if you were terri schiavo?

[Webster]

You know, the sad part is that I think all these started out because of money. Here is an exert of how it all begin............ Read it and draw your own conclusion....

what is the source of those exerts? do you have the complete document(s)?

The source is from Court ruling by Judge Greer in Feb. 2000'

If interest, go here for the timeline:

from when she was born to 3/23/2005

http://abstractappeal.com/schiavo/infopage.html

specifically, the excert is from here:

http://abstractappeal.com/schiavo/trialctorder02-00.pdf

[CoffeeGuy]

what better than a court determined guardianship.

You gotta be kiddin'.

I'm not suggesting that its the perfect way, "but it's a hell of a lot better" than what is happening now.

Your opinion is not wrong. I just dont agree with it.

[AlecWest]

I can see the next mods meeting, hehe. "Lessee," someone says. "We don't allow discussion of religion. And we don't allow discussion of politics. Hmm ... should we extend the ban to bioethics?"

I'd certainly not want to be any of the judges involved. Advances in medicine have possibly bypassed conventional legal thinking ... at least in this country. Our system of justice is pretty black and white. We have "criminal" courts (where evidentiary requirements demand "beyond a reasonable doubt") and we have "civil" courts (where only a "preponderance of the evidence" is required). But because of advances in medical science making extraordinary means of keeping someone alive more commonplace, we've finally reached a point where a human's life can be decided upon in a "civil" case ... based on the lesser standard of preponderance.

The issue isn't whether Terri's in a persistent vegetative state (or not). It isn't even whether or not Michael is her legal guardian. The issue is "What did Terri Schiavo want?" I'm not certain the answer to that question can be proven either way "beyond a reasonable doubt."

Anyhoo, this is not meant to justify keeping her alive ... nor is it meant to justify not keeping her alive. It's just a comment on the legal conundrum this case raises ... a case that would not exist if extraordinary means weren't in place to keep Terri alive.

P.S. BTW, the Schiavo case isn't the only bioethical conundrum out there. Try this one:

https://www.videohelp.com/forum/viewtopic.php?t=263161

[Conquest10]

I think she should die. But not the way they are doing it. It's just wrong to starve some one to death.

What other way is there?

The one thing that bothers me is her husband. I think he's a scum bad that does not want to do any thing to help her. No physical therapy he said, no wheel chair to go out side. If she dies he gets one million dollars. He wants her to die.

You think he is a scumbag because he doesn't get her therapy and take her outside? What would be the point to that? It would be like me calling you a scumbag for not buying a treadmill for a paraplegic.

[shelbyGT]

The people that are getting arrested for trying to bring Terri water/food need to realize if they COULD do that they would kill her. She'd choke, she is unable of swallowing. Anyone with a brain can see past the publicity stunts of those people. (And don't tell me they aren't when they are 10 year old kids doing it).

[offline]

@ Alecwest

That is Baldrick's rules. It was not mod inspired.

@Coffeeguy

So the alternative in your view should be ...?

[Zisguy1]

It just seems morbidly ironic that a woman will most likely starve to death in a hospital.

FWIW she's not in a hospital, she's in a hospice (end-of-life care facility).

[AlecWest]

@ Alecwest

That is Baldrick's rules. It was not mod inspired.

I know ... just being a little cheeky. :P Speaking of cheeky, something came to me yesterday that had me laughing. It's insensitive. It's politically incorrect. But, I can't get the thing out of my head so I'll just post it. And before posting it, I realize this may offend some (or all) people. Sorry, in advance. I mentioned it to a friend at work and he said it sounds like a cartoon "Callahan" might draw. Anyhow.

I imagined a comic strip with 5 panels ... labled Monday, Tuesday, Wednesday, Thursday, and Friday. It's titled "Watching the Schiavo case." All five panels have the same scene. Two old men are sitting on a sofa in their teeshirts and undershorts, holding beers in their hands, and staring blankly at the TV in front of them. The panels remain consistent on Monday through Thursday. But, on Friday, one of the two men says, "Ya know, I think I'd rather die than live in a persistent vegetative state." The other man replies, "Quiet! Can't you see I'm listening?"

[hudsonf]

If I was in that condition I would prefer to die. If it was made legal I'd prefer to have assisted suicide then to starve to death. I really feel sorry for the family but I don't think she will ever come out of it.

[CoffeeGuy]

@ Offline


Alternative ? No alternative.

[vitualis]

CoffeeGuy: and hence the problem.

Because, "no alternative" is unacceptable. Keeping the "status quo" is automatically a decision in favour of a particular position.

We cannot go back in time to ask Terri herself. Her wishes to her current situation can only be given by the people who knew her then and are still around NOW. In the situation of conflicting family opinion, the courts have looked at the evidence and have eventually ruled in favour of the ex-husband every time. We should not as uninvolved third parties presume to know better than the actual people presiding over the case because we don't.

Why have all the various cases by the Schindler's and third parties (e.g., Jed Bush) failed?

1. There is no reason why the ex-husband shouldn't be the next of kin or legal guardian
2. That the feeding tube should be removed probably IS Terri's wish
3. The Schindler's assertions simply are not ground in medical of scientific fact

(and movements by Jed Bush to have himself made Terri's guardian are frankly offensive and stupid).

Regards.

[AlecWest]

Why have all the various cases by the Schindler's and third parties (e.g., Jed Bush) failed?

1. There is no reason why the ex-husband shouldn't be the next of kin or legal guardian
2. That the feeding tube should be removed probably IS Terri's wish
3. The Schindler's assertions simply are not ground in medical of scientific fact

First, Michael isn't an "ex-husband," he's Terri's current husband. I think the reason why the Schindlers have lost every court case is predicated on that issue ... that Michael is recognized under the law as her true next-of-kin ... even though he's moved on to a marriage-like relationship with another woman and had two children by her. And, as a civil case, the judges must look at the preponderance of medical evidence which sides with the husband's belief that Terri's condition is irreversible. The Schindlers' only chance of winning in these trials rested with Terri herself ... that she'd exhibit some sort of behavior that convinced the majority of physicians caring for her that the diagnosis of PVS needed revision. Terri didn't.

So, the statement by the legal next-of-kin indicating Terri's wish to be taken off life-support, coupled with the preponderance of medical opinion that her condition was irreversible, was an unbeatable combination.

The bioethical question that remains will probably remain unanswered until the next case like this comes up ... and may remain unanswered even then. Namely, should the removal of "extraordinary means" keeping anyone alive be decided upon based on a preponderance of evidence ... or whether human life is so precious that the individual's wishes need to be known "beyond a reasonable doubt."

[otpw1]

Why have all the various cases by the Schindler's and third parties (e.g., Jed Bush) failed?

1. There is no reason why the ex-husband shouldn't be the next of kin or legal guardian
2. That the feeding tube should be removed probably IS Terri's wish
3. The Schindler's assertions simply are not ground in medical of scientific fact

First, Michael isn't an "ex-husband," he's Terri's current husband. I think the reason why the Schindlers have lost every court case is predicated on that issue ... that Michael is recognized under the law as her true next-of-kin ... even though he's moved on to a marriage-like relationship with another woman and had two children by her. And, as a civil case, the judges must look at the preponderance of medical evidence which sides with the husband's belief that Terri's condition is irreversible. The Schindlers' only chance of winning in these trials rested with Terri herself ... that she'd exhibit some sort of behavior that convinced the majority of physicians caring for her that the diagnosis of PVS needed revision. Terri didn't.

So, the statement by the legal next-of-kin indicating Terri's wish to be taken off life-support, coupled with the preponderance of medical opinion that her condition was irreversible, was an unbeatable combination.

The bioethical question that remains will probably remain unanswered until the next case like this comes up ... and may remain unanswered even then. Namely, should the removal of "extraordinary means" keeping anyone alive be decided upon based on a preponderance of evidence ... or whether human life is so precious that the individual's wishes need to be known "beyond a reasonable doubt."

Put yourself in the position of the judge. I feel this decision was not made lightly.
No way am I going to second guess this.

[jimmalenko]

I voted NO.

[gll99]

Disreguarding the brain damage for now.

Is a feeding tube considered an extraordinary means to keep someone alive.

So if I was in the hospital with stomach problems and needed a tube but otherwise in great physical health just suicidal and said take that tube out I want to die would the hospital comply?

If it led to a court case would the courts rule in my favor?

[vitualis]

Is a feeding tube considered an extraordinary means to keep someone alive.

So if I was in the hospital with stomach problems and needed a tube but otherwise in great physical health just suicidal and said take that tube out I want to die would the hospital comply?

If it led to a court case would the courts rule in my favor?

Its not that simple.

The context is important.

For example, most people would probably consider that being intubated (i.e., tube put into your trachea) and artificially ventilated to be "extraordinary measures". However, if the chances of recovery (back to normal health) are good, then it would not be "so extraordinary".

For example:
(i) Intubated and ventilated after a serious drug overdose
Iii) Intubated and ventilated after respiratory failure from lung cancer

It is the same procedure, but the context is completely different. What makes it "extraordinary" is that it is a significant invasive medical procedure that although will keep your body alive, is also probably irreversible.

Back to your enteral feeding example. If there were a pretty good chance that you would get better with feeding and you didn't want it because you were suicidal, it would be a tough call for the treating team. At one level, we would have to respect your autonomy (and as such, would look at other possibilities ... e.g., intravenous feeding). At another level, if we through that you had a significant mental illness, we would probably treat you, but this would be in the context of the mental health act so that we would be working within the confines of the law.

Furthermore, there are also more than one forms of feeding with a tube. One is a nasogastric tube (which is basically a flexible tube that goes down your nostril into your stomach). This is relatively simple to insert and remove and is used for temporary feeding. Where a more permanent tube is required, as PEG tube is used which is a tube that goes through the abdominal wall into the stomach. This needs to be put in as a surgical procedure.

Regards.

[AlecWest]

Put yourself in the position of the judge. I feel this decision was not made lightly.

I'm sure it wasn't made lightly. It goes right to the heart of our system of justice. Before extraordinary means became a medical reality, the only case where a judge could issue a ruling that determined the life or death of a person was a capital criminal case. And before a death sentence was issued, a jury had to determine whether the person was worthy of it beyond a reasonable doubt. But now, civil cases requiring the lesser standard of preponderance allow judges to make a similar life or death decision. And in the context of a civil case, not one of these judges did anything improper.

I would (personally) like to think that a human life is too important to leave to the lesser standard of preponderance. But, I don't know of any practical way to implement this. It would require a whole new kind of legal system ... halfway between "criminal" and "civil" justice. And legal experts would have a tough time selling the concept to the Supreme Court.

[lumis]

the judge isnt making the decision.

terri's legal guardian her husband said she would not want to live in that condition.

terri's court appointed guardian at law said she was in a PVS.

schiavo's parents, jeb bush & the florida legislature have been trying to skirt the law for years.

i'm seeing all these people on the news who have been in coma's and recovered.. its a media ploy to raise doubt in those uneducated in this case.. there is a big difference between a coma & being in a PVS.

if anything, michael schiavo should sue terri's parents, jeb bush & the state of florida for causing schiavo to suffer in a PVS all these years and causing him emotional distress.

i'm kind of sick of this story, to me it seems like terri's parents havent accepted the reality that their daughter is gone, not even aware of her own existence. she's only left with primative physical reactions, blinking, moaning, coughing, etc.. she is reflexive, not cognitive.. her parents need lots of counseling.

[Ward River]

If I were Terri Schiavo I wouldn't care one way or the other.

Because I can't.

[lumis]

kind of like david cross donating his body to necropheliacs. :P

[AlecWest]

If I were Terri Schiavo I wouldn't care one way or the other.

Because I can't.

Especially with the morphine IV they're now giving her at the hospice.

[Conquest10]

Its not like she could before anyway.

[AlecWest]

Its not like she could before anyway.

True ... but isn't it curious. All this time, everyone involved in this case says that Terri's death would be painless. If that's true ... and if Terri wouldn't know any discomfort anyway, why the morphine??? Is the hospice just padding her bill with an extra unnecessary charge?

[ZAPPER]

the judge isnt making the decision.

terri's legal guardian her husband said she would not want to live in that condition.

terri's court appointed guardian at law said she was in a PVS.

schiavo's parents, jeb bush & the florida legislature have been trying to skirt the law for years.

i'm seeing all these people on the news who have been in coma's and recovered.. its a media ploy to raise doubt in those uneducated in this case.. there is a big difference between a coma & being in a PVS.

if anything, michael schiavo should sue terri's parents, jeb bush & the state of florida for causing schiavo to suffer in a PVS all these years and causing him emotional distress.

i'm kind of sick of this story, to me it seems like terri's parents havent accepted the reality that their daughter is gone, not even aware of her own existence. she's only left with primative physical reactions, blinking, moaning, coughing, etc.. she is reflexive, not cognitive.. her parents need lots of counseling.

It is not very often that I agree 100% with someone, but you hit the nail square on the head.
I am not real big on trivial law suits, but I think that this time I would like to see it just to tell people to butt out of peoples private matters. This whole thing should have been settled long ago with the doctors explaining the best that they could what they knew and the family crying, holding hands, praying or whatever it is that normal families do. And then giving the OK to let her die in peace without the rest of the world having to ever hear about it.

[lumis]

Its not like she could before anyway.

True ... but isn't it curious. All this time, everyone involved in this case says that Terri's death would be painless. If that's true ... and if Terri wouldn't know any discomfort anyway, why the morphine??? Is the hospice just padding her bill with an extra unnecessary charge?

they're probably covering their asses.. they dont want to be dragged in to court for 15 years over a non-issue.. even if they have to eat the bill for the morphine its still a million times better than having to deal with terri's family and/or michael schiavo.

[vitualis]

Believe it or not, the morphine is mostly used for the family.

Small doses of morphine are harmless in this setting and do not "hasten death". They do suppress some body reflexes (like rapid breathing) so the body "appears" calmer. Terri herself wouldn't know the difference in any meaningful sense.

In other situations where people ARE aware before they die (e.g., some cancer patients), morphine is also useful as it is not only good for pain, but also a good anxiolytic (i.e., it relieves anxiety).

Regards.

[AlecWest]

One interesting note of compatability between Michael Schiavo and the Schindlers. Michael wants an autopsy performed to show the extent of her brain damage in no uncertain terms. The Schindlers agreed. At least, that will hopefully put a lot of issues to rest for everyone involved (and everyone not involved) in the matter.

Last word was that Terri's kidneys have likely shut down.

Small doses of morphine are harmless in this setting and do not "hasten death".

Correct. The Schindlers took issue with that but I concur with you.

they're probably covering their asses.. they dont want to be dragged in to court for 15 years over a non-issue.

Yes, that may have crossed a few minds. But, as vitualis said, it's probably more to set the family at ease that there's no possibility of pain.

[enstg8er]

Not Dead Yet, an organization of persons with disabilities who oppose assisted suicide and euthanasia, maintains that the starvation and dehydration of Terri Schiavo will put the lives of thousands of severely disabled children and adults at risk. (The organization takes its name from the scene in Monty Python and the Holy Grail in which a plague victim not dying fast enough is hit over the head and carted away after repeatedly insisting he is not dead yet.) Not Dead Yet exposes important biases in the “right to die” movement, including the fact that as early as 1988, Jack Kevorkian advertised his intention of performing medical experimentation (“hitherto conducted on rats”) on living children with spina bifida, at the same time harvesting their organs for reuse.

Besides being disabled, Schiavo and I have something important in common, that is, someone attempted to terminate my life by removing my endotracheal tube during resuscitation in my first hour of life. This was a quality-of-life decision: I was simply taking too long to breathe on my own, and the person who pulled the tube believed I would be severely disabled if I lived, since lack of oxygen causes cerebral palsy. (I was saved by my family doctor inserting another tube as quickly as possible.) The point of this is not that I ended up at Harvard and Schiavo did not, as some people would undoubtedly conclude. The point is that society already believes to some degree that it is acceptable to murder disabled people.

http://www.thecrimson.com/today/article506716.html

[Webster]

One interesting note of compatability between Michael Schiavo and the Schindlers. Michael wants an autopsy performed to show the extent of her brain damage in no uncertain terms. The Schindlers agreed. At least, that will hopefully put a lot of issues to rest for everyone involved (and everyone not involved) in the matter.

I wonder whose best interest is this for. Not Terri for sure.
Hell, the woman is not even gone yet, and they already talking about chopping her up. X-ray/CAT scan will show the same thing without having to saw her skull up....................
Somehow, this to me is not right.
Just my worthless opinion.
Like they said, opinion is like an a__hole, every body have one.

[AlecWest]

I wonder whose best interest is this for. Not Terri for sure.
Hell, the woman is not even gone yet, and they already talking about chopping her up. X-ray/CAT scan will show the same thing without having to saw her skull up....................
Somehow, this to me is not right.

You're right ... it has nothing to do with Terri. But, the same law that gives Michael Schiavo the right to order the plug pulled allows him the right to dispose of the body in any manner he chooses. He's thinking about himself on this one. If he just said, "Send her body to a crematorium immediately," there'd always be some joker (or several jokers) out there suggesting he had something to hide. Matter of fact, that's what the Schinders are suggesting and is why they agreed to the autopsy. While Michael is using the autopsy to tell everyone, "See, I told you so," about the state of Terri's brain, the Schindlers want a forensic expert to check for signs that Michael may have "done something" to hasten Terri's demise.

BTW, here's a brief transcript of a Court TV discussion between two lawyers on the legal and bioethical questions related to the case ... one lawyer being in favor of the tube being pulled, the other against. Interesting reading:

http://courttv.com/talk/chat_transcripts/2005/0324schiavo-debate.html