The Terry Schiavo issue in the states, right to die?

Eoghan-psych

mrhankey88 wrote:

well if you believe in god and what he says then you do what you can to save life, simple as that.

According to the bible *I* read, that belief also involves the assurance that *god* can save lives.

Science has had her for 15 years - now she's in the hands of whatever gods, if any, are up there.

Beruthiel

Eoghan-psych wrote:

I'm looking into getting a living will and maybe a form of the medicalert bracelet - there seems to be a version in the states for 'living will' type things, DNRs etc.

I have spent the last 30mins doing up a rough draft for my solicitor, I found this site quite useful if you wish to do your own one.

http://www.oasis.gov.ie/death/legal_issues_following_a_death/making_a_will.html?search=wills

Zombrex

Eoghan-psych wrote:

Let's be *very* clear here - "she" [in so far as "she" still exists] has been in a PVS for 15 years. Contrary to public opinion, that does not mean "she's a little under the weather". It means her brain is broken - kaput. An ex-brain.

Terry Schiavo the woman, the human, the person, has been dead for over a decade. The ethical thing to do would be a barbiturate overdose, but that isn't allowed by law in her state. The best alternative is removing the feeding tube.

Why? The only possible justification for assisted suicide is if the person is fully aware, wants to die, is in pain and will die anyway. She is not in pain. She is not going to die anyway. And she certainly isn't fully aware. They believe she has no higher brain functions, but she has plenty of lower brain functions. Who are we to say that we don't believe her existance is worth while.

If this was actually her wish, that she made clear to everyone before she died, then I would have no problem with this decision, it should have been done 15 years ago. But we are basing all this on the word of the husband, who says his wife might have not wished to live like this over 15 years ago. How many of use would like to be held in a life or death situation by someone else based on there assessment of something we said to them 15 years ago.

As some in the Irish Times pointed out, if she is truely brain dead then there is no harm in her continuing to live with the care of her parents because she is gone. If she is still semi-self aware on some level then it would be wrong of us to kill her on the word of her husband 15 years after she entered this state.

If she is truely "gone" then starving her to death isn't going to make that much of a difference. But we cannot be certain she is really gone until they do an autopsy, which they obviously can't do till she is dead.

johnnyc

why don't they jsut eject with something that would kill Instantly and move on to the next story

Eoghan-psych

"She" has been dead for 15 years. Without *constant* medical intervention, her body would cease all functioning.

This absolutely should have been done 15 years ago - that's what her husband has been trying to do!

It is not a case of saying "her existence is not worthwhile" - she is in PVS, she *has* no "existence". "Lower" brain functions are the human equivalent of behaviour exhibited by amoebae. Her brain isn't pining for the fjords, it is *broken*.

There is indeed "no harm" in keeping her body alive - but what *good* is there in it? The medical expertise and resources expended on needlessly caring for her body could better be used caring for a person with some hope of an actual life.

As for determining whether or not she is gone - the autopsy is virtually irrelevent. Brain scans such as CT and MRI are equally as effective, and it is on the basis of these scans, and behavioural measures, that she was diagnosed as PVS.

Wicknight wrote:

Why? The only possible justification for assisted suicide is if the person is fully aware, wants to die, is in pain and will die anyway. She is not in pain. She is not going to die anyway. And she certainly isn't fully aware. They believe she has no higher brain functions, but she has plenty of lower brain functions. Who are we to say that we don't believe her existance is worth while.

If this was actually her wish, that she made clear to everyone before she died, then I would have no problem with this decision, it should have been done 15 years ago. But we are basing all this on the word of the husband, who says his wife might have not wished to live like this over 15 years ago. How many of use would like to be held in a life or death situation by someone else based on there assessment of something we said to them 15 years ago.

As some in the Irish Times pointed out, if she is truely brain dead then there is no harm in her continuing to live with the care of her parents because she is gone. If she is still semi-self aware on some level then it would be wrong of us to kill her on the word of her husband 15 years after she entered this state.

If she is truely "gone" then starving her to death isn't going to make that much of a difference. But we cannot be certain she is really gone until they do an autopsy, which they obviously can't do till she is dead.

Zombrex

Eoghan-psych wrote:

"She" has been dead for 15 years. Without *constant* medical intervention, her body would cease all functioning.

Without the constant medical intervention of food you would die aswell.

Eoghan-psych wrote:

This absolutely should have been done 15 years ago - that's what her husband has been trying to do!

So he suddenly remembered a converstation he had with her 15 years ago and decide now would be a good time to leave her to die?

Eoghan-psych wrote:

It is not a case of saying "her existence is not worthwhile" - she is in PVS, she *has* no "existence". "Lower" brain functions are the human equivalent of behaviour exhibited by amoebae. Her brain isn't pining for the fjords, it is *broken*.

Yes but you do not know for sure that she is not there, there there is no glimmer of existance. She is certainly very very badly brain damaged, but the doctors cannot tell for sure that all her upper and lower brain functions are gone without doing an autopsy. Her parents believe she shows glimmers of self-awareness. You are taking an awful risk assuming she is not self aware.

Eoghan-psych wrote:

There is indeed "no harm" in keeping her body alive - but what *good* is there in it? The medical expertise and resources expended on needlessly caring for her body could better be used caring for a person with some hope of an actual life.

The "good" is that you don't take the risk killing someone who might still have brain activity on some level.

Eoghan-psych wrote:

As for determining whether or not she is gone - the autopsy is virtually irrelevent. Brain scans such as CT and MRI are equally as effective, and it is on the basis of these scans, and behavioural measures, that she was diagnosed as PVS.

Medical science of the brain is not nearly at the level of precision you seem to believe it is. It is not possible to tell beyond all doubt that this woman is completely brain dead

Mikros

Wicknight wrote:

So he suddenly remembered a converstation he had with her 15 years ago and decide now would be a good time to leave her to die?

Well this case has been in the courts in one form or another since 1998. And it was as early as 1994 that her husband attempted to stop treatment. The fact that 15years has passed is more about the amount of time spent in courts rather than her husband deciding, as you put it, now would be a good time to leave her die.

Wicknight wrote:

You are taking an awful risk assuming she is not self aware.

This is always a very difficult debate but I think the point is that she didn’t want to be kept alive in the state she is in now. This is according to her husband and is also what the courts in America have agreed with. If you accept that position, then keeping her alive is wrong in my opinion. You are then taking a risk that you are keeping her alive in a state she would never want to be in… and if you think she might be self aware you are risking prolonging her suffering indefinitely.

Also using the term “starving” her to death is emotionally loading the debate, yes removing the feeding tube will result in her death by dehydration, but there is no evidence she is suffering as conscious awareness is impossible in a persistent vegetative state. By all medical opinion that is the situation in this case.

Eoghan-psych

Wicknight wrote:

Without the constant medical intervention of food you would die aswell.

Wrong. It does not take medical intervention for me to eat - I have full, conscious control over my body. Not only *can* I feed myself, but I am self aware that I *need* to feed myself and can take action to meet that need.

Ah, but what about babies I hear you ask - they cannot feed themselves, BUT they have the ability to learn, and their neural system is actively developing to enable them to do so. Terri Schiavo is not in that situation - she cannot feed herself, is unaware of the *need* to feed, and will never improve from that situation as her neural system is not regenerative.

Wicknight wrote:

So he suddenly remembered a converstation he had with her 15 years ago and decide now would be a good time to leave her to die?

No, he has been trying constantly for the past 15 years - Terri's parents however have launched dozens of legal challenges. This has been in the news for years, it has only gained international attention this time. It just happens that now, 15 years on, he is winning the fight against her parents.

Wicknight wrote:

Yes but you do not know for sure that she is not there, there there is no glimmer of existance. She is certainly very very badly brain damaged, but the doctors cannot tell for sure that all her upper and lower brain functions are gone without doing an autopsy. Her parents believe she shows glimmers of self-awareness. You are taking an awful risk assuming she is not self aware.

A diagnosis of PVS is not easy come by. An autopsy would not reveal the level of functioning, merely the neural capacity - it would reveal brain atrophy or vascular expansion etc, all of which can be seen on CT and MRI scans. MRI scans have the added bonus of showing the *activity* of the brain [in fMRI form], from which level of functioning can be deduced when combined with behavioural measures. Her higher brain functioning is absent - that is how a PVS diagnosis is arrived at. The brain trauma and behavioural deficits are sufficient that the medical conclusion is that she is not self aware.

Wicknight wrote:

The "good" is that you don't take the risk killing someone who might still have brain activity on some level.

That would be a risk if she was living in a hut on a desert island. She is not. She has been under constant medical examination for 15 years - and the medical consesus is that her brain activity is absent in any meaningful way - the "human" part of her is not there. *Corpses* have "brain activity on some level".

Wicknight wrote:

Medical science of the brain is not nearly at the level of precision you seem to believe it is. It is not possible to tell beyond all doubt that this woman is completely brain dead

It is *more* than capable of telling, beyond any reasonable doubt, that this woman is in a persistent vegetative state. Medical science is far more precise than you see to think.

Fysh

Wicknight wrote:

Without the constant medical intervention of food you would die aswell.

Yes. Because all of us need to be attached to life support machinery and supervised by medical staff in order to eat. *applauds*

Wicknight wrote:

Yes but you do not know for sure that she is not there, there there is no glimmer of existance. She is certainly very very badly brain damaged, but the doctors cannot tell for sure that all her upper and lower brain functions are gone without doing an autopsy. Her parents believe she shows glimmers of self-awareness. You are taking an awful risk assuming she is not self aware.

The majority of neurologists who have looked at her have said she has irreversible brain damage and there were two scans taken, one in 1996 and one in 2002. The only neurologist to counter this tried to claim that the second scan showed evidence of improvement - this was rejected by a judge based on lack of support of the idea from other neurologists. Given that we've previously accepted that in her position she requires constant medical care and supervision, I'm wondering why you're willing to trust the parents (not medically trained) over several neurologists.

Wicknight wrote:

The "good" is that you don't take the risk killing someone who might still have brain activity on some level.

Might, despite 15 years of no improvement and a significant majority of field experts so far having deemed her condition to be irreversible. Stretching the boundaries of credulity here - seriously, given that medical resources are far from limitless, why is it worth investing much further time and effort into someone who so far has shown no evidence of either improvement or the possibility of improvement?

Wicknight wrote:

Medical science of the brain is not nearly at the level of precision you seem to believe it is. It is not possible to tell beyond all doubt that this woman is completely brain dead

Frankly, given the number of neurologists involved and the presence of MRI scans in more than one case, I'm prepared to believe that, you know, they might be on the money with this. Her brain is, basically, broken. Not in a "give it a while and it'll heal" way, in a "wow, pretty much razed to the ground, huh?" kind of way, judging by the majority of medical opinion.

Zombrex

Fysh wrote:

Yes. Because all of us need to be attached to life support machinery and supervised by medical staff in order to eat. *applauds*

All of us need help obtaining food. Did you kill the cow you ate for dinner last night? I hope not. The idea that it is just nature taking its course by stopping feeding her is barbaric. She can't feed herself, but neither can the army soldier who had both his arms blown off. He can't feed himself, and will require life long help to feed himself. She we just let nature take its course there as well.

Fysh wrote:

The majority of neurologists who have looked at her have said she has irreversible brain damage
...
Might, despite 15 years of no improvement and a significant majority of field experts so far having deemed her condition to be irreversible.
...
why is it worth investing much further time and effort into someone who so far has shown no evidence of either improvement or the possibility of improvement?

Because the damage is irreversible doesn't mean we should kill her. God I feel like I am in Nazi germany.

Fysh wrote:

Her brain is, basically, broken.

Her brain is undoubtable "broken," but they cannot be certain that she does not still exist in some form of self-aware state, even if she only lives on with primiative brain functions.

As someone who hopes but does not believe in existance after death, I think any exisitance is better than oblivion. And the idea that we should kill this woman to save money, or time, or medical costs is, or the feelings of the husband, is in my view horrific.

Eoghan-psych

Wicknight wrote:

All of us need help obtaining food. Did you kill the cow you ate for dinner last night? I hope not. The idea that it is just nature taking its course by stopping feeding her is barbaric. She can't feed herself, but neither can the army soldier who had both his arms blown off. He can't feed himself, and will require life long help to feed himself. She we just let nature take its course there as well.

Now you're being silly. I'm feeling quite peckish right now, so when I leave the office I'm going to go home, under my own power, go to my fridge and take out the Cruch Corner yoghurt I've been saving and eat it. This will all be done under my own conscious control. Terri Schiavo cannot do that. Terri Schiavo will *never* be able to do that.

In fact, had the 50 people arrested for trying to bring her water gotten through, they would have KILLED HER. She would have drowned.

Wicknight wrote:

Because the damage is irreversible doesn't mean we should kill her. God I feel like I am in Nazi germany.

True. Thing is, the damage is much more than "irreversible". It is catastrophic and profound. The brain damage you caused by drinking that pint or that glass of wine the other night is also irreversible - but it is so minor that even the cumulative effects across your entire lifespan are negligible [barring alcohol abuse, which can bring on Korsakoff's for example - definitely not negligible].

Wicknight wrote:

Her brain is undoubtable "broken," but they cannot be certain that she does not still exist in some form of self-aware state, even if she only lives on with primiative brain functions.

"Primitive" doesn't mean "basic". Self awareness as we use the term when describing humans is a higher cognitive function. It is not simple reaction to stimuli.

What you need to realise is that neurology and neuropsychology are *far* more advanced than you realise, and that experts have examined Terri Schiavo *many* times - their consensus view is that she has no self awareness.

Wicknight wrote:

As someone who hopes but does not believe in existance after death, I think any exisitance is better than oblivion. And the idea that we should kill this woman to save money, or time, or medical costs is, or the feelings of the husband, is in my view horrific.

She *has* no human existence - that is the whole point. Imagine, if you will, a night's sleep with no dreaming. She has expressed to her husband that she would not want to be kept in such a state. If you *would*, then don't tell your family that you don't.

If there *is* any higher power out there, she's in her hands now - human reason and science have kept her alive for 15 years.

dearg_doom

O/T but:

simu wrote:

What social security issue is this?

President Bush is trying to force huge changes to USA's social security system (ie effectively abolishing it)

This was becoming a major issue, just when Joe Regular copped on just what it meant(finacially and in terms of 'risk') to him and his, just before all this hit the headlines.

The timing for such a religiously charged issue(Bush's undoubted strongpoint) to come up was very convenient, but them's the breaks.



link
link
linky
linkee

dearg_doom

neuro-praxis wrote:

Can't you?

Lucky you.

That is the most patronising post I've ever read.

I salute you, and have now changed my attitude and have realised that I was talking nonsense thanks to that extremely incisive and well made argument.

Cheers.



And to answer your question, No, as I said, I can't think of anything crueler.

If my parents had to make their decision, if I was in Terri's state, then I would hope they would stop medical intervention.

dearg_doom

Wicknight wrote:

Er, my grand father was kept alive by a machine for weeks before he died. And I bet he was glad of those extra weeks.



That argument is 15 years to late .. and I think starving to death is hardly "dignity" ... there is not reason to kill her, the parents are willing to look after her

I'm sorry to hear about your grandfather, but his experience has nothing whatsoever to do with this case.


This argunment is not 15 years too late! This is not an issue that has a sell-by date FFS, even if it wasn't this particular case, it WILL come up again.

As has been said earlier, there is no 'her' left to look after unfortunately, it is just cruel keeping her body alive with a machine.


And no matter what 'you' think of starving to death, the simple fact is that she would have a more dignified/peaceful end if the media would refuse to report on stories like this so sensationally. It just lacks respect imo.

dearg_doom

mrhankey88 wrote:

well if you believe in god and what he says then you do what you can to save life, simple as that.

Actually, I'm agnostic myself, but I have read the Bible, Koran and other religious texts.

And in the Bible you are told that the body is but a vessel for your soul, which is immortal.

And my point is that there is no life to save anymore unfortunately, just a body to 'keep alive'.

Which is not right imo.

Evil Phil

Wicknight wrote:

And the idea that we should kill this woman to save money, or time, or medical costs is, or the feelings of the husband, is in my view horrific.

These aren't the reasons the feeding tube has been removed. It was removed because it has been determined that this was her wish when she was aware. She's not being killed, she's being allowed to die as this is what she wants. All other arguments for or against removing the feeding tube are irrelevant.

neuro-praxis

Let us imagine that we have no notion of her wishes.

Then, I have to ask.

Who was it cruel to to keep her alive? And if the answer is - her - then why? If she was brain dead then surely there was nothing cruel about feeding her every day?

Evil Phil

That thought had occured to me - if she's no longer aware well then she's not aware of what's happening to her. So I suppose it isn't cruel to continue feeding her but I do think her wishes should be followed, out of respect if nothing more.

Eoghan-psych

neuro-praxis wrote:

Let us imagine that we have no notion of her wishes.

Then, I have to ask.

Who was it cruel to to keep her alive? And if the answer is - her - then why? If she was brain dead then surely there was nothing cruel about feeding her every day?

The care expended on her, for no gain or benefit whatsoever, detracted from the care which could have been provided to other patients, patients who could actually benefit from the medical aid.

That is to say nothing of the ongoing anguish caused to the family.

Zombrex

Evil Phil wrote:

but I do think her wishes should be followed, out of respect if nothing more.

We don't know it is her wishes, that is the whole point. The husband believes that she would not want to live like this. Is he right? We don't know. Her parents, sister and brother don't think so.

Zombrex

Eoghan-psych wrote:

That is to say nothing of the ongoing anguish caused to the family.

Her entire family want her kept alive. I think letting her starve to death causes them more anguish

Evil Phil

I don't see the the care she's received has detracted from the care afforded to others, after all the States has plenty of wealth and the best health care in the world, and is the weakest argument I've heard on either side.

The continued anguish to her family can be argued either way, that's what her husband and her parents have fought so bitterly over. The situation is that she expressed a wish to die if she ended up in a vegetative state without a chance of recovery. It has been decided that this is the case and her wishes have been upheld by the courts.

Evil Phil

Wicknight wrote:

We don't know it is her wishes, that is the whole point.

The courts have decided that it is, I don't envy them either.

Eoghan-psych

Wicknight wrote:

Her entire family want her kept alive. I think letting her starve to death causes them more anguish

Eh, no. Or is that *not* her husband who has been trying for a decade to adhere to his wife's wishes? Is he just some stranger who wandered by the hospice one day?

Eoghan-psych

Evil Phil wrote:

I don't see the the care she's received has detracted from the care afforded to others, after all the States has plenty of wealth and the best health care in the world, and is the weakest argument I've heard on either side.

The continued anguish to her family can be argued either way, that's what her husband and her parents have fought so bitterly over. The situation is that she expressed a wish to die if she ended up in a vegetative state without a chance of recovery. It has been decided that this is the case and her wishes have been upheld by the courts.

You *really* need to look at the US healthcare system. Here in Europe we tend to take state-provided healthcare for granted. In the states, there is *no* NHS, no Health Boards. If you're broke, officially policy can be summed up as "don't get sick".

A night in A&E in Ireland will set you back about E50. In the states it could be 10 times that for the same treatment - most likely a lot more.

The simple fact is that there is a finite capacity, in *any* country, for healthcare provision. The term "flogging a dead horse" comes readily to mind.

Evil Phil

Eoghan-psych wrote:

You *really* need to look at the US healthcare system. Here in Europe we tend to take state-provided healthcare for granted. In the states, there is *no* NHS, no Health Boards. If you're broke, officially policy can be summed up as "don't get sick".

So if her healthcare is being funded privately then how is she taking from somebody else or preventing another patient from receiving care?

If the courts has decided that her wishes were to be kept alive or that there was a chance of her recovery and if the care was funded by the state is, again, an irrelevant argument. She'd be as entitled to it as the next patient.

Zombrex

Evil Phil wrote:

The courts have decided that it is, I don't envy them either.

No, the courts decide that she is in PVS and that he is next of kin, which means his wishes of what should be done are followed. He claims that his wishes match what he believes she would have wanted.

Eoghan-psych

Evil Phil wrote:

So if her healthcare is being funded privately then how is she taking from somebody else or preventing another patient from receiving care?

If the courts has decided that her wishes were to be kept alive or that there was a chance of her recovery and if the care was funded by the state is, again, an irrelevant argument. She'd be as entitled to it as the next patient.

If her care is being funded privately, then her parents are needlessly tying up resources for their own selfish wishes. Private funding doesn't just magic up more staff.

She would indeed be "as entitled as the next patient" if the next patient was, like her, little more than a rather cumbersome draught excluder.

It's all well and good and nice and fluffy and wooly to say "she's alive, keep her alive at all costs", but it very rapidly descends to meaningless and pointless assessments of what people are "entitled" to or what people "should" get.

Human resources are finite - they should not be expended on frivolous, pointless causes.

Evil Phil

Cumbersome draught excluder?! hoohkay ...

Anyway Wicknight, I'd imagine her husband would have a very good idea of what her wishes were. I can't see any other reason for him to go down this path. If he wished to unburdan himself he could have given legal gaurdianship to her parents, after all they fought long and hard for it. What's missing is her written consent and I reckon that her husband is in a much better position to know than her parents.

Eoghan-psych

Evil Phil wrote:

Cumbersome draught excluder?! hoohkay ...

Misplaced sentimentality is a destructive force. Look at the number of people on this board [and this board is *far* from unique] who refuse to accept, for example, that neurologists etc. can determine the "person-ness" of a brain.