What do you all think? I apoligize for the length.
Fla. case raises hard end-of-life questions
By Richard Willing, Anita Manning and Deborah Sharp, USA TODAY
CLEARWATER, Fla. " A brain-damaged woman was receiving nourishment through a new feeding tube Wednesday, a week after her husband had tried to have such treatment ended but was blocked by the Florida Legislature.
Terri Schiavo seen with her mother Mary Schindler.
By Matt May, Getty Images
Doctors in Clearwater, Fla., resumed treating Terri Schiavo on Wednesday, a day after a hastily written state law extended the severely brain damaged woman' s life and the controversy that surrounds it.
Acting on an extraordinary order by Florida Gov. Jeb Bush, doctors at Morton Plant Hospital gave Schiavo' s liquids intravenously and resumed feeding her through a tube. The feeding tube had been removed Oct. 15, after Schiavo' s husband, Michael, won court permission to allow her to die.
Schiavo, 39, has been in what doctors call a " persistent vegetative state" since 1990, when a heart attack cut off oxygen to her brain. Moved by pleas from her parents, Bush and the legislature pushed through a law on Tuesday that, for now at least, has trumped 10 years of court decisions by compelling doctors to treat Schiavo.
Bush and state legislators appeared to be influenced by videos of Schiavo that were released by her parents, Bob and Mary Schindler, who are fighting to keep their daughter alive. The videos, made available on the Internet and shown on TV, have made this " right to die" dispute different from those involving drug overdose victim Karen Ann Quinlan and car accident victim Nancy Cruzan.
In the videos, Schiavo seems aware of her surroundings and capable of greeting visitors and opening her eyes on command. Neurologists say that it' s an illusion, that Schiavo' s movements are reflex actions that do not mean her damaged brain can consciously perceive objects. The Schindlers say she responds to their voices and could benefit from experimental treatment.
" You can' t underestimate the power of that video," says Rita Marker, director of the International Task Force on Euthanasia and Assisted Suicide, an Ohio-based group that backs the law that saved Schiavo. " It says, ' Look, no matter how you try to get around it, this a person that you' re starving.' "
Schiavo' s case raises painful end-of-life questions that have become more familiar to doctors, lawyers and patients' families as science has improved its ability to prolong life: When is further treatment useless, or just plain wrong? And who should decide?
The case also raises legal questions that have not been considered in such situations, including whether two branches of government " in this case, Florida' s legislature and governor " can overturn the decisions of the third, the state' s courts.
Michael Schiavo says that his wife, who left no instructions about whether to keep her alive in such a situation, once told him that she would not want to be kept alive artificially. His attorneys said Wednesday that she had signs of organ failure after fluids were reintroduced to her system. The hospital would not confirm that.
Schiavo is still his wife' s legal guardian and is no longer allowing her parents to see her. His attorneys have not said what they will do next, but legal analysts already are calling the law that saved Terri Schiavo a violation of her privacy rights.
A look at some of the medical and legal questions raised by the Schiavo case:
The medical issues
Q. What does it mean to be in a " persistent vegetative state" ?
A. It means the brain is functioning only at a very rudimentary level, says Kenneth V. Iserson, professor of emergency medicine at the University of Arizona Health Sciences Center in Tucson. He says people in this state are not dead; they have sleeping and waking cycles and often can breathe on their own. But they cannot feel pain, express themselves or receive communication. They might have basic, but not voluntary, reflexes, Iserson says.
Q. How many people are there like this across the country?
A. There are 10,000 to 25,000 adults and 4,000 to 10,000 children in persistent vegetative states, says Ronald Cranford, neurologist and clinical ethicist at the University of Minnesota. (Cranford has testified in court in support of efforts to withhold nourishment from Terri Schiavo.)
Q. Is such a person able to remain alive only with ventilators or feeding tubes?
A. Most people in this condition require feeding tubes, but a small number can swallow liquids, says Gerry Maitland, neurologist and professor of clinical science at Florida State University in Tallahassee. They cannot move their arms to feed themselves.
Q. Her parents say that Terri Schiavo is responsive and is moving her eyes and mouth. Does that mean her brain could be functioning?
A. In a persistent vegetative state, the thinking, cognitive, conscious part of brain has been disconnected from the part responsible for rudimentary functions such as eye movement or face movements, Maitland says. In this situation, he says, Schiavo can appear to be conscious because parts of her brain that control involuntary movements are functioning. Her parents maintain that she responds to them.
Q. Do patients ever come out of this state?
A. It' s generally accepted among neurologists that any patient who has been in a persistent vegetative state as long as Schiavo will not come out of it. The part of the brain destroyed by a lack of oxygen cannot regenerate, most neurologists say. But a few say they would not rule out the possibility of some recovery.
Q. Because Schiavo was off the feeding tube for several days, is she more likely to die now even though she' s back on a feeding tube again?
A. Unless she suffered damage to her kidneys or other organs when the feeding tube was disconnected, her status is not likely to change, Maitland says.
Q: Is there a medical standard for deciding when someone should no longer be kept alive?
A. No. There are thousands of people in a persistent vegetative state because their family members or others with medical powers of attorney have decided not to withhold food or life support.
Q. What is the medical definition of death?
A. Medical experts say there is no universal definition. It generally is accepted that death occurs with the cessation of heart or brain functions.
The legal front
Q: Is there a legal " right to die?"
A: Florida law says so. A 1990 statute allows a person in a vegetative state, such as Schiavo, to have nourishment such as a feeding tube removed. Usually, an " advanced medical directive" filed while the person is still competent spells out his or her desire not to be treated when there is no hope of recovery.
Q: Is it unusual for terminally ill patients to reject treatment?
A: No. Nearly every state has a " death with dignity" law to allow patients or their representatives to reject extraordinary treatment.
Q: But what about someone like Schiavo, who left no record of her wishes?
A: Florida law spells out a pecking order of relatives who can speak for her " legal guardian, husband, adult children, parents and so on. To have nutrition withheld, a relative must persuade a judge by " clear and convincing evidence" that such a move would have been the patient' s decision.
Q: Did that happen in the Schiavo case?
A: Yes. Michael Schiavo, Terri Schiavo' s husband and guardian, has battled her parents in Florida and federal courts since 1993. First they fought over whether Michael should be removed as guardian. More recently they' ve fought over whether the Schindlers could stop Michael from having Terri' s feeding tube removed. Michael has won in court.
Q. Has a law like the one passed to save Terri Schiavo been tried?
A. Legal observers say no, which makes its validity unclear. " It presents a new legal issue that I' ve never heard of," former Florida Supreme Court Justice Stephen Grimes said Wednesday, referring to the legislature' s end run around the judicial branch.
Q. Where does the dispute go from here?
A. Probably back to state court. Debbie Bushnell, an attorney for Michael Schiavo, says Schiavo' s legal team is " trying to determine what our strategy is." Analysts say Schiavo could challenge the new law as a violation of his wife' s right to privacy and equal protection under the state Constitution. He also could claim that lawmakers and Bush violated the state Constitution' s separation of powers.
Q. What has the U.S. Supreme Court said?
A. In 1990, the court ruled that comatose patient Nancy Cruzan could have her feeding tube removed if her parents could convince Missouri officials that she would have wanted that. They did, Cruzan' s tube was removed and she died that year. The standard used then " " clear and convincing evidence" that the patient would want life support removed " now is used in Florida and other states.
Well, in the case of a respirator etc. I can see no problem with pulling the plug... but these cases are much more complicated.
This woman can actually smile when her family comes in - clearly she recognizes their voices.
I am also troubled by the fact her " husband" has " remarried" and has 2 children by his new " wife" . -- he clearly has something to gain by her death.
This whole thing stinks like s*** , I would side with the family.
I can only speak for myself. I have made it very clear to my wife and other family members that if I were to ever be in a state like her, where I could not feed myself, use the bathroom, talk, etc...etc... and had to have machines or other devices to keep me alive, to let me die in peace.
If I can' t function on my own then I do not need or desire to function at all.
I truely do not understand how any one else thinks that they have the right to keep a person alive only to suffer in a hospital bed with machines attached just to keep the bodily functions working. That is not being alive that is mearly prolonging the enevitable and forcing the prerson to suffer.
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didn' t know this guy remarried hmmm , that does add a twist to it , as for the other part , i can not accept leaving someone starve to death because they can' t feed themselves , to me that' s outright criminal and anybody who would do that should have criminal charges brought up against them , i mean it' s not like pulling the plug , she' s being starved to death
Listen, they removed the f-e-e-d-i-n-g tube. That' s not right, If this joker is divorced and remarried then his power of attorney should be challenged.
Don' t forget that the judicial bench has an agenda to forward. Right to life issues come into play and they can' t let that get into the abortion debate.
The husband has not actually remarried, he is living common law with a woman who has one child with him since his wifes situation began and is carrying another of his children. Same same in my book. He as reason to want her out of the way.
This woman is not on life support as we normally recognize it. She has a beating heart, functioning lungs and her mind is still working. She is on a feeding tub because of the complications of feeding her orally. It' s less dangerous and less work than to attempt to put things in her mouth and hope she swallows them properly. Sort of like a new born child.
Further if I understand this correctly her condition is a result of poor or improper care when she was recieving medical attention and there was a large monatary settlement that the husband controls.
Now I have no problem with a persons wish to die if unable to survive without life support in the tradition way but there is no document to prove this was her wish nor does the rest of her family. who has remained loyal to her believe that was her wish. The only one who wants her gone is someone with a vested interest in the money and his new honey. That' s hard to swallow.
I think the guy is a jerk and just wants her totally out of the way. He couldn' t keep it in his pants long enough to see his wife through this so I have little or no use for anything he has to say or trys to make anyone believe she said.
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Now you have to picture a combination of PeeWEE Herman and Wally Cox but with less muscle tone, trying to be intimidating None of this is funny! Message edited by Cougar Mag -- 1/7/2005 1:16:42 AM >/b]
Location: land of the Lilliputians, In the state of insanity
Posts: 24,186
RE: Right to die case in Florida
Quote:
If I can' t function on my own then I do not need or desire to function
at all.
Here here. I feel the same, and have put it in my will. As for
this case, they have let it stagnate in litigation way too long. I would hate to
be the person making this choice.
As for the husband, if he wants to remove himself from the responsibility
of taking care of his ex/invalid wife, can he not sign custody over to her
parents? I dont see what the problems is. That is if there isn"t an
insurance thing going on here.
I just read logs post, that sheds some lite on the situation.
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kaafir mushrik
Unintended consequences and God have one thing in common: Liberals dont believe in either of them.
Right to die case in Florida
