Sunday, March 20, 2005

Not A Light & Funny Post - My 2 cents on Shiavo

I admit, I am not much of a news watcher these days. Overall, I find it too sad & stressful, but there are some things I find I just can't ignore.

Terri Shiavo, for fellow news avoiders, is a woman at the center of a battle that has me very worried. Her husband wants her to die; her parents want her to live. Sounds like a lot of cases so far, right? The catch here is that this woman is NOT in a coma (or persistent vegitative state). Her only form of medical support is a feeding tube, and her estranged husband who already has a new family and life apart from all this - wants to remove her feeding tube so that she starves to death. Does anyone else remember a landmark case in the mid-1980's that came down as "No, you really can't starve people to death. It is inhumane, cruel, and illegal." Yet, the state of Florida in its quest to be the biggest embarrassment we've got, said, "Oh, sure, pull the tube. Starve her, kill her."

Heh?

So the whole thing is getting kicked to the federal level and Congress is meeting to have a giant freak out, as well they should. Maybe Congress will decide to cut Florida free already. Here is what congress is thinking of passing:

"Under the House legislation, a federal judge would decide whether withholding or withdrawing food, fluids or medical treatment from an incapacitated person violates the Constitution or U.S. law.

It would apply only to incapacitated people who had not left directives dealing with being kept alive artificially and for whom a state judge had authorized the withholding of food or medical treatment." - cnn, March 17 2005

Why do we need a law that says it is illegal to tarve people to death? Isn't it illegal NOW to starve people to death? Let's try a few test cases.

Case #1. Your Grandmother is getting up in years, has developed senility and can't dress, bathe, or feed herself anymore. Are you allowed to deny her her medication so that her bloodpressure spins out of control and she dies? Can you stop bringing her meals so she starves to death?

Case #2. Your teenager is being a royal pain in the butt. Can you lock him in the closet and deny food & water until he is dead?

Case #3. You have a sudden stroke that robs you pf a lot of function and your ability to communicate. You are not dead or in a coma, and over the years you do manage to communicate with facial expressions with people you know and care about. Your parents want to get you the help of one of the many doctors who sees greater recovery is possible, but your estranged husband wants to deny you food & water until you die.

Hmm. Admittedly, the line between who is alive & who is dead has a gray area. But this woman is not in that gray area, so honestly, I don't see how her right to live her life has been completely circumvented. It is #1 on the American hit parade.

Watch your right, folks. All of them. The sandy bank is eroding from under our feet and I am very worried we won't realize how bad it is until we are sliding down the cliffside.

4 Comments:

At March 21, 2005 at 3:54 PM, Blogger Doug Mc. said...

You are, of course, entitled to your opinion; but it seems to me that the source you've based your opinion on is, to put it mildly, one-sided.

Might I respectfully suggest that you take a look at this item? It is remarkably informative.

Thanks.

 
At March 23, 2005 at 1:36 AM, Blogger Lilly said...

Everything I have read, admittedly just the tip of the iceberg, is biased. The link you sent was interesting, but no less biased where the author deviated from factual timeline info. He himself states he is a "fan" of the Florida judicial system. I am not a fan. I see clear inconsistencies and blatant contradictions.

From your link, this tidbit from a precedent:
"In Browning, we stated:
In making this difficult decision, a surrogate decisionmaker should err on the side of lifeā€¦ In cases of doubt, we must assume that a patient would choose to defend life in exercising his or her right of privacy."

In this case there is a great deal of doubt. We have an individual with no written documentation of any kind about what she might have wanted. Frankly, that alone should be sufficient to say, without that we cannot authorize the removal of her feeding tube. That should have been the end right there. Then, her husband's motives are in question. Her state of consciousness is in doubt (2 out of 5 expert doctors do not categorize her state as PVS).

I would also point out that people even under extraordinary circumstances and even if terminally ill are not necessarily allowed to suicide just because they wish it. Prisoners, who surely have less rights than ordinary citizens, are not allowed to hunger strike to death. They are force fed by the state.

Finally, this Florida statute is just plain dangerous (excerpt):

"(The Florida) Legislature declares that the laws of this state recognize the right of a competent adult to make an advance directive instructing his or her physician to provide, withhold, or withdraw life-prolonging procedures, or to designate another to make the treatment decision for him or her in the event that such person should become incapacitated and unable to personally direct his or her medical care.

The Legislature has also defined what is a "life-prolonging procedure":


"Life-prolonging procedure" means any medical procedure, treatment, or intervention, including artificially provided sustenance and hydration, which sustains, restores, or supplants a spontaneous vital function. The term does not include the administration of medication or performance of medical procedure, when such medication or procedure is deemed necessary to provide comfort care or to alleviate pain."

At first reading, it looks ok - either you have a living will or you must have a document stating you have been designated by the person who is currently unable to act, to act in their place. The court is acting as though the husband, with no living will and no documentation of any kind, has this clear power.

Now this is my bias and experience talking. If anyone other than the person themselves or someone clearly and in writing appointed by that person to act in this capacity on their behalf is allowed to pull FOOD and WATER away from an incapacitated person, that is a miscarriage of justice. That is dangerous to many people, some of whom I know, who have relied on others for their medication, food, water, mobility - their survival. Would a negligent caretaker be in the clear for discontinuing insulin to a diabetic? How about failing to resupply IV fluids to someone who is bedridden, so they dehydrate and die. How about signing a living will, a DNS order, and then slashing your wrists? Read the statute. Scary.

Also scary is this quote from the linked site:
"Some believe that removing Terri's feeding tube would cause her pain and is inhumane (I'm no doctor, but the medical information I've seen on this subject uniformly says the opposite.)"
Huh?? Starvation is horrible. Physically gruesome. If that tube is pulled for any length of time, I sincerely hope that Terri is not aware on any level of what will be happening to her. Did you know that as recently as the 1950's, it was common knowledge in the medical community that newborn infants could not feel pain? Our ability to heal and keep people alive has outstripped our ability to understand the subjective experience. That's ok, that is the way of fast technology, but what the court needs to be careful of is that no one can know what she might feel or experience and it could very well be cruel.

The fight to control one's own destiny is a decades long war within the disabilities community. Until very recently, a person here in Washington State could not direct their own non-nurse caregiver to give them their own medication, something most of us just reach for ourselves. Here we have a case of clearly expressed wishes (give me my pill) on the part of a competent adult, essentially using the arm of another to carry out their own wishes, and still the courts were rocked by this. With Shiavo, we have no clear expression of will, no clear intent, and a questionable action (starvation). Even the court-loving link stated, "Her statements to her friends and family about the dying process were few and they were oral." How is that "clear and convincing evidence?" I say, without a written living will or similar written expression of intent, or possibly very clear preponderance of opinion prior to her loss of communication, that the court must, as they say, err on the side of life.

I think the court is wrong-headed to even play the "what would she want" game. Either she clearly expressed it or she did not. And if she did not, it is too late to find out and the state is obligated to err on the side of life.

 
At November 22, 2005 at 3:27 AM, Blogger Willie said...

When did they do all this? Last I checked was a week ago. Payday Loans Cash Advance

 
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