This Schiavo business is idiotic. 15 years in the courts (plus this mornings decision) all coming up with the SAME RULING. The last time I was this annoyed with media coverage and politicians was during that friggin' Elian Gonzalez episode. It's tough being a Republican right now (though not as hard as if the Capital Gains rate was at 20%).

Did anyone see Hannity & Colmes last night? Hannity was down if Florida outside the hospice that houses Terri. He had the Schindler family on and was actively encouraging them to call Michael Schiavo a murderer (they even said outright that they thought he assaulted Terri to put her in the position she is in and wanted her dead to "silence" her). I have read alot about this case and even watched some of the video of Terri but this is the first I heard that her being in a coma wasnt the result of a medical condition but may have been foul play. This thing really has gone beyond a simple right to die case and is now being turned into a movie of the week, repleat with grieving family fighting for justice for injured child, cartoon villain (is he killing her for the money or to cover up his other crimes?) and crusading journalist fighting to save Terri. I guess the only thing they need to happen is for her to sit up and point at Michael Schiavo and call him a murderer. Unfortunately I dont think this story is gonna have a happy ending no matter what your perspective.

thinka bout this on health care with the government has to save a life mantra

or poverty programs

its a bad pandoras box

Bill, I just wanted to say that I think you're one of the few people, blogger or otherwise, who has remained sane on this subject.
Though my assessment might be biased, as I agree with your stated position on this issue :)

Sorry, Bill, but while I enjoy your site and I enjoy Pinkerton, I had to laugh at the notion that anything a politician does will inexorably bind him/her to a certain follow-up. Good grief, we're talking about eels dipped in liquid butter.

Salt Lick, I think you miss the point. A specific politician isn't necessarily bound to vote for socialized medicine and whatnot. The point is that in fighting for their own values on an issue that should have been covered outside of their jurisdiction, they have expanded the power of the federal government in a way that will be greatly disadvantageous for them when they are no longer a majority.
This is exactly why small government is defended--not because people are afraid of what THEY will do when they're in power, but what their opponents will do with the power they've expanded.

Just out of curiosity, what do you think about these comments?

Pinkerton is right when he says:
"future Republicans will have a hard time urging federal restraint in the name of decentralization"

But I don't believe that's a bad thing. Republicans have been on the wrong side of this argument too many times and they need to do some soul searching..

The part rhetoric in regards to judicial activism needs to be confronted instead of arguing for absolute states rights.

i meant to say "party rhetoric".

Like, "let's BOOGIE!"

I agree that Congress put their emotions before their authority in this matter, though I feel that legally the probate law of Florida does not allow a guardian to restrict sustinance to their ward.

In the matter of socialized medicine, the fact is we already have limited socialized medicine in this country, and Terri's bills have been paid by Medicaid for quite sometime. Her husband frittered away her nearly $750,000 award in the malpractice suit, mostly on attorney's fees. That award was supposed to be used for the care of Terri for the rest of her life. In the trial, experts testified that in her condition she could expect a normal lifespan. He never did fulfill that promise; in fact, he refused to allow or pay for doctor recommended therapy. Unfortunately, he is an apparent cad and the taxpayers are paying for it.

The real villain in this whole episode, in my estimation, is Judge George W. Greer. His negligence in not requiring Michael Schiavo to comply with state law requiring yearly "guardianship plans" is unforgivable, especially since there has been no court-approved plan in effect for Terri's care since July 1, 2001. Under Florida probate law, without an approved "guardianship plan", the guardian has no authority to act on behalf of the ward. Why the state of Florida would allow a judge to ignore implicit probate law is anyone's guess.

Amen to Dale Franks.

I am going to stan mute on the issue of right to life/right to death.

Did she express her wishes/ does she retain some consciousness and wish to go on living.

My greatest horror was when I read the following description of what this woman will endure.

Because you see, we are not merely talking about removing the feeding tube, the woman from what I hear is not on an aspirator so she can swallow.

It is the prohibition by the court against any attempt to feed her, give her water or shaved ice that upsets me for the following reason

"Launching a person in Terri’s situation into a coma is the only way to avoid a painful death by starvation, he said, describing what happens to the human body when it is deprived of food and water.

“People who die of starvation, their acid eats through their stomach, they develop infections in their body, their body starts to dissolve from the inside out, they develop seizures, [and] frequently it breaks their back,” he said. “They have to have medications to essentially put them into a coma to not have their body break their back or something of that nature.”

I am not certain if she were turned over to Al Quedar and they cut her head off on a video which manner of death would be more painful that or what the court has decreed.

This is not allowing a person to die with dignity, it is murder and a most painful one.

Why are the Courts and her Husband in such a hurry for her to die? Why not give her water or shaved ice to relieve her suffering?

She will take longer to starve to death that way.
Is that the reason?

My greatest horror was when I read the following description of what this woman will endure.

And yet I've also read more than one description that goes like this ...

She won't starve to death. She'll have multiple organ failure culminating in cardiac arrest as a result of dehydration, and during that time the nurses will keep her as comfortable as possible by giving her morphine and likely a sedative such as Ativan, as well as artificial tears, saliva, and a lip moistening gel. A side effect of the morphine will be to suppress her respiration, which will hasten the process. Her body will be comfortable. Her mind won't know the difference, because she has no capacity to experience anything cognitively. I've been through this with five relatives in the past 12 years, including my grandmother last month. It's the most humane way to go given the doctor's legal inability to intentionally provide a drug for the purpose of causing someone's body to shut down. When I go, I want to die instantly; but if I were to suffer an extended illness or be profoundly incapacitated, this is how I would want to go.

... to other descriptions that the option is commonly used in Alzheimer's, coma and PVS patients, even up to a declaration in the Washington Post by a neurologist that Schiavo will feel "no hunger" because the portion of her brain that causes such awareness is gone (an assertion which I actually don't quite believe, based on the obvious bias of the rest of the article).

So tell me Dan - like most aspects of this case - which story do you take at face value?

I have no idea.

Something that comes to my mind, that I've not seen mentioned anywhere, is the suicide angle of living wills. If I attempt to kill myself, for whatever reason (financial, love life, whatever), and fail....it's a crime.

But if I leave word to kill me if I'm sick and won't get better, that's not only ok, it is legally binding.

So. If we stipulate that suicide is always wrong and we also stipulate that there exist methods of keeping a terminally ill person alive...why are living wills legal?

(I should note that I am definately in favor of living wills. I have one and it is as strict as I could make it in terms of letting me die.)

Bill,

States' rights and "limited govt." are not absolutes. The preciousness and value of each life is. You argue about the next "not so clear" case, but ... what is this?

Check out Hewitt's take re: the 5th and 14th Amendments. These, in add'n to Art. III of the Const. make clear that Congress has the power to ensure that a person's life is not deprived without due process.

If we are all dead and/or ruled by out of control judges, then what value will our saved resources have?

"He never did fulfill that promise; in fact, he refused to allow or pay for doctor recommended therapy."

Doug, read the GAL (Guardian Ad Litem) report. Michael tried every form of rehabilitation for years, even when doctors were telling him that it wouldn't do any good. You are perpetuating a myth that he NEVER fought for rehabilitation.

As for the money, blame the parents. They're the ones who can't let go. And I'm sure they have generous GOP benefactors on their side to keep this fight going as long as they need.

States' rights and "limited govt." are not absolutes. The preciousness and value of each life is.

Oh really? Each and every life? Even the ones that can't pay under a private health care system? Those in a coma for 20 years? What?

These decisions are made in the medical field all the time, so soundbites about the inviolable preciousness of each life do not intersect with reality.

And a thorny edge of bioethics is on the horizon, as we sort out what treatments are moral, and what defines "life." Assuming the continued exponential advance of medical knowledge and ability, perhaps within 30-50 years, we will be as Gods, with the ability to do a variety of ethically tricky things (very soon, think of growing entire bodies for transplants that lack higher brain function).

By most accounts, Schiavo has received more due process than any other PVR patient in history - but the result of all of that procedure is unfavorable. So the idea that this specific case has received somehow less due process isn;t quite accurate, and the judgments that you are making have large implications for the whole medical/legal protocol for PVR/comotose/etc patients, across a variety of states, as well as the financial burden on the healthcare system.

I can't quite recall the exact statistics, but a massive majority of health care expenditures are dedicated towards heroic and extensive efforts to save patients at extremely advanced ages, in extremely poor health. I'm not suggesting that there is anything naturally wrong with this, but having a paternalistic state declare that every life must have protection till the end, no matter how bleak the situation, and no matter the financial status or wishes of the family, is frankly naive. And would break our system.

The unequivocal life soundbites remind me of the immutable antiwar logic about the death of innocents in a war. Realistic human calculus demands more complex and often upsetting decisions that can't be encapsulated in simple rhetoric.

So tell me Dan - like most aspects of this case - which story do you take at face value?

I have no idea.

Posted by Bill from INDC at 22.03.05 20:42
*************************************************
I was going to say If you tell me the version in your post is a true and accurate protrayal I would believe it, You have a lot of credibility with me, but then you went and said "I have no idea." ;-) So we are back to square one.

I would be inclined to go on the side of caution.

Well, that's what i'm saying. A lot of facts in this case - assertions, demand a level of knowledge that most of us don't have. So my tendency is to err on the side of caution by not taking too much stock in any of them without verification ...

Unless I start researching, which I may do ...

Just addressing the dehydration issue.

I am fairly sick of people saying "she will feel no pain" since this is really mostly speculation on the part of doctors. It isn't like they have a way to interview the patient to find out for certain, and the truth is that there is far more we do not know about the brain, than we do know.

Neurologists can't tell me why my son has autism, they can't tell me what it is about his brain that makes it work differently than mine. Until they can figure out those things, I will take a pass on believing their comments about whether or not somebody in PVS can feel pain.

I am fairly sick of people saying "she will feel no pain" since this is really mostly speculation on the part of doctors.

I would agree with that. For example, the doctor's unequivocal assertion in the WaPo article I skimmed today seemed ridiculous.

Then again, pump anyone full of Ativan and morphine and their pain will be rather dimninished.

So we are now debating cost/benefit analyses to figure out which human beings are to be allowed to live and which are to be put to death?

Just Me;

Dehydration death due to the endorphins involved is very peaceful.. it is only bad in the case of some one who is well functional

Doug;

but you can see if we have a group of democrats in the majority of congress using this same logic to pass some kind of overeaching socialist agenda... it is wrong as a matter of principle

Well, that's what i'm saying. A lot of facts in this case - assertions, demand a level of knowledge that most of us don't have. So my tendency is to err on the side of caution by not taking too much stock in any of them without verification ...

Unless I start researching, which I may do ...

Posted by Bill from INDC at 22.03.05 22:31
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Then let's discuss an issue that does not take so much expertise. It has been stated that she can swallow. Whether that is true or not, what is true is the Court Order forbids even shaved ice, as well as it forbids manual feeding or drinking water.

Now to my mind this goes past, removal of a feeding tube, pulling th plug and allowing the person to die.

There is not ONE of us, posting here who would survive such treatment.

That is not allowing to die, it is instead a Court Ordered execution of an American Citizen who has not been charged, or convicted of a capital crime.

In a manner I might add that would be forbidden to perform on any convicted criminal on Death Row.

Last Fall my family decided that the medication my mother was on for dementia was doing nothing but keeping her in a state where she was unaware of her surroundings almost all of the time. My brother who lives back home and has had the burden to seeing to everything on a day to day basis ordered her medication stopped except for that needed to keep her comfortable.

At the end for some time her mind cleared up, my last memory of my Mother is her smiling, knowing who I was on my visit and being able to talk to me a little bit. Jan 1 She passed peacefully in the company of her husband, daughter grandson and two of my brothers. I had returned home from my visit and to go the funeral all I had to do was close a still not completely unpacked suitcase.

So its not like I am suddenly thinking about these things for the first time.

Darleen -

So we are now debating cost/benefit analyses to figure out which human beings are to be allowed to live and which are to be put to death?

What do you think goes on every day in American hospitals?

Do you think a homeless man without insurance gets heroic, leading edge care that would save his life with certain maladies? Or that he would be kept on life support for 40 years, with no one to pay for it?

Do you think that families without means or insurance have the option that the Schindlers have?

Seriously, think about what you said, and think about what my post actually says. A federal government mandate to determine an inviolable culture of life is at odds with reality, and all of the noble soundbites in the world will not change that.

And many of the conservatives that are understandably fighting so hard against the apparent barbarism of removing a feeding tube - a protocol that's more common than many realize - are the same people that (rightly, IMO) shun the concept of universal or socialized health care, which would conceivably guarantee life for everyone, yet also horribly reduce the average standard of care (in addition to the terrible economics).

To be clear, I'm not advocating some sick society that casually makes these decisions - that's why we have laws and protocols about such things, and it's of course an automatic protocol to acutely err on the side of life; that's what medicine is all about, in addition to quality of life.

But once again, the implications of this case stretch far beyond what one thinks of Michael Schiavo, or whether this is the first time an average individual has learned about the removal of feeding tubes and read varying assertions about the consequences.

It's a very complex case plagued by a vast amount of misinformation, and I believe that it's unwise to form a very strong opinion without the correct information, or without thinking of the strategic consequences of any emotional decisions.

Bill

This is not the case of a homeless guy who needs meds .. this is a woman who was received a judgement based on her what would have been her life expectancy if she had had the rehab she was denied post-judgement.

It's not a matter of just pulling her feeding tube, no one is allowed to even feed her by mouth. That's as deliberate an act of starvation than the bio parent we prosecuted for having a child chained to bed and malnourished for years in a dark room. Do you know what non-stimulation does to someone NOT cognitively impaired? Think of what 10 years of similar enforced non-stimulation does to someone brain-damaged who needs the extra stimulation.

I'm suitably unimpressed with Pinkerton's leap of "logic" ... Trying to protect Terri's Constitution rights means we have to put all medical in the hands of the government.

And the conflicts of interest in this case are astounding, right down to Felos' connection with the :::ahem::: "right to die" movement and his association with the HOSPICE Terri is at (why was she moved to a HOSPICE? Terri was never terminal or in the state of dying.) Seems an RN at the HOSPICE was just fired for refusing to sign a petition protesting Congress on this issue.

Yes there is a lot of information in this case, but there is a bottom line that actually makes Terri's condition fairly irrelevant (the debate over whether or not she has a brain) ... Terri left NO documentary evidence of her wishes. She has family willing to care for her and her care is NOT extraordinary. Therefore, the law should have erred on the side of life and awarded guardianship to her family.

darleen, you are focusing more on the finer merits of this specific case, whereas I am debating the implications of statements like "The preciousness and value of each life is absolute," so we're talking past each other a bit.

It's not a matter of just pulling her feeding tube, no one is allowed to even feed her by mouth. That's as deliberate an act of starvation than the bio parent we prosecuted for having a child chained to bed and malnourished for years in a dark room.

And alzheimer's patients are also let go by this cruel fate. Are you ready to enact a federal law that develops a protocol for all of them? Are you ready to look past your horror at the implications of this protocol in this case? Are you advocating euthanistic "active killing" in other situations?

I'm not going to get into the specifics about "conflicts of interest," because you are asserting that the most litigated PVR case in history failed Terry Schiavo's constitutional rights at every step of the way, and I can neither agree nor disagree with you. My gut instinct doubts it, but you may very well be right.

Terri left NO documentary evidence of her wishes. She has family willing to care for her and her care is NOT extraordinary. Therefore, the law should have erred on the side of life and awarded guardianship to her family.

But Florida law seeks to determine what the patient's wishes are in the absence of a written legal document and assigns them via testimony from witnesses, family and the assistance of court-appointed guardians. IMO, the entire issue of federal involvement hinges around whether this Florida law is constitutional or not.

If you find that it is not, then conceivably an entire family that is in agreement that a loved one should be let go would not be allowed to discontinue care, and if no one had the ability to pay for care, the onus would fall on the government, as such an action would be a violation of the patient's constitutional rights. I'm not disagreeing with your gut instinct on this matter (compassionate and makes a lot of sense), but the implications are tricky.

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