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Schiavo case
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Schiavo case - March 23, 2005 4:33:00 PM
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tucker
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Does it upset anyone else that politicians, celebrities and others are stating that Mrs. Schiavo is not in a persistent vegetative state (PVS)because she is smiling, laughing, "appears to be tracking a balloon", etc. based on short segments of videotape? This is just getting ridiculous...
How about the family stating that she can recover if she had more therapy? I'm sorry but if a patient cannot actively participate, there is little therapy can do.
What are your thoughts on the subject? Has anyone treated a patient in a PVS that made any progress functionally? In my experience, I have not.
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Re: Schiavo case - March 23, 2005 5:13:00 PM
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Dr.Wagner
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Everyday I am more and more regretting I voted conservative this past election.
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Re: Schiavo case - March 23, 2005 8:56:00 PM
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Randy Dixon
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Dr. Wagner,
I'm a conservative, I gave up on the Republican party because they aren't. Hopefully the result of all the silliness they are pulling is that as the pendulum swings they gave it a big enough push that it will swing hard towards sanity.
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Re: Schiavo case - March 24, 2005 12:07:00 AM
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Andrew M. Ball PT PhD
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If any of these idiot politicians, democrat or republican, really cared about the issue of giving people at the end of life a voice --- then they would mandate that everyone at age 18, when they registered for the draft, needed to fill out a living will so that THEIR voice would be heard --- not what others THINK their voice might be.
This is sickening smoke and mirrors. BOTH sides should be ashamed!
Drew
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Dr. Andrew M. Ball, PT, DPT, Ph.D.
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Re: Schiavo case - March 24, 2005 12:36:00 AM
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Jeep
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Drew-
I cannot ignore your choice of words(perhaps unintentionl)........"end of life".
She is not suffering a terminal disease. All her organs are(or at least were, before pulling her feeding tube) functioning.
The only thing ending her life, is the elimination of food and water. Anyone and everyone would be in an "end of life" situation with those deprivations.
Her barbaric demise, based solely on heresay, is shameful.
We, as a society, are in serious trouble. We/they/some are now determining who is qualified/and or entitled to live. Very scary!!!
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Re: Schiavo case - March 24, 2005 1:58:00 AM
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jma
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Truly a sad case going on her. This will make a lot of people who do not want or are willing to fill out a will or proxy, rethink it seriously.
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Re: Schiavo case - March 24, 2005 3:07:00 AM
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Jeep
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>>>This will make a lot of people who do not want or are willing to fill out a will or proxy, rethink it seriously.<<<
Absoutely!!!
However, we are confronted with a case that is without such written declarations.
As a result of "heresay", a severely handicapped woman is being barbarically starved and dehydraded until death.
We cannot dismiss that her "Value/purpose/message" of life came/is to come after/or as a result of, her incapacitation. Every life has an importance- it may not come in the form we/society expect.
Can we say Helen Keller?
In light of such, we cannot judge the value of any life----only respect it and protect it.
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Re: Schiavo case - March 24, 2005 3:22:00 AM
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JLS_PT_OCS
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This is a tough situation.
What to do when you have that many neurologists with that many different opinions?
Along with this, I wonder how much personal motivation is going on. Do her parents really want her alive for her, or do they want her alive so they still have someone to visit and still 'have a daughter'. Does her husband want her to have her wishes fulfilled, or does he want his life to be able to move forward?
I think, in the absence of a clear written directive or living will, we have to respect her live, PVS or not.
Just because I would not want to live that way, doesn't mean I can tell someone else what they should do.
I agree with Jeep in that this is #1 not an end of life issue and #2 an example of a life not being protected.
And Wags, I know what you mean about electoral buyer's remorse. I voted Dem this year to cleanse myself for voting Rep last time. From now on, I am sticking to principles and voting Libertarian across the board.
This seems to be a lose-lose situation no matter how you look at it...
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Schiavo case - March 24, 2005 3:25:00 AM
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dross
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Jeep makes a good point about her persistent vegatative state not damaging her organs, so her life is ending because of starvation. But as doctor there is big difference between helping someone die and withholding life saving treatment.
But the issue here is that she alledgedly expressed to her husband what her wishes would be if she ever wound up in this situation. And when do the parents step aside and let the husband make the choices? I dont have the answers.
But it not up congress to deceide in these things. The GOP "less government" platform is no where to be found.
The lessons of this should be what the politicians are focusing on. Living wills and Bulemia should be on the on front page every paper.
It makes me sick. The Bush boys are way to involved.
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Re: Schiavo case - March 24, 2005 3:38:00 AM
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PTupdate.com
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I agree with chirx. She entered into a marriage contract with her husband. He indicates that she never wanted to live in a certain type of state. Do I think it's weird he waited 7 years to make this decision? Do I wonder if he has other agendas? Yes, but that does not change things. It is not up to the government to step in and alter this marriage rules, especially when everybody is pontificating marriage right now.
Who say's someones parents get to jump into the life of a married couple and start making decisions? Where will it stop? Ooops, the parents don't like the little league team Dad put the kid on, let's step in and sue to get OUR way. Ooops, Mr Congressman doesn't like how your allocating your savings, he better step in and make sure you have enough for the kid's college and that new roof.
Yes, the process sucks. I had to make the decision to stop food and water from my Dad. Docs said it would last a day, but it took 13. Try living with that!.... realizing he was stronger than anybody thought, and there may have been a chance of recovery.
There are thousands, if not millions of kids starving to death in third world countries....where is the outcry for them?
John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: Schiavo case - March 24, 2005 3:41:00 AM
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dross
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John,
He didnt wait 7 years. This fight has been going on for 7 years. But good point about the marrige agenda!!
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Re: Schiavo case - March 24, 2005 3:44:00 AM
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SJBird55
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I also see it slightly differently. There is now so much technology there medically. I guess we mentally may not be at a point to be able to necessarily easily answer questions at times. 100 years ago, this particular kind of case would not have existed - she would have died.
When is it appropriate for certain interventions and when it is appropriate to say "no thanks." It is kind of an individual question really. And then, there isn't anything in place that determines who should make a decision when the patient is in need of someone speaking on his/her behalf (in those cases where nothing is provided in writing).
Even if all the paperwork were in order, in a case like the current one, it would still be very, very difficult for the person held responsible for making the decisions. And when you do actually sit down and determine your patient advocate, it really isn't easy. I actually have a letter typed up for my advocate to give to my parents. My parents aren't listed as my advocate, and they don't know it - it would tear them to pieces to do what I would want done. And if I ever am in a situtation like that, I may be gone, but for those that live on, I don't want them to have anger or disappointment directed at my advocate.
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Re: Schiavo case - March 24, 2005 4:04:00 AM
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Diane
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Hmmnn... also in the news, wasn't there a similar case, a woman who had been comotose somewhere for twenty years, who suddenly started talking again? I wonder if that's what set this little political episode into gear, gave it fuel?
I agree that withholdment of food/water is a horrible way to "let" someone die, no other options available. Barbaric even. I much prefer the Dutch arrangement. Here there are several MDs who are willing to administer a bit more morphine than is quite necessary, to permit graceful and painless slipping away to happen.
I hope by the time I enter an extreme and vulnerable state, legal euthanasia will be available as an option, and that my human 'vet' and I have had several long and personal chats about it. Lately I took my cat (15+ years old) in to be put down. She couldn't get comfortable in any position and a hind leg started to have a life of its own. A cat that can't relax is in an end of life crisis. It was quick and peaceful.
(Hey, I warned everyone to not vote Republican.. shame on them for ramming some law through without allowing cultural consensus to develop and evolve.)
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Re: Schiavo case - March 24, 2005 4:14:00 AM
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jma
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Yes, I heard about that case as well but I don't recall if there was any motion to have the feeding tube removed or if that subject was ever brought up. Although if it did, while the exact same circumstances were going on, things would be different. There is always hope.
JMA
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Re: Schiavo case - March 24, 2005 6:41:00 AM
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Jeep
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>>> She entered into a marriage contract with her husband. He indicates that she never wanted to live in a certain type of state<<<
That constitutes heresay. We do not condem known criminals to death based on heresay. I guess her crime must be her handicap. SCARY!! VERY VERY SCARY!!
And add to that:, when convicted criminals are sentenced to death, it is done swiftly and compassionately. How many criminals have been sentenced to death via babaric starvation/dehydration?
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Re: Schiavo case - March 24, 2005 7:50:00 AM
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JLS_PT_OCS
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Jeep, I agree with your position here about the case.
However, if you are under the impression that the death penalty as practiced in the US is either swift or compassionate in any way, I must DISagree with you strongly. But that's another thread... :)
I think Jeep brings up a great point about heresay. This goes to the heart of what we mean when we talk about who can make decisions for us when we are incapacitated. If your spouse can say, speak for you in "any" matter, than what's the point of a living will, power of attorney, or will? We have those things so your spouse can't just make any decision at all on your behalf.
And if we don't have those documents, we shouldn't assume anything. So I guess it falls to the law to provide some kind of answer on who makes the choice. Because both the action to remove the tube and inaction to leave it in are considered choices.
"If you choose not to decide, you still have made a choice." -Neal Peart
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Schiavo case - March 24, 2005 9:47:00 AM
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mcap56
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This is a difficult one and I respect everyone's opinion either way. We have no idea of knowing what she would have wanted or the motivations of anyone involved. We know very few of the details involved. In light of this, none of us, or Congress for that matter could make a good decision here.
This has been examined in many courts over a period of several years. They have all of the details and they have all come to the same conclusion. In cases like this the decision goes to the husband, then the family and if there is no agreement, the courts are available. Who wouldn't sympathize with her parents? So it's tough, but that doesn't mean Congress should be involved.
I would imagine there are those in Congress who are truly concerned about her welfare but I question the motivation of most. What about the memo that circulated amoung conservatives about how this was a good political issue.
When president Bush was governor of Texas, he signed a law that would allow doctors to remove life support equipment, even over objections of the family provided that he/she appealled to an ethics board. If the patient's relatives had the means to pay for care or if they could find a facility willing to take the person then they could avoid that process. Here is an example of a resent result of that law from the LA Times:
*At Texas Children's Hospital, a 6-month-old boy, born with a fatal form of dwarfism in which his lungs were too small to support his small body, died shortly after his breathing tube was removed. His mother objected but could find no facility willing to care for the boy.*
I beleive that the president had good intentions when signing this law. It had bipartisan support and allowed for more patient/family rights than previously existed. However, it is not consistent with his current stance.
No one should be playing politics with this one. And.....they are.
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Re: Schiavo case - March 24, 2005 12:19:00 PM
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dosrinc
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Jeep did you actually compare Terry Shaivo to Hellen Keller? Please tell me you did not.
Rick
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Re: Schiavo case - March 24, 2005 2:06:00 PM
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Jeep
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RE-read------
"We cannot dismiss that her "Value/purpose/message" of life came/is to come after/or as a result of, her incapacitation. Every life has an importance- it may not come in the form we/society expect.
Can we say Helen Keller?"
I am discussing judgements people impose of what constitutes a persons "value". Her{HK} value, contributions and importance did not come in a "form" society expected. Many would have considered Helen Kellers life to have little value, capable of very little, and put her away in an institution when a small child. Thank goodness that did not happen!!
As related to schiavo- some subjectively judge her current life as without value, and are imposing their judgement by not allowing her to live. I quite disagree- Her current life has proven exceedingly valuable.{creating huge awareness of living wills and healthcare directives, that would likely not have otherwise happened} I'll bet you can't get an appt. with a family lawyer for a month for a living will/directive, because of Ms. Schiavo.
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Re: Schiavo case - March 24, 2005 5:05:00 PM
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Dr.Wagner
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My biggest concern, as myself and critical care doctors are on the front lines of this...is the government's attack on the POA or next of kin declaration of recusitation status or terminal ween.
Am I now gonna get a knock on my door from some lawyer stating I am being sued because someone is challenging a "no code" that I respected based upon the next of kin? If I choose NOT to recusitate will this be challenged if the family decides the POA has some "hidden agenda".
SCARY STUFF people. This is more than just this family, it is EVERY hospital in EVERY city. I have withdrawn care or have NOT "coded" many many people...big brother is watching.
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Dr. Wagner DO
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