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James Rondon
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« Reply #30 on: February 27, 2005, 08:44:11 PM »
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And where does it stop?
That's my question for you.
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mike
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« Reply #31 on: February 27, 2005, 09:53:34 PM »
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If, God forbid, the tube is removed... I wonder what the doctors and nurses will do as Terri begins to feel the pains of dehydration and starvation?

As a late-comer to this discussion, I'll try not to repeat too much of what someon else may already have said. I skimmed the thread, reading only the most reacent posts in detail.

I don't have enough knowledge of the particular cases in question to make a judgment.

But, I do have 25 years of experience helping people make these kinds of decisions. As Connie has said, removing a feeding tube from a person with significantly altered mentation is not at all the same thing as active euthanasia.

As the body becomes dehydrated, there is less pain and discomfort, and the individual usually gradually fades away. However, when a person (e.g. someone with advanced Alzheimer's disease who cannot eat) is artificially hydrated and nourished, then their sensation of pain and discomfort is maximized. They can occasionally live a long time this way, but usually still only live a year or less (according to some recent well done studies).

Yet, this short time is a time of more intense suffering and pain than it would be if the individual were not artificially nourished. If the condition is irreversible and terminal, then I would suggest that maximizing suffering during the time that person has left to live is the exact opposite of what we should doing --- which is to minimize suffering and maximize dignity.

This is a very difficult issue, particularly when it becomes personal, and I am not passing judgment on anyone who has posted on this thread. It's just that I have very often run across folks who want to do the right thing by their elderly relatives, and who do not understand that artificial hydration and nutrition causes more, not less, suffering.

Mike
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« Reply #31 on: February 27, 2005, 09:53:34 PM »
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Mere Nick
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« Reply #32 on: February 27, 2005, 10:20:15 PM »
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Thanks for the input.

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But, I do have 25 years of experience helping people make these kinds of decisions. As Connie has said, removing a feeding tube from a person with significantly altered mentation is not at all the same thing as active euthanasia.

I would be hard pressed to explain to someone how it isn't a type of euthanasia.  I'll have to double check the instructions the doctors now have, but I believe right now I instructed them that, if a feeding tube is the only way to feed her, they are to have one in for a week or so to give everyone involved time to evaluate her situation.

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As the body becomes dehydrated, there is less pain and discomfort, and the individual usually gradually fades away. However, when a person (e.g. someone with advanced Alzheimer's disease who cannot eat) is artificially hydrated and nourished, then their sensation of pain and discomfort is maximized. They can occasionally live a long time this way, but usually still only live a year or less (according to some recent well done studies).

Do Alzheimer's patients in a real advanced stage really feel pain and all?  It seems mom is so far gone she doesn't notice a thing.  Sort of a waking obliviousness.  Is the pain enough to break through the fog?  How is pain really measured when someone is so demented?

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This is a very difficult issue, particularly when it becomes personal, and I am not passing judgment on anyone who has posted on this thread. It's just that I have very often run across folks who want to do the right thing by their elderly relatives, and who do not understand that artificial hydration and nutrition causes more, not less, suffering.

Very difficult, indeed.  I don't want her to suffer and I don't want to starve her or make her thirst.  Right now it seems that being the one responsible for such decisions means that I'm the legally designated low life bum no matter what.
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They turned me loose from the nervous hospital.  Said I was well.  Mmm hmm.

Suffering for your beliefs is called faithfulness, making others suffer for your beliefs is called being a jerk.

His cross, like the ark in the wilderness, is the center around which his people are to encamp; so that they cannot separate into factions, or withdraw from each other, without retiring at the same time from the presence of the cross.
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« Reply #32 on: February 27, 2005, 10:20:15 PM »
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Mere Nick
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« Reply #33 on: February 27, 2005, 10:46:00 PM »
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Of course I also like the DH. Why have one slot in the line up that is a joke? The days when pitchers could hit (ala the Babe) are long gone.
Why, Jim, you must be a comsymp or some such to advocate such heresy.

Societal decline accelerated with the advent of the DH.  It teaches the young that people with certain positions in life can shirk their responsibilities.  The pitchers can take batting practice just like anyone else who has any sympathies for what is generally accepted as common decency.
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taller, better looking and smarter . . .

They turned me loose from the nervous hospital.  Said I was well.  Mmm hmm.

Suffering for your beliefs is called faithfulness, making others suffer for your beliefs is called being a jerk.

His cross, like the ark in the wilderness, is the center around which his people are to encamp; so that they cannot separate into factions, or withdraw from each other, without retiring at the same time from the presence of the cross.
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« Reply #34 on: February 28, 2005, 01:38:48 PM »
I know personally what it feels like to have artifical hydration and nutition.  I had that done to me two years ago.  It kept me alive while I couldn't eat or drink.  It didn't cause me anymore pain then normal.
Isn't dignity just another word for pride.  I had no dignity when I was in the hospital, and I really didn't care.  I was just happy to be alive and have the ones I love by me.
Nick, I'm sorry for your difficult situation and I'm sure God will help you through it.
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« Reply #35 on: February 28, 2005, 07:10:18 PM »
Nick,
No way that you are a "low life bum"! (Except for this weird desire to watch pitchers look foolish).
It sounds like you are trying your best in a very difficult situation. I am sure your heart is in good shape and whatever decision you make will be made in love.

My mom is 83 and in the last year has started going down hill. I hope  I do as well as you.

Jim
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« Reply #35 on: February 28, 2005, 07:10:18 PM »
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« Reply #36 on: February 28, 2005, 10:17:54 PM »
Nick,

I am sure you are doing the best you can, and I hope I didn't come across as disparaging you. This is a tough decision. It is much easier to speak in hypothetical cases, and often different when it is personal. You are in my prayers.

When life is nearly over, trying to keep the heart beating just a little longer often just prolongs the act of dying, rather than prolonging life. I would never advocate killing someone because I don't think they don't have a chance. But, it is often best to just try to keep a dying person comfortable, and not do invasive uncomfortable things that are fruitless in any case.

Mike
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« Reply #37 on: March 01, 2005, 01:54:55 PM »
Mike,

If you did come across as disparaging, that's ok.  The important thing is to do what's right by mom and you seem to know that figuring out what "doing right" means gets real hard in some of the tough situations that confront us.

Thanks to you and some of the others here, I'm going to make further inquiries with her doctors to gain more information on such things as feeding tubes and the like.  

I don't want to be cruel by withholding food and water, and I don't want giving her food and water to be perceived by her as cruel, either.  She appears to be completely unaware of all things.  I don't want the last thoughts running through her mind, if thoughts can actually do that at all anymore, to be that folks were being mean and causing her pain.
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taller, better looking and smarter . . .

They turned me loose from the nervous hospital.  Said I was well.  Mmm hmm.

Suffering for your beliefs is called faithfulness, making others suffer for your beliefs is called being a jerk.

His cross, like the ark in the wilderness, is the center around which his people are to encamp; so that they cannot separate into factions, or withdraw from each other, without retiring at the same time from the presence of the cross.
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« Reply #38 on: March 01, 2005, 10:45:13 PM »
I had a very bad experience in this area.  My grandmother's health deteriated to the point that she had to go in a nursing home.  She was still able to function on many levels, but could not care for herself.  Mini strokes were taking their toll on her mental capacity as well as making her physically weak.  She still enjoyed her regular tv shows, sewing,  working puzzles and visiting with friends and family.  She didn't remember everything (who does?) but she was still herself.

Because my parents often travelled at that time, I was given a medical power of attorney, "just in case".  I never really expected to be the one making the big decisions, though.

Once when they were out of state I got the call.  She was in the emergency room, and her heartrate was very low and erratic.  They wanted to put in a temporary pacemaker.  I said I didn't know if I should give permission, and the doctor told me, "It's only temporary.  If you find out it's something she doesn't want, then we can take it out, but I need a decision right now."  So I said ok.  

Big mistake.

When we got to the hospital where the procedure was done (they had to fly her there) the doctor told me that they would have to replace the temporary pacemaker with a permanent one in a couple of days.  I told him that I had found out that she had already refused a pacemaker and didn't want one and that the ER doctor had said she didn't have to keep it.  He told me, "Oh no!  Now that we've put this one in, you have to authorize the permanent one.  Otherwise it's just like killing her."

At that point I wanted to take out the ER doctor's pacemaker . . .

Grama lived another year (almost).  She sat around in her wheelchair with a confused look on her face.  She would look at the tv sometimes if you put her in front of it, but she didn't watch.  She never sewed again.  Never did another puzzle.  Usually didn't recognize her own family or friends.  She never wanted to eat, even the sweets that she had loved so much before. 

She died a horrible death.  The nursing home called me (parents were gone again) to say they'd sent her to the hospital.  We rushed to see her.  She had a great deal of internal bleeding.  She rocked back and forth on the gurney trying to cover up with the thin little blanket they'd given her, moaning, "Cold, cold" over and over.  This lasted for about two hours before something finally burst inside and blood poured from every orifice of her body.

If I had known that she didn't want a pacemaker she would have simply slipped away without pain a year before.

It's  a terrible burden to bear, but I'm glad my dad was gone and didn't have to see how his mother died.  I took her death very hard and blamed myself for her suffering at first, but I have gotten past that.

Yes, Nick, you will probably feel like a low-life bum no matter what you do.  There is no good choice when choosing between evils.  Just be willing to forgive yourself.


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James Rondon
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« Reply #39 on: March 01, 2005, 11:08:01 PM »
Regarding Terri, for those who have not been able to see the actual video footage of her condition, awareness, etc., aside from the few short snipets that have been shown on the news, here are a couple of links:

http://web.tampabay.rr.com/ccb/videos/hows_that_cold.rm

http://web.tampabay.rr.com/ccb/videos/balloon.rm

http://web.tampabay.rr.com/ccb/videos/Terri_Swab.rm
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« Reply #39 on: March 01, 2005, 11:08:01 PM »
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« Reply #40 on: March 02, 2005, 02:54:18 PM »
I've seen these video's and some others of her.  She seems pretty happy when her parents are there talking and doing things with her.
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« Reply #41 on: March 03, 2005, 10:28:49 PM »
Its heart breaking to see her and think shes encompassed by those who seek her life.
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Mere Nick
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« Reply #42 on: March 06, 2005, 03:02:22 PM »
Here's something from Clyde Wood, a local writer here in Weaverville NC.  An interesting take on the woman.

 From Clyde Wood

Terri Should Have Been A House

The North Carolina Real Estate manual is a pretty useless household item. At about four inches, it is too thick to level an uneven table or sofa. It isn't heavy enough to make a good door stop and it takes up too much desk space to make a good paper weight. But if you're a real estate salesman or a slum lord, like myself, it's an invaluable reference source to have around.

About half of the manual deals with math in one form or another and the other half deals with law. A small portion is dedicated to your imaginary rights as a property owner.

You are told of what is referred to as the Bundle of Rights to any piece of property. It is stated that you own everything within your property lines, everything below it to the Earth's core and the air space above to infinity. This, in my opinion, makes the moon one very large time share.

There are far more laws dictating what you can't do with property than what you can do with it. You can declare the air space above your property a No Fly Zone if you wish but you can't set up a missile system to enforce it. You can't build a house within a fifteen foot strip on any side of your property line. You pay taxes on that strip but about all you can do is mow it or plant corn. You can't even do that if there's a creek or gully running through it (depending on where you live). You ultimately don't even own it at all if your local powers that be decide that your property would best serve the public good in some other form than freehold property.

Most of this is of no concern to a real estate agent. He or she is only concerned with the specific laws governing an agent's actions during a transaction. That you might start taking pot shots at passing airliners is none of his or her concern so long as the papers have been signed your check has cleared. But what a real estate agent must know, that which does apply, is quite substantial. Real estate law began as a straight forward confirmation of an agreement between two parties and evolved into the convoluted mess that exists today simply because the world is full of idiots.

Some guy says he has a farm to sell and another guy asks how large it is. The first guy says that it will wear a man out going from one end of it to the other. So, sight unseen, the second guy lays down his cash only to find out later that he purchased a seventy-five foot high cliff with a couple tomato plants growing in a bucket at the base. Because Scroundrel A happened to meet up with Idiot B a new law was passed. This continued throughout history to cover any forseeable issue with property transactions because just about any underhanded thing you can think of has been attempted at some point in time and there has always been an abundant supply of dolts to fall victim to them.

Everything today, no matter how seemingly insignificant, must be express (in writing). Intent, as we so often hear, "the founding fathers' intent," carries very little weight in real estate and is usually dismissed in real estate disputes. Even though everyone in the community was aware of the old lady's intent to leave her property to her son who devoted many years to her care, the simple fact that she didn't put it in writing leaves open the door for her daughter who left home thirty years ago to became a prostitute in Los Angeles and hadn't so much as phoned home in all that time. Despite the old lady's intent, the daughter is legally entitled to half of the property that should have, by all the laws of common sense, gone in total to the son. Things have to be in writing.

So. why the rudimentary course in real estate, you ask? It goes to prove a point, a postulation that we are a more Godless society than we'd like to admit. We do have a god but it's the little "g" diety. Our god is cash.

Property, either through utilization, leverage or sale IS cash. As such, we have our convoluted system of laws designed to protect not so much the property but someone's interest in it, i.e., their money and the tax money Uncle Sam subsequently extracts from them. Under the big "G" God it is people and how we treat each other that takes precedence. Under our little "g" god it is property that takes precedence.

Case in point, Terri Schindler-Schiavo, a person who has been deemed by our court system to be NOT a person but rather the property of another person. This nation has watched the story unfold for quite some time now and it sickens me what has transpired. One would think that it is a no brainer situation, "Why kill when someone (Terri's parents) is willing to take care of her.

Then we learn that it's about money. Terri's husband is apparantly getting itchy fingers, wanting to start writing checks off of that large settlement when his wife finally shuffles the coil. I would like to hear a judge give the following options to Mr. Schiavo, "You can forfeit all cash related to this case and kill your wife or transfer custody to her parents, be granted a divorce and then get the hell out of my court. You decide, jerk." Without the incentive of financial gain I'd be willing to bet that Michael Schiavo wouldn't be in such an all fired hurry to starve his wife to death.

If Terri Schiavo was a ranch style house on a third acre parcel of land this case would be over and done with. Her husband says that it was her will, her wish, her intent not to remain in the state she is in. Michael Schiavo has not, however, produced a single piece of paper to verify this claim. The gravity of the case, it's impact on others, would without doubt demand a ruling based on what is or is not express within a contract and not a person's INTENT. We do not really know Terri's intent. It seems to me, since Terri has been deemed to be property, she should be judged according to same rules we use for property.

I am amazed that this case has progressed to this point. I am baffled at the lack of common sense displayed by our courts and the inability to recognise the transparent nature of this case. I'm further amazed that, in a nation where a man can get dragged to death simply because of his skin color, that the plaintif in this case, a true slimeball if there ever was one, is still breathing. And I am disappointed that, as it seems to be heading that way, this nation will stand by wringing it's collective hands while a young woman is slowly murdered in the legal light of day.

If Terri Schiavo were a house the market would decide her fate. Someone who loved her would keep the windows clean, the lawn mowed and the picket fence out front repaired. Someone who found her charming would put in the time, money and hard work that any investment requires. If she were a house our little god powers that be might indeed remove her from the hands of her current owner but they would not bulldoze her so long as there was an interested buyer willing to pay the back taxes.

Well, Terri has an interested buyer. She has a motivated buyer, a buyer willing to pay higher than market value. She has a buyer motivated by love, her parents. It is really that simple and it is unconscionable to me that the courts do not concur. We are truly a screwed up society when one can find truth in the statement, "Terri should have been a house." God help us.
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taller, better looking and smarter . . .

They turned me loose from the nervous hospital.  Said I was well.  Mmm hmm.

Suffering for your beliefs is called faithfulness, making others suffer for your beliefs is called being a jerk.

His cross, like the ark in the wilderness, is the center around which his people are to encamp; so that they cannot separate into factions, or withdraw from each other, without retiring at the same time from the presence of the cross.
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« Reply #42 on: March 06, 2005, 03:02:22 PM »
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Annie
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« Reply #43 on: March 07, 2005, 09:13:27 PM »
Nick,
When I lived in Ashville, I went to school in Weaverville.  I went to Weaverville Primary School.
That was a good article by the way.  I'll have James read it.  He'll understand the real estate lingo.
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Mere Nick
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« Reply #44 on: March 07, 2005, 11:01:02 PM »
Really?  We live in Weaverville.  My kids went to North Buncombe Elementary and would sometimes play ball there at the primary.

When did you live in the Asheville area?
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taller, better looking and smarter . . .

They turned me loose from the nervous hospital.  Said I was well.  Mmm hmm.

Suffering for your beliefs is called faithfulness, making others suffer for your beliefs is called being a jerk.

His cross, like the ark in the wilderness, is the center around which his people are to encamp; so that they cannot separate into factions, or withdraw from each other, without retiring at the same time from the presence of the cross.
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