Lower the cost of ongoing disability cases if participant can't feed himself -- pull the feeding tube if a guardian says participant would have wanted it that way

This seems to set an awful precedent for any disabled person who can no longer feed himself or herself -- any such person arguably has become dependent on "artificial life support" and is a candidate for a guardianship-assisted "right to die":

http://www.cnsnews.com/ViewCulture.asp?Pag...L20031015b.html

http://www.nytimes.com/2003/10/15/national/15FEED.html

This is probably why many advisors etc have advocated the setting up of Healthcare Surrogates with a Power of Attorney etc. You do it while you are sane and in good health and able to rationally choose someone who you feel will do either what you told them or do what they thing is the right thing. This gives a chance that the decisions will not be emotional or selfish.

Many people would probably name their spouse as having the Power of Attorney, on the theory that you would always trust your spouse to act in your best interests. Perhaps this case will make some people reevaluate that assumption. Of course, saying or implying to one’s spouse that you do not trust him or her may raise other issues.

Don't get me started. I've been following this story for some time and the parents have at least some proof that Terry's condition may be a result of strangulation by who else but her "loving" husband! The courts refuse to even look at this evidence. This makes me so angry I could spit nails! We depend on our legal system to do the right thing, well it sure has failed this time.

This whole "right to die with dignity" thing has become a license to kill people that have become an inconvenience or cost "too much" money to care for. People in this country better wake up and start fighting back before it's their turn to be killed..er "allowed to die with dignity".

There was a doctor not too long ago who killed a patient without getting any permission from anyone. Said it was a "mercy killing" and because the women was 85 and very ill, it was just accepted and has been swept under the rug! Read about it here: lifenews.com

Carolyn

Someone still has to make the decision. Who? The hospital or Doctor who have income considerations? The spouse who might be either too emotional to be rational or might have a secret to protect? Parents or relatives who might have secret agendas beyond inheritances?

There should be someone and not left to chance. The only thing to do is to set the parameters and conditions before you need them. If the wrong choice is made suchas choosing an idiot husband only because you think that he loves you, then that is what you chose and you live or die by the consequences of you adult rational decisions.

The alternative is indefinite "life" with uncontrolled "care" at exorbitant uncontrolled prices which will be left behind for all others to pay. The only ones who will benefit are the unconcerned "care givers".

More news:

http://www.nytimes.com/2003/10/16/national/16FEED.html

"The case has attracted members of religious groups and advocates for the disabled who say that Mrs. Schiavo's death could set a chilling precedent.

"'This case threatens all people who are deemed incompetent whether it's due to dementia, Alzheimer's, brain injury or mental retardation," said Diane Coleman, president of Not Dead Yet, an organization in Forest Park, Ill., that opposes the right-to-die movement. "What disabled people are seeing is the courts will not protect us, and the health care system will not honor our rights.'"

The alternative is indefinite "life" with uncontrolled "care" at exorbitant uncontrolled prices which will be left behind for all others to pay. The only ones who will benefit are the unconcerned "care givers".

When we choose life, we all benefit. An affirmation of the value of human life has value to society. Though such a value is hard to pin down in dollars, it needs to be part of the balancing, too, if there is balancing to be done.

GBurns

You are right that no one wants to be kept alive artificially with ventilators and whatever else when there is no hope of recovery. In these situations it is appropriate to pull the plug and let nature take its course. However, the fear of having this kind of inappropriate, uncontrolled extension of life should not open the door to the kinds of "killing for convenience or gain" that we are seeing.

Terry Schiavo could live for who knows how long and the only "artificial or extreme" measures being taken to keep her alive is feeding her. She is not in a "vegetative" state as her husband asserts, she opens her eyes and reacts to people around her. She has never been given any rehabilitative therapy to see what, if any, progress she could make towards a recovery. Now she is being sentenced to die by the cruelest method short of outright torture, being left to starve to death over the next two weeks. There is nothing "right" about it and this kind of treatment is exactly what the courts should be protecting citizens from, not aiding and abetting it.

If the wrong choice is made such as choosing an idiot husband only because you think that he loves you, then that is what you chose and you live or die by the consequences of you adult rational decisions.

This is just BS, pardon my French. Because someone trusts a flim-flam man who takes their money, they got what they deserved and person who stole the money shouldn't be held accountable because is was their decision to trust him? Because someone chooses a physician who turns out to be grossly incompetent, they should have no recourse because they chose the physician? All those people who were misled by bogus health plans shouldn't be compensated because they chose the plan? People are misled every day. And while I agree that as adults we should be held accountable for our actions and our choices, this doesn't give someone else license to take advantage of us just because they have the ability to fast-talk or deceave someone into making a bad choice.

This case should scare the living daylights out of anyone with a pulse and it should be the catalist for people in this country to start working to reverse this "worship of death as the answer" trip this country is on. If its inconvenient for us to have a baby, we kill the baby. If its inconvenient for us to care for someone, just kill them. If its too expensive to care for someone, just kill them. If we can make money off of killing human embryos, by all means. It just sickens me.

Carolyn

Dave,

This lady did not choose anything, life or otherwise. When she should have or could have, she did not and so the choice fell to others who now seem to have all failed her, including society in general.

ccassetty,

RE:

"This is just BS, pardon my French. Because someone trusts a flim-flam man who takes their money, they got what they deserved and person who stole the money shouldn't be held accountable because is was their decision to trust him?"

" Because someone chooses a physician who turns out to be grossly incompetent, they should have no recourse because they chose the physician?

That is the point. The person who made the bad choice will be long gone and will have no recourse. Unless they can do it from the grave.

That is why I advocated a rational choice in advance of the need NOT a choice made as a matter of trust or love.

It is sad that this cruel method was chosen, but we (the society) are the ones who will not allow assisted suicide or mercy "killings", either of which would have been easier on this lady. We are also the ones who are so civilized and religious that we dare not trust anyone of us with the power to make those decisions either.

We cannot eat our cake and have it too.

GBurns

It is apparent that we have two fundamentally different views of this.

The rush to allow mercy killings and assisted suicide is exactly what is leading to this kind of disregard for the innate value of the life of Terry Schivo and others like her. The point is she shouldn't be dying at all, by starvation or a "mercy killing". She has not been given the chance to even try to recover because her husband has refused to squander the 1.3 million dollar settlement he received for her care and rehabilitation on her care and rehabilitation. For all we know if she had received the rehabilitative care she should have received, she could be feeding herself by now.

But rather than recognize that she is a human being who has not been given the treatment and care she deserves, all the courts see is a "vegetable" that has the "right to die." This is the mentality that the "right to die" folks are creating and it is the easy way out. If someone is dying or severely disabled, rather than put ourselves through the arduous process of keeping them comfortable and meeting their physical and emotional needs in the process, its just easier to put them out of their misery.

Some day the people of this country are going to look back on this period in our history and wonder how we ever let our society become so hard hearted and cruel. And it won't be the "so called civilized and religious" who appose these mercy killings and assisted suicides that they will be condeming.

Carolyn

Now you have caused me to have to go and research this story and your report of a settlement made for her care.

I am now curious to see why this settlement was not used for her care and why the court disregarded it, assuming that is what it was for etc etc.

As for "mercy killings" there has never been "a rush". As soon as the idea got some publicity the outcry stopped it. There have been ver few assisted suicides and most of them involved the same doctor, who was stopped by the actions caused by the outcry as soon as it became public.

Using the term "rush" is exactly the type of emotional, irrational and inaccurate reporting that stops a lot of progress that could be made by debating, researching and evaluating things so as to arrive at a solution.

However, you are right in that one day we will be regarded as having been heartless and cruel, but it just might be for our lack of a structure that takes care of our citizens whether young, elderly, uninsured or in poverty and/or homeless. Our lack of regard for humans and human life which already permeates our very materialistic society is why there is this lack of attention or care for this woman.

As for "mercy killings" there has never been "a rush". As soon as the idea got some publicity the outcry stopped it. There have been ver few assisted suicides and most of them involved the same doctor, who was stopped by the actions caused by the outcry as soon as it became public.

I think you have a little more research to do. Oregon has legalized assisted suicide and Vermont is thinking about legalizing it. And groups such as the Hemlock Society are pressuring for this kind of legislation throughout the country.

There have been 126 physician assisted suicides in Oregon in the last 5 years and there is some evidence that this number is less than the actual number because of a querk in the way these assisted suicides must be reported.

Subscribe to the free newsletter or browse through the stories at Lifenews.com for some eye opening information.

Assisted suicides and mercy killings are 2 separate things. I stated that there was no "rush" regarding merck killings and your response states nothing regarding this. I stated that there were very few assisted suicides and you responded with 126 in 1 state.

This is the sort of hysteria and faulty logic that clouds rational thought. How many states have not legalized assisted suicide? What percentage of the US population does that represent?

Legalized marijuana covers more of our population but that still has not yet constituted a "rush" or even interest beyond a cursory level. Hurricanes affect more people but that does not have the nation trembling in fear or being righteously indignant.

The actions of 1 small not very densely populated state is not cause for me to need to do reaearch, however, the fact that you do not or cannot realize the "smallness" of the issue directs the need for research and rational thought elsewhere.

Yes, I suppose 126 lives in one state that has legalized assisted suicide doesn't constitute a "large" problem as a percentage of the population as a whole. But neither did the massacre at Columbine or the World Trade Center tragedy. I don't think percentage of population is the issue. The issue is right and wrong. The issue is, if something isn't done, it could happen to me or mine or other innocent people.

The movement to legalize assisted suicide and euthenasia is growing in this country. And the time to stop it is now. Just how many people have to die to constitute a high enough percentage to where we should start worrying? Just how many states have to make it legal before those of us who see this as absolutely wrong should take action? If you want to call it unwarrented hysteria and ignore it, you certainly have that right. I will continue to try to be active as much as I can in any small way I can to try to stop this insanity before it gains a larger foot hold.

After listening to one of the family members on a radio broadcast on Saturday afternoon, I have spent a few hours reading up on this very sad case.

I have since joined those who have emailed the Governor and politicians in the hope that they will intervene and get, "as one lawyer" requested, a "time out" to that the issue can be investigated and side issues resolved.

This case seems not to be about the right to life or the right to die as much as it is a case of the manipulation of a failed judicial system and failed social services and criminal justice. I also place a lot of blame on Terri's friends and family. They have had years in which to have taken action to ensure that criminal investigations into the allegations regarding the husband. There was also time regarding the allegations made by the various nurses and care givers. There was time to have had the husband removed as guardian or at least monitored. There was no need for all of this to be last minute.

I do hope that good sense prevails and that Terri is spared.

If there is anyone reading this who has not intervened with an email to Gov Bush, a Florida politician, your Party State officials, your Senator and Congressman even if not in Florida, the US Attorney General, President Bush and the newsmedia, ANYONE, ANYWHERE, PLEASE take a few seconds and try to do something to get this matter reviewed in a timely and just manner regardless of your position on right to die etc. This is not a right to die or any other such issue, it is an issue of a miscarriage of justice. The lady needs a fair hearing, give her a chance.

You know, I can't comment on this case specifically, because I haven't kept up with it, but it is interesting to note that our belief in the sanctity of human life has been eroded in many ways. It had been about 30 years since the State of Ohio had executed anyone. Now, in the last several years, about 6 people have been executed (which is a pittance compared to other states). Interesting that no one has raised a fuss about those lives. I guess our beliefs in the sanctity of life only apply to some, and not others.

In my mind, life is precious, and if saveable with some modicum of quality (as defined by the person involved) then it should be saved. Each of us should examine our own beliefs, and those of our loved one (and for god's sake, ask them and talk to them to find out what their wishes are for life maintaining technologies), and do what is necessary to memorialize those wish. Most states now have mechanisms for doing so. Most people still don't take advantage of them.

Some recent news -- late Monday evening -- from an AP article on the Tallahassee [Fl.] Democrat Web site:

House votes to let governor intervene in Schiavo case

JACKIE HALLIFAX

Associated Press

TALLAHASSEE, Fla. - The Florida House voted Monday to give Gov. Jeb Bush the power to issue a "stay" in the case of a brain-damaged woman whose feeding tube was removed last week by her husband's order.

The House voted 68-23 for the bill. The Senate planned to take it up Tuesday.

* * *

Senate President Jim King, R-Jacksonville, originally said he didn't want to intervene. He later agreed to, but said he wanted to limit the scope of the bill as much as possible.

---------------------------------------------------

Another newspaper covered the Jim King angle yesterday, before the newly reported agreement on his part to go along with a special bill on the Senate side.

http://worldnetdaily.com/news/article.asp?ARTICLE_ID=35161

From that article:

"Volunteers with the Terri Schindler-Schiavo Foundation have learned Senate President Jim King is opposed to the bill and has said he would not present it to the upper house for a vote.

"According to his website, King is a member of the Florida Hospice Board of Directors and the Florida Task Force on Government-Financed Health Care, and is a recipient of the Hospice Hall of Fame Award.

"Last year he wrote an amendment to the Advanced Directives Law expanding the definition of "proxy."

"'The way it reads now, a total and complete stranger that doesn't even know the patient can come into the institution and say it's in the patient's best interest to die – that was his contribution to the law,'" said Pat Anderson, attorney for Terri's parents, Robert and Mary Schindler."

---------------------------------------------------

A hospice is a wonderful place for folks who want to live their final days as comfortably as possible. My cousin was ably and lovingly assisted by hospice employees when she died of cancer recently. But doesn't someone like King risk at least the appearance of impropriety by simultaneously being on a task force on government-financed health care as well as the board of directors of a hospice trade association? As in, "let's encourage the really sick, old ones on 'life support' to go to a hospice rather than run up hospital or rehab expenses"?

As a result of this string of messages, I looked at the most recent decision of the Court of Appeal of Florida, Second District, in this case, 851 So. 2d 182 (2003). (The Florida Supreme Court declined to review this decision.)

This is the fourth time since 2001 that the Court of Appeal has looked at the case of Terry Schiavo on appeal from the guardianship court in Florida. In the guardianship hearing that preceded this decision, the court heard testimony from five physicians: two selected by Terry Schiavo's husband, two selected by her parents, and one independent physician appointed by the guardianship court (after the husband and parents could not agree on an independent physician). All of these physicians had access to current medical information about Terry Schiavo, including high-quality brain scans. Each physician reviewed her medical records and personally conducted a neuological evaluation of Terry Schiavo. Lengthy videotapes of some of the examinations were presented to the guardianship court. The Court of Appeal decision states: "It is likely that no guardianship court has ever received as much high-quality medical evidence in such a proceeding."

The decision further states: "On the issue that cause this court to reverse our last decision, whether new treatment exists which offers such promise of increased cognitive function in Mrs. Schiavo's ceredbral cortex that she herself would elect to undergo this treatment and would reverse the prior decision to withdraw life-prolonging procedures, the parents presented little testimony. Dr. William Hammesfahr claimed that vasodilation therapy and hyberbaric therapy "could help her improve." He could not testify that any "specific function" would improve. He did not claim that he could restore her cognitive functions. He admitted that vasodilation therapy and hyperbaric therapy were intended to increase blood and oxygen supply to damaged brain tissue to facilitate repair of such tissues. These therapies cannot replace dead tissue. Although the physicians are not in complete agreement concerning the extent of Mrs. Schiavo's brain damage, they all agree that the brain scans show extensive permanent damage to her brain. The only debate between the doctors is whether she has a small amount of isolated living tissue in her cerebral cortex or whether she has no living tissue in her cerebral cortex." Two of the doctors said that Terry Schiavo is not in a persistent vegetative state; three said she is in a persistent vegetative state.

In upholding the decision of the guardianship court, the court concluded by noting that "the difficult question that faced the trial court was whether Theresa Marie Schindler Schiavo, not after a few weeks in a coma, but after ten years in a persistent vegetative state that has robbed her of most of her cerebrum and all but the most instinctive of neurological functions, with no hope of a medical cure, but with sufficient money and strength of body to live indefinitely, would choose to continue the constant nursing care and the supporting tubes in hopes that a miracle would somehow recreate her missing brain tissue, or whether she would wish to permit a natural death process to take its course and for her family members and loved ones to be free to continue their lives."

It now appears that the Florida legislature is going to intervene and stay the court decision.

This is the fourth time since 2001 that the Court of Appeal has looked at the case of Terry Schiavo on appeal from the guardianship court in Florida.

The Florida courts ... well, I won't go there. The Florida Bar might take my Bar card away, which I might need if I return to the practice of law in Florida.

Two of the doctors said that Terry Schiavo is not in a persistent vegetative state; three said she is in a persistent vegetative state.

OK -- tie decision. Tie goes to the runner? In a case of dueling experts, why not presume the individual is still "in there" and wants to continue to live?

"... the difficult question that faced the trial court was whether Theresa Marie Schindler Schiavo, not after a few weeks in a coma, but after ten years in a persistent vegetative state ..."

Oops, the appellate judges tipped their hand! Call the lady a vegetable and it gets a lot easier, for sure.

" ... or whether she would wish to permit a natural death process to take its course"

Thanks for that insight, your honors, but in the long run, we're ALL dead! I'd like to forestall that eventuality by continuing to eat, however. Let's presume Terri would like food and water, too.

"... and for her family members and loved ones to be free to continue their lives."

Nobody's taking anybody else's "lives" away, except the "guardian" who's decided that's what Terri wants. The fellow who's living with his girlfriend and their child. Another one on the way. The fellow from whom Terri said she wanted a divorce, shortly before the "potassium imbalance" that induced her "heart attack" at age 26. (Don't you just hate it when that happens?) Her husband can get a divorce and "continue" with his life if he chooses to leave Terri ... her folks are desperately wanting to continue to use their lives to help their daughter enjoy hers, such as it is.

And to spend the malpractice award on making sure that Terri continues to get medical treatment after her death. After all the executor and heir has expenses that they will incurr in making sure that the money is spent for the purpose awarded.

The proposed legislation in Florida known as "Terri's Law" does not require that funds be provided for Terri Schiavo's rehabilitation. The legislation states:

"The Governor may issue a one-time stay to prevent the withholding of nutrition and hydration from a patient, if, as of October 15, 2003:

(a) The patient has no written advance directive;

(b) The Court has found the patient to be in a persistent vegetative state;

© The patient has had nutrition and hydration withheld; and

(d) A member of the patient's family has challenged the withholding of nutrition and hydration."

The proposed legislation then goes on to state that a person may not be held civilly liable and is not subject to regulatory or disciplinary sanctions for taking any action to comply with the stay.

My understanding is that the intent of the legislation is to give the Florida legislature additional time to determine whether the current procedure--which gives the guardianship court the power to make decisions about life-prolonging procedures--should be changed.

In this regard, I would note that the court decision I cited above further states:

"The judges on this panel are called upon to make a collective, objective decision concerning a question of law. Each of us, however, has our own family, our own loved ones, our own children. From our review of the videotapes of Mrs. Schiavo, despite the irrefutable evidence that her cerebral cortex has sustained the most severe of irreparable injuries, we understand why a parent would hold out hope that some level of cognitive function remained. If Mrs. Schiavo were our own daughter, we could not but hold to such a faith.

But, in the end, this case is not about the aspirations that loving parents have for their children. It is about Theresa Schiavo's right to make her own decision, independent of her parents and independent of her husband. In circumstances such as these, when families cannot agree, the law has opened the doors of the circuit courts to permit trial judges to serve as surrogates or proxies to make decisions about life-prolonging procedures."

The court then went on to say: "It may be unfortunate that when families cannot agree, the best forum we can offer for this private, personal decision is a public courtroom and the best decision-maker we can provide is a judge with no prior knowledge of the ward, but the law currently provides no better solution that adequately protects the interests of promoting the value of life."

This is not the decision of a court that places no value on human life.

In the benefits world, many of us make decisions that have an impact on people's lives--both in designing and administering benefit plans. In some cases, those decisions may be "life-and-death" decisions. However, someone must decide.

I have a medical directive in place. I encourage others to execute a medical directive and to use their roles as benefit professionals to encourage the use of medical directives.

It is interesting that some people, in the interest of relieving suffering, suggest that the feeding tube be removed. Starvation is very painful, and is a prime example of suffering.

The funds for Terri's care including rehabilitation were already provided in the malpractice settlement awarded.