Keep Schiavo alive?

[franko]

Toronthab said:

People want to kill Terri Schiavo because they see no value in her. Some, but not all would be deterred from this course if theyt had to stab her in the heart. Better to starve her to death and of course drug her up so we won't be disturbed and upset by the terrible sight of such monstrous behaviour. No one has the "right" to kill an innocent human being

You are right -- no one would take a knife to her (though some would administer an unhealthy dose of drugs). But as

MC said:

The current course of action is not to kill her but to stop feeding her.

Is it not more monstrous to force-feed her to keep her alive?

[franko]

Toronthab said:

as to a better faster way to kill people we find inconvenient or useless, maybe we could group them together and use...oh I don't know...say ....ovens.

Well, for a while there was Reasoned and reasonaable debate on an issue.

[M. Beaux-Eaux]

This may well sound cynical and trite, but I must wonder how much of this situation is a direct consequence of the attitude "we have the technology and we must use it."? Is this maintenance a feeble reaching out toward some notion of immortality through advances in the medical sciences?

That is something quite different from the healthy human desire to alleiviate another's suffering. Of course alleiviating that suffering may well include euthanasia as an option.

Did I obtain an overdose of morphine for my dying father as per his request? I did not.

Back to square one...

[franko]

M. said:

This may well sound cynical and trite, but I must wonder how much of this situation is a direct consequence of the attitude "we have the technology and we must use it."? Is this maintenance a feeble reaching out toward some notion of immortality through advances in the medical sciences?

Not cynical, nor trite. Rather, bang-on.

A hundred years ago . . . fifty years ago. . . there'd have been no debate nor discussion. Just a realization that life is fleeting and that we'd better make the best of it while we can because no one knows what tomorrow may bring. There'd have been no fifteen years of nutrition pumped into a stomach. The sadness at the loss of a young life would have been long ago mourned. Instead, the family would have been able to move on instead of being bound with incredible sadness for so long.

That is something quite different from the healthy human desire to alleiviate another's suffering. Of course alleiviating that suffering may well include euthanasia as an option.

And then the question is asked: at what point do we alleviate?? And the question after that: when does the right to die become responsibility to die? I'm not sure that the one will not lead to the other.

Did I obtain an overdose of morphine for my dying father as per his request? I did not.

I have been involved with far too many people who have faded away from life . . . some quietly, some in great pain. I wanted to be able to reach out and take the pain away. I wanted to be able to reach out to the families that were hurting, watching a loved one suffer. I watched Les Invasions barbares and waffled between "how ridiculous to end life that way" and "what a great way to go -- to celebrate life with friends". And I still don't have an answer.

But I do believe that Congress and Bush were out of line to intervene.

[blaise]

BadCompany said:

Its a more fundamental issue than a simple IQ test score, Blaise. Its a quality of life argument. Congress isn't going to demand answers from Schiavo, they simply want to see her, for themselves, before making a decision. You know, an "informed" decision. Will it be the only basis for their decision? I would hope not, but I am sure that any sane person, if charged with such a decision - for whatever reason the charge ended up in their laps - would want to at least see the person for whom they are making such a monumental decision.

From personal experience, I can tell you straight out that flat-lined cortical activity does NOT always mean zero mental capacity. I knew a baby girl, who from about two weeks after birth, who showed zero mental activity, on every known measuring instrument. "Entire upper brain is gone" they said. "No cortex" they said. "No frontal lobe" they said. "Won't live longer than a 4 minutes, if the plug is pulled" they said. All in their considered opinion. Emphasis on "opinion." So, the plug was pulled. For 9 months, she kept on breathing, even though there was nothing that said she should have been able to do so. Recognized her mother (confirmed using standard psychological tests), responded to audio stimuli (though they said she was deaf), responded to visual stimuli. Even learned simple motor responses, such as holding her head up, and indeed, sitting. Never once did an EEG show any activity.

She eventually died, and I would never for a second argue that her quality of life was anything remotely close to being acceptable, but its not always about test scores on our (still) primitive neuro machinery.

The brain itself is still poorly understand. The machines used to study the brain are still in their infancy. Who knows what they are missing. Is Terri Schiavo being used as a political pawn. Sure. So what? Do we disregard a life simply because its too political? Is legislation more important than life? Isn't legislation supposed to be about life?

I haven't witnessed any of the events you describe, so I can't explain all of them. You should know that respiration is controlled both by the cortex and the autonomic nervous system. We breathe during sleep and unconsciousness as well as during physical exertion, but we can control the rate and force consciously (try it). Someone in a permanent vegetative state can respond to noxious auditory and visual stimuli, such as loud noises and bright lights. I am skeptical about unaided sitting up, although decerebrate muscle movements are possible. I pointed out to HFLA that the damage to Schiavo obviously affects both hemispheres. As you must have learned in your courses, the consequences of hypoxia affect the cortex first (manifested by loss of consciousness), then descend to lower levels. Prolonged anoxia (in a vacuum or in a CO2 H2Oenvironment--by which I mean drowning) results in brain death and just plain death by anyone's definition. Schiavo's myocardial infarction did a nasty job on her brain.

[blaise]

Habs_fan_in_LA said:

Killing the infirm, retarded, physically challenged and intelectually impaired is wrong. I don't want to be the judge.

She's not intellectually impaired, she has no intellect left. Her open eyelids may suggest wakefulness but it's not so. Yawning, grunting, and meaningless swallowing may occur. There may be random limb or head movements. Obviously both hemispheres of the cortex have been extensively damaged. Otherwise, one hemisphere may still be operable, which is not the case. Heart failure that deprives the brain of oxygen affects the cortex first, followed by failure at lower brain levels.

Severe intellectual retardation, as distinct from a vegetative state, would look far different. You may have seen such unfortunates in an institution, or you may have encountered some individuals with less severe retardation in public.

[blaise]

M. said:

This may well sound cynical and trite, but I must wonder how much of this situation is a direct consequence of the attitude "we have the technology and we must use it."? Is this maintenance a feeble reaching out toward some notion of immortality through advances in the medical sciences?

That is something quite different from the healthy human desire to alleiviate another's suffering. Of course alleiviating that suffering may well include euthanasia as an option.

Did I obtain an overdose of morphine for my dying father as per his request? I did not.

Back to square one...

It is a well-reported fact that many oncologists fail to administer enough morphine (or other opioid) to mitigate the severe pain of cancer patients. Why? Because they don't want to be accused of creating addiction to a controlled substance! As though a terminally ill cancer patient would seek out street dealers! This is ludicrous. They should understand pharmacology well enough to realize that pain antagonizes the euphoria of morphine--the effect doesn't occur. Give the same dose to a person who is not in pain, and it would induce euphoria. They should reread their texts, or better yet, junk them in favor of some up-to-date literature.

[Toronthab]

franko said:

Well, for a while there was Reasoned and reasonaable debate on an issue.

Franko, all positions are reasonned. The issue lies with the starting principles. My mother believes that no one would carve up a third trimester baby, crush his or her skull and suck it our with a vacuum device. She thinks we're too civilized. maybe you do too. The admonition by allusion to the good citizens of Germany is entirely appropriate and reasonable. Most of us and I am not excluding myself in this, don't really care much what happens around the world. Rwanda.

That said, I have been wrong in this debate. While intravenous feeding is ordinary care and not heroic, the circumstances of no reasonable hope of a return to a conscious life render the million dollar per year cost an unacceptable burden upon the community.

I was apprised of my failure to draw a necessary distinction listening to the CBC this AM, by a professor of bioethics at Boston College. He (a jesuit, by the way) pointed out that Christianity has consistently held this view throughout the centuries. No right winger, he is opposed to abortion, but argues that there is no parallel to be drawn in this instance. I apologize for my error in this matter. Those who argued that in this instance the situation constitutes heroic efforts were right, and I was wrong. Following my advice would have been a very considerable waste.

In this, I don't gainsay the content of Hardcap's excellent Harvard post which might well contain reasons for us not to consider her situation as hopeless.

I'll be perfect from now on.

[Toronthab]

M. said:

This may well sound cynical and trite, but I must wonder how much of this situation is a direct consequence of the attitude "we have the technology and we must use it."? Is this maintenance a feeble reaching out toward some notion of immortality through advances in the medical sciences?

That is something quite different from the healthy human desire to alleiviate another's suffering. Of course alleiviating that suffering may well include euthanasia as an option.

Did I obtain an overdose of morphine for my dying father as per his request? I did not.

Back to square one...

You were right not to obtain an overdose of morphine for your dad. In my case, after operating on my dad after he suffered a heart attack, they came in and asked if we wanted to try an additonal procedure that had virtually no hope of bringing him back. It was time. We said no. My friend's father, fully conscious and enjoying the company of his gathered family, had to assent to the pulling of the plug as he watched. I can hardly imagine such courage. He received the last rites, embraced his family and passed to another life.
I am told by paliative care friends that medication, like morphine is delivered to alleviate pain and at some point the dosage can slow and affect respiration bringing on death. This really can't be avoided some times, and so long as the intent is to alleviate the pain, the secondary consequences are innocent.

I would never so despair (I hope) that I would, as a primary intent, deliver an intentional overdose to anyone. Love is an act of the will and is rooted in priniciples followed.

[blaise]

Toronthab said:

Franko, all positions are reasonned. The issue lies with the starting principles. My mother believes that no one would carve up a third trimester baby, crush his or her skull and suck it our with a vacuum device. She thinks we're too civilized. maybe you do too. The admonition by allusion to the good citizens of Germany is entirely appropriate and reasonable. Most of us and I am not excluding myself in this, don't really care much what happens around the world. Rwanda.

That said, I have been wrong in this debate. While intravenous feeding is ordinary care and not heroic, the circumstances of no reasonable hope of a return to a conscious life render the million dollar per year cost an unacceptable burden upon the community.

I was apprised of my failure to draw a necessary distinction listening to the CBC this AM, by a professor of bioethics at Boston College. He (a jesuit, by the way) pointed out that Christianity has consistently held this view throughout the centuries. No right winger, he is opposed to abortion, but argues that there is no parallel to be drawn in this instance. I apologize for my error in this matter. Those who argued that in this instance the situation constitutes heroic efforts were right, and I was wrong. Following my advice would have been a very considerable waste.

In this, I don't gainsay the content of Hardcap's excellent Harvard post which might well contain reasons for us not to consider her situation as hopeless.

I'll be perfect from now on.

There's nothing for you to atone for or be ashamed of. You were unaware of the wide range of pathological changes that can occur in the traumatized brain as well as of how the damage is assessed and the possible interventions. It is important for members of this forum to understand that Schiavo is not handicapped, she is incapable of intellectual processing as the result of massive damage to beoth cerebral hemispheres. There is no point in feeding her because her state is irreversible.

Here's another thought-provoking point. Suppose Schiavo were to develop cancer while she reposes in this vegetative state. Would it be proper to provide her with surgery, irradiation, and chemotherapy in an effort to sustain her "life"? I don't think so. I would wonder about the astigmatic view on life of anyone who did favor it. It would verge on fanaticism.

[franko]

Toronthab said:

Franko, all positions are reasonned. The issue lies with the starting principles. My mother believes that no one would carve up a third trimester baby, crush his or her skull and suck it our with a vacuum device. She thinks we're too civilized. maybe you do too. The admonition by allusion to the good citizens of Germany is entirely appropriate and reasonable. Most of us and I am not excluding myself in this, don't really care much what happens around the world. Rwanda.

Perhaps my reaction was unreasonably harsh. I just felt that the allusion to the ovens was crass. Perhaps I am just too sensitive in this matter, having just seen yet another family watch as a husband/father faded away in pain. As he lay in the hospital bed – having said his good-byes to his family and drifted in and out of consciousness, waking only to re-administer medication (he was self-medicating and in such pain that the hospital staff raised the intake level beyond what they had ever seen before) I began to seriously re-think my stand on active euthanasia (I still stand on the appropriateness of passive euthanasia; that is not taking heroic or dramatic measures to save life). My fear of adopting the active (mercy killing) is that right to die would eventually become responsibility to die to save the health care system money . . . then defining quality of life . . . then defining who has the right to live (only the perfect).

As a Christian, I look to the Bible, but there is no scriptural directive for this case. If God were to perform a miracle and raise her up, now would be the time. If He doesn’t . . . let her go in peace.

I'll be perfect from now on.

You'll be one up on me.

[M. Beaux-Eaux]

Toronthab said:

You were right not to obtain an overdose of morphine for your dad.

I am not to this day convinced that I did the right thing. After all, it was his request, not my suggestion. He knew how much pain he was in and had a real grasp on much longer he had.

According to the palliative care doctor attending him (and a second) there was no hope of recovery.

I would never so despair (I hope) that I would, as a primary intent, deliver an intentional overdose to anyone. Love is an act of the will and is rooted in priniciples followed.

Again, I would have been fulfilling a (last) request, not imposing my will or judgement.

Sometimes love means having to say you're sorry.

[blaise]

Toronthab said:

I am told by paliative care friends that medication, like morphine is delivered to alleviate pain and at some point the dosage can slow and affect respiration bringing on death. This really can't be avoided some times, and so long as the intent is to alleviate the pain, the secondary consequences are innocent.

I would never so despair (I hope) that I would, as a primary intent, deliver an intentional overdose to anyone. Love is an act of the will and is rooted in priniciples followed.

Of course morphine at high doses can depress respiration to the point of inducing death. That is precisely what happens with heroin overdose. Sometimes morphine at sublethal doses cannot produce adequate analgesia and the sufferer endures agony. Fortunately, pharmacologists are seeking analgesics with greater efficacy that also provide a greater marhin of safety. Think of it as greater headroom, so to speak.

Ask yourself this: If the patient is in unremitting agony, is it an act of love to prolong it? You may be honoring your personal morality at the expense of someone who is crying out for relief. That person will die anyway of a terminal illness. Does it matter in the eternity of time whether death occurs on a Monday rather than a Tuesday or Wednesday or the following week? I wouldn't expect you to deliver the fatal dose personally (the professionals must take that responsibility, depending on the laws of the land. But withholding that relief is as much playing God as providing it.

[BadCompany]

Blaise said:

It is important for members of this forum to understand that Schiavo is not handicapped, she is incapable of intellectual processing as the result of massive damage to beoth cerebral hemispheres. There is no point in feeding her because her state is irreversible.

And this is where you keeping missing the point. The whole issue revolves around whether or not the damage to her brain is massive enough that there is in fact NO intellectual processing. Some say yes, some say no. That there is damage is not in question, nor really, is the issue of recovery. What is at issue, is whether there is enough life to warrant feeding.

You keep making this long range diagnosis, with nothing more than media reports and sound bytes as a basis for this diagnosis. So far, the legal system has agreed, but I highly doubt that matters to you. If they didn't, and if they had of ruled that she was capable of intellectual processing, you undoubtedly would have chalked it up to this vast, right-wing religious conspiracy you fear has permeated every aspect of western civilization.

The problem isn't with members of this board not understanding the condition Schiavo is in; the problem is you assuming you know exactly what condition she is.

[Cranky]

Toronthab said:

Well, at least you did suggest it was worth but a little. I am not a fundamentalist Christain and indeed, I often find them a huge irrational embarassment in the face of the immense and continuing spiritual, historical, and intellectual fecundity of Christianity.

That said, I believe people do genuinely discover at least the beginnings of a spiritual life and often are doing their level best to live with integrity according to the lights they are given.

Assuming your "I have contempt for those who try to impose their will based on ink spread on a page." refers to the above, I am always struck by how blind people who manifest such a simplistic and bigoted are. It is almost invariably employed by people who want to kill other people through abortion and other homicides. The ultimate imposition of ill will.

Your poetic or romantic use of the term "philosophical" is also unintentionally ironic. Inclusive and fully reasonable philosophical positions are for the most part theistic. One is ohterwise generally adrift in the moral relativism and unintelligibility if Rousseau's "contrat social", so-called "secular humanism" and of course the social darwinism operative in this issue.

You would do well to temper your contempt.

Did you understand what I meant? Focus on the word "impose" which also stands for "force into", "apply by authority", "indoctrinate".

You say that you find fundamentalist Christian a huge irrational embarrassment. How different is it from my statement?

I could not care less for anyone forcing others to act in a certain way because "it is written" in the Bible, Koran, parchment or whatever. Morality does NOT originate from ink spread on a page. Unless of course one believes that that ink was spread directly by the hand of God or his/her messenger. Then of course we have the secondary issue of which God or prophet?

"Inclusive and fully reasonable philosophical positions are for the most part theistic." Is that one God or many? Is that inclusive of all "teachings"? Or is it limited to the "teachings" of the Bible? Koran? Sacred Scrolls? Are atheists immoral or perhaps not capable of reasonable philosophical positions? Are atheist barbarians?

It goes to fundamental rights. Everyone has a right to believe in whatever religion they want to believe, or if they DON'T want to believe, BUT those who try to IMPOSE THEIR WILL on others based on THEIR belief of what is the "truth and right" based on THEIR version of ink spread on a page are, well, contemptuous.

[Cranky]

It seems that we all have a story to tell and this subject is touching us.

I am probably older then most of you and I had my share of casket carrying and watching people passing away in front of my eyes. It's a gut wrenching experience and it hurts like Hell. Unfortunately, it is a path that all humans witness and all humans take.

I wish someone could say without any doubt if there is any consciousness. Then answer the second question is if there is any ANY hope of change. With neither answered beyond a reasonable doubt, well……are we or can we act as God’s?

[franko]

Mr. said:

It goes to fundamental rights. Everyone has a right to believe in whatever religion they want to believe, or if they DON'T want to believe, BUT those who try to IMPOSE THEIR WILL on others based on THEIR belief of what is the "truth and right" based on THEIR version of ink spread on a page are, well, contemptuous.

And might I suggest that it goes both ways? For someone to attempt to impose their non-belief on another based on THEIR belief of what is "the truth" is equally contemptuous.

The question is one of imposition. To state "this is what I believe" is acceptable; to try to influence or convince another to "come to the light" (whatever that light may be) is equally acceptable; to condemn a person for disagreeing or to mock a person's believe system because you feel it does not match up to yours speaks of a superiority complex that is not becoming.

That being said, I'm right and everyone else is wrong. ;D

[M. Beaux-Eaux]

franko said:

That being said, I'm right and everyone else is wrong. ;D

Hey, that's my job!

[HardCap]

This sums up my feelings:

No choice for Terri
Debra J. Saunders

Thursday, March 24, 2005

I'VE HEARD the clamor as to why Terri Schiavo must die. No one, it is said, would want to live like her. Her parents, Robert and Mary Schindler, are religious fanatics. Many of her so-called supporters are "pro-life" zealots. Evil GOP geniuses passed a special law to help her live. And so, she must die.

I've followed this poignant case for two years. Also, my husband served at one time as an unpaid informal adviser to the Schindlers. I've heard the arguments, and they often start with: No one would want to live like that.

After all, this case is supposed to be about Terri's "right to die," even though no one knows for sure that she wants to die. She never wrote a living will or other document asserting as much. A court decided that she would want to die, based on casual remarks she made to her husband, Michael Schiavo, and his brother and sister. She told them she would never want to be kept alive by machines.

I hate to insert facts here, but it is a fact that a feeding tube is not a machine. Yet somehow the courts found that those casual comments have the force of a legal document -- and apply to a feeding tube, when they were meant for a respirator.

In so ruling, a judge also ignored claims made by Michael Schiavo when he sued the hospital that first treated Terri in 1990 for $16 million for failing to detect her potassium imbalance. As Newsday reported in 2003, he won $300, 000 for himself for loss of consortium and $700,000 for his wife -- based on the presumption that Michael would care for Terri for the rest of her life.

It was not until 1998 that Michael Schiavo acted on the basis of his wife's stated wish not to live on life support.

Here's another slogan: A husband has a right to determine a wife's fate. It doesn't matter if he has a conflict -- in this case, two children he sired with a woman he calls his fiancee -- he still has a supreme right over Terri's fate.

Another reported fact: Michael Schiavo won't approve an MRI, although Terri is said to have had one years ago.

Those who argue that Terri should die note that her doctors say her prognosis is hopeless. Doctors are always right, correct?

There is the argument that the courts have adjudicated on this and sided with the husband. That's why the Schindlers and Republicans compare Terri to death-row defendants. The courts keep finding them guilty, and their lawyers keep filing appeals, because there should be no doubt as to the defendant's guilt and access to a fair trial.

If the law is going to give the benefit of the doubt to convicted killers, it makes sense to extend it to a woman whose only crime is that she is disabled.

OK, I'll take a deep breath and break from the polemics. This is a complicated case, and people of good faith can disagree. This involves a heartrending decision that no one would take lightly.

Do I have problems with Congress passing a law for one person? Do I believe it is possible that Michael Schiavo, who did go to great lengths early on trying to help his wife, still has the best interests of Terri in mind? Do I want the government to stay out of end-of-life decisions that families are forced to make at a painful, raw time in their lives? Was I appalled when I heard Bob Schindler say on TV that he told his daughter, who is starving, he would "take her out for a little ride, get her some breakfast?" Yes, yes, yes and of course.

I also don't enjoy watching the Schindlers' attorneys make silly legal claims in a desperate attempt to entice the federal court to change course, when it is clear to me that the courts, federal and state, are going to stick to their guns, as they have the power to do.

But spare me the rhetoric about Republicans being hypocrites on states' rights -- fresh from the mouths of Democrats who don't want to let Alaskans drill in the Arctic National Wildlife Refuge, who don't want states to determine their own gun-control laws and couldn't wait for the feds to storm the home of the Miami family of Elian Gonzalez.

Let me also say that Congress -- with 47 Democratic votes, I'll add -- didn't pass a law requiring that the feeding tube be reinserted in Terri Schiavo. It passed a law handing the case on to federal courts.

I'm no fan of Rep. Tom DeLay, R-Texas. But the House majority leader is right in this case. It's not clear Terri Schiavo would want to die. A husband does not -- in my book -- have an absolute right to withdraw life- sustaining treatment for his wife.

I wish the courts had ruled in Terri Schiavo's favor, even as I accept the fact that they have not and likely will not. It is possible, after all, that Terri Schiavo wants to die. It's just too bad that she will die, regardless of whether she wanted to or not.

[blaise]

HardCap said:

This sums up my feelings:

No choice for Terri
Debra J. Saunders

Thursday, March 24, 2005

I'VE HEARD the clamor as to why Terri Schiavo must die. No one, it is said, would want to live like her. Her parents, Robert and Mary Schindler, are religious fanatics. Many of her so-called supporters are "pro-life" zealots. Evil GOP geniuses passed a special law to help her live. And so, she must die.

I've followed this poignant case for two years. Also, my husband served at one time as an unpaid informal adviser to the Schindlers. I've heard the arguments, and they often start with: No one would want to live like that.

After all, this case is supposed to be about Terri's "right to die," even though no one knows for sure that she wants to die. She never wrote a living will or other document asserting as much. A court decided that she would want to die, based on casual remarks she made to her husband, Michael Schiavo, and his brother and sister. She told them she would never want to be kept alive by machines.

I hate to insert facts here, but it is a fact that a feeding tube is not a machine. Yet somehow the courts found that those casual comments have the force of a legal document -- and apply to a feeding tube, when they were meant for a respirator.

In so ruling, a judge also ignored claims made by Michael Schiavo when he sued the hospital that first treated Terri in 1990 for $16 million for failing to detect her potassium imbalance. As Newsday reported in 2003, he won $300, 000 for himself for loss of consortium and $700,000 for his wife -- based on the presumption that Michael would care for Terri for the rest of her life.

It was not until 1998 that Michael Schiavo acted on the basis of his wife's stated wish not to live on life support.

Here's another slogan: A husband has a right to determine a wife's fate. It doesn't matter if he has a conflict -- in this case, two children he sired with a woman he calls his fiancee -- he still has a supreme right over Terri's fate.

Another reported fact: Michael Schiavo won't approve an MRI, although Terri is said to have had one years ago.

Those who argue that Terri should die note that her doctors say her prognosis is hopeless. Doctors are always right, correct?

There is the argument that the courts have adjudicated on this and sided with the husband. That's why the Schindlers and Republicans compare Terri to death-row defendants. The courts keep finding them guilty, and their lawyers keep filing appeals, because there should be no doubt as to the defendant's guilt and access to a fair trial.

If the law is going to give the benefit of the doubt to convicted killers, it makes sense to extend it to a woman whose only crime is that she is disabled.

OK, I'll take a deep breath and break from the polemics. This is a complicated case, and people of good faith can disagree. This involves a heartrending decision that no one would take lightly.

Do I have problems with Congress passing a law for one person? Do I believe it is possible that Michael Schiavo, who did go to great lengths early on trying to help his wife, still has the best interests of Terri in mind? Do I want the government to stay out of end-of-life decisions that families are forced to make at a painful, raw time in their lives? Was I appalled when I heard Bob Schindler say on TV that he told his daughter, who is starving, he would "take her out for a little ride, get her some breakfast?" Yes, yes, yes and of course.

I also don't enjoy watching the Schindlers' attorneys make silly legal claims in a desperate attempt to entice the federal court to change course, when it is clear to me that the courts, federal and state, are going to stick to their guns, as they have the power to do.

But spare me the rhetoric about Republicans being hypocrites on states' rights -- fresh from the mouths of Democrats who don't want to let Alaskans drill in the Arctic National Wildlife Refuge, who don't want states to determine their own gun-control laws and couldn't wait for the feds to storm the home of the Miami family of Elian Gonzalez.

Let me also say that Congress -- with 47 Democratic votes, I'll add -- didn't pass a law requiring that the feeding tube be reinserted in Terri Schiavo. It passed a law handing the case on to federal courts.

I'm no fan of Rep. Tom DeLay, R-Texas. But the House majority leader is right in this case. It's not clear Terri Schiavo would want to die. A husband does not -- in my book -- have an absolute right to withdraw life- sustaining treatment for his wife.

I wish the courts had ruled in Terri Schiavo's favor, even as I accept the fact that they have not and likely will not. It is possible, after all, that Terri Schiavo wants to die. It's just too bad that she will die, regardless of whether she wanted to or not.

The Arctic National Wildlife Refuge is federal property and doesn't belong to Alaska. The Grand Canyon doesn't belong to Colorado. Yosemite doesn't belong to California. Yellowstone soen't belong to Wyoming. And so forth.

[blaise]

BadCompany said:

And this is where you keeping missing the point. The whole issue revolves around whether or not the damage to her brain is massive enough that there is in fact NO intellectual processing. Some say yes, some say no. That there is damage is not in question, nor really, is the issue of recovery. What is at issue, is whether there is enough life to warrant feeding.

You keep making this long range diagnosis, with nothing more than media reports and sound bytes as a basis for this diagnosis. So far, the legal system has agreed, but I highly doubt that matters to you. If they didn't, and if they had of ruled that she was capable of intellectual processing, you undoubtedly would have chalked it up to this vast, right-wing religious conspiracy you fear has permeated every aspect of western civilization.

The problem isn't with members of this board not understanding the condition Schiavo is in; the problem is you assuming you know exactly what condition she is.

I don't know if this impresses you, but a very recent poll reveals that twice as many Americans are in favor of removing the tubes as are in favor of keeping them in. They have heard all the arguments and have come down one way and not in the other. Most Americans have come to favor stem cell research. Most Americans would favor limits on abortion but not to outlaw it. At least on these issues of life and death, most Americans do not agree with the religious zealots.

Charles Fried, a conservative jurist who has represented several Republican administrations, opines that with its Schiavo law, Congress demeans the states. It is "mischievous" and "inappropriate."

It is ironic that as governor of Texas, Bush signed a law affirming the right of hospitals to pull the plug in hopeless cases. The arch-conservative Supreme Court justice Antonin Scalia writes that "clearly and promptly ... the federal courts have no business in this field [of deciding when life is or isn't worthless]."

[HardCap]

Blaise said:

I don't know if this impresses you, but a very recent poll reveals that twice as many Americans are in favor of removing the tubes as are in favor of keeping them in. They have heard all the arguments and have come down one way and not in the other. Most Americans have come to favor stem cell research. Most Americans would favor limits on abortion but not to outlaw it. At least on these issues of life and death, most Americans do not agree with the zealots.

Zealots ? Who are the radicals ? Bizarro world - prevent the killing of convicted murderers (and if you must execute - make their deaths as painless as possible - but - kill the innnocent woman who cannot defend herself thru stravation and dehydration - they shoot horses, don't they?

[blaise]

HardCap said:

Zealots ? Who are the radicals ? Bizarro world - prevent the killing of convicted murderers (and if you must execute - make their deaths as painless as possible - but - kill the innnocent woman who cannot defend herself thru stravation and dehydration - they shoot horses, don't they?

You out of your league here. The starvation and dehydration felt by Schiavo is not painful, because the brain INTERPRETS pain. It is not automatic. There are nociceptive afferent fibers in the dorsal horn of the spinal cord that convey impulses to the thalamus, but these are gated and do not automatically pass everything up. There are also tracts that are capable of nulllifying nociceptive impulses. Vibratory electrical stimuli, for example, can stimulate the afferents in such a manner that pain is not perceived. There is an endogenous pain-control system in the brain that is mediated by endorphins (the body's counterpart to opiates). Check the gate theory of pain for which Wall and Melzack (Ron Melzack of McMaster University, that is) won the Nobel prize a long time ago.

I don't oppose capital punishment on principle. I do oppose executing people who are not guilty of the capital crimes imputed to them. So many convictions have been overturned recently that many states are putting a hold on executions.

[BadCompany]

Blaise said:

I don't know if this impresses you, but a very recent poll reveals that twice as many Americans are in favor of removing the tubes as are in favor of keeping them in. They have heard all the arguments and have come down one way and not in the other. Most Americans have come to favor stem cell research. Most Americans would favor limits on abortion but not to outlaw it. At least on these issues of life and death, most Americans do not agree with the religious zealots.

Charles Fried, a conservative jurist who has represented several Republican administrations, opines that with its Schiavo law, Congress demeans the states. It is "mischievous" and "inappropriate."

It is ironic that as governor of Texas, Bush signed a law affirming the right of hospitals to pull the plug in hopeless cases. The arch-conservative Supreme Court justice Antonin Scalia writes that "clearly and promptly ... the federal courts have no business in this field [of deciding when life is or isn't worthless]."

No, it doesn't impress me. Why should it?

[HardCap]

Blaise said:

You out of your league here. The starvation and dehydration felt by Schiavo is not painful, because the brain INTERPRETS pain. It is not automatic. There are nociceptive afferent fibers in the dorsal horn of the spinal cord that convey impulses to the thalamus, but these are gated and do not automatically pass everything up. There are also tracts that are capable of nulllifying nociceptive impulses. Vibratory electrical stimuli, for example, can stimulate the afferents in such a manner that pain is not perceived. There is an endogenous pain-control system in the brain that is mediated by endorphins (the body's counterpart to opiates). Check the gate theory of pain for which Wall and Melzack (Ron Melzack of McMaster University, that is) won the Nobel prize a long time ago.

I don't oppose capital punishment on principle. I do oppose executing people who are not guilty of the capital crimes imputed to them. So many convictions have been overturned recently that many states are putting a hold on executions.

What league are you talking about? Am I a replacement poster or something, not worthy of an opinion? lol - it will be interesting to see if your medical opinion of a pain free death will be borne out...

[blaise]

HardCap said:

What league are you talking about? Am I a replacement poster or something, not worthy of an opinion? lol - it will be interesting to see if your medical opinion of a pain free death will be borne out...

Painful sensations are transmitted along neural pathways and are interpreted by the brain. I have read that prisoners who went on a hunger strike to their death reported that they no longer felt the pangs after a certain point. And this was in people who retained their thought processes. If you will enlighten me on the mechanisms by which the decerebrate Schiavo feels the pain, I would be much obliged.

[M. Beaux-Eaux]

Blaise said:

I have read that prisoners who went on a hunger strike to their death reported that they no longer felt the pangs after a certain point. And this was in people who retained their thought processes.

So you do believe in life after death. ;D

[HardCap]

Blaise said:

Painful sensations are transmitted along neural pathways and are interpreted by the brain. I have read that prisoners who went on a hunger strike to their death reported that they no longer felt the pangs after a certain point. And this was in people who retained their thought processes. If you will enlighten me on the mechanisms by which the decerebrate Schiavo feels the pain, I would be much obliged.

They did drink water and didn't dehydrate, now did they? Seems dehydration is the cruelest way to go...not a pretty sight...

Symptoms of Dehydration

If all food and fluids (nutrition and hydration) are removed from a person -- whether that person is a healthy Olympic athlete who takes food and fluids by mouth or a frail, disabled person who receives them by a feeding tube -- death is inevitable. That death will occur because of dehydration.

As a person dies from lack of food and fluids, his or her

Mouth would dry out and become caked or coated with thick material.
Lips would become parched and cracked.
Tongue would swell, and might crack.
Eyes would recede back into their orbits.
Cheeks would become hollow.
Lining of the nose might crack and cause the nose to bleed.
Skin would hang loose on the body and become dry and scaly.
Urine would become highly concentrated, leading to burning of the bladder.
Lining of the stomach would dry out and he or she would experience dry heaves and vomiting.
Body temperature would become very high.
Brain cells would dry out, causing convulsions.
Respiratory tract would dry out, and the thick secretions that would result could plug the lungs and cause death.
At some point within five days to three weeks, the person's major organs, including the lungs, heart, and brain, would give out and death would occur.

[Source: Brophy v. New England Sinai Hosp., 398 Mass. 417, 444 n.2, 497 N.E.2d 626, 641 n.2 (1986) (Nolan, J., dissenting).

[HardCap]

and another thing...

Not Dead at All
Why Congress was right to stick up for Terri Schiavo.
By Harriet McBryde Johnson
Posted Wednesday, March 23, 2005, at 4:50 AM PT

The Terri Schiavo case is hard to write about, hard to think about. Those films are hard to look at. I see that face, maybe smiling, maybe not, and I am reminded of a young woman I knew as a child, lying on a couch, brain-damaged, apparently unresponsive, and deeply beloved—freakishly perhaps but genuinely so—living proof of one family's no-matter-what commitment. I watch nourishment flowing into a slim tube that runs through a neat, round, surgically created orifice in Ms. Schiavo's abdomen, and I'm almost envious. What effortless intake! Due to a congenital neuromuscular disease, I am having trouble swallowing, and it's a constant struggle to get by mouth the calories my skinny body needs. For whatever reason, I'm still trying, but I know a tube is in my future. So, possibly, is speechlessness. That's a scary thought. If I couldn't speak for myself, would I want to die? If I become uncommunicative, a passive object of other people's care, should I hope my brain goes soft and leaves me in peace?

My emotional response is powerful, but at bottom it's not important. It's no more important than anyone else's, not what matters. The things that ought to matter have become obscured in our communal clash of gut reactions. Here are 10 of them:

1. Ms. Schiavo is not terminally ill. She has lived in her current condition for 15 years. This is not about end-of-life decision-making. The question is whether she should be killed by starvation and dehydration.




2. Ms. Schiavo is not dependent on life support. Her lungs, kidneys, heart, and digestive systems work fine. Just as she uses a wheelchair for mobility, she uses a tube for eating and drinking. Feeding Ms. Schiavo is not difficult, painful, or in any way heroic. Feeding tubes are a very simple piece of adaptive equipment, and the fact that Ms. Schiavo eats through a tube should have nothing to do with whether she should live or die.

3. This is not a case about a patient's right to refuse treatment. I don't see eating and drinking as "treatment," but even if they are, everyone agrees that Ms. Schiavo is presently incapable of articulating a decision to refuse treatment. The question is who should make the decision for her, and whether that substitute decision-maker should be authorized to kill her by starvation and dehydration.

4. There is a genuine dispute as to Ms. Schiavo's awareness and consciousness. But if we assume that those who would authorize her death are correct, Ms. Schiavo is completely unaware of her situation and therefore incapable of suffering physically or emotionally. Her death thus can't be justified for relieving her suffering.

5. There is a genuine dispute as to what Ms. Schiavo believed and expressed about life with severe disability before she herself became incapacitated; certainly, she never stated her preferences in an advance directive like a living will. If we assume that Ms. Schiavo is aware and conscious, it is possible that, like most people who live with severe disability for as long as she has, she has abandoned her preconceived fears of the life she is now living. We have no idea whether she wishes to be bound by things she might have said when she was living a very different life. If we assume she is unaware and unconscious, we can't justify her death as her preference. She has no preference.

6. Ms. Schiavo, like all people, incapacitated or not, has a federal constitutional right not to be deprived of her life without due process of law.

7. In addition to the rights all people enjoy, Ms. Schiavo has a statutory right under the Americans With Disabilities Act not to be treated differently because of her disability. Obviously, Florida law would not allow a husband to kill a nondisabled wife by starvation and dehydration; killing is not ordinarily considered a private family concern or a matter of choice. It is Ms. Schiavo's disability that makes her killing different in the eyes of the Florida courts. Because the state is overtly drawing lines based on disability, it has the burden under the ADA of justifying those lines.

8. In other contexts, federal courts are available to make sure state courts respect federally protected rights. This review is critical not only to the parties directly involved, but to the integrity of our legal system. Although review will very often be a futile last-ditch effort—as with most death-penalty habeas petitions—federalism requires that the federal government, not the states, have the last word. When the issue is the scope of a guardian's authority, it is necessary to allow other people, in this case other family members, standing to file a legal challenge.

9. The whole society has a stake in making sure state courts are not tainted by prejudices, myths, and unfounded fears—like the unthinking horror in mainstream society that transforms feeding tubes into fetish objects, emblematic of broader, deeper fears of disability that sometimes slide from fear to disgust and from disgust to hatred. While we should not assume that disability prejudice tainted the Florida courts, we cannot reasonably assume that it did not.

10. Despite the unseemly Palm Sunday pontificating in Congress, the legislation enabling Ms. Schiavo's parents to sue did not take sides in the so-called culture wars. It did not dictate that Ms. Schiavo be fed. It simply created a procedure whereby the federal courts could decide whether Ms. Schiavo's federally protected rights have been violated.

In the Senate, a key supporter of a federal remedy was Iowa Sen. Tom Harkin, a progressive Democrat and longtime friend of labor and civil rights, including disability rights. Harkin told reporters, "There are a lot of people in the shadows, all over this country, who are incapacitated because of a disability, and many times there is no one to speak for them, and it is hard to determine what their wishes really are or were. So I think there ought to be a broader type of a proceeding that would apply to people in similar circumstances who are incapacitated."

I hope against hope that I will never be one of those people in the shadows, that I will always, one way or another, be able to make my wishes known. I hope that I will not outlive my usefulness or my capacity (at least occasionally) to amuse the people around me. But if it happens otherwise, I hope whoever is appointed to speak for me will be subject to legal constraints. Even if my guardian thinks I'd be better off dead—even if I think so myself—I hope to live and die in a world that recognizes that killing, even of people with the most severe disabilities, is a matter of more than private concern.

Clearly, Congress's Palm Sunday legislation was not the "broader type of proceeding" Harkin and I want. It does not define when and how federal court review will be available to all of those in the shadows, but rather provides a procedure for one case only. To create a general system of review, applicable whenever life-and-death decisions intersect with disability rights, will require a reasoned, informed debate unlike what we've had until now. It will take time. But in the Schiavo case, time is running out.


Harriet McBryde Johnson is a disability-rights lawyer in Charleston, S.C. Her memoir in stories, Too Late to Die Young: Nearly True Tales from a Life, will be released in April.

[blaise]

M. said:

So you do believe in life after death. ;D

C'mon. you know what I mean. Such accounts have come from IRA prisoners who refused food and related that after a certain number of days of fasting they no longer felt hunger.

If there is life after death, then those who want to keep Terri Schiavo alive on religious grounds shouldn't mind her dying shortyly. After all, they KNOW that she will be restored to youthful health and vigor after she passes through St. Peter's pearly gates.