figure that you are engaging in sophistry.
Here are the questions you need to answer to support your contention:
What are Terri’s wishes?
How you know them with certainty?
Lets start there.
I’d agree that adding “It is an argument, not a premise. If you don;t agree to an obvious truth statement, then we all expect you to explain. Otherwise, I will figure that you are engaging in sophistry.” does make it definitely an argument, not an exercise in logic. And adding that to the cake mix :), since it isn’t an obvious truth statement, then there’s no need to explain. And since there’s no need to explain, there’s no need to assess as sophistic. As noted above (somewhere around the 7th/8th floor, I think ), if the mood strikes I can work a quality sophistic argument from either of its respective P’sOV, but since all I’ve really mainly been doing is stating facts & rebutting specious claims (“troll,” “petty,” etc.), one thing that definitely is an “obvious truth statement” (I promise I’m not mocking you, I just liked the turn of the phrase. ) is that I’m not engaging in sophistry.
I’m sure it might seem as though I am to some who’re used to such behavior (or at least *think* they see it) in people who disagree with their perspective, but since I’m an odd duck already in that I don’t rise to emotional arguments or bogus claims, it should follow logically that I don’t behave sophistically either. As the old commercial about summer colds went, I’m “a different animal.”
RE: Paul Deignan’s post (March 18, 2005 05:38 PM)
What are Terri’s wishes?
How you know them with certainty?
To be fair to bill-infopro, he did say that he wanted to “broaden the focus” a bit. I interpreted that as meaning to escape the shackles of the Shiavo saga specifically and address things more globally, in fact as policy. Should we change policy? Are current laws inadequate? How do we implement the appropriate laws to accomodate or empower the individual above an interventionist government, opportunistic legislators/judges/deists, or for that matter, should we? Who’s realm reigns supreme when debating the singular most important facet of one’s existence – our essence?
I submit that ultimate control radiates outwardly from the individual. “Victim” at the core. Next is spouse/mature children, then parents, then extended family, then designated friends. Beyond that I’ve not yet decided, but you can be damn sure it isn’t some politician or priest no matter how divine in their own mind. My right to live my life trumps their intention however sincere or contrived. Let them obsess about their own problems and leave me alone. Should they ignore that demand, I’ll make it my focus to haunt them from the grave until they join me in the afterlife… at which point we’ll have words and I’ll smack ’em in the face. Can someone help me put those sentiments into law, especially the haunting bit?
Now, if I’ve not presented to paper or person my wishes adequately, then it is my own fault for being negligent, and I do not deserve full consideration since, by default, I have placed an undue burden upon those upon whom I proclaim to care. They should be allowed to decide my fate, even if it is a mistake, because they do not deserve to be punished (an ethical burden if not an emotional and financial one as well) for my irresponsibility. By that same token, I have NOT relenquished that authority to a government or ANY of its tentacles and I expect strict adherence to the hierarchy that I’ve so far defined. Are these expectations unreasonable?
Oops. “Whose”, not “who’s”. Duh.
RE: julie’s post (March 18, 2005 05:14 PM)
…Are they going to start and stop iv’s just to give her pain meds q x d? prn? No. If she isn’t going to be hydrated, I don’t’ see how a heplok will even work.
The IV would be drip line into major vein so starting/stopping is not a problem.
Her heart may pump, but her veins will collapse and it will be close to impossible to start an iv, it will compromise the effectiveness of the absorption of IM drugs. Sometimes, circulation can completely shut down to your lower body.
A major vein is not going to collapse. To the point of circulation ceasing to lower body (I’m almost certain one would need to be very close to death for this), coma will likely have already come into play.
For the sake of argument, assuming that is true, it’s not good enough. You’re having 4 impacted wisdom teeth pulled and I provide you with aspirin. Some med will reach important, and not so important, nerve centers but do you want to argue that is adequate? And let’s say, you throw up the 2 aspirin I give you. Hey, I gave it to you! That the route was ineffective is not my problem!
We’re not talking aspirin here – we’re talking high concentration opioids or other drug that may be administered focally and not peripherally.
Boy, are you in for a rude awakening if you or a love one ever become seriously ill. Only recently has pain management been recognized as important. As I already indicated there are all sorts of problems regarding managing pain for her.
I had a close relative in another state die six months ago and pain management was not a problem – during his last days, he got whatever he wanted whenever he wanted. I accompanied a member of my immediate family in my home state through surgery less than a month ago – he got whatever he wanted whenever he wanted. Maybe we’re just lucky.
How is giving a drug that depresses the respiratory center of your brain when your respirations are already so low the drug would be contraindicated because it could kill a patient, not euthanasia? It’s certainly not within any standard of care.
Does every pain medication depress respiration? It is not even agreed that strong opiates do. Further, the Florida Law as I read it allows doctors to prescribe pain medication even to the point of death since the intent is to help the patient and not to euthanize. That would fall into the realm of proper care especially considering this extreme example.
They will not be allowed to treat her pain in the most effective manner. Why do you think they won’t give her an IV? If you don’t feed her or give her antibiotics if she gets ill she is still going to die soon anyway. Palliative care generally includes hydration because to do otherwise is unnecessarily painful. So, why won’t they give her an IV and allow her to be properly medicated?
Could you provide a link illustrating the prohibition of IV for drug intervention in Schiavo’s case? I’m surprised at this and think it (IV for pain relief) should be allowed.
It’s not my job to convince you of anything.
Well, to be honest, you’re spending an awful lot of time parsing my comments to not be trying to convince me of anything. At any rate I just though it would be useful to the debate to know with certainty what is and what is not allowed for Schiavo’s care. Empty rhetoric is rather pointless since the continued focus is so specific. We are making very specific judgement calls which warrant very specific facts – to ignore them makes any judgements based on them irrelevant and inapplicable.
Bill,
It is obvious that you are unwilling to answer the simple question, “Do you know Terri’s wishes?”
The fact that you cannot and will not acknowledge that you are being asked this question demonstrates that you engaged in honest debate.
Sophistry bill. It’s a waste of time. My argument stands.
Anonymous,
All of these issues have the same basis. What is the person’s wishes and how can they be known with certainty.
Anyone who wants to discuss these issues needs to start there. If that can’t be answered, there is no standing in a democracy for derivative arguments.
… are not engaged in honest debate.
I had a big point by point response but I am not going to post it. Your link is junk, by the way. More akin to Medicine for Moonbats. You don’t know what you are talking about and are just making things up or grabbing them off the internet without any idea what they mean. It’s obnoxious and arrogant and a waste of my time. I swore I would never get into a discussion about the law with a non lawyer again for the same reason. And, now I’ll add medicine and you to the verboten list. Your inability to empathize with other people’s suffering is off putting, to say the least.
RE: Paul Deignan’s post (March 18, 2005 09:35 PM)
All of these issues have the same basis. What is the person’s wishes and how can they be known with certainty.
If wishes remain as either abstract or explicit thought, and only thought, shared between loved ones, then derivative argument will inevitably follow, otherwise these issues do not necessarily have the same basis. I should think that written thought or intent while in a state of coherence should trump the esoteric as potentially unsavory as that might be. Can we know with certainty if someone might change their mind (assuming they have the coherence to think such things) about life or death post trauma? No, we cannot. However, I think we as individuals should have the right to make educated guesses as to the life we think we might or might not want should the horrific occur.
As it stands now, law allows such daliance. It seems to me to be the best compromise to respecting one’s right to live and to die. I’ll allow any individual to address their spirituality when creating the survival guidelines while alive and cognisant of being, and I’ll follow those desires to the best of my ability in view of the unknown that may or may not lie beyond our Earthly existence. I don’t have to know what they are thinking or not thinking while vegetative – I’ll have a record serving as roadmap to do the most righteous. I hope the roadmap is a written one but verbal will suffice in view of the hierarchy that I described in a previous post. Note that the spirituality need not be of a particular denomination or creed… it may be, and not unreasonably, agnostic or atheistic in nature.
Anonymous,
Unlike hand grenades and horseshoes,a person cannot be “part dead”. Where is the possibility for compromise in the case of uncertainty?
Once dead, that’s it. Death is terminal. The one thing we cannot allow is to compromise other’s fundamental right to life because we are somewhat inclined to believe something more than something else.
The ability to know intent is fundamental.
RE: julie’s post (March 18, 2005 10:47 PM)
I had a big point by point response but I am not going to post it. Your link is junk, by the way. More akin to Medicine for Moonbats. You don’t know what you are talking about and are just making things up or grabbing them off the internet without any idea what they mean. It’s obnoxious and arrogant and a waste of my time. I swore I would never get into a discussion about the law with a non lawyer again for the same reason. And, now I’ll add medicine and you to the verboten list. Your inability to empathize with other people’s suffering is off putting, to say the least.
So I would take it that you are a lawyer and a physician/nurse? Wow, you have a lot of time to post on the web… but your experience is still impressive. I’m sorry if I am being “obnoxious” and “arrogant” and am “wast[ing]” your time. I’d prefer that you post your “big point by point response” and that you would enlighten me among other misguided readers. Why not share your insight since you are the only one that knows what we’re talking about?
About the links – I supplied a link that provided a contrarian view to pain medications depressing respiration unduly. This particular link mentioned opioids but there are assuredly others. Ultram/Tramadol is another though there is a slight chance of dyspnea. I don’t have a PDR to scan at the moment. However, the fact remains that not every pain medication will depress respiration by default so there is an option for relief. We clearly won’t agree on the level of relief since no matter what I say, you’ll say that it is insufficient and the process is inhumane. I can’t debate that position anymore. Next, I’d still like a bona fide link showing that IV medication is not allowed for Mrs. Schiavo understanding that there is a chance that typical veins may collapse at some point during intervention, that capillary flow may diminish transiently or permanently, and that the statute reads “(4) Nothing in this section shall be construed to condone, authorize, or approve mercy killing or euthanasia, and no treatment authorized by this section may be used for such purpose.” I read over and over that IVs in general are not allowed but still do not know if IVs for medication are an acceptable exception. Until I see a legal statement clearly stating that this modality of pain relief is, as you put it, verboten, I’m not buying it.
Finally, spare me your judgement on empathy. I have treated plenty of chronically ill patients of all ages and demographics in the clinic to understand it, so your preconceived notions are falling on deaf ears. Further, one need not have that experience anyway to be empathetic. And you talk off putting. Frankly, julie, I’m a bit surprised. I expected more.
RE: Paul Deignan’s post (March 18, 2005 11:01 PM)
…The ability to know intent is fundamental.
OK. I gather that in view of this fundamental that you do not recognize or support living wills or advanced directives? If this is an incorrectly derived conclusion, under what conditions do you accept them? And in what form?
Bill,
You’re not in a good position to be asking much here because you have been dodging questions yourself.
Why do you waste your time doing this?
Anonymous,
Not at all. In fact, I just wrote a reply on this earlier (a few posts up).
I don’t know if Julie’s post was addressed to me, since she only mentioned “your link” & didn’t say whose (After all, there *have* been quite a few posted by different folks.), so I won’t bother with it beyond noting that I read the vituperation & figured that if it *was* for me, that it was apparent that the link hadn’t been followed or read. 🙂 I did, though, want to address a point Paul raised; i.e., that I haven’t answered whether or not I know Terri’s wishes.
Frankly, one might’ve thought the answer to the query would’ve been self-evident without *need* for any sort of explanation (or even having the question itself even asked to begin with ). Since I’m neither God, Michael Schiavo, nor Madame Ninotchka, it’s unlikely in the extreme that I *could* know them, any more than it’d be too likely that anyone else here would. The only person I could hazard a guess *might* know would be her husband, so that by its very nature trumps any guesses anyone here might make. Since I don’t make a habit of specializing in the guessing bidness , I didn’t presume to try; just call it a character flaw. 🙂 What I did do, of course, was to note that there’s only one person who actually *might*, & we all know how he feels, }:)
I really do get quite a few chuckles out of the antics of a number of the denizens here; reminds me a lot of the trolling & occasionally amateurish attempts at baiting that go on on a number of the usenet NGs I’ve lurked/participated in over the past couple of decades. A lot of the folks there had trouble with the concept that someone might actually be better at their games than they were but chose not to indulge in such transparent absurdities simply because it didn’t make any logical sense to. I guess as long as there are schools there’ll be sandboxes, & the highly contagious Keyboard Immunity Syndrome will infect more folks than it won’t.
Some folks, fortunately, have an unusually high resistance to the aforementioned affliction & are thus better equipped to keep their cool than their less fortunate compadres. 🙂
[I’d almost put money down that there’ll be attempts by troll wanna-be’s to rake me over the coals for *that* obviously true statement too. Won’t bother me in the slightest if they try. As noted, since I specialize only in facts & not emotional rants, neither my blood pressure nor my ire are too awful likely to head northward. Oh, I admit it *can* be done, of course; it’s just that the amount of force required is higher than any I’ve seen exhibited in this particular sandbox. To thieve a great line from Arlo Guthrie, “I’m not proud .. or tired.” After all, it doesn’t take a great deal of energy to parry novitiate thrusts. :)]
Bill,
So, after all the heeing and hawing, you are actually agreeing with the first point of my three point argument.
Are we agreed then that we (and that includes the “husband”) do not know Terri’s wishes with certainty?
Bill,
BTW, why the “husband” rather than the parents? SInce the parents knew Terri for many more years and were formative in the development of her ideas, it makes sense that they would have knowledge superiority over a “husband” of a scant five years.
Why would you not presume that the parents know better?
RE: bill-infopro’s post (March 19, 2005 01:17 AM)
I don’t know if Julie’s post was addressed to me…
The “Medicine for Moonbats” link and mildly cantankerous banter of law towards the end of this thread? Julie is clearly addressing me. I’m the idiot and my drivel offends.
I’m just amazed at how often these online discussions devolve which is why these debates of sensitive issues should be done in person. Politics can be a rough and tumble debate and everyone accepts that; hence, extreme positioning is par for the course. Other issues that are infinitely more personal should be handled with a bit more care. Sadly, it isn’t.
RE: Paul Deignan’s post (March 19, 2005 12:42 AM)
Not at all. In fact, I just wrote a reply on this earlier (a few posts up).
I see. OK, so I’ll cut to the quick based on this post: Paul Deignan at March 18, 2005 04:42 PM
It seems to me that a written directive is your mandate to ensure than a benevolent state not intervene. That would certainly be ideal and not unreasonable. I should think a consensus could be attained to define such a requirement.
As law stands now, however, oral directives are accepted with the spouse as default custodian. While an outsider may debate the merit earned by or motivations ascribed to such a companion, guides have been codified, appealed, and concluded. Until new law is created or new interpretation of old law is tested/appealed/accepted, then we are stuck with this nebulous inevitability.
Anonymous,
There is no such creature as a “benevolent state”, just people in charge that haven’t taken advantage of you yet to your knowledge.
Oral directives are not acceptable. This is the first case where the people are asked to accept this nonsense. We do not.
Think of that. Anyone could claim anything. Here the evidence is that Terri did not wish to be put to death, it is only that a judge willfully decided to dismiss that evidence. It could be a third cousin instead of the “husband” claiming that Terri “wants to die”. A third cousin would be possibly more credible in this case.
It could be a person totally unrelated with an imaginative story. It could be me claiming that you prefer not to have an IV if you are unconcious. You would be at the mercy of the unelected judge.
As we see with Greer, the judge would not even need to follow the written law — not even defer to Congress or statue.
You may feel OK that no one would possibly lie to a judge about your wishes. How smart is that?
Foolishness is not a good basis for legal precedent. Why empower tyrants?
“Are we agreed then that we (and that includes the ‘husband’) do not know Terri’s wishes with certainty?”
Nope, Paul, we are not agreed to that, as I’m reasonably certain you already know. };) (And he calls *me* a sophist. ) There’s a significant difference in saying that the only person who might be in a position to know is Michael, & saying that “the ‘husband’ [doesn’t] know Terri’s wishes with certainty.” Sorry, ace, but you can’t sucker me — I’ve been observing trollers for too long to be that inexperienced at spotting them. But don’t worry, you haven’t bored me yet, either; good absurdist arguments to me are a little like Jackson Pollock paintings — they’re a little nonsensical & I haven’t had the desire to make one since I was in the 5th grade, but I can certainly appreciate the beauty in them. 😉
RE: Paul Deignan’s post (March 19, 2005 02:13 AM)
I used the term “benevolent state” to portray a state that has the intent to sustain life by default, a position some would say was benevolent. I don’t believe in a benevolent state either but more as an intrusive entity in wait that, while necessary, needs be checked.
Oral directives are not acceptable. This is the first case where the people are asked to accept this nonsense. We do not.
You are incorrect. Oral directives are acceptable and default to the spouse first. This is the first case that has been litigated to such a degree but it is not the first case where oral directives determined terminal/PVS/profoundly-incapacitated patient outcome. I just went through this with a family member in my state and the priest and hospital told me and the patient that the spouse, by default, makes life-death determination in lieu of definitive documentation. If you prove to me that is wrong, I’ll be on the phone with the hospital’s ethics board to complain post haste. I accept this position though I need not worry about vocal orders now because mine and my families are written. I do not know the law of every state regarding oral advance directive; suffice it to say, it exists.
As far as potential abuse by a malevolent third-party, that is possible; however, there is an order of precedence that determines who decides first. A judge is not going to allow just anyone to come up and claim primary responsibility. No judge will toss that responsibility out indiscriminantly. They are loathe to deviate unless the decision is forced upon him/her. I just don’t accept that “a person totally unrelated with an imaginative story”, or even you, is going to walk in to court and into a hospital and past other relatives to hijack a patient. Hypothetically, it could happen, but I just don’t think that to be a rational consideration.
Clarification: “oral advance directive” is probably not the proper operative word. I use it in place of any legal phraseology that would be more precise.
Bill,
Now you have preformed a complete 360 on the simple question of whther it is possible to know Terri’s wishes with certainty.
Congratulations! You are now arguing with yourself over the most basic and irrefutable truth statement.
You don’t even know your own mind. The argument should be good. Please proceed wthout me.