• All Purchases made this month instantly go into the draw to win a USD $ 100.00 credit to your HoP account.
 
Page: 12
Pele
BRONZE Member since Dec 2000

Pele

the henna lady
Location: WNY, USA

Total posts: 6193
Posted:I don't know how many of you have been following the Terri Schiavo case here in the U.S. but she is a woman who lived in a vegitative state for 15 years. Her feeding tube was pulled 13 days ago and she finally died.
It has been an enormous battle between her parents, who maintained hope that she would wake up, and her husband who wanted to honour her spoke, but unwritten, desire to not be held on life support in such a way.

For the full story... http://story.news.yahoo.com/news?tmpl=st...amaged_woman_94
br>
Now, I really don't want this to be a huge debate over religious reasonings.

However, this is a pretty powerful thing. The husband had rights over the parents...and I agree with that.
I also think the parents were being wrong in believing she would be fine after 15 years like that. No way.
Could you imagine being caught like that? Did she dream? Was there nothing? Did her soul/spirit move on long ago?

And there are still lawsuits. The parents are accusing her husband of being abusive to her...over 15 years ago! And that he has no right to have her cremated and buried with his family in Pennsylvania. Now...keep in mind, he lives with another woman and has two kids with her. He had to move on at some point, but kept fighting for his wife out of honour for her wishes and because he did love her.

It also brings to light the purpose of a written will. We don't think of that much but she only told her husband what she wanted, and 15 years she was kept in no-kind-of living life.

Do you think that the courts should have kept intervening as they did? Jeb Bush (yes, you guessed it, related to idiot Pres. Bush) even rushed a "Terri Bill/Law/something" through to attempt to protect her.
But was it really protecting her?
Do you think her parents were being selfish and/or cruel to keep her like that?
There was also a battle between the husband and the parents over a malpractice lawsuit that is nuts.

I don't know. There is *alot* wrong with all of this.

Should a person simply have the right to die without it turning into an inter/national affair?

Would you want to be kept on support in that state? And if so, for how long before you wish people to move on?


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

Delete Topic

spritie
SILVER Member since Sep 2001

spritie

Pooh-Bah
Location: Galveston, TX

Total posts: 2014
Posted:I think a person SHOULD have a right to die. I think what the courts did in this instance was horrible. I certainly do not want to be kept on any sort of mechanical life support. When my body becomes that "out of it" for lack of a better term, I really don't want my spirit to be forced to endure something that miserable.

What I also don't understand in this particular instance is why George himself had to get involved in the issue. He came back from TX early to have someone in Washington sign something that would grant her an extra while before the tubes got pulled. What they signed was only related to this particular case as well. Now, don't we as a nation have much more important issues to be dealing with than whether one single woman should or should not have her feeding tube removed?

Something else to note is who is footing the bill for her to live in a vegatative state for 15 years? The lawsuit Pele mentioned gave her husband some amount of money. However, a good chunk of that money has been used for legal fees and such so that there is little left to actually pay her medical bills (which I have heard were easily $6000 a month). So, who actually footed the bill and is having the taxpayers foot such a bill the right thing to do?


Delete

_So_
BRONZE Member since Feb 2004

Skinny poi maker
Location: Moscow, Russia

Total posts: 313
Posted:Thats the story i only heard about today. But it is very sad first of all. And then it pulls out very different feelings, which are hard to be explained. First thing which i didnt understand and would be really grateful if you explained - is was her brain active during the last three years, or was it dead from the scientific point of view. If it was disfunctional, then it was f'n cruel to keep her in such a condition for 15 years (it is possible if im not mistaken).
I understand that her parents could not just cut her off the feeding tube and all the other things, that keeped her pseudo alive, because it is really hard to just refuse to hope.
But. It is absolutely cruel to leave a person to be a vegetable. 15 years! If she dreamed, if she had some kind of brain activity, then oh dear, we cant even imagine how terrible it is to be outside the life while being absolutely disfunctional... If it was possible, i'd signed the document that was saying, that i dont want to be kept like that for a time longer, then the doctors consider critical. And i would have signed it right now, really. Or even then when i just turned 18. But there is no such thing in russia i think...
As for me, i would never wanted to stay in such a condition for such a long time. There are ppl, who's lifes can be saved with the help of donor organs. Id prefer to be donor rather then a vegetable.

But may Terri rest in peace now. She can finally be free. And may her parents and husband stop that argument - their beloved wife and daughter is dead. And if she can see them, then she's definitly not happy ab all that...


Delete

Pele
BRONZE Member since Dec 2000

Pele

the henna lady
Location: WNY, USA

Total posts: 6193
Posted:The lawsuit was $1 mil.

Cost of her care was somewhere around $75,000 per year.
And that is not counting legal fees, or the fact that while her parents were fighting to keep her alive, her husband was legally responsible for the bills.

According to accounts, he used the mil. to pay both the med bills and the legal fees.
Supposedly, as of March, he only has around $50 grand of that left, and he is intending to use it for burial fees and if there is any left after that for the continuing legal fees against the parents.
So really...he didn't win anything in that lawsuit.

And ooooooohhhh I complety agree with you about the Bush bill signing issue. That screwed my panties in a tight knot. He is the reason why this country needs to be reminded that we have laws about seperation of church and state!

Thanks for your thoughts spritie!
Pele


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

Delete

spritie
SILVER Member since Sep 2001

spritie

Pooh-Bah
Location: Galveston, TX

Total posts: 2014
Posted:_So_, there isn't exactly a form that we can sign that says I don't want to kept alive under such measures. However, we can create what is called a "living will" which explicitely states our desires about being kept alive under extraordinary measures and for how long.

The sad thing is that not many people actually have a living will. They have voiced their opinions to their loved ones, but that is not something that will hold up in a court. It needs to be something formal that is signed. Even then, there are still usually some issues if some of the family wants things one way and the document says something else.


Delete

Zauberdach


Zauberdach

Sometimes sword wofter
Location: Edinburgh

Total posts: 199
Posted:This is exactly the reason why politicians should never ever be allowed to dabble in anything. They aren't even allowed to run governments, that's the job of civil servents.

If the Bushes had true Conservative values surely they would have stressed that this was a family affair that needed to be solved within the family with the minimum of disruption?

I also thought Republicans believed in less state intervention?


IMPORTANT: Any views or opinions are solely those of the author and do not necessarily represent those of a sane person.

"just get the f**k on with it and make me the anti-christ already!"

Delete

_So_
BRONZE Member since Feb 2004

Skinny poi maker
Location: Moscow, Russia

Total posts: 313
Posted:Yes, Spiritie, i heard about that. Thats the disconnection between what the law says and what it actually means, consists of and leads to... You mean that if for example someone signs the living will, where he says that he doesnt want to be kept alive longer then 3 months after the brain damage for example, the family may argue ab that? How? what kind of arguments can they give to the court?

This situation with Terri is terrible fron the human point of view first of all because of the fight between the three main ppl in her life. Thats awfull..


Delete

spritie
SILVER Member since Sep 2001

spritie

Pooh-Bah
Location: Galveston, TX

Total posts: 2014
Posted:The most common cases where something like that goes to court are when for instance the husband agrees with the living will but the other relatives don't. Or, when the living will is written by a homosexual and the partner agrees with it. If the family is less than pleased about that whole relationship, then they have a tendancy to argue.

I'm not entirely certain what the courts can actually do about it though. It seems people like to argue about everything though. For instance, if someone doesn't like what so-and-so was bequeathed in a will, they can argue that in court as well (as stupid as that sounds it actually is somewhat common).


Delete

_So_
BRONZE Member since Feb 2004

Skinny poi maker
Location: Moscow, Russia

Total posts: 313
Posted:Hm... then whats the point in the living will? Whos will is it - the person's who is dying, or his family's? If there is a document, that is signed, then it should be considered as the only will... no? =/

And i just visited the web site, made by Terris parents, and they are insisting, that -
quote:
"Terri is purposefully interactive, alert, curious, lovely young woman who lives with a very serious disability. She lives free of any life support machines and receives nutrition through a tube that is present only at meal times".
im confused...


Delete

spritie
SILVER Member since Sep 2001

spritie

Pooh-Bah
Location: Galveston, TX

Total posts: 2014
Posted:I agree with you _So_ in that one should do as the will states no matter what the opposers think or feel.

In Terri's case, I do believe she had been living in a vegatative state in that she had been brain dead from an injury for 15 years. I do believe the feeding tube was the only "tube" in her in that she could breathe on her own, but was not capable of doing much else because of her brain dead state.

To me, that's really not much of a life, but I know those are only my opinions. I know there are many that feel differently about that. So, in my instance, I'd want that tube to be removed.

Part of what is amazing to me is that she was able to survive for 13 days without any form of food or water. I don't see how that is possible since I thought at least water was required for a person to live more than 5 or 6.


Delete

Cody
SILVER Member since Sep 2003

Cody

That guy from Reno
Location: Reno, Nevada USA

Total posts: 556
Posted:The tough thing about this case is that she was on the boarderline. The only mechanical means needed to keep her alive was a feeding tube, heck the pope has one and many other people rely on them to live. But the problem was that Terry was gone, the Terry that she was died 15 years ago an all that was left was a husk. Her soul moved on if you will. The sentimates from thos who supported the feeding tube were pure emotion. Not wrong, but I don't think that they understood. Even though the news finally clarified that the people trying to bring her bread and water were performing a symbolic jesture, it is a good representation of the misunderstanding of the issue. May she finally rest in peace.

Cody Canon
Controlled Burn, Reno Nevada

Delete

_So_
BRONZE Member since Feb 2004

Skinny poi maker
Location: Moscow, Russia

Total posts: 313
Posted:And the doctors stated, that she could have lived for 2 weeks without the food and water. PPL! A healthy person can die without water in two weeks, what can we say ab the sick one!

Delete

_So_
BRONZE Member since Feb 2004

Skinny poi maker
Location: Moscow, Russia

Total posts: 313
Posted:the thing is, that she could not have breathed if her brain was dead...
im totally, disgustingly confused...


Delete

munkypunks
GOLD Member since Jan 2005

munkypunks

enthusiast, but not enthusiastic
Location: Los Angeles, California

Total posts: 367
Posted:Written by: _So_

Hm... then whats the point in the living will? Whos will is it - the person's who is dying, or his family's? If there is a document, that is signed, then it should be considered as the only will... no? =/

And i just visited the web site, made by Terris parents, and they are insisting, that -
quote:
"Terri is purposefully interactive, alert, curious, lovely young woman who lives with a very serious disability. She lives free of any life support machines and receives nutrition through a tube that is present only at meal times".
im confused...



A living will is created by the person who subsequently becomes disabled. Usually it will involve naming someone to have "power of attorney" i.e., to make legal decisions for the person when he/she can't, and a "health care advocate" to make health care decisions. This may or may not be the same person. It will also state very specifically what the person wants or doesn't want. The ones I've seen have a checklist, which includes life support (like artificial respirator), feeding tubes, extraordinary medical care (like bizarre or experimental surgery), etc. So you can say "If I'm brain dead, I don't want anything, but if I'm conscious I want a feeding tube but no artificial life support." Or whatever.

The problem is that Terri Schiavo didn't have one. (Not that I blame her; she was 26 when the heart failure occurred. Now that we see the horrible ramifications, they say more people are getting them, hopefully younger people also.) So, when her wishes aren't spelled out and notarized, the fights start.

Sometimes, legal problems occur no matter what. My great aunt had a living will that said she wanted nothing, but the doctors hooked her up to the machines anyway until they could get approval from the hospital's lawyers to let her go. It just shows how ironclad everything has to be.

And as an aside, someone mentioned that Terri was brain dead, so how could she breathe on her own. That's not technically correct. She wasn't brain dead; she had massive brain injury that destroyed much of her brain tissue. But the part of her brain that controls involuntary behavior, such as breathing and blinking, was in tact. That was the source of the big fight - if part of her brain was functioning, shouldn't she be kept alive?

The news reports are that Terri died early this morning. I hope that after the autopsy they will finally let her rest in peace. ubbangel


You can't fall off the floor, but sometimes you need a chair to reach the cookie jar.

Delete

spritie
SILVER Member since Sep 2001

spritie

Pooh-Bah
Location: Galveston, TX

Total posts: 2014
Posted:Sorry, my bad. MunkyPunks is right. She wasn't brain dead (as one rather stupid newspaper article that I first read reported), but brain damaged as a result of heart failure in 1990.

Delete

munkypunks
GOLD Member since Jan 2005

munkypunks

enthusiast, but not enthusiastic
Location: Los Angeles, California

Total posts: 367
Posted:I wasn't sure if you were just shorthanding for the ease of posting or what. I think many people - such as that reporter - don't understand the difference.

You can't fall off the floor, but sometimes you need a chair to reach the cookie jar.

Delete

_So_
BRONZE Member since Feb 2004

Skinny poi maker
Location: Moscow, Russia

Total posts: 313
Posted:yes, thanks, guys =) now i understand the situation fully (the internet does not always give correct information, and i forgot ab it...)
so the part of the brain that is responsible for the reflective functions was alive, and the part that makes a person a person was dead - thats in simple non-scientific words...

Well, there's too much to say and nothing to say more at the same time.

The main thig is that the problem with autonasia will remain. I would have signed the living will.

And the mystery of the case will remain. Terri took it with her when she died.

And yet again, may she rest in peace. And may her family stop that awful argumnt.


Delete

Spanner
BRONZE Member since Feb 2003

Spanner

remembers when it was all fields round here
Location: in the works... somewhere...

Total posts: 2790
Posted:Written by: Pele
However, this is a pretty powerful thing. The husband had rights over the parents...and I agree with that.



Why? Not that I necessarily disagree with you - I'm not certain on how I feel about the issue yet - but if the husband has rights over the parents, surely this means that at the point of marriage, the family is literally giving their daughter away. This used to be very much the case but it sounds a little old fashioned in this day and age. No offence.

Written by: Pele
Do you think that the courts should have kept intervening as they did? Jeb Bush (yes, you guessed it, related to idiot Pres. Bush) even rushed a "Terri Bill/Law/something" through to attempt to protect her.
But was it really protecting her?
Do you think her parents were being selfish and/or cruel to keep her like that?



Well, it seems to me that whoever backed these laws being rushed through had very different motives to those of Terri's parents. Towards the end, this was always going to be a big political issue and I couldn't imagine Jeb Bush & Co. going out their way to refrain from using that to their advantage, so I don't believe they were acting out of true concern.

As for her parents, no parent wants to have to think about letting their child die, especially in this way, but if they'd accepted her prognosis earlier, it wouldn't have meant that they believed in her any less. Having seen their website, I think their claims about Terri's quality of life were sadly over-optimistic and 15 years is a long time to be in denial. So although it does seem selfish and they may come to feel the same way in the future, I do feel sympathy for them.

Written by: Pele
I don't know. There is *alot* wrong with all of this.



I also expect that, despite the recent exposure, there's still a lot about this we don't know.

Written by: Pele
Would you want to be kept on support in that state? And if so, for how long before you wish people to move on?



It would highly depend on the extent of the damage, as there can be quite a difference between being brain damaged and being on life support. I certainly wouldn't want to wait around for new science to fix me, neither would I expect my family to.


"I thought you are man, but
you are nice woman.

yay,

:R"

Delete

Zauberdach


Zauberdach

Sometimes sword wofter
Location: Edinburgh

Total posts: 199
Posted:Written by: Spanner

Written by: Pele

However, this is a pretty powerful thing. The husband had rights over the parents...and I agree with that.




Why? Not that I necessarily disagree with you - I'm not certain on how I feel about the issue yet - but if the husband has rights over the parents, surely this means that at the point of marriage, the family is literally giving their daughter away. This used to be very much the case but it sounds a little old fashioned in this day and age. No offence.




I think what is being suggested is that a persons partner should have the ultimate say, husband or wife, as to what happens to their loved one.


IMPORTANT: Any views or opinions are solely those of the author and do not necessarily represent those of a sane person.

"just get the f**k on with it and make me the anti-christ already!"

Delete

Spanner
BRONZE Member since Feb 2003

Spanner

remembers when it was all fields round here
Location: in the works... somewhere...

Total posts: 2790
Posted:Yes, I understand that smile But why?

"I thought you are man, but
you are nice woman.

yay,

:R"

Delete

peter pan


newbie


Total posts: 9
Posted:I think the fact that it was portrayed as the fanatics from the religious right fighting to stop her husband from allowing her to die has given many people the wrong impression.

She was severely handicapped, but nonetheless alive (at least physically). The stopped giving her food and water so she slowly starved to death.

Knowing the real story definitely changes it....


Delete

DoktorSkell
SILVER Member since Jan 2005

DoktorSkell

addict
Location: Van Diemans Land

Total posts: 475
Posted:Not trying to be insensitive here.
But i am just glad that its all over


Fair luna bright, fair luna moon
it shines at night but fades too soon
fair luna moon, fair luna bright
forever we dance
we dance under starlight

Delete

munkypunks
GOLD Member since Jan 2005

munkypunks

enthusiast, but not enthusiastic
Location: Los Angeles, California

Total posts: 367
Posted:Written by: Spanner

Yes, I understand that smile But why?



Ask Jeb and W about the "sanctity of marriage."

And it works both ways - the wife would have final word over the parents if the husband is incapacitated. I think there's some language about the spouses leaving their parents and cleaving unto one another...or something like that. The idea (at least in American law) is that you are no longer a child under your parents' control, and that marriage is a legal contract with rights and obligations.

Most people don't think about the full ramifications of that when they get married. But a spouse can bind you to a financial obligation, while a parent cannot. And the spouse is responsible for the care and upkeep of the other one. Why would decision-making about health care be different? Would it be right to allow the parents to decide to keep Terri alive even though legally Michael is the one who has to pay for her care?


You can't fall off the floor, but sometimes you need a chair to reach the cookie jar.

Delete

Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Having just lost two kids after their parents withdrew support...and now having a girl on the unit whose parents NEED to withdraw support, but aren't, and having withdrawn support on my own father, I think I have a fairly informed opinion on all this...

...which I will elaborate on once I'm not on call and once I've slept.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

Delete

MiG
GOLD Member since Apr 2004

MiG

Self-Flagellation Expert
Location: Bogged at CG

Total posts: 3415
Posted:I just reckon that the person you choose to spend the rest of your life with, and who wishes to spend their life with you (ie, get married to), should have more say over the people you get stuck with, whether you like it or not (family).

But thats just me, and i'd rather die than be left in that state, especially for 15 years.

and, as a side note, im going to put in my will that i want an autopsy performed, to make certain im dead before i get buried.


"beg beg grovel beg grovel"
"master"
--FSA

"There was an arse there, i couldn't help myself"
--Rougie

Delete

myco
BRONZE Member since Nov 2004

myco


Location: melbourne, victoria, australia

Total posts: 2084
Posted:i work with a few people who are in, for want of a better term, a persistent vegetative state, and have been for many years. it's a very difficult subject, because unless it has been communicated by the person whether they want to remain alive or not, all we can do is guess. the people i have in mind aren't going to improve, and it is completely unknown what sort of mental activity they have. as they were wither born with their disability or acquired it at a young age (2 men were in car accidents when they were very young), the people responsible for decision making regarding medical treatment are parents, and their wishes are unknown.

i've spoken to my partner about this a bit, and he's told be pretty clearly that he doesn't want any invasive therapy (tube feeding, etc) to keep him alive if he were in a situation like that . he hasn't spoken to his parents about it though, and if something did happen, his folks would have the final say in what happened, because we're not married. i think that generally, but not always, spouses would have a better idea about a persons wishes than parents.


Delete

Catalyst
SILVER Member since Nov 2003

Catalyst

member
Location: Virginia

Total posts: 103
Posted:yeah...well, the fact of the matter, is that things like this happen every day...the only reason that we have heard about it is because the parents and the ex were fighting aout it...there are so many factors to consider....the husband's judgement to not have any rehabilitative therapy for the entire time that terri was in the hospital...would that have made a difference?? I think that ultimately, your partner should have a say in what's going to happen to you. So, if the parents kept her alive...and then they died four years later, then what....the whole thing all over again. Personally, I would want my dog to die with more dingity. So, yes....most important is a living will. Everyone needs to write one to be sure that your wishes are followed in case of something tragic....morbid, I know....but the safest bet. I think that it would suck to be on a feeding tube....for a day, much less years.

Delete

Pele
BRONZE Member since Dec 2000

Pele

the henna lady
Location: WNY, USA

Total posts: 6193
Posted:Written by: Spanner

Written by: Pele
However, this is a pretty powerful thing. The husband had rights over the parents...and I agree with that.



Why? Not that I necessarily disagree with you - I'm not certain on how I feel about the issue yet - but if the husband has rights over the parents, surely this means that at the point of marriage, the family is literally giving their daughter away. This used to be very much the case but it sounds a little old fashioned in this day and age. No offence.





No offense Spanner. It is on the basis currently that we generally confide in our spouses more than a parent, and that we have shared lives as spouses..especially in the realm of finance, which is a major concideration in these cases. That is where this comes from, and frankly, I agree with it.

Though speaking of the old fashion route, when was the last time you went to a wedding? They *still* say "Who gives this woman away?" unless told not to. So yeah, it is still there conceptually.

As for the politcal involvement. I do not at all *believe* the motives were to protect her. In fact, for a country which is supposedly politically seperated from church, many of our leaders disgustingly use it as leverage in campaigns, and in my eyes this was another religiously charged political campaign. However, I can only state as "fact" what has been said, and that is that this was to "protect" her.

I have to say two things I also find very interesting about this right to die case, and the other two that have been in the US since the 70's.
Terri essentially put herself in this position. Not only by not having a living will (really through no fault of her own, it is not common practice) but also she had an eating disorder which caused an imbalance of potassium in her system, and that caused her initial collapse. Of the other two cases, one was from a car accident and the other was also self inflicted from drug and alcohol reprocussions.
Personally I think I can understand this happening from a car crash alot easier than from the self-inflicted ways. Do you at all think that might have possibly played into the prolonged denial of the families?

A living will need not be drawn up by an attorney. You can do video/audio with a written copy stamped by a notory republic here in the US at least. It is what I have done, and *anyone* with a child, I personally feel, must have one of these stating clearly who the child should go to in the case of parental death, as well as whether or not you want the child on life support.

I also want to say there are stipulations that need to be put into a living will. A time frame for a miraculous recovery (ex: pull the plug after 6 mos), that you do not want to be maintained on life support if diagnosed as clinically brain dead or permentently in a vegitative state, only after receiving (insert number here) co-oberating diagnosis from independent physicians. Things like that.
It also helps to put funeral wishes in there. Morbid, I know, but necessary.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

Delete

Spanner
BRONZE Member since Feb 2003

Spanner

remembers when it was all fields round here
Location: in the works... somewhere...

Total posts: 2790
Posted:Written by: Pele

No offense Spanner. It is on the basis currently that we generally confide in our spouses more than a parent, and that we have shared lives as spouses..especially in the realm of finance, which is a major concideration in these cases. That is where this comes from, and frankly, I agree with it.



I understand smile What I found interesting was that Terri apparently met Michael in 1982, at the age of 19, and dated him for only 5 months in 1984 before marrying him in that same year, at the age of 21. It was in 1990, 8 years after they had met and a mere 6 years after their marriage, that Terri collapsed. By the time she died, she had been unwell for 15 of the 23 years she known him for.

If I were ever to be in the same situation, having married after a brief courtship and at a reasonably young age, I couldn't be 100% certain, however much I loved my spouse, that I'd prefer him to make such a decision for me, over my family who have known me my entire life. But to reiterate munkypunk's point, although it's not a situation we like to forsee, it's certainly something worth considering when thinking about the ramifications of marriage and also a strong argument for making a living will.

I do agree that her state being inadvertantly self-imposed had a lot of bearing on Terri's parent's denial and also that it's a classic case of the church versus state issue. In my opinion, it was the coincidence of Terri's parents sharing the view of Bush etc. that prolonged the suffering that a living will would more likely have ceased. May she rest in peace frown


"I thought you are man, but
you are nice woman.

yay,

:R"

Delete

Gnarly Cranium
SILVER Member since Feb 2005

Gnarly Cranium

member
Location: San Francisco

Total posts: 186
Posted:WHY does everyone seem to think that this thing is any of their damn business, anyway?

This kind of thing happens all the time. In fact, the way MOST people end up dying is when the decision is made to lay off with the tubes and wires and gidgets and rescustication. Of course they're usually conscious for it, but still. Sometimes the line is very blurry. Sometimes the person has just enough awareness left to be trapped and suffering yet unable to communicate their wishes. In Terry's case there was MASSIVE brain damage, like every part of her cortex was affected and substantial portions of it had actually disintegrated. If it's bad enough for the courts to be able to decide pretty quick there's no chance anybody's home, it's probably pretty bad. About as clear cut as it gets.

So why did it get so totally blown out of proportion THIS time? Why are all of these idjits coming out of the woodwork to stand vigil on the lawn uninvited for Terry and ignoring all the other people this is happening to? Do any of them even know what HER religious beliefs were-- not hearsay from her parents, do they know? Do any of them give the slightest crap whether or not she'd want this circus raging on through court and news for years, Would any of THEM want a bunch of religious wacko strangers trying to wrest control over whether or not they live or die when they're unable to make the choice themselves? Would any of them want to made famous as a twitching, drooling, helpless lump with no choice whatsoever in whether or not their face is getting stuck all over posters and TV and used as a symbol by whatever political or religious cause feels like showing it off? Do any of these people really give a crap who she is or what she might feel or want or what's really best for her (her, not them!), or are they just all having a huge party wanking on their own sense of righteousness and their own beliefs?

This is a very personal, individual situation. It's nobody's business but her friends and family, whether it turns into a big debate or not. There is NO way for anyone else to possibly determine how things should go.

I mean gawd, give the poor woman a rest and leave her ALONE already! If you want to carry a glass of water to someone you don't even know... take the damn thing to Africa or someplace where people WITHOUT massive brain damage are dying from injustice that is clear to anyone.

Sheesh!! rolleyes


"Ours is not to question The Head; it is enough to revel in the ubiquitous inanity of The Head, the unwanted proximity of The Head, the unrelenting HellPresence of The Head, indeed the very UNYIELDING IRRELEVANCE of The Head!" --Revelation X

Delete

Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:So time for some verbal diarrhea because I just finished one of those rotations. Yup. I just finished pediatric critical care. And I lost two patients this month, one aged 3, one aged 9. I'll talk about them.

This'll be a long post and I don't care if you read it. I just want it off my chest.

"Casey" (obviously not his real name) was a 3yo boy with a history of septo-optic dysplasia. That means that the area of his brain around the pituitary gland didn't form right, and because the optic nerves cross right in front of the pituitary, he was born blind, too. So he had grown up blind and dependent on hormones to replace those made by his pituitary gland, but other than that he was a pretty normal 3yo kid.

Casey got a bad bacterial pneumonia. And he got really unlucky. See, after certain types of bacterial infections in children, the body can have an immune response called the Hemolytic Uremic Syndrome (HUS), in which there's an immune reaction against blood platelets, causing them to clump together, which makes a mess of the small blood vessels, wrecks red blood cells, and causes the kidneys to fail. Normally HUS resolves after a few weeks and the kidneys recover. However, Casey got atypical HUS. So after several weeks, his kidneys never came back. He remained on continuous renal replacement therapy (similar to dialysis in principle, but slightly different in the nitty-gritty) and his lungs...they had holes in them. So every time he breathed, he would leak air out of his lungs and into his thoracic cavity, which would build up around the lung (a pneumothorax) and cause the lung to collapse. So he had to have tubes running through his chest wall to drain that air.

And there we sat with Casey. Lungs down with a breathing tube in, kidneys down, liver not doing so hot, and continuously having trouble with his various blood cell counts. And getting nowhere. When one day, Casey's heart rate dropped and blood pressure dropped. Now that isn't supposed to happen. So we spanked him full of epinephrine and atropine and, after a couple of days (because it takes a while to take a "road trip" with a kid like this) we sent him down to the CT scanner because we were afraid something might be going on inside his head.

The good news is that we found the problem...
...and the bad news is that the problem was that about half of his brain had been replaced by an abscess that stretched all the way from the ventricles in the middle of the brain to the inner lining of the skull, the meninges, a huge pocket of pus, probably caused by the same bacteria that had caused the pneumonia. And because he didn't have a working pituitary gland we'd been giving him stress-dose steroids, which suppressed his immune system...and made the abscess worse. We'd made it worse, but we'd had no choice because we were stuck between a rock and a hard place on him.

Now Casey's mother was 23 years old, a poor black woman, and his father was in Jail. Casey's mother also had a 3 month old baby at home fathered by another jackarse who had run away as soon as he'd knocked her up. To make things worse, only 6 months ago she'd lost her sister and nephew to a car accident. She was a sweetheart, though. I really liked her (she once asked me if I was single redface ubblol ) but this was too much for her. So her mother (Casey's grandmother) came down from Lansing to take over.

The scene was an exercise in urban sociology. See, in African-American culture, the rank of "Grandma" is only below "Great-Grandma." And so Grandma comes in, this rather obese lady in a wheelchair. Now she has no business needing a wheelchair, but that is her throne. She is to be waited on hand-and-foot by her family. And she calls the shots. And I have to say, I loved this woman because she loved her family with a fierceness that I rarely see. And when we updated her on Casey's condition, she cried. I think the one thing that might be worse than losing a child is losing a grandchild, because you have to watch your grandchild die and your child suffer.

And then she said "If Casey lives through this, he won't be able to run and play, he won't be able to talk, he won't have any quality of life, so it's time to let him go and be with God. God will take care of him." It was Wednesday night and they made the decision that we would continue to do everything we could to keep Casey alive, although place his comfort at premium importance until Friday morning. That would give time for all the family to arrive from Lansing and for everyone to say good-bye to Casey. And then on Friday morning, we would pull his breathing tube, give him high-dose morphine, and let him go.

On Thursday evening his dialysis machine clotted off. I wasn't there when it happened, but the staff spoke to his family and suggested that, even though they had planed for the "ritual" on Friday morning, perhaps it was time to stop the dialysis rather than have another machine brought up and just let what would happen happen.

Casey's heart rate got slower, and slower, and that night at about 4 in the morning, my pager went off. I had left on my sign-out when I left for the day that I wanted to be paged in the middle of the night if he died. It read "Mike, just wanted to let you know that Casey just died. He was comfortable and had family at bedside. -Christy" (Christy was one of the residents.)

His family could have resisted, they could have made us do everything, try to drain the abscess, but they valued quality of life over quantity of life, and they let him go.

"Sadie" was a 9-year-old girl who had been born with a bad heart. It had three chambers, and because of that, the blood pressure in her lungs was almost as high as the blood pressure in her body. Because she had been intubated in the Neonatal Intensive Care Unit (NICU) at birth, the sterility imposed on her lungs (I believe this, anyway) caused a HORRIBLE asthma.

And she came in an attack. We tried everything. We gave her albuterol, salmeterol, ipratropium, steroids, aminophylline (a "big-gun" anti-asthma drug)...and she just got worse and worse. And I had to watch this sweet little girl sitting there gasping for breath, smothering while her own lungs rebelled against her, begging for water that we couldn't give her because we were afraid she'd suck it down into her lungs by accident.

Sadie's parents were well-educated, well-to-do, and very involved in her care. We took them into a room and explained that we didn't want to put a breathing tube into Sadie because that would increase the pressure in her chest cavity, giving her heart even more work to do, and that would kill her.

And they wouldn't hear of it. They wanted everything done. So Sadie needed to sit there and smother and gasp and beg for water and I had to watch it. It was the most brutal and inhumane thing I have ever seen. No sadistic torturer could figure out how to do that to a prisoner. Worse than pain, worse than nausea is the feeling of being starved for air. I had nightmares about watching her gasping for breath 60 times a minute while sneaking in little croaks of "water, please!" "I wanna go home!"

And then they made us intubate her. And even on the ventilator, she continued to gasp for air because we couldn't give her high enough pressures without shutting off her heart. And I had to watch her work to breathe over the ventilator. And FINALLY after THREE DAYS of this, Sadie's family, who knew that she was born with a congenital heart condition that would ultimately be fatal, let us give her high-dose morphine to kill her breathing drive and keep her comfortable. She died within an hour of the increased dose of morphine, but she went comfortably.

And when I went in there, I had to be professional. I forced myself to calmly look at her family and say "I am so sorry." And then I stood over Sadie's body and did one off the most unprofessional things I've ever done: I kissed her forehead, wished her "Godspeed, little sweetheart," and left a tear sitting on her face. My eyes are tearing up right now thinking of it. Her family had made us torture her to death!

Which brings me to my father. He died of aspiration pneumonia. I held his hand as they pulled his tube. I decided to withdraw support because I loved him, because I understood futility, and because I knew that even if he recovered he would spend months yet again in a rehabilitation nursing home learning how to swallow again...only to get sick again.

He visited me the afternoon he died. I saw him clear as day with my Third Eye. He was young, strong, dressed in his Navy Univorm from WWII, and he was grinning at me with a smile that spoke of love, of pride, of a man released from immense suffering, and gratitude.

I've seen many people die in various ways from slow to fast, peaceful to ugly to violent. I don't get how people can place quantity of life above quality. Are they sadists? Do they like watching people suffer? How can you love a child and yet keep that child alive to die a gasping, choking death?

The problem with medical science is that we can do so much, but we can't stop the ultimate process. In the end everybody dies. And although we can put it off, Death still is my colleague. In the end, I sign out my patients to Him. And when He shows His face at the bedside to consult on one of our patients, we know it. He is the ultimate physician because only He can end all suffering.

So to everyone here, I beg you:

PLEASE think about your feelings on this, and PLEASE talk to your friends and your family and your loved ones. You are NOT too young to die. Heaven forbid, a car could hit you today, or you could be diagnosed with cancer today. What outcomes are important to you? Do you want to continue to work? What body image issues matter to you? Do you want to be able to walk? Please have this talk, and write down your wishes. Also please consider organ and/or anatomical donation and your feelings on this, as well. Make that known. Your last act could to be save a life...or to play a role in saving millions.

Don't make a doctor torture you to death because of a mess like the Schiavo case.

hug


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

Delete

Page: 12