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Saturday, March 19, 2005

Schiavo reconsidered

Majikthise has a great summary of the issues, and has also made one persuasive comment here. I still stand by my utilitarian argument, that Schiavo is effectively dead and it's pointless to fight over whether she should be simply extinguished and end the indignity, or whether her body ought to be kept twitching for the delight of jackals…but this other point, that I thought was particularly well-articulated on blog.bioethics.net, gives me second thoughts.

The time has come So, it is clear that the time has come to let Terri die. Not because everyone who is brain damaged should be allowed to die. Not because her quality of life is too poor for anyone to think it meaningful to go on. Not even because she costs a lot of money to continue to care for. Simply because her husband who loves her and has stuck by her for more than 15 years says she would not want to live the way she is living.

I'm more likely to be swayed by arguments about compassion for the living than about rights or respect for the dead. It's clear that her husband has made great sacrifices to carry out those wishes (not the least the way he is standing up to the outrageous vilification of the right), and he has the valid legal rights in this case.

If someday I were to be a mindless hulk, I would want my wife to be able to do what she felt was best. And damn any superstitious ninnies who get in the way of allowing her to find peace and closure and dignity because they think my idling quasi-corpse needed salvation.


Good stuff by Rivka, and interesting additional information over at Alas, a blog: a CT scan of Schiavo's brain.

image

I am not a medical doctor, but I do have that Ph.D. in neuroscience (I am eminently qualified to analyze the brains of fish and insects), and that is one ghastly mess. That's not much of a brain, it's a balloon bobbing about in there.


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Comments:
#19505: — 03/23  at  08:14 AM
Last night on talk radio, I listened to a nurse who had cared for Terri Schiavo who has made a sworn statement that Michael Schiavo kept asking, "When is the bitch going to die?" Does that sound like a loving husband to you? He is the ONLY person who stands to gain by Terri's death - by receiving money from her life insurance. He also told this nurse about all the ways he was going to spend the insurance money, if only Terri would go ahead and die. He has already broken his marriage vows to love Terri in sickness and in health by fathering two children with another woman. Why would he not divorce Terri and let her parents, who love her, assume responsibility for her care? Why would he refuse $1 million from a California businessman to turn Terri's care over to her parents? Because if Terri dies, Michael gets the insurance money, free and clear. But if he takes the $1 million and turns Terri's care over to her parents, who would see to it that she gets therapy, there is a slight chance Terri might recover enough to tell the world what really happened to her. The interviewed nurse told about how Michael would lock himself up with Terri and later the nurse would find bruises in Terri's armpits and groin and under her breasts. The nurse said she suspected Terri had received injections in these locations, and that it might have been insulin. Doesn't this strike anyone as the least bit suspicious? This nurse said she went to the police and they asked her if she actually witnessed Michael Schiavo injecting his wife with anything, and the nurse had to answer "no." Thirty-three (33)doctors have said there is a possibility that Terry could be rehabilitated to a degree. Did you know that she was actually walking and learning to feed herself at one point, but Michael Schiavo discontinued her therapy? He did not want her to get better. Let's face it folks, the law is assisting a man in getting rid of his helpless wife, and it seems he is going to get away with this crime and get some money out of it to boot. I find it very pathetic that our courts will not intercede and protect the rights and the life of a helpless woman who cannot speak for herself. Too many people are calling this woman a vegetable. I have watched her on video, and she does not appear to be a vegetable to me. You all better pray you never wind up in Terri's condition, because this could happen to you, too.



's avatar #19507: PZ Myers — 03/23  at  08:52 AM
This slandering nurse is a fraud.

Your claims are ridiculous and false.

I think that one thing that thoroughly discredits the Schindler's case is the way people are swallowing these outright lies so readily.

PZ Myers
Division of Science and Math
University of Minnesota, Morris



's avatar #19508: Chris Clarke — 03/23  at  09:02 AM
I'm finding a fair amount of hope in the fact that a significant majority of Americans seem to be thinking more critically about this than the lunatic talk-radio parroting above would seem to imply. I think Delay done went and stumbled onto a wedge issue to peel regular folks away from the Talibaptists.

In other words, I find it useful to watch who's swallowing the lies. It's a diagnostic. People like Radford above are probably beyond help, but there seems still to be hope for most of us.

"I do not think we should antagonize the religious when it is not warranted, though I think we should be willing to do so whenever it is.”
-- Glen Davidson



#19512: — 03/23  at  10:01 AM
Kathleen Radford, you are seriously misinformed.

Everything you heard on the radio and repeated in your posting was false, with most of it a flat out lie, pushed by those whose beliefs are more important than the facts. Your repeating them compounds the lies. Let me give you a little guidance:

To wit the nurse you heard on the radio was Carla Sauer Iyer, who in 2003, seven years after she had cared for Terri Schiavo, submitted an affidavit to the court loaded with inflammatory accusations against Michael Schiavo. Judge George W. Greer, the Florida circuit judge (incidentally he’s a Republican Baptist who had to resign from his long time family church because of harassment by his fellow parishioners) who has presided over the Schiavo case, dismissed Iyer's allegations as "incredible" and noted in a September 17, 2003, order that not even Terri Schiavo's parents sought her testimony in the case. He further noted that "…neither in the testimony nor in the medical records is there support for these affidavits as they purport to detail activities and responses of Terri Schiavo."

In his decision Judge Greer wrote
The remaining affidavits [including one from anther nurse, Heidi Law] deal exclusively with events which allegedly occurred in the 1995-1997 time frame. The court feels constrained to discuss them. They are incredible to say the least. Ms. Iyer details what amounts to a 15-month cover-up which would include the staff of Palm Garden of Lago Convalescent Center, the Guardian of the Person, the Guardian ad Litem, the medical professionals, the police and, believe it or not, Mr. and Mrs. Schindler. Her affidavit clearly states that she would "call them (Mr. and Mrs. Schindler) anyway because I thought they should know about their daughter." The affidavit of Ms. Law speaks of Terri responding on a constant basis. Neither in the testimony nor in the medical records is there support for these affidavits as they purport to detail activities and responses of Terri Schiavo. It is impossible to believe that Mr. and Mrs. Schindler would not have subpoenaed Ms. Iyer for the January 2000 evidentiary hearing had she contacted them as her affidavit alleges.
Judge Greer’s determination of Iyer’s veracity is almost certainly accurate.

Furthermore, you should read a detailed chronology of the case and the voluminous court decisions and briefs on the case. For that go to Abstract Appeal. You will find that far more informative than a political radio show that specializes in misinformation and propaganda.

And, if you’d like to know who the real villains in this public tragedy are ,visit the web site of The American Journal of Bioethics where you can find a run down of the multimillion dollar campaign by right wing ideologues to break Michael Schiavo, a lone individual trying to do right by his wife.

And for a briefer but informed discussion of the facts concerning Terri Schiavo go to Majikthise.

Or go to Respectful of Others a website run by a clinical psychologist for an analysis of assorted medical opinions offered by the Schindlers in their court filings. Especially read his entry Friday, March 18th Terry Schiavo, Part I: The Medical Post."

Ms. Radford, read all those references and you may come to a decidedly different conclusion, provided you’re open minded and not an ideologue like the political forces who are trying to score political points at the expense of all concerned. It would also behoove you to be skeptical when listening to right wing pundits on the air and do a little digging before opining on a situation about which you know precious little.



#19515: — 03/23  at  10:40 AM
Orac, have medical practices changed when dealing with patients who are brain dead or nearly so, or who are unconscious and suffering from severe injury or disease, and who are unquestionably going to die without recovering any significant function? I am aware of cases from 25 to 30 years ago in which patients like this were "allowed" to die in hospital by modifying their fluid intake in some fashion. I thought it was common practice at the time (common in the sense of not unusual for the type of case rather than in the sense of frequent).



#19520: Hank Fox — 03/23  at  12:01 PM
Chris, re: "I think Delay done went and stumbled onto a wedge issue to peel regular folks away from the Talibaptists."

I agree. I think the issue is opening some eyes.



#19527: Hank Fox — 03/23  at  01:38 PM
A panel of federal appeals court judges has rejected the appeal to reconnect the feeding tube. All that remains is an unlikely request for the Supreme Court to hear the case.

Now we get to see how the Bushistas spin the outcome.

Some off-the-cuff predictions:

"We've got to get rid of these dangerously-independent, liberal activist judges."

"It's all the Democrats fault, for blocking Bush's judicial appointees."

"Evil liberals and heartless money-grubbing Democrats want to kill helpless people, whereas good solid Christians like Republican candidates for Congress want to save and cherish life."

"If we could just get the Ten Commandments back into schools and courthouses, and stop the liberal atheist agenda from destroying the freedom-loving Christian heart of this great nation, we'd never have to go through this heart-rending process again, because we'd all have a godly moral compass that would tell us what to do every time."

If they're willing to be really vicious about it:

On the day Terri Schiavo dies, a visibly-saddened Bush and conservative members of Congress will fan out to appear on all the TV talk shows, and speak of the senseless tragedy of her death and the sadness of the nation at her passing. They will manage to spin this into both the anti-abortion debate and the continuing sales pitch for gutting Social Security.

Finally, if they're willing to pull out all the stops and just leave us breathless with their sheer manipulative audacity:

Bush, who has not managed to appear at a single one of the 1500-plus funerals for servicemen and -women killed in Iraq, will go to Terri Schiavo's funeral. And then, in full view of the cameras and microphones, he will cry.



#19549: — 03/23  at  04:19 PM
One of the unheralded ironies of this entire case is that the Florida trial judge, George Greer, is a Republican, a life-long Southern Baptist, and alledgedly a conservative. Sadly because the man has tried to do right he's been harangued, harassed, and threatened by his fellow parishioners to the point that he's resigned from the Baptist church to which he's belonged for decades. If those Baptists are Christian, who presents the greatest threat to this democracy, such Christians or the Taliban? One guess which I'd pick.



#19565: — 03/23  at  09:01 PM
Death from dehydration is, as you can imagine, unpleasant and painful. This is my only concern in Ms. Schiavo's case, as I am an RN who believes in death with dignity and the right to refuse medical intervention. My thoughts on this case are twofold: first, I think that given the degree of atrophy in her brain, it's unlikely that she has any self-awareness or is cognizant of pain. Second, in the event that she does indeed feel pain, remember she is in a Hospice House. Hospices' main concern is comfort care and the emphasis on a peaceful death. They use narcotic medications such as morphine much more freely than with healthy individuals. I refuse to believe that Hospice would ever allow her to suffer.



#19587: — 03/24  at  08:56 AM
Isn't it interesting that the Right to Lifers are the ones who fought against a quick injection for people in these circumstances and WANTED, once the plug/tube was removed to let nature take it's course? Now, they're screaming about the inhumanity of it, but this is what THEY WANTED!



's avatar #19589: Ken Cope — 03/24  at  09:23 AM
If any of these dimwits succeeded in hydrating TS, she'd drown. Worse, there has been litigation over the administration of communion multiple times, to which MS has objected. Can't you see the death certificate, "Asphyxiated by communion wafer." Many deaths among Alzheimer sufferers occur from the aspiration of food or liquid, leading to pneumonia; it's suspected Reagan went that way.



#19591: — 03/24  at  09:54 AM
gingerplum -

Thank you, thank you, for bringing up the vital role that Hospice can play in providing death with dignity. It is a very important point, further demonstrating that those who are in support of "pulling the tube" are not insensitive to the issues of human suffering.

Not many doctors (let alone TS's parents) can fully comprehend TS's quality of life over the past couple of years. But given all the evidence, it seems clear that allowing this mindless body to finally fade away is the humane, ethical, and moral thing to do.

Knowing that your child is going to finally be at rest, at peace, without pain...

...What else could a parent want for his/her child?

That is, unless there are grander issues at hand...

...and I think we all know what they might be (ahem, Republican Agenda, ahem).

Once in a while you get shown the light, in the strangest of places if you look at it right.

-Jerry Garcia



#19997: — 03/27  at  12:14 AM
I hope the Florida Board of Nursing is paying attention... IF the nurse(s) and CNA(s) really were 'sneaking' food & fluids to their patient against medical and/or nursing orders and the careplan and if they failed to report their concerns to the board there are several investigations/prosecutions due.
Also, how can a patient be lethargic and hysterical at the same time?



#20450: — 03/30  at  09:41 AM
Annmarie Britan's comment's are dead-on correct. I've thought exactly the same thing. What the hell would any competent nurse be doing by offering Jell-O and thin liquids (water, etc) to a patient with a G-tube on Aspiration Precautions? If this doesn't discredit Ms. Iyer once and for all as a nutcase and a disgrace to her profession, I don't know what will.



Trackback: The Assault Continues Tracked on: Bloodless Coup (63.66.160.28) at 2005 09 27 16:20:40
From the LA Times (reprinted at NYNewsday) a report that the Bush administration has sent its lawyers to the Supreme Court to ban late-term abortions. In their appeal to the Supreme Court, the Bush administration lawyers said the lower courts...



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