October 22, 2003 at 2:16 pm #30734
I was just wondering what you all think about the man in Florida who won the right to discontinue his wife’s feeding tube (she has been in a coma/vegetative state for 10 years) against the wishes of her parents. Now governor Bush signed something saying that it must be replaced. What are your thoughts on this? I have a feeling this will be a good debate!October 23, 2003 at 4:30 am #30735
Ok, I’ll start as I must admit this is a politically, emotionally charged arguement but I know there will be some good opinions out there and maybe someone will come up with something that I haven’t thought of yet (oh amyk where are you…you always make such good and articulate points!) Anyway, I for one am hopping mad that they are making this woman (and her family) a political bean bag. I’m also really upset that they are taking this decision away from her husband (who has the right to make it) and instead the governor is making the decision! I for one will be spending the weekend making out my living will, as even though I know my husband knows my wishes I don’t want him (or any of the rest of my family) to have to make any decisions that would be hard for them to make…instead they can just read it off the paper and take it to court if they need proof of “my wishes”…October 23, 2003 at 5:37 pm #30736DreyParticipant
I absolutely think that people have the right to die. We talk so much about patient autonomy and giving patients all the options so that they can make an intelligent choice. If all the options have been laid out for them, and the patient says “I do not wish to be kept alive artificially,” then who are we to say they made the wrong decision? Specifically, who do the politicians think they are to get involved in this? Have powers over life and death suddenly become the responsibility of the public domain?
Some people argue that the woman is brain damaged and perhaps not mentally capable. However, I have had discussions numerous times with people I love and they have clearly expressed their views on how they want to die. I would find it very hard to believe that her spouse would not be aware of her wishes. If there’s a living will, that’s supposed to be as good as a legal contract! Interfering in this case would be just as bad in my mind as the government suddenly invalidating other random contracts that people make.
Just my :twocents:
AudreyOctober 23, 2003 at 7:44 pm #30737amykParticipant
😉 Sorry, momsurg, I don’t have a lot to say on this one. It seems v. political-business-as-usual. I thought the woman had no living will, and that’s what the problem was — no documents. Putting the tube back in satisfies the religious right, the miracles crowd, and (I’m guessing) a good chunk of the senior population. I just hope the in/out doesn’t go on too much longer, it’s grotesque.
Government always has final say over life/death, from morning-after pills to “don’t let ’em go” rules in advanced old age. I think it’s only recently that many states took failed-suicide laws off the books, too. Only way I know of to avoid gov’t interference in death is to go swiftly on your own, or to see it coming and arrange to be in another country with more liberal assisted-suicide laws. My own father, whose cancer is in remission, lives in dread of being kept hanging on with tubing, and I wouldn’t be surprised if one day he kissed everyone goodbye and flew off to Amsterdam to take care of things on his own terms & as swiftly/painlessly as possible. And I can’t really say I blame him.
amyOctober 23, 2003 at 8:07 pm #30738
Yes, I think the contentious issue in this “debate” is the fact that there is nothing in writing…only the husband’s “she wanted…” versus her parent’s “she wanted…”. I still think that legally the husbands rights (as next of kin and legal guardian) need to outweigh her parents beliefs, unless of course she had given them health care power of attorney (as she did not). Now the husband is denying the rest of the family the right to see her, which seems to be taking a horrible situation and making it WORSE! The thing that I’m so bothered by is the government’s weighing in on it, and reversing an “already made” decision. This scares me, they are undermining the legal guardian, the healthcare profession, and basically making what should be a dignified death a horror show. Again, everyone out there, don’t settle for “telling” your next of kin what your wishes are, WRITE it down…October 23, 2003 at 11:53 pm #30739maggie52Participant
Actually I’d say the senior population would most likely side with the husband bc they are a lot closer to facing the question themselves and ( in practice) are more realistic than all those do-gooders out there…THE HUSBAND of course should have the decision-making power (unless he was a convicted pychopath or something) and it HORRIBLE that this is getting bounced back and forth. LET THE WOMAN DIE for goodness sakes!October 24, 2003 at 7:58 am #30740CynthiaParticipant
First, she is NOT in a coma. Terry IS brain damaged. Due to a potassium imbalance she suffered a heart attack and although she survived, she lost a great deal of her mental capacity. That said, she CAN talk…although it is only a few words such as “momma”. She DOES have preferences such as “she doesn’t like blankets tucked around her”. She DOES recognize a few people. So the question is not concerning someone who is completely comatose and unresponsive.
SEcond her husband is living with a woman who is expecting their second child. I think perhaps HE MAY have interests other than Terry’s at heart. If he truly thought Terry’s wish were to die this way, why did he wait THIRTEEN years after her accident to decide to starve her? And why did he wait until AFTER the one million doller settlement was spent before taking this action?
Third, dehydration is a horrible way to die…..not to mention the nausea, hallucinations etc. We would condem anyone who treated an animal this way…why do we think it’s acceptable for a human being to be starved/dehydrated to death?October 24, 2003 at 12:44 pm #30741**DONOTDELETE**Participant
You know, I was just at an end of life conference in San Francisco…and interestingly, they (experts in the field of ICU, and end of life care) actual believe (now) that dehydration and starvation isn’t so horrible. They explained that when the body goes into starvation mode, ketones are produced, an acid which actually blunts the nerve endings sensitivity to pain. Endorphins are produced in this “starvation” state which helps relax the body and makes the individual feel more at ease. The lack of water helps keep pulmonary secretions at a minimum and helps maintain the airway. They say that, when terminal patients were asked about their end of life fears, the number one fear was the fear of pain…and number 2 was the feeling of suffocation. If the airway remains dry, and their sensation to pain is dulled…they argue that the end of life experience is better. These experts recommend withdrawing all feedings and liquids which only serve to prolong life, miserably.October 24, 2003 at 4:19 pm #30742LaramisaParticipant
I think the thing that really complicates this situation is what Cynthia mentioned – that the husband has apparently now spent all the settlement money. And has been in a relationship with someone else but for some reason hasn’t gotten a divorce. And the parent’s disagree.October 25, 2003 at 6:59 pm #30743maggie52Participant
I agree myimd- they’ve known since the mid 90’s that starvation is the mor epleasant way to go and I susually bring that up pt’s families who are deciding what to do w/ a feeding tube ( or whether to put one in in the first place.)October 25, 2003 at 8:37 pm #30744CynthiaParticipant
We aren’t talking about a TERMINAL patient! …and TERRY isn’t in pain. She’s NOT suffering and has many more years to live. She ENJOYS LIFE!!! So a “better way to die”??? She ISN’T dying! …or at least wasn’t until they refused to feed her.
As for the “better way to die”…have you actually WATCHED a person die of starvation and dehydration? I have. My grandfather was 95 and very frail. Eating was a chore….one day it was just too much of a chore and he stopped. The starvation wasn’t so bad but the dehydration?….THAT stinks. What about the CRAMPS and PAIN as all your body organs and functions close down? ….a better way to die? compared to WHAT? Compared to cancer…perhaps. Compared to a heart attack…perhaps. But to say it’s an EASY way to go is absurd. It DOES HURT, and there IS PAIN. The most merciful thing was when my grandfather slipped into a coma.
Terry isn’t dying of ANYTHING except starvation or perhaps it’s better to say she’s dying of dehydration. To try to compare her misery to any other way of dying is odd to me. 30 years from now perhaps this issue of HOW Terry should die would be an appropriate topic. Perhaps then she will be facing a crisis that makes dehydration seem pleasent….perhaps….but then again, perhaps NOT. Perhaps she will die in her sleep of old age and dehydration would have been the AWFULL option for her.October 26, 2003 at 2:06 am #30745**DONOTDELETE**Participant
Cynthia, you’re right, it does depend on the individual situation. Clearly, if you take an otherwise healthy person, and starve them, their death would be unpleasant. But somewhere between *healthy*, and *dead*, there’s this “dying, teminal” patient that may benefit from these measures. I’ve seen many, many people die in our ICU…and some certainly have benefited from less NGT feedings, and IVF (as evidenced by the CXR, the level of agitation, including the vital signs). I didn’t bring up starving people and say that it may have benefits for some, to say that everyone should be starved…or even this woman Terry should be. Honestly, I don’t know much about Terry, or this case…I simply stated the above to demonstrate a growing idea among intensivists.October 26, 2003 at 2:48 am #30746amykParticipant
Cynthia, just curious, how do you know she enjoys life?
amyOctober 26, 2003 at 7:17 am #30747twinkleParticipant
while i don’t believe that the husband is thinking in terms of the patient’s best interests (another woman..large legal settlement..stinky to me), BUT if the court ruling is that she must die..(forgive me for my lack of medical knowledge) can’t they give her some sort of more humane way to die? if i recall my pharmacology class correctly, there are drugs (can’t for the life of me remember what) which in large doses induce peaceful sleep and then…cause death. does this exsist? starvation and dehydration just doesn’t seem right. perhaps this is one of those “do not kill”, just “let die” things?October 26, 2003 at 7:50 am #30748
What I think this all comes down to is would this woman want to be kept alive by artifical means (which is what is happening) or would she prefer to be allowed to die. This may be a very different answer for each person and dependent on the situation. Every doctor that I have seen interviewed about this woman said that she does extremely little that could be considered meaningful. But beyond all of this, I think the thing that is more scary is that the government is stepping in and reversing the rights of the husband. Now, yes maybe his motives are confused right now, but this court case has been going on for YEARS, far before the settlement money ran out and I can’t even fault him for moving on-I sure wouldn’t expect my husband not to move on with his life if I was in the same state as this woman. I don’t know what the right answer is as far as this woman is concerned, but I am pretty convinced that it is not government intervention!
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