[AZ Male RN]

Let this be a lesson to all of us. PUT YOUR WISHES IN WRITING!!!!!!
I think it is murder to starve a person to death. It is one thing to allow someone to die that is terminal. Terri was NOT terminal! She was brain damaged. To me a vegetative state is when you are basically in a coma, and Terri was not in a coma. Who knows what thoughts are going through her mind or what pleasures she has? Sure there is not much hope that she would recover any further than she has already but that does not give anybody the right to starve her to death! If her so called husband cared for her so much, why did he have a girlfriend and have children with her? There are laws against adultery!! His children are proof that he is an adulterer and may be he should be prosecuted.

[lpn181]

I agree with MartinRN and think that the rest of you should take a serious look at yourselves and think about what you are saying and the profession you are in and have some ethics and some moral value. I have worked with developmentally disabled individuals for five years now and when people say that she has no quality of life..how dare you. You don't know what she is capable of or if she even knows what is going on. She may not know much if any of what is happening to her, but what if she does? I have seen the individuals I work with make great progress over the years and sure it takes much longer that it would a "normal" person, but they still deserve some compassion and the right not to starve to death.

[sparkysbird]

I'm just a nursing student so I really can't state a "professional" opinion. My personal opinion however, is that it is morally wrong to starve a person to death. I keep hearing from the press that she is not suffering but the other night the husband's attorney quoted the nurses notes as stating that during placement of a suppository the patient grimaced and I think he said squirmed. I'm no expert but isn't grimacing an indication of pain on a pain scale?

[Faizi]

The Shiavo case is complicated due to disagreement among her family -- Michael Shiavo vs. The Shindlers.

If there was agreement in the family, the story would not be on national news. Withdrawing feeding tubes is done every day and the person dies without news coverage.

Admittedly, I am biased because I had the experience of watching a fairly cognizant woman die of starvation over about four weeks. I felt like a murderer. The woman suffered and cried out. She was in her nineties and had been in long term care for several years. One day, her nieces and nephews decided to take her tube away. No one ever visited her. I was horrified to watch her slow death.

From the little I have seen on television, Terri is probably less cognizant than this woman but does have some awareness. I would have trouble starving her. I have seen other people in vegetative states that I would be more willing to see starve as an act of mercy.

On the other hand, she had been a lovely young woman who was somewhat shy and avoided cameras. How heinous that she is now seen all over television in a rather unflattering state. She would have been appalled. No one would want to live in that state.

But she is no longer that same young woman. She is greatly altered. Severely brain damaged. Infantile. Yet, feeling and aware on that infantile level. There is no way to know whether she wants to live or die.

Had they taken away life support in the first few days or weeks of her vegetative state, things would have been far less painful, I reckon. So few people are educated enough to realize prognosis.

My husband died nearly fifteen years ago when he was thirty eight. He had lymphoma and tumors proliferated throughout his brain. He had one cerebral hemorrage that left him paralyzed on the right side and he had a feeding tube and catheter. He was one miserable human being. He could not speak. Just thrashed around.

I said, "If he has another hemorrhage, do nothing. No ventilator."

He had a hemorrhage and a was intubated. Brain dead.

Fortunately, he died while still on the ventilator. I would not have maintained him in that state. He had malignant tumors throughout his brain. The night before his first hemorrhage, he had such terrific pain that he forced me to tie a handkerchief around his head and cursed me when I could not make it tight enough for some relief.

It was my duty as a wife and a friend to let him go. I was not letting him go. He was going.

I think it is very important for physicians to be frank and honest about prognosis in a crisis situation. Tough call, I know. But there does come this point when anyone with common sense knows that there is no hope for a viable life. Families don't want to accept that but they should be told bluntly.

Several years ago, my mother suffered a hole in her esophagus. Took a couple of days for the problem to be absolutely pin-pointed. Emergency surgery on a seventy nine year old woman. She had to have a feeding tube. There were no promises of a full recovery. Very difficult decision.

We opted for the surgery. Very difficult surgery. She came out of it but she was nuts for a month or so. I thought, "What have we done?"

She came home with a feeding tube and had home nursing for a month or so and with the family staying with her at night.

Once home, she regained her mind. She recovered and began to be able to eat and drink again on her own. The tube was removed.

About three months after that, she had encephalitis. Totally nuts and in a semi coma in the hospital. Another feeding tube. Accurate diagnosis and medical treatment plus about three months of rehab and she came out of it.

She is now a very healthy eighty two year old woman. Tiny - four foot eight and ninety four pounds. A dynamo. She looks better now than she did before the hole in her esophagus.

Decisions during a crisis are so difficult. I knew what to do with my husband. My mother's crisis had more grey areas.

I feel a lot of compassion for the Terri Shiavo situation. For the Shindlers and for Michael Shiavo. She is not going to get better. She is going to stay the same as she has been for about fifteen years. For whatever reason, Michael Shiavo is going with what he remembers her saying before she was in this state.

She is not now that person. She is very different. Severely brain damaged but some cognizance.

As a nurse, I know that I would have difficulty starving her. Very tough.

But, when I look at the photographs of her as a young, healthy seeming woman, I can see reason for letting her die.

Very difficult, complicated case. In a year or so, she could die of pneumonia or influenza. Quite likely. She could die from complications of a UTI. Her situation is very tenuous. Why starve her? Why not let her parents care for her until the end?

On the other hand, why prolong her misery? She could not have wanted to live like this.

But she has not been the same Terri for years. There is no way to know now what she could want.

There will be an autopsy that will show severe brain damage.

Well, duh. We know that she is severely brain damaged.

Very difficult case.

It should have been a very personal matter. Government should have never been involved. The disagreement between husband and parents brought on the intervention of government.

Just a very sad and complicated case.

I don't think that there is a right opinion. I just hate to see a personal matter politicized. The religious right involved. Yet, in polls, evangelistic Christians are split on keeping her alive and letting her die.

There is just no right or wrong for Terri. The legal aspects of her situation are as grey as the physiological.

If the parents were in agreement with the husband -- or the husband in agreement with the parents, her death would not be played out in public.

I have seen a lot of deaths. I have never seen a completely painless death. It's just hard to say whether the pain is perceived by the observer or the patient.

Very hard. Is the grimace at the suppository part of perceived pain or reflex?

Terri is two weeks out now. She is yet a young, strong woman. She could die tomorrow or she could go another two weeks.

Interesting nursing lesson for the populace. Most people -- journalists, everyone -- are ignorant of how resolutely people can cling to life; what life means; life that does not adhere completely to science.

Lichen exists on air. So can humans for a time.

I wonder how aware Michael Shiavo can be of such biological resolution? Must be hard for him. I reckon he thought that she would have succumbed by now. He is a RN.

You kind of have to wonder how his nursing experience has influenced him.

If he has never done it, he should work in long term care.

Very difficult case.

I am pulled both ways.

The decision is personal, right or wrong. So far, the courts have upheld that premise.

If the tube was re-inserted now, she would exist in an even more compromised state. I reckon it is too late now to put it back.

Faizi

[michigancna]

I encourage everyone that brings the topic of Terri Schiavo up to make out a living will. I am GLAD the government did not decide to make legislation to rule on our right to die. People have the right to determine their quality of life, they should also have the right to determine how they want to die. Lets say that Terri did tell her Hubby to not allow her to live the life she had after several doctors say there is little chance for recovery - How would you like to live another 15 years, waking up in Terri's body? Her case was about not having a living will, not a case of "is she awake or is the body in PV State?" It was about her right to choose when to die. It was quoted in Newsweek - the parents said "Even if Terri said she wanted to die, we would not let her", how selfish is that?

[nursinghumor]

[ QUOTE ]
michigancna said:It was quoted in Newsweek - the parents said "Even if Terri said she wanted to die, we would not let her", how selfish is that?

[/ QUOTE ]


I agree, my living will is made out and very specific.

The parents desire to keep her alive seemed to be purely for their own comfort. Like a family that simply cannot let go of a dying patient.

The decision to die should be up to the patient, or closest living relative who was her spouse in this case. I find it pretty damning that the parent chose to ignore her wishes as expressed by Michael Shiavo.

Andrew Lopez, RN
http://www.4nursing.com