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  • Choosing How It Ends

       March 22, 2005

    I really don't want to discuss Terri Schiavo. I feel like a) the facts of the case are in dispute and you can read conflicting things all over the Internet about it and b) people far smarter than me have tackled some of the legal aspects of it.

    Then, I read Rachel Lucas' take on the whole thing:

    Let's see. I have a dog named Sunny, as many of you know. I signed a contract at the pound taking responsibility for her and I clearly am her legal "next of kin." Now, it's very likely that some day, Sunny will have arthritis in her hips and legs, and she might eventually be unable to move around on her own.

    So! Who knows Sunny better than me? No one! So you must take my word for it when I say that I "know" Sunny would not want to suffer from arthritis to the point that she couldn't even walk around. Really, she wouldn't. I am telling you.

    So here's my idea to (1) save time and money, (2) to fulfill Sunny's "wishes", and (3) to enforce her "rights": when she gets to the point where the arthritis in her hips and legs is so severe that she can't even stand up and/or walk over to the food and water bowls....WE JUST LET HER LAY THERE AND DIE!!

    That's what gets to me about this case. Why does she have to be starved to death? That's what's so horrific to me. We don't really know how much she's aware of, but I do know that her family and the people who have taken care of her for all of these years are aware of it. Even if Terri Schiavo doesn't know and can't feel what's going on, these people can. Imagine how hard it would be to lose a loved one to a vegetative state and then imagine how hard it would be to watch them starve to death. Just imagine, for a moment, that everyone agreed that Schiavo was beyond hope and had expressed a wish to not be kept alive. Why in the world couldn't she receive a lethal injection instead? For Badini's sake, when Go For Wand broke her leg in the 1990 Breeder's Cup, they didn't just leave her hobbling on the track, they put her out of her misery. Why don't people get the same consideration?

    I know that some of our readers have drafted living wills and here's my question. Could I write a living will that says that if I'm in a vegetative state and there's no hope, that I want to die, but that I don't want to be starved to death? Could I legally state that I wanted to be killed with a lethal injection?

    I'd guess that this falls under the same laws as physician-assisted suicide (an aside-I support physician-assisted suicide, but I have to say that Dr. Kevorkian did his cause no good by being such a creepy lover of death), but it's not quite the same thing. I'd like to know specifically what would stop me from demanding how my life be ended.

    The Schiavo case is really horrible, but maybe some good can come out of it. Maybe more people will get living wills and maybe we'll change some laws (if necessary) so that we'll be as humane to our fellow men and women as we are to our pets.


    Posted by at March 22, 2005 08:23 AM

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    Comments

    #  March 22nd, 2005 2:43 PM      Laura
    Euthanasia is not legal here in Louisiana, but nutrition was withheld from my mother in law, a terminal cancer patient, for the last couple weeks of her life. FWIW, I was against it, it looked... beyond awful. I had nightmares and I'm not especially sensitive. I don't know how much of it she was aware of. I also know people whose family members have been killed in this way who said it wasn't bad at all.

    My husband and I made living wills yesterday that specify that we don't want extreme measures like ventilators, but that we don't consider nutrition an extreme measure... our attorney is looking over the wording, and I'll let you know what she says. As far as I know, you can request a lethal injection all you like, but if you don't live in Oregon, you won't get one.  
     
    #  March 22nd, 2005 4:07 PM      Laura
    Just one more thought - obviously I'm not in favor of euthanasia, and I was unhappy that it became law in Oregon. But the voters wanted it and I'm glad that there is a law that sets parameters and defines it, rather than leaving in the hands of a judge to "interpret." If we as a society decide to approve euthanasia, we should do it - and not by a chickensh*t backdoor measure of starving people to death, but a more humane lethal injection just like the criminals get.

    People on BOTH sides of this issue ought to start lobbying their state legislatures to put this issue up to a vote; then let the chips fall where they may.  
     
    #  March 22nd, 2005 6:16 PM      james
    laura,

    the issue here is one of letting a person alone so that they die on their own, not one of euthanasia. there is a distinct difference - one is the taking of a life by an affirmative action, the other is allowing a life to expire by non-action, i.e. by "letting nature take its course."

    i think that the latter is a far cry from euthanasia.  
     
    #  March 22nd, 2005 7:24 PM      Daddy
    This whole case is a train wreck. As with anything else, peoples' opinions are only as valid as the information they receive....and our only source of info on this matter is the MSM. (Any bloggers down there?).

    Listen to some people, Michael Schiavo is a hero; listen to others, and he's a conniving, cold-blooded, abusive gold-digger.

    Make living wills and living trusts, people. This way we can make sure that a future Nazi administration can't turn attention away from a failed foreign occupation and a miserable economic policy. ;)  
     
    #  March 22nd, 2005 10:50 PM      Laura
    James, I understand what you mean, but euthanasia is defined this way:
    dictionary.com - The act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, as by lethal injection or the suspension of extraordinary medical treatment.

    I don't call nutrition "extraordinary." Especially when I do the cooking, barely edible is more like it. ;-) I grant you that other dictionaries have slightly different definitions. The Merriam-Webster online has a definition that doesn't fit my position as well as the one on dictionary.com.

    My point is this - it's all about semantics. What you seem to define as euthanasia, I call criminal neglect. The same "non-action" applied to babies or pets will send you to jail. Also, a cop is in Schiavo's room to prevent any visitors from putting food or water in her mouth; if the theory is that the tube is the "extraordinary" part, what's with that additional step? That is part of the reason I call this euthanasia. I doubt we'll agree on this - but we can prevent this from happening again by getting our state legislatures to put legal definitions and guidelines in place.  
     
    #  March 22nd, 2005 11:06 PM      Laura
    oops... I changed this sentence about three times and still never got it right - What you seem to define as euthanasia, I call criminal neglect.

    What I meant was, What you seem to define as natural death, I call criminal neglect.

    Sorry...  
     
    #  March 23rd, 2005 12:43 AM      james
    whether it's "neglect" or not depends on the applicable standard of care and whether the person charged has a responsibility to meet that standard.

    laura, youre saying that the failure to insert a feeding tube into a person unable to feed herself rises to the level of neglect. that's certainly a reasonable position, though i think that there are good arguments to be made on the other side.

    regardless, the whole equation changes when a legally capable person knowingly and willfully instructs others to not meet that standard of care. in that instance, i don't think that it rises to the level of neglect.

    i don't think that it's as easy as you make it sound in calling for action by state legislatures. of course, legislatures can define euthanasia and declare whether an omission rises to that level, etc. but that won't "prevent this from happening again."

    the problem in this case is a dispute about what the patient's wishes are. the only thing that will prevent misunserstandings like this in the future is for each person to take the time to draft a living will.

    that is, unless your end goal is that it should never be legal for a person to be allowed to die, even if that is his wish. in that case, i suppose that lobbying the legislature can prevent "this" from happening again.


     
     
    #  March 23rd, 2005 10:43 AM      southernmiz
    When family disagrees about the patients right to die, the guardianship of patient should be awarded to the part of the family who has no conflict of interest (another wife and kids) and wants her to live.

    Right to die is for life support cases: life support is on oxgen and fed with IV. Do not kill patients who may be rehabilited with therapy to speak better, walk and talk, and we do not know that Terri cannot as she had no speech therapy or other rehab.

    The husband wants her dead. The courts want her dead. Change the law. You may be next.  
     
    #  March 23rd, 2005 10:59 AM      Laura
    My end goals would be -
    1. to define the applicable standard of care so that people can know if it's being violated. Are feeding tubes equivalent to a ventilator or not? Is ordinary care that an unskilled person can provide (i.e. feeding with a spoon or bottle, changing a diaper, turning a patient to prevent bed sores) considered medical care?
    2. to define the circumstances under which that standard of care can be breached. Should quality of life be considered?
    3. to define who can choose to breach that standard of care. In the absence of a living will, who gets the final say? What evidence is necessary to prove that medical intervention should be stopped? When is a spouse considered estranged? Can the doctors make this decision independently? Insurance companies?

    This is not an ordinary "right to die" case. An otherwise physically healthy woman with a really bad quality of life will die based on what other people claim she said she would have wanted. If "quality of life" is a consideration, many, many other people are eligible to have nutrition withheld. Dr. Cranford, who insists Schiavo's brain has liquified, advocates starving Alzheimer's patients and others who can't lift a spoon. I think we need to define the differences between physician assisted suicides, DNR orders, and euthanasia. Letting judges decide on a case by case basis seems like an extraordinarily bad idea to me.  
     
    #  March 23rd, 2005 8:10 PM      KVBigSis
    In Wisconsin, a feeding tube cannot be removed without a signed power of attorney for health care. Here's the feeding tube language from the form:

    PROVISION OF A FEEDING TUBE

    If I have checked "Yes" to the following, my health care agent may have a feeding tube withheld or withdrawn from me, unless my physician has advised that, in his or her professional judgment, this will cause me pain or will reduce my comfort. If I have checked "No" to the following, my health care agent may not have a feeding tube withheld or withdrawn from me.

    My health care agent may not have orally ingested nutrition or hydration withheld or withdrawn from me unless provision of the nutrition or hydration is medically contraindicated.

    Withhold or withdraw a feeding tube Yes __________ No ____________

    If I have not checked either "Yes" or "No" immediately above, my health care agent may not have a feeding tube withdrawn from me.

    -------------------

    I think this is a pretty good standard, and it errs on the side of life.

    We did have one client who, as a specific request in his Power of Attorney for Health Care, requested an overdose of a pleasure-causing chemical should he be in a terminal condition and unable to communicate. I doubt if that desire would be followed, but it would be interesting to see it play out.

    Kris, you do realize that you HAVE watched someone basically starve to death, don't you?  
     

     

     


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