Honestly, I have a hard time seeing how not feeding someone when there is food available is the same thing as letting them die naturally. I expect that my problem is that I have a hard time seeing removal of a feeding tube as refusing medical treatment.
It’s a kind of medical intervention, the same as a ventilator is. A gastric tube delivers food to the stomach of someone who can’t feed himself or swallow food, a ventilator artificially operates the person’s lungs. You’ll die without food the same way you’ll die if you can’t breathe. It just takes longer. When you say “not feeding someone when there is food available,” you make it sound like there is a hungry person sitting in bed and nobody will hand her a sandwich. What we’re discussing in this case is a comatose person who was being fed protein goop through a tube that dripped into her stomach. They stopped putting the goo in the tube. It is life support. If you’re saying some people would be willing to accept being kept alive by a gastric tube but not a ventilator, I am sure you’re right. You can be conscious and take your food through a tube; if you are on a ventilator, you’re probably comatose, and that’s often where people start saying they’d want a relative to pull the plug.
Feeding someone is not really medical treatment even if you need a nurse to maintain a feeding tube.
The point for Terri Schiavo was explicitly to end her life. It was no longer about extreme care. It was about allowing someone to “live” (using that term loosely here) in that state. That was partly for her (she had expressed to her husband and others when she was alive she would not want to live like that) as well as allowing everyone else closure and move on with their lives. There was zero point in letting Terri live like that. It served no purpose beyond maybe allowing her parents to cling to the fantasy (and make no mistake it was a fantasy) their daughter was still around and might be rehabilitated.
This is a gross oversimplification. Schiavo was not capable of eating in any normal sense - she could not take food into her mouth, chew, or swallow. The only way for her to take in nutrients was through the feeding tube, which is not a naturally-occurring configuration.
Yes, I have seen them. Well, it wasn’t that gooey, really, and it came all clean and bagged up. And both times I have known people with them, when they got to the end of their road they did not want to have any more – though both wanted water. So I know that in the twilight of life people sometimes don’t want to eat (through a tube or otherwise) and I think it would be cruel to force them to do it.
I also know that people often say they don’t want heroic measures and that they would want to be taken off the machines and so on – but I also know that when in the situation, those same people find that they do want to live after all. And I am not sure that when people say they don’t want heroic measures if they are terminal that food and water are what they have in mind.
Understand, Terri was already dead in almost every sense that matters to us. All that was left was the shell. As it happened her body kept ticking along but Terri, the soul if you will or what people knew as Terri (her personality, dreams, etc.) was long since departed. There was literally no brain left capable of forming even the simplest of thought. All higher functions were gone. She was literally incapable of thought. In her case calling her a vegetable was pretty close…a bit more complex but she was experiencing life at that point probably about the same as a carrot.
There was no Terri, at all, that could say she wanted to live. When Terri was alive she expressed to others that she would not want to live like that. They carried out her wishes.
And they can change their minds whenever they want. This situation involved someone who was unable to make a decision at the time because she wasn’t conscious.
I agree different people have different views on this - I said so upthread. It’s important to be clear on that if you’re going to create a document to guide your loved ones in handling the situation. But yes, I am confident some people would not want to be kept alive indefinitely through a gastric tube if their consciousness and their ability to experience their lives was already gone.
Well, I think this is true, that is my sense of my memory of the case. Mostly it is my recollection that people do not want to say that, though: they want to talk about it in terms of a natural death. But while I am all for a natural death I am not at all sure that hers was in that class. It was it seems to me to have been at best not a voluntary death – euthanasia rather than suicide. Probably it was best, certainly she-as-she-was, was not coming back.
Maybe, but there are very many people who have those and I am not really ready to say that anyone who has a feeding tube and cannot speak should have it removed because it is not natural.
That’s the whole point of this case: she could not make a decision on her own, so ‘suicide’ was not an option. The end result was something like euthanasia, but according to her husband, those were her wishes.
We’re not talking about involuntarily removing anybody’s feeding tube. We’re talking about what happens when a person does not want to be kept alive that way.
Having been there I thought I might comment. For me the decision was and still is between the person I love and trust the most, which for me is my wife.
The rest of my family, who love me and I them, shouldn’t be anywhere near this decision.
When I was declared brain dead, if my wife had pulled the plug I would have been fine with the decision.
It took me years to get used to my wife caring for me, sharing unbearable intimacies. The thought of one of my children, a parent, or a sibling going through that is unimaginable to me. Although they would all want to do it, that will never be an option.
There are things that are far worse than being dead.
I thank you, by the way, for your probity in this conversation. I have myself no interest in the motives of her parents or of her husband, for as far as I could see they were all trying to do what they thought was right, with their own mixed motives and personal experiences.
I am interested in the grey areas of what you mention – dead in every sense that matters to us. I am curious about when we dare to decide that a life is over in every sense that matters to us.
Well, I am with you on the first half, but having some difficulty with the second. I think it was something so very like euthanasia that is, well, was. And I am not so in love with life at all costs as all that. But I do think we ought to go ahead and call it what it is.
It seems to me that we are talking about at best a non-voluntary removal of her feeding tube, because nobody seems to have asked her about being kept alive that way – it was a matter of reasoning from general to specific, which sometimes works and sometimes does not. If we know what someone wants in specific, then they are the one making the call and while there is always room for changing one’s mind,in the end they made that decision, to write that thing down and too much fussing about with whether they meant it at the moment it actually came up is, well, self indulgent or something like it.
When we do not know, we have to do the best we can. I get that. But the best we can does not seem to me to be the same thing as being certain we have done the right thing – more like accepting that we have done the most right thing amoung a plethora of not all that right things.
I thank you also, for your clarity of articulation on this issue, it seems you have given it (not the Schiavo case necessarily; the greater subject) a lot of thought.
So killing unconscious people is OK? So long as they don’t feel it?
Feeding is medical treatment?
Yeah, only one side. The “good” guys never made a spectacle, never. My gigantic bad.
That would be fine. It doesn’t change the argument. Nobody is saying she committed suicide. In fact very few people would consider it suicide if a sick person turns down medical intervention. Even the Catholic Church is okay with that, at least in some circumstances.
How is it non-voluntary? That presumes she wanted to be sustained by a feeding tube, and there’s no evidence for that. She hadn’t left a will or a testament of her own, which would have been the best way to settle this. Her husband said she’d had told him (in conversation, not a legal setting) that she would not want to be kept alive in this way. It wasn’t possible to ask her after her stroke, so that was the best available evidence.
So “at best” we’re talking about a situation where someone was kept alive, after a fashion at least, through a kind of intervention she apparently did not want. Her husband and family tried a bunch of unorthodox treatments after everything else had failed, and that didn’t work either. After he said ‘enough, she wouldn’t have wanted this,’ she was kept alive for a very long time while they argued about it in court.
I agree with you. Sometimes we don’t have all the information or total certainty, and we have to make a choice with what we do have. This is a particularly difficult example.
Thanks for weighing in Blinkie, I was hoping you would contribute to this thread.
For reference:
http://www.msnbc.msn.com/id/7328639/
It was gone. There’s a difference between that and what happened to Blinkie. (hey, man, thanks for chiming in.) It’s a detectable difference, and easily so.
I believed, and still believe, that Michael Schiavo should have stepped out of the decision making process when he began a new life with a new woman. I believe his second family would affect the decisions he made for his first wife, and that he would no longer have Terri Schiavo’s best interests at heart when he had a new partner and children to consider. I believe he lived as though he were divorced (by starting a new relationship and having children with another woman), and that his rights to have a say in Terri’s treatment should have been those of an ex-husband. I remain disgusted by his continued interference in Terri Schiavo’s life and death.
Yeah, much better to place those decisions in the hands of Congress.
I’m probably going to regret this, but once more time: his in-laws (the Schindler family) encouraged him to move on with his life and see other women. It wasn’t until he said ‘we’ve exhausted all the treatment options, and in accordance with her wishes it’s time to let her go’ that they decided he had a conflict of interest and was trying to murder Terri.