PRAY FOR TERRI SCHIAVO by Conscience

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Friday, March 25, 2005 2:09 PM

I believe in solving problems, not sharing them.

Dr. Hammesfahr was NOT appointed by the court. He operates a cash in advance clinic where he claims to have successfully treated over 250 pts but apparently does not have either case histories or papers in peer-reviewed journals to support his claims. Judge Greer basically called him a fraud because he could not produce evidence for what he said or what he was proposing to do.

Hammesfahr also claims to have been nominated for the Nobel Prize. Apparently, the nomination was by a Congressman (don't know who) and obviously wasn't voted on/ approved by the Nobel committee.

Edited to add: The link to Scientology is interesting, but it seems very weak. Michael Schiavo would have to be a member in order for the allegations to make sense. Being in Clearwater doesn't mean that the whole case is being directed by Scientologists. Heck,I was in Clearwater and my MIL lived there for years and neither one of us even knew that they were based there.

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Friday, March 25, 2005 2:47 PM

Quote:
Originally posted by SignyM:
Dr. Hammesfahr was NOT appointed by the court. He operates a cash in advance clinic where he claims to have successfully treated over 250 pts but apparently does not have either case histories or papers in peer-reviewed journals to support his claims. Judge Greer basically called him a fraud because he could not produce evidence for what he said or what he was proposing to do.

Hmmm... I think we are mincing words here. Dr. Hammesfahr is a board certified physician and one of the 5 "court proceedings approved" physicans to exam Terri in 2001-2002 and provide their expert opinion to the case.

http://abstractappeal.com/schiavo/trialctorder11-02.txt

Abstractappeal.com has lots of good court documents to go thru. 3 of the 5 original physicians determined PVS, but the other two (including Dr. Hammesfahr) were more optimistic.

Ok. So Dr. Hammesfahr doesn't operate in a completely academic research mode. Not all MD who are busy treating patients are. But there *is* at least one paper that he has published, compared to none that could be found for the other 3? I don't know, maybe he does has something new. There is probably an academic study some where that self-promotes how the majority of "new" ideas come purely out of academic studies.

Quote:
Originally posted by SignyM:

Hammesfahr also claims to have been nominated for the Nobel Prize. Apparently, the nominaiton was by a Congressman (don't know who) and obviously wasn't voted on/ approved by the Nobel committee.

Ok. So, how many of the 5 Dr's got nominations from US Congress-people? Or any sort of Gov'tal award? from any country?

By the by, I think 5 hours of Physical Exam for 5 days straight would bore anyone for hours on end. I think your attention would drift now and then and not necessarily focus on whatever the matter at hand is. If you are asked to track a balloon for 2 hours back and forth continually, I think you would be bored and maybe look out the window and just !$#* look at anything other than the !#%!@# balloon just for spite.

The bastard is clapping his hands again - can someone tell the F!#@ker to stop that crap!

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Friday, March 25, 2005 3:03 PM

I believe in solving problems, not sharing them.

I actually had a reason to look up Hammesfahr before I knew he was connected to the Schiavo case. I was looking it up because of a parent who was considering treatment for their brain-damaged child. There's only so many times that someone can claim that their method works spectacularly but science hasn't caught up with it "yet" before I start to wonder whether there's any real benefit. Even taking into account that medicine dismisses unconventional theories (ulcer-causing bacteria for example) you would think that if his treatment is SO miraculous, after this many years people would have taken notice.

And, yes, it makes a difference whether the neurologist was "court appointed" or "court approved". I've shopped my kid around to enough neurologists to know that if you look hard enough, you WILL find one who will eventually implement what you want done or agree with what you already believe. Whether or not they can actually deliver is another story. As always, caveat emptor. Hammesfahr was requested by the Schindlers.

And finally- I have heard MY work described by a politician and I got the queasy feeling that he had not a single coherent notion as to what I actually did. Being nominated for the Nobel by a Congressman may be meaningful in the world of politics, but not in science or medicine.

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Friday, March 25, 2005 3:42 PM

INDECISIVETWIT

This is a Florida attorney's blog & it is FANTASTIC. I found it on a search for biased information & it's been very helpful to me. It's VERY thorough.

[url] http://www.abstractappeal.com

I hope it's as helpful to you.

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Friday, March 25, 2005 4:19 PM

Quote:
Originally posted by SignyM:
I actually had a reason to look up Hammesfahr before I knew he was connected to the Schiavo case. I was looking it up because of a parent who was considering treatment for their brain-damaged child. There's only so many times that someone can claim that their method works spectacularly but science hasn't caught up with it "yet" before I start to wonder whether there's any real benefit. Even taking into account that medicine dismisses unconventional theories (ulcer-causing bacteria for example) you would think that if his treatment is SO miraculous, after this many years people would have taken notice.

Well, I don't know him and haven't actually read enough about him other than his report, 3 short clippings, and what's in the court documents. Can't say that I am completely free of skeptism about him - I am just pretty much a skeptic about most everything to begin with. Medicine especially is a big hocus-pocus deal we don't know enough about, but keep practicing it on real live people. It takes quite a while before some of these "unconventional" theories get a nod from the guys in the ties and lab coats. Just look at where we are finding and extracting some of our best medicine today. Back to the forest of the indigenous people where "witchcraft" are being practiced and cures being administered. Those herbs sure had a problem selling themselves without the medical juggernaut purifying it and selling it in pill forms.

Quote:
Originally posted by SignyM:

And, yes, it makes a difference whether the neurologist was "court appointed" or "court approved". I've shopped my kid around to enough neurologists to know that if you look hard enough, you WILL find one who will eventually implement what you want done or agree with what you already believe. Whether or not they can actually deliver is another story. As always, caveat emptor. Hammesfahr was requested by the Schindlers.

I meant that he wasn't some *kook* that just stepped off the curb and started spouting things in front of the camera. I meant that he was on the case. But you had something else in mind and I'm curious. So explain to me the difference specifically (I guess maybe it's in the legal sense?) between "court appointed" and "court approved".

Quote:
Originally posted by SignyM:

And finally- I have heard MY work described by a politician and I got the queasy feeling that he had not a single coherent notion as to what I actually did. Being nominated for the Nobel by a Congressman may be meaningful in the world of politics, but not in science or medicine.

Yeah, well one politician - but we can't just arbitraily extend that to every single policitian and certainly not specifically when it comes to nomination awards. While I might not disagree with you that politicians in general are a bunch of unneeded hacks - it comes to reason that these same hacks won't wipe their collective or singular asses without a nod from their cronies. I'd more than willing to bet that if an award or nomination of some sort comes out from a Congress-person's orifice, it certainly wouldn't be generated by that Congress-person's complete free-will and own volition. That said, we do have Congressmen in the capital who aren't just complete hacks, but have other real professions to back themselves with - I believe a handful of them even hold real M.D.'s.

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Saturday, March 26, 2005 2:35 AM

I believe in solving problems, not sharing them.

Our agency (Which is primarily engineering, scientific and techinal) is run by a Board of 13 politicians. As far as politicians go, there are three kinds (1) the career politician for whom it's all about money (2) the ideologues, who couldn't process a new idea if their life depended on it and (3) the extremely rare statesperson, who actually thinks about what is best for their consituency in a fact-driven manner. Judging by our Board's corrupt decisions and listening to their individual comments, I don't think we have ANY of (3) on our Board!

EDited to add: AFA "court appointed" and "court approved"- Court appointed is when a professional is selected by the judge, court approved is when the professional is selected by someone else. I would like to think that it doesn't matter WHO is selected, but also having gone thru various legal matters, it makes a difference which judge, arbitrator, doctor, psychologist, attorney, jury etc. is working on a case.

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Tuesday, March 29, 2005 11:34 AM

I just read on Yahoo! News (via the AP) that Michael Shiavo has asked that an autopsy be performed after Terri passes on. I think this should show once and for all that he had nothing to hide with regards to how bad her condition was. If she wasn't as bad off as he and most of the doctors are saying, then he wouldn't want an autopsy because it would show that she still had some mental capacity.

Right?

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Tuesday, March 29, 2005 12:04 PM

::bump:: I really want to hear what people have to say

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Tuesday, March 29, 2005 12:31 PM

I’ve never subscribed to the “Michael Schiavo is a bad guy” theory. I’m sure his intentions are noble. But an autopsy would seem to be a rather dangerous way of finding out if we were right about killing someone. The fact that we need an autopsy should give people pause on just how confident we really are about Mrs. Schiavo's mental health. There's no going back from that point.

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Tuesday, March 29, 2005 1:34 PM

I have a vote and I'm not afraid to use it!

http://www.miami.edu/ethics2/schiavo/timeline.htm

This seems like a good timeline of what-happened/ was-done when. The whole thing is quite interesting, but one bit stood out. Mrs. Schiavo's husband had a thalamic stimulator experimentally implanted in 1990 to try to improve his wife's condition. That is why she can't have an MRI.

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Tuesday, March 29, 2005 6:30 PM

HEATHERN

Quote:
The US governments or governments in general, should not be in the practice of killing people because they do not exhibit enough awareness. As the president said, we should err on the side of life.

said by the president who sentenced more people to death than any other US governor ever

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Tuesday, March 29, 2005 6:46 PM

Okay, let's just get something straight here. What I think the government should not be doing is getting involved in this situation PERIOD! These types of decisions are (sadly) made everyday within families!

If my mother, who isn't old yet but will eventually be, was to get so sick that she could only survive on various forms of life support, it would be up to my family and I to decide what to do. We, along with her doctors, would decide whether or not she should remain on life support for the rest of her life. The doctors would tell us the odds, and we would decide what to do. It would be the WORST decision I could imagine making, but it would be OURS to make.

I feel for Terri's family, I really and truly do. I am very very close to my family, so I empathize with them. I can't even bare to think about the day when I won't be able to call my parents on the phone throughout the day to talk to them, and I can't imagine not seeing them ever again. However, like I said, every day families everywhere face the type of situation Terri's family is dealing with, and the government does not try to decide for them, right? Why then is this case so all fire different? Why suddenly does the government decide to get involved?

I welcome all responses to what I just posted.

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Tuesday, March 29, 2005 6:59 PM

Quote:
Originally posted by HeatherN:
said by the president who sentenced more people to death than any other US governor ever

Governors don’t sentence people to death. Courts do that.

Quote:
Originally posted by Caite:
Okay, let's just get something straight here. What I think the government should not be doing is getting involved in this situation PERIOD! These types of decisions are (sadly) made everyday within families!

I don’t know the court history, or what precedents have been set, but I agree with you completely. These are painful decision that must be made, but they must be made by the family. In my opinion, the court should stop short of sentencing a person to death for being an invalid. I see nothing wrong with the court absolving liability for the death of a person in Mrs. Schiavo’s condition so that family and their doctors are free to make whatever painful decisions that feel they must, but state mandating the killing by neglect of a person is barbaric, in my opinion. States should not be involved in the killing of innocent people.

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Wednesday, March 30, 2005 1:34 AM

I have a vote and I'm not afraid to use it!

Quote:
States should not be involved in the killing of innocent people.

Iraq. Death row. Texas "Futile care" law.

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Wednesday, March 30, 2005 4:12 AM

People on death row have been convicted of a crime and are not legally innocent.

I'm not completely familiar with the "Futile Care" law, but to my knowledge it doesn't obligate a person's death if they can't pay, does it?

Even in war, the state mandated act of killing innocent people for the purpose of killing them is considered barbaric.

But the truth is, I've never really thought about it that much, until now. This is a disturbing issue for me. I believe in the so-called “right” to die, but I also believe that “right” cannot logically extend past a person's ability to clarify his or her wishes. If we don’t have some way of ascertaining the explicit wishes of the person in question, then I believe the state must logically assume that the “right” to live must take precedent. Is that not a reasonable position for the state to take? I’m I completely seeing this the wrong way.

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Wednesday, March 30, 2005 9:39 AM

XENOCIDE

Finn,

I just can't sympathize with your 'preference for life' in the face of Terri's expressed wishes.
To head off the objection I expect, let me say that in our society the court is the trier of fact. Courts have tried this case repeatedly and have found, on every occasion, that the removal of the feeding tube would be the expression of her will.
This is a question of right to die, not right to life. We (through our congressional and executive intermediaries) should not force a life on this woman that she would not want.

I found this oped helpful (I'm a luddite so you may have to cut and paste):
http://www.creators.com/opinion_show.cfm?next=2&ColumnsName=miv

-Eli

If voting mattered, they'd make it illegal.
http://www.bcpl.net/~wilsonr/farpoint.html

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Wednesday, March 30, 2005 9:44 AM

XENOCIDE

I also found this blog enlightening, even though the author and I disagree.
http://tonyplank.blogspot.com/

-Eli

If voting mattered, they'd make it illegal.
http://www.bcpl.net/~wilsonr/farpoint.html

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Wednesday, March 30, 2005 10:29 AM

I have a vote and I'm not afraid to use it!

Finn,
True story: There once was a murder trial where the defendant said - I didn't kill him, I just had my knife out and the guy fell on it.
It didn't go far, and it shouldn't have.
Same as your lame excuses for why it's OK for government to kill innocent life. We didn't kill children, we just dropped a 500lb bomb next to a school. We didn't execute innocent people, we just didn't review DNA evidence (Roughly 10% of all people on death row are provably innocent). We didn't kill poor patients, we just legalized it.
It's that incredibly twisted rationalizing that makes you and your cohorts look - .... you fill in the blank.

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Wednesday, March 30, 2005 12:33 PM

But they aren't killing Terri! Like I said in my earlier post, her legal guardian is making a decision that people are faced with all the time. Multiple doctors have said that there is little to no chance of her ever being able to be off life support. Whenever doctors tell a family that it's the family has to make a decision about whether or not to keep the person on life support or "pull the plug."

I respectfully disagree that this is anything like government sanctioned killing.

And nobody has answered this question of mine yet: WHY is THIS case any different?

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Wednesday, March 30, 2005 12:52 PM

Quote:
Originally posted by xenocide:
Finn,

I just can't sympathize with your 'preference for life' in the face of Terri's expressed wishes.
To head off the objection I expect, let me say that in our society the court is the trier of fact. Courts have tried this case repeatedly and have found, on every occasion, that the removal of the feeding tube would be the expression of her will.
This is a question of right to die, not right to life. We (through our congressional and executive intermediaries) should not force a life on this woman that she would not want.

If it truly were in “the face of Terri’s expressed wishes,” then you would get no argument from me.

Quote:
Originally posted by rue:
Same as your lame excuses for why it's OK for government to kill innocent life. We didn't kill children, we just dropped a 500lb bomb next to a school. We didn't execute innocent people, we just didn't review DNA evidence (Roughly 10% of all people on death row are provably innocent). We didn't kill poor patients, we just legalized it.
It's that incredibly twisted rationalizing that makes you and your cohorts look - .... you fill in the blank.

Maybe it was the expressed wishes of all those people to die.

Quote:
Originally posted by Caite:
And nobody has answered this question of mine yet: WHY is THIS case any different?

I don’t know that it is.

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Wednesday, March 30, 2005 1:03 PM

Quote:
Originally posted by Caite:
...

And nobody has answered this question of mine yet: WHY is THIS case any different?

It's about pretty white people and the media likes to show that... Same reason why of all of the spouses murdered with unborn babies in them and Lacy Peterson / Scott Peterson is the case being shown. Same reason why Jon Benet Ramsey gets airtime...

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Wednesday, March 30, 2005 1:43 PM

I agree with you. I think this case has a certain appeal for the media and politicians. They've all decided to jump on the bandwagon shouting "me too me too!"

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Wednesday, March 30, 2005 11:56 PM

SOUPCATCHER

I was reading some commentary the other day to which I had an immediate visceral negative reaction (which I've found often means that I've stumbled onto another cultural bias I didn't know I had). The premise was that Theresa Schiavo (and Nancy Cruzon, etc.) are/were so compelling because they represented the ideal woman - at least in the eyes of those who want to turn back the clock to a mythical time (Out of the workplace. Kitchen. Barefoot. Pregnant. Now.). They are technically alive. They need constant care/protection. They don't talk back. They don't think for themselves. They're the perfect wife. Her wishes don't matter. What matters is that this perfect specimen of womanhood be protected.

I'm still rolling that one around the head and trying it on for size.

One thing that's bothered me about the whole situation (aside from just the act of shining a national spotlight onto the tragedy of one woman, her husband, and her parents) is the bulemia. Theresa had a severe enough eating disorder that it resulted in a heart attack from an imbalance of potassium. How long do you have to be a bulemic before you get to that point? And how hard is it to recognize the warning signs of bulemia if you're living with someone who has an eating disorder?

There's a lot of tragedy involved. But the one that led to all the others was that Theresa Schiavo felt that she didn't measure up to the accepted norms of beauty that we are bombarded with every day.

* editted to add: Well. I hope the grieving will eventually lead to healing.

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Thursday, March 31, 2005 8:10 AM

Terri Schiavo passed away this morning.

This whole thing is just sad.

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Thursday, March 31, 2005 10:19 AM

REEQUEEN

Quote:
The premise was that Theresa Schiavo (and Nancy Cruzon, etc.) are/were so compelling because they represented the ideal woman - at least in the eyes of those who want to turn back the clock to a mythical time (Out of the workplace. Kitchen. Barefoot. Pregnant. Now.). They are technically alive. They need constant care/protection. They don't talk back. They don't think for themselves. They're the perfect wife. Her wishes don't matter. What matters is that this perfect specimen of womanhood be protected.

Interesting. And disturbing.

"He has a gorm horizon. All gorm that falls past it is lost forever." UserFriendly http://ars.userfriendly.org/cartoons/?id=20050114

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Thursday, March 31, 2005 10:25 AM

I have a vote and I'm not afraid to use it!

Caite:
Yes I do agree with you that it wasn't about the government killing innocent people. I just couldn't take the hypocracy anymore of people who pretend to defend the innocent, when, by their own words, they don't really give a cr*p.

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Thursday, March 31, 2005 10:36 AM

I have a vote and I'm not afraid to use it!

And yes, it is all very sad.

On a less personal note, it does raise the end-of-care issue. Almost nobody dies at home anymore. We will be in the medical system, and receiving medical care. There is a substantial chance that at some point, someone is going to have to make an end-of-care decision for us, or we will have to make it for a family member. Pretending this issue isn't there isn't going to make it go away. It's a natural consequence of modern medicine.

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Thursday, March 31, 2005 11:01 AM

I believe in solving problems, not sharing them.

I have a somewhat different take. I'm not sure its exactly stereotyping (although there is some of that going in too). What I see going on is a tremendous- and I mean TREMENDOUS- amount of projection. Because the press has not bothered to show any of the OTHER 473 million seconds of Terri's life to dispute our projections, we are free to imagine Terri however we want. If Terri has actually recovered, she would not have been as appealing as Terri the victim, who could be the canvas of our hopes and fears.

In many ways, the same thing happens in the anti-abortion crowd. The embryo is the ideal child: undemanding, full of potential, who NEVER disappoints. The fact that it is helpless and silent allows it to become the ideal canvas for our fantasies. If you think this isn't true, just watch what happens to attitude once the child is born: Reality sets in and suddenly it's just another mouth to feed.

There may be SOME sexism at work here. It's probably not as conventional to project onto a male because we simply don't accept them as being helpless. In fact, it would be an appropriate study for the medical community to determine whether more men than women are removed from various forms of life support, more old than young, more blacks than whites etc. It would reveal our prejudicial responses by exposing its influence on our perceptions of essentially equivalent medical diagnoses.

BTW, I'm sick of people driving themselves into hysteria over this one case. Blinkin' idiots, all of them.

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Thursday, March 31, 2005 11:09 AM

I believe in solving problems, not sharing them.

RUE:
"Same as your lame excuses for why it's OK for government to kill innocent life. We didn't kill children, we just dropped a 500lb bomb next to a school. We didn't execute innocent people, we just didn't review DNA evidence (Roughly 10% of all people on death row are provably innocent). We didn't kill poor patients, we just legalized it.
It's that incredibly twisted rationalizing that makes you and your cohorts look - .... you fill in the blank."

FINN:
"Maybe it was the expressed wishes of all those people to die."

Finn, if this is all you had to say on the topic, you just conceded the argument. And, you made yourself look like a callous moron to boot, completely de-legitimizing your stance as the compassionate one. Way to go, dude!

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Thursday, March 31, 2005 11:29 AM

REEQUEEN

SignyM:

Quote:
I have a somewhat different take. I'm not sure its exactly stereotyping (although there is some of that going in too). What I see going on is a tremendous- and I mean TREMENDOUS- amount of projection. Because the press has not bothered to show any of the OTHER 473 million seconds of Terri's life to dispute our projections, we are free to imagine Terri however we want. If Terri has actually recovered, she would not have been as appealing as Terri the victim, who could be the canvas of our hopes and fears.

That's what I meant by "interesting and disturbing" - it's not particularly the perceived sexism (although my perception of sexism is involved; I'm female, it basically has to be), but the psychological factors that cause such projection.

Which are disturbing to me, as they seem to be an expression of a tendency to eliminate the individual, actual, live, living people from the equation, inserting some sort of idealized fantasy of what a human - most likely Christian - being should be.

Other than that, personally I have no idea what Ms. Schiavo would've been like, and no real opinion on that matter.

Quote:
In many ways, the same thing happens in the anti-abortion crowd. The embryo is the ideal child: undemanding, full of potential, who NEVER disappoints. The fact that it is helpless and silent allows it to become the ideal canvas for our fantasies. If you think this isn't true, just watch what happens to attitude once the child is born: Reality sets in and suddenly it's just another mouth to feed.

Um....see my comment above.

Quote:
There may be SOME sexism at work here. It's probably not as conventional to project onto a male because we simply don't accept them as being helpless. In fact, it would be an appropriate study for the medical community to determine whether more men than women are removed from various forms of life support, more old than young, more blacks than whites etc. It would reveal our prejudicial responses by exposing its influence on our perceptions of essentially equivalent medical diagnoses.

I'd be very interested in seeing a study like that. It was one of the questions I had (unexpressed as that question was) about what SoupCatcher had quoted.

Another good question/study to do, would be to see how many of the "life culture" promoters have faced a similar choice among their family members, and what did they end up choosing. Because I really think - especially given that DeLay (I think) has made a similar choice (in consensus with other family members) as Mr. Schiavo, for his own father - that the divide is really not that great, except as it applies to this controversy surrounding Ms. Schiavo.

I could be wrong, of course.

Quote:
BTW, I'm sick of people driving themselves into hysteria over this one case. Blinkin' idiots, all of them.

Yuh-huh. I'm not hysterical, just morbidly curious. I swear.

"He has a gorm horizon. All gorm that falls past it is lost forever." UserFriendly http://ars.userfriendly.org/cartoons/?id=20050114

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Thursday, March 31, 2005 11:37 AM

I believe in solving problems, not sharing them.

"It's about pretty white people and the media likes to show that... Same reason why of all of the spouses murdered with unborn babies in them and Lacy Peterson / Scott Peterson is the case being shown. Same reason why Jon Benet Ramsey gets airtime..."

If someone had told me two weeks ago that Jasonzz and I would agree on something, I would have told them they were taking some pretty good drugs. But the impossible happened. I'm still in shock.

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Thursday, March 31, 2005 12:30 PM

GWYNETHH

Why does it seem that those who most fervently believe in a kind and just God with the promise of life everlasting after death are the loudest in keeping the dying/dead on machines?

Do these people believe that torturing the sick and dying by stretching out the dying process is doing Gods will?

Surely human intervention is trying to prevent God from calling them home. Oh OK it is a MYSTERY (yes it has to be in CAPS as it can’t be answered or have to make sense because it is religion).

With deep sorrow for Terri, her husband, family, and all those in similar circumstances.

With deepest contempt for those people and politicians who tried to butt in. May they have a slow and painful departure from this world to allow them to have a chance to enjoy what they would force on others.

Gwynethh

Are You Asking me to Dance?

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Friday, April 1, 2005 10:01 AM

DANFAN

This post is tied to a post by Signym, but that was just a convenient entry point. These thoughts are really directed at everyone.

The discussion on this thread is focused on Terry Schiavo’s specific case. This is understandable since the thread was initiated as a plea for prayer for her. But, it seems to me that if the discussion is to focus on the bioethics of the situation (as it seems to have evolved to be), then Terry needs to be dropped out of the picture for a while. The framework and guidelines for handling “right to die” situations needs to be defined first. Then specific cases can be interpreted within that framework.

With that in mind, I see two dimensions to the general debate: ethical and legal. They are interrelated. But they are not the same…

I think that the ethical issues should be resolved first… they drive the legal issues. For me, the ethical issues seem to be most focused on the morality of ending the life. While the debate over who should be able to end it is also an ethical parameter, it seems to be more firmly rooted in legal considerations.

Ethical issues

1) Is it acceptable to end life for medical reasons under any circumstances?

2) If yes, then what conditions constitute acceptable circumstances (brain death, persistent vegetative state, severe handicap, simple desire of the patient)?

3) Again, if the answer is that life can be ended for medical reasons, then what constitutes acceptable techniques for ending life (“active” euthanasia vice “passive” withholding of of care)?

4) If passive techniques are acceptable (i.e. “withholding support of life”), what constitutes acceptable types of support to withhold (heart stimulation, breathing stimulation, food/water)?

If the answer to the primary ethical question is “no, it is not acceptable to end life for medical reasons,” then the legal issues are very straightforward… anyone who does end life for those reasons has committed murder and should be prosecuted. If the answer is “yes,” then the legal issues become more complex.

Legal issues (assuming it is acceptable to end life for medical reasons)

1) Who should be empowered to decide to end a life and in what order of precedence?

2) If only the patient can make the choice, then what record of that choice is required (written, direct verbal, indirect verbal attested by other than patient)?

3) If only the patient can authorize it, what is to be done if no clear authorization exists?

4) If it can be authorized (or the patient's authorization attested to) by other than the patient, then in what order of precedence?

The answers for some of the questions above may be multivalent… i.e., one set of answers for brain dead patients, another set of answers for cognitive, but severely handicapped patients, etc.

I suppose the point of this rambling post is that whether you fully agree with my definition of the “layers” of this issue as laid out above, the fact is that it IS a layered issue. And the discussion, to be productive, needs to start at the top layer and drill down. If everyone jumps in somewhere in the middle or near the bottom, and then compounds the error by applying all of their unstated assumptions to a specific case (for which all the evidence is not fully and indisputably available), then we end up with people screaming at each other…

“The elephant is like a snake!”
“No, the elephant is like a tree trunk!”
“Shut the f*ck up!”
“F*cknuts!”

Where is the utility in that?

[EDITED to correct typos]

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Friday, April 1, 2005 2:08 PM

I have a vote and I'm not afraid to use it!

Not a response.

I've been thinking about the Pope. As I write this he is said to be dying. By the time I finish, he may already be dead.

There are parallels with Mrs Schiavo regarding the ending of life-sustaining care, but there are differences.

The Pope was (and at this point is reported to still be) mentally intact though failing of body. Comprehensive medical treatment might realistically preserve his life for some indefinite time longer, and withholding care will kill him - a person who is unmistakably alive and present. Mrs Schiavo, on the other hand, had a healthy body but a brain so badly damaged by most estimations she was no longer there.

The Pope opted to not go to hospital where respirators, catheters, modern drug therapy (to support cardiac function), IVs and feeding tubes, and constant monitoring might have helped him through this crisis. He has a feeding tube and breathing tube, and antibiotics. But he is without standard medical care that would be routinely performed under other circumstances (car accident). The Pope's circumstances make all the difference in the care that was selected.

In hospital, the other possibility is that he could have ended up permanently on a respirator, mentally alive but physically on life-support.

It is clear he chose death over a degraded life.

Is that suicide? Is it a sin? Or, by giving up on this life, is he doing God's will and obeying his call?

What might have happened if his wishes weren't known? It comes down to a gamble.

You could withhold aggressive treatment surmising he is beyond recovery, and provide comfort care. Or you might aggressively treat, hoping for recovery but also risking a person on permanent life-support. And if that happens, do you then treat every infection and every crisis until the heart or lungs finally give up? Or, recognizing the futile, do you eventually withdraw the commitment to care you initiated - the antibiotics, life support or nutrition?

I believe in many cases these withdrawal-of-care decisions have to be made.

If you are Bush, you always, without question 'err on the side of life' (or at least claim to). You treat aggressively and provide unending support. Ideally, everyone dies as late as possible, as a 'code'.

Or perhaps that is torture. Flogging the person forward through pain and distress until the body finally, mercifully, stops.

I know something about Parkinson's, as my dad died of it. What would become the final process of death by pneumonia, as it unfolded, was complicated and ambiguous, and ultimately brutal. He couldn't move or talk. The staff told me the morphine put him 'out of it'. Two days before he died I discovered he was cognizant and would communicate with blinks. It must have been hell, a death march.

Stepping back, I'm curious who will argue the legislature should be involved in this common tragedy?

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Friday, April 1, 2005 6:11 PM

I believe in solving problems, not sharing them.

Rue- I'm sorry to hear about your dad. It must have been a helluva death, indeed.

Three cases from my neuro bulletin board really stand out. Two of them were sisters, young girls who inherited a more aggressive form of mom's mitochondrial disease. The first died at about 6 y/o; the doctors believed her case was hopless and the mom agreed to a DNR. It must have haunted her, because her second daughter was treated aggressively with everything in the medical armamentarium. She had nuerologically regressed to the point of total care and was multiple meds for seizures. When her gut shut down, she was put on total parenteral nutrition through a central line. When her kidneys shut down, she was put on dialysis. The central line became infected many times, and she was treated aggressively with powerful IV antibiotics, and the line was moved several times. She was kept alive like this more than four years- two years more than her sister. In the end, of course, she died anyway. I have to wonder- which course did the mom feel was best?

Then there is a man who was fervently out to "save" Terri. He and his wife adopted a child whose brain was so totally destroyed (I think by in utero CMV infection) that he was only expected to live for a year or two. The boy is now 16. He is profoundly retarded, non-communicative and total care. He has such severe contractures that his hip joints have pulled out of their sockets and he's had several arm and leg surgeries. His scoliosis is so bad that it's causing him severe consipation. He can't see. He needs to be suctioned. The adoptive parents have totally wrapped their lives around taking care of this boy. Is it just me, or does this seem ghoulish???

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Saturday, April 2, 2005 9:13 AM

Terry Schiavo didn’t die because a bomb meant to destroy a brutal despotic regime accidentally killed her. She didn’t die because a jury accidentally judged her to be guilty of a crime she was not. She did not die because the hospital’s resources were limited. All of which are tragic examples of deaths that have and do occur, but Mrs. Schiavo’s death was not an accident and there was plenty of resources to keep her alive. Calling me “callous moron” and a “hypocrite” because I am skeptical of the reasoning behind orchestrating tragedy when there is already plenty of tragedy that would seem to be quite inherent in the processes of society would seem rather juvenile. It is unfortunate that the two of you chose that line of rhetoric. I’ve not instigated any personal attacks and I'm not interested in discussing Rue’s single-minded anti-war or anti-Bush socialist politics. I’m simply trying to understand something that is naturally deeply disturbing.

Most in my family are religious conservatives. I think that we all disagree with artificial means of sustaining life, largely on religious grounds. Keeping with this belief, none of my family, as far as I know, has ever lived on a ventilator or any artificial means of sustaining life for more then 3 days, if the doctor determined the care to be indefinite. But no one in my family has ever starved to death. Sometimes it was taxing on the family. There was a period of about a year and half in which my great grandmother was basically fed applesauce everyday, because she couldn’t feed herself. I am told that my great great grandmother lived that way for 6 years in a nursing home, but I was very young then. We could have decided that their lives were not worth living and simply stopped feeding them, but that was a notion that never crossed my mind and if it was ever considered by anyone else in my family it wasn’t mention to me. Allowing someone to die is not the same thing as forcing it to happen.

Taking someone off life-support was not supposed to mean that you locked them in a room away from the people who love them and systematically starve them until they die, because their lives have been ruled by the government not to be worth living. That’s not what I thought it meant when I signed my will, and I’m thinking now that perhaps I need to spell that out in my will. I can only hope that my last days are quick and painless, but life rarely ends so cleanly, and the next best thing would be to have people who love me enough to feed me applesauce until I die. I don’t ever want to be so cynical that I stop believing that old age should burn and rage at the close of day. But I also don’t want to live in a state of suspended animation while my family struggles to keep me alive at whatever cost.

At this stage, I hope Mrs. Schiavo is in a better place and her family can come to terms with their loss.

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Friday, April 8, 2005 1:43 PM

I believe in solving problems, not sharing them.

This was emailed to me from the St. Petersburg, FL Times Deputy Editor of Editorials. I just had to pass it on.

Living Will is best revenge

Like many of you, I have been compelled by recent events to prepare a more detailed advance directive dealing with end-of-life issues. Here’s what mine says:

* In the event I lapse into a persistent vegetative state, I want medical authorities to resort to extraordinary means to prolong my hellish semiexistence. Fifteen years wouldn’t be long enough for me.

* I want my wife and my parents to compound their misery by engaging in a bitter and protracted feud
that depletes their emotions and their bank accounts.

* I want my wife to ruin the rest of her life by maintaining an interminable vigil at my bedside. I’d be really jealous if she waited less than a decade to start dating again or otherwise rebuilding a semblance of a normal life.

* I want my case to be turned into a circus by losers and crackpots from around the country who hope to bring meaning to their empty lives by investing the same transient emotion in me that they once reserved for Laci Peterson, Chandra Levy and that little girl who got stuck in a well.

* I want those crackpots to spread vicious lies about my wife.

* I want to be placed in a hospice where protesters can gather to bring further grief and disruption to the lives of dozens of dying patients and families whose stories are sadder than my own.

* I want the people who attach themselves to my case because of their deep devotion to the sanctity of life to make death threats against any judges,elected officials or health care professionals who disagree with them.

* I want the medical geniuses and philosopher kings who populate the Florida Legislature to ignore me for more than a decade and then turn my case into a forum for weeks of politically calculated bloviation.

* I want total strangers - oily politicians, maudlin news anchors, ersatz friars and all other hangers-on - to start calling me “Bobby,” as if they had known me since childhood.

* I’m not insisting on this as part of my directive, but it would be nice if Congress passed a “Bobby’s Law” that applied only to me and ignored the medical needs of tens of millions of other Americans without adequate health coverage.

* Even if the “Bobby’s Law” idea doesn’t work out, I want Congress - especially all those self-described conservatives who claim to believe in “less government and more freedom” - to trample on the decisions of doctors, judges and other experts who actually know something about my case. And I want members of Congress to launch into an extended debate that gives them another excuse to avoid pesky issues such as national security and the economy.

* In particular, I want House Majority Leader Tom DeLay to use my case as an opportunity to divert the country’s attention from the mounting political and legal troubles stemming from his slimy misbehavior.

* And I want Senate Majority Leader Bill Frist to make a mockery of his Harvard medical degree by misrepresenting the details of my case in ways that might give a boost to his 2008 presidential campaign.

* I want Frist and the rest of the world to judge my medical condition on the basis of a snippet of dated and demeaning videotape that should have remained private.

* Because I think I would retain my sense of humor even in a persistent vegetative state, I’d want President Bush - the same guy who publicly mocked Karla Faye Tucker when signing off on her death warrant as governor of Texas - to claim he was intervening in my case because it is always best “to err on the side of life.”

* I want the state Department of Children and Families to step in at the last moment to take responsibility for my well-being, because nothing bad could ever happen to anyone under DCF’s care.

* And because Gov. Jeb Bush is the smartest and most righteous human being on the face of the Earth, I want any and all of the aforementioned directives to be disregarded if the governor happens to disagree with them. If he says he knows what’s best for me, I won’t be in any position to argue.

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Tuesday, April 12, 2005 1:52 PM

I believe in solving problems, not sharing them.

Huh.

Was that what they call a "loaded question"?

Nah......

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Tuesday, April 12, 2005 2:11 PM

EMBERS

um, are they trying to raise her from the dead?

personally I was hoping this thread was dead...

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Tuesday, April 12, 2005 9:55 PM

SOUPCATCHER

Weird spate of troll incursions we've been having lately, isn't it? I feel pretty silly because I did a greeting message to a user recently and then saw that they were on this crazy multiple-thread-starting lower-case spree. It's gotten to the point where, if I don't recognize a username, I'll scan the post to see if there are all caps or no caps, and check the user profile.

Actually, I'm not sure this is exactly a troll. I did a search on the username and a couple of other accounts popped up (one at free republic). It's obviously someone who is not familiar with Firefly and only came here for this thread. Potential convert?

Best case scenario is they buy the DVDs, get hooked, and spread the word to their friends. Worst case scenario is they can't figure out that this thread is just one small part of an online collection of fireflyfans and instead decide to just come here for the real world events discussions.

* editted to remove last two sentences. No need to fan the flames and all that.

---------------------
Next up: Early "Nutcrusher" Jubal and the Firebuggers

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Monday, May 9, 2005 7:29 AM

Florida Med Examiner sez Schiavo autopsy report still weeks away:

http://www.wftv.com/news/4466469/detail.html

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Haken needs a new development system. Donate.
http://www.fireflyfans.net/thread.asp?b=5&t=3283

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Saturday, May 28, 2005 6:47 PM

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Haken needs a new development system. Donate.
http://www.fireflyfans.net/thread.asp?b=5&t=3283

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Wednesday, June 15, 2005 4:32 AM

Autopsy report to be released today.

http://www.wftv.com/news/4608315/detail.html

(edited to add:)
News item on the released autopsy report

http://www.wftv.com/news/4608901/detail.html

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Haken needs a new development system. Donate.
http://www.fireflyfans.net/thread.asp?b=5&t=3283

Given the freedom to do so, anarchy will result in an organic organization unto itself.

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Wednesday, June 15, 2005 6:11 AM

HKCAVALIER

Well, she was blind when they claimed she could see family members and her brain was less than half the size of a normal adult. Unrecoverable. And no evidence of physical harm or trauma of any kind. Huh.

HKCavalier

Hey, hey, hey, don't be mean. We don't have to be mean, because, remember, no matter where you go, there you are.

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Wednesday, June 15, 2005 6:26 AM

HERO

Quote:
Originally posted by HKCavalier:
Well, she was blind when they claimed she could see family members and her brain was less than half the size of a normal adult. Unrecoverable. And no evidence of physical harm or trauma of any kind. Huh.

Always nice to find out you did the right thing after the fact. Lesson for Iraq there. Sure, the WMD's were never found, but the mass graves and torture chambers were.

I wonder how people would react if it turned out the other way round. If Schiavo was shown to be capable of a meaningful recovery, would the left have abandoned its pro-death position in favor of one that allows more in-depth review BEFORE they killed her? Doubt it. Again its like Iraq. They ignore the 10,000 things justifying our invasion both before and after it occurred, and side with terrorists and insurgents because, for all their faults, they are anti-Bush and thus can't be all that bad.

H

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Wednesday, June 15, 2005 7:11 AM

CONSCIENCE

Her physical state if irrelevant. The fact is she was a human being, and therefore didn't deserve to be starved to death by her murdering, adultering husband Michael Schiavo.

May Michael Schiavo burn in hell forever!!!!

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Wednesday, June 15, 2005 8:20 AM