phew
Shortly after my grandmother went into Hospice House, they stopped feeding her. Apparently, her metabolism had slowed to the point where food was causing more stress on her body than lack of food would; she simply didn’t have the strength to digest anymore. It seemed to me (and my mother, a Hospice nurse herself, agrees) that she was actually more alert and stronger once she stopped eating than she was when food was being forced into her. This by itself is anecdotal evidence, but the fact that the Hospice staff actually had protocol in place to make this decision suggests to me that it’s not at all uncommon.
You have to remember that it takes energy to digest food. Once the metabolism slows and the organs start breaking down, that energy may not be there anymore. It is possible (IMHO) that forcing a patient to eat when they’re on the verge of death actually causes them more distress than allowing them to starve.
This link (courtesy of DoctorJ) states that none of the doctors who have signed affadavits testifying to Terry Schaivo’s ability to recover have actually examined her in person. A few of them have actually taken the trouble to look at her medical files; many freely admit that they have based their judgements solely on the edited videos that her parents have released, and not the uncut footage. I really have to question the accuracy of their claims, considering they’ve never even seen the patient in person.
Sorry–I didn’t see that this thread had been re-activated.
Once they remove the feeding tube (and, presumably, stop any IV fluids), she would become dehydrated over several days, which would lead to kidney failure, then electrolyte imbalances, and then heart arrhythmias, which would lead to death. It’s hard to say how long it would be, but I’d guess less than a week.
It won’t be easy on the family, because waiting for something like that makes every second seem like an eternity, especially as emotionally-charged as this situation has been. I don’t think it makes any difference for Terri, though; she does not have the capacity to suffer.
My impression is quite the opposite–they believe that she is conscious, and that she is responding to them, and that her current state is worth maintaining. That is the crux of the case; if it only hinged on her chances of recovery, I don’t think the parents would have much of an argument. This is why the parents released the videos that they did, and why their supporters are careful to refer to her as “brain-damaged”, as if she has taken a nasty bump on the noggin. (It may be factually true, but doesn’t convey the scale properly at all.)
They claim that her swallowing function might be able to be retrained, but even if that could be done (a big “if”), she would still require a feeding tube, because the danger of aspiration would be so high. There really would be no benefit to retraining her swallowing reflex, except that it would give some fodder to the media and the parents’ supporters that she could recover.
From the standpoint of medical ethics, withholding and withdrawing life-sustaining care are generally considered to be equivalent. Both are considered “passive euthanasia”, which is considered to be an ethical option (unlike “active euthanasia”).
This is based not in the principle of nonmalfeasance (“First, do no harm”), but in the principle of patient autonomy, and the right of the patient to refuse or discontinue a treatment. When the patient cannot make that decision, that right carries over to the patient’s decision-makering proxy (though it would probably be disputed in a situation in which withdrawing care is not that reasonable, such as someone who has clear signs of a good prognosis).
As to the differences between withdrawing a feeding tube and a respirator, there really aren’t any, except that people have a hard time believing that someone who can breathe on her own and unassisted is also unconcscious and unaware. There are plenty of people out there right now who are perfectly interactive and engaged who depend on PEG tubes for nutrition. This is not one of those cases.
This was the conversation when CrazyCatLady mentioned this a few nights ago:
Me: You mean you can just sell your spouse like that?
CCL: Yeah, I guess it does.
Me: And nobody told me about this before?
CCL: Tell me about it!
I just thought of something.
If and when she dies, can you imagine what a clusterf–k her memorial service/funeral will be? I assume both Michael and her parents will attend.
Yikes!
Worse than that, imagine the media presence. :mad:
Any decent funeral director would have the media tossed out, even going so far to call the cops.
I wasn’t implying that they’d enter the funeral home or anything like that, but they would gather across the street or wherever is the closest point off of funeral home property to get a good shot of the front door, and freedom of the press would dictate that the police just cordon them off to make sure they didn’t trespass on funeral home property.
The Florida politicians just made it illegal to remove feeding tubes. Link. This battle isn’t over yet.
So much time, effort, and emotion spent on one person. I just don’t see the value, sorry.
You aren’t the only one. I’m generally against euthanasia, myself, but this isn’t euthanasia - it’s heroic efforts to keep a slab of meat breathing and eating, not a person.
Clicking on that link now shows that’s wrong. The Florida House passed a bill, but it wasn’t ratified by the state Senate.
While your wording is a bit coarse, I agree with your sentiment. About 11 years ago, a very dear friend was shot. Some person jumped him, shoved the barrel of a gun aginst his cheek and pulled the trigger. The bullet passed through his brain and stuck in the brain stem.
In that moment, he was gone. But his body kept on. The EEG’s that ran nonstop showed random tiny firings of brain electricity. I went to see him about 4 days after he was shot. I needed to see him to say goodbye. It was horrifying. Aside from the small burnmarks around the small bandage on his cheek, he appeared to be fine. His eyes were open. However…he was gone. Completely gone. He died about 13 days later, never showing any further signs of meaningful brain activity.
What a flashpoint subject. The machine can keep going but the esssence, spirit, soul, however you view what makes one person a person… was gone with my friend. It is likely gone with Mrs. Schaivo as well- and has been for many years now. My personal feeling is that the crime is keeping her machine going, when Terry Schaivo died long ago. Your Spiritual Mileage May Vary.
DrJ, are you certain coma patients don’t sleep? Cuz I sure did. I can even remember some of the dreams I had in the days I was coming out. Even my nurses, family and friends could tell the difference between my “asleep coma” and my “awake coma”. My neurologist told me the only difference between coma and persistent vegetative state was that one was acute and one was chronic. He may have just been oversimplifying, though.
As far as her “responding”…yes, when friends and family were in my room I “smiled” (read: grimaced) and “responded” (read: grunted and groaned). However, apparently, as my nurses would enter the room when no one was visiting I could still be seen “smiling” and “responding” (grimacing and grunting) despite the fact no one was there. I can’t help but wonder if a camera was in her room while no one else was there if we’d see her acting the same way.
He was not oversimplifying so much as he was wrong. Neither a coma nor a PVS necessarily lasts forever, but either can last forever.
“Coma” is a word that is thrown around pretty haphazardly. In a true coma, there are no sleep-wake cycles and the patient is unarousable. Of course, there is a spectrum from a PVS to a coma, and PVS can be a “transition state” from coma to consciousness. That’s probably where you were if you were showing such “cycles”.
This is not to say Terri is in such a state; those who recover from a PVS do so within three months. After that, it is considered permanent.
ABC News is reporting that the tube has been pulled.
RIP, Terri, unless this is appealed.
They pulled it once quite a while ago. The parents appealed and had it put back in.
The judge is ordering it removed. I haven’t seen anywhere that it actually has been removed to this point, however.
It was pulled twice before, then put back several days later.
Unless Congress passes some narrow law (which will be thrown out by SCOTUS) I can’t see that the parents have any other options. They’ve appealed to just about everyone except the U.N.
Ok, I have a question. I’m not trying to be snarky or funny or rude, but I was wondering:
Many people here have objected to the removal of the feeding tube because it’s not a matter of witholding live saving measures, it’s taking away things that were already in place. What if they left the tube in, but just stopped feeding her? Then, it’s just a matter of that nurse not bringing her nutriants today–witholding the live saving measure. I’m sure Mr. Schiavo already thought of that and it wouldn’t work, because I’m sure it would have happened already. But what about the Dopers who objected to the removal? Would you have the same objections to this?
It’s irrelevant. The tube indicates nourishment. Leave the tube and stop the feeding, the net result is the same.
That’s just semantics. Based on quotes recently from President Bush, I am inclined to guess that in the next 24-36 hours he will issue an Executive Order demanding the permanent replacement of her feeding tube. That cannot be rescinded.
It’s horrible.