A woman @ the hospital I work at is being starved and dehydrated..

[maveric]

for the purpose of ending her life. Just like the woaman in Florida.

She is brain damaged from an MVA (motor vehicle accident), but somewhat alert, responsive to stimuli and does show signs of emotion. She is not on a ventilator, just a blow-by mister. This woman is 37 yrs old and has 3 young children. Her husband wants her "out of her misery", for reasons unknown to me.

This woman is able to communicate through eye gaze and physical twitches.

The other day we were given a directive to remove her feeding tube and just let her pass.

I care for this woman at times and have noticed an increased sense of fear and anxiety in her emotional state. This is sickening!

I realize that death is a part the job of working in healthcare but its tough for me, as a caretaker, to just let this lady, for whom I've been caring for, die.

IMO, she is aware of the situation and wants to live. She's scared and more agitated than ever before.

Granted there is no quality in her life, and the financial burden on the family and insurance company is of great proportion, but the method that is being used to end her life is cruel, and the staff and I have to watch this.

Is Dr. Kervorkian such a monster after all?

[ShaneGR]

1. Well, Kervorkian ended the life of people who wanted to die

He did take it over the edge though.

As for this woman, if she is capable of showing emotion, which clearly demonstrates her will to live. CALL the police or something. Or definitely call a newspaper.

[DuctapeFatwa]

8. Call every newspaper and TV net you can think of, hell call FOX

Call Jerry Falwell, call Satan, call everybody you would want her to call if it were you in the bed.

[Mairead]

13. I second Ductape's suggestion: call the newspapers! call the churches.

Call everyone. If this woman is aware enough to communicate even minimally, she's definitely aware enough to have rights.

[maveric]

15. I would have to do it anonymously due to confidentiality laws.

I could get sued, fined, fired and/or lose my license if my name gets out.

You'd have to also ask yourself if its really my business to get involved in others family matters.

I'm e-mailing the Union-Tribune and the local news stations. People need to be aware of this.

[DuctapeFatwa]

31. Fine, do it anonymously, do it as Ann Coulter, just do it NOW

Do it for selfish reasons. If you don't and she dies, you will not feel the same about yourself for the rest of your life.

I am sorry to sound harsh, but sometimes you just have to do things.

[Woodstock]

37. If the instructions were given, she likely has a living will

or gave power of attorney to her husband, willingly, and it is her wish was for this to happen.

This is what I'd wish in those circumstances, and it would be horrible for someone to go against my wishes on such a personal matter. This isn't for you to decide - it's for her to decide. If her husband is acting on her behalf, it's for him to decide.

If you can't handle accomodating her wishes, perhaps you should consider another field.

[NNN0LHI]

61. You damn right. Holy Jesus! CALL SOMEONE! n/t

[Cronus Protagonist]

2. What would you propose?

I have no idea what other options there might be. A lethal injection?

Click Here To See Fair & Balanced Buttons, Stickers & Magnets

[maveric]

6. How about not letting her die?

But then again who would bear the financial burden for the 24 hr care that is needed?

I am torn by this and perhaps this post is solely for the purpose of venting.

This lady wants to live but her family wants her to die and I have to watch the whole disturbing process.

[Eloriel]

10. Financial burden oughtn't be part of the equation

And I'm a little disturbed that you would let it be.

Please, please, please try to do SOMEthing about this. Does your facility have a chaplain? Others have said call the police or newspaper. How about other family -- parents, sisters or brothers, etc.?

Please do something about this. You'll live with your actions (or inactions) about this forever, and her responsiveness right now will haunt you.

Eloriel

[blondeatlast]

19. You are spot on, Eloriel.

[blondeatlast]

18. She should be eligible for Social Security and Medicare.

When I worked at my state's center for DD, nearly all of them, regardless of age, were on Social Security and Medicare, plus some state funding. She should be eligible. I agree with Ductape (see those pigs in the air?!), call the news or YOUR church (if you have one).

[mlawson]

26. You mean MediCAID???

Not Medicare??? The woman is 37, Medicare starts at 60-something.

My mother was on Medicare, and it was quite random, I found out, what it would pay. Hospice care, I think is covered by both programs, and without a time limit.

But in most places, Medicaid kicks in, once the family's assets are down to $2000. And they do check everything.

[Mairead]

78. No, if she's permanently disabled she gets SS and Medicare

Medicaid is for the functioning poor

[Woodstock]

38. you don't know that she wants to live

see my post above

[diamondsoul]

76. Mmmph. I'm not a physician, so I can say this-

Overdose of pain-killing medication. *Terminal patient given self-medicating painkillers. Amount taken to relieve pain caused suppression of respiratory function resulting in death.* That simple.

Happens all the time, and on occasion with the help of family members when a terminal patient is too weak or stoned to dose themselves. Nobody will ever admit that, of course, but it happens.

Why are we so afraid to die anyway? Yeesh it isn't like any of us will avoid it entirely! Sorry, just one of those things that sometimes has me scratching my head.

[patdem]

3. True...my sig other is apalled at the starvation order....there are pills

WE DO NOT EVEN STARVE DEATH ROW INMATES TO DEATH...BUT give them a 'considered un cruel punishment'...IF WE WERE TO STARVE THEM TO DEATH THERE WOULD BE A HUE AND CRY ABOUT HOW CRUEL IT IS...

I agree...to starve a person to death is the CRUELEST of deaths....wny not use the DEATH PENALTY and let them go quietly???

Irrational!!!!

[DCDemo]

4. Dr K isn't a monster

He identified a major issue in this country and tried to be a maverick in pursuit of greater knowledge and understanding, and thus, change in the system.

I don't entirely approve of his approach, but I like his cause.

Watching my grandfather waste away for 8 years attached to machines when his eyes clearly indicated he wanted to be freed of his imprisonment (ALS) convinced my entire family - we ALL have living wills.

In fact, I'm pretty sure watching him die (mom's side) convinced my dad to hide his mortal ilness so that he could avoid confinement in a hospital, or prolonged life attached to machines.

I know these are both HORRIBLE situations, but at least the one in FL is giving lots of press to an ever-growing, important issue. Too bad there's not any real human interest, moral, or ethical discussion - just pronouncements.

It's a very complicated issue, but the law should not force a dying/comatose/vegetable person to die, nor should it force that person to live. Choosing one's own time of death if one is facing agony, decline, or vegetative state, is one of the most important of all human rights. It's between you and your God.

[Woodstock]

40. well said

this is all about what the patient - when of sound mind - wanted

[Old and In the Way]

60. My Mom died of ALS too

Nothing more horrible than this disease.

She did not want to be maintained in a state of absolutely no physical sensation/movement even though her mind was not affected.

It is not an easy thing for society, but I do agree that this is for the wife's family to decide. If he is doing for ulterior reasons, he'll have to live with himself.

I think living wills is something that would address this type of issue, but I think most people (myself included) don't seem to want to confront the implications of our own mortality.

[DUreader]

5. You can take action, you believe she wants to live, call media

call police

[maveric]

9. There is a legal order signed by a San Diego judge.

And she has no family in the US. She's from mexico originally and her parents are dead. Calling the police is pointless.

I could make an anonymous call to the TV news stations though.

[blondeatlast]

21. If you are in SD area, call the Spanish language stations.

Also, call a church; her belief is on her hospital record, I assume?

[maveric]

25. Ahh HAAA!! Thats how I will do it. Didnt think of that one.

They'll be all over a story like that. I cannot go on the record though! I know that a womans life is in jeopardy but I'll have remain anonymous.

XETV in Tijuana.

[blondeatlast]

49. Let us know how this goes. Whatever you do, though, you

MUST protect yourself, no matter how harsh it will get for the patient.

Praying for both of you.

[Woodstock]

41. I pray to God someone like you doesn't keep me alive

when the person I love and trusted most follows my wishes and lets me die with peace and dignity

[Clark Can WIN]

72. I pray to God

you never have to face that situation.

Where your previous judgements of a worthwhile life were no longer hypothetical. Where you may lay in a body than can see your mothers laugh, and watch your childs smile, and hear your brothers laugh all the while communicating it to them in small ways.............

And then have some greedy bastard starve you before you can recover.

I would pray for you too.

[Woodstock]

79. you are assuming I have not experienced these things

and you are wrong

I stand by what I said - a person's wishes should be honored

that is what love is all about

[Clete]

7. Death by dehydration is a common procedure in hospice

care. When a patient, especially those who suffer from Alzheimers and other diseases where the mind is no longer functioning, come to the point where prolonging their life would be cruel, then food and water is withheld and opiate drugs administered to relieve any suffering. The patient's passing on is fairly easy then.

The reason they are allowed to die as contrary to giving them a quicker injection has more to do with our uncertainty about mercy killing, which is the next step that Kervorkian advocated.

[Eloriel]

11. It sounds like you support killing someone who doesn't want to die

Or probably doesn't want to die, judging from Maveric's descriptions.

Eloriel

[Clete]

17. I don't support anything because I don't know the answer.

Neither do you. You don't know if the person doesn't want to die. I am making a statement of what is being done today. The poster doesn't seem to know if what is going on is accepted procedure, so I am giving her a little piece of my knowledge about this so that she can ask questions about it before she calls the police. I have had some personal experience with this at my age.

When my father died, it was back when a patient was kept alive at all costs. When he finally died, his chest was a mass of bruises and he had broken ribs from having his chest pounded to restart his heart. He should have been allowed to die when it was known his condition was terminal. I would have pulled the plug on the life support myself and gone to jail if I could have gotten past the ICU nurse then.

My mother and I begged the doctors to please just let him be comfortable until he died, but there were laws against that then. Instead I had to watch an elderly dying man suffer for the eight extra days of life they gave him instead of being allowed a peaceful passing a week earlier.

A couple of years ago I sat up all night with my stepdaughter while her mother died. Her mother had Alzheimers. She was in its last stages where she had forgotten to do everything including to swallow when she ate. She didn't recognize anyone and was in a vegetative state with tubes keeping her alive. My stepdaughter made the decision to stop the tubes and that in essence would let her die from dehydration. She had an IV which administered a measured dose of morphine, so she had no suffering. Even though it was a traumatic experience for my stepdaughter.

You know Eloriel, I appreciate your knowledge and your dedication to keeping the rest of us on top of things, but sometimes you go over the edge with your strident, accusatory posts. I think you could have asked me about this in a PM before making that mean accusation.

[blondeatlast]

24. I remember those days. My BIL had pancreatic cancer and no hope of surviva

beyond a month. The hospital was not allowed to give him any ADDICTIVE painkillers--sheesh.

[Clete]

52. Ah yes the terminally ill could get addicted.

And imagine, the new regime wants to take us forward back to those days.

[TNDemo]

30. I just went through this with my mother in June.

She had early onset Alzheimer's and died shortly after her 70th birthday, after years of suffering. It had gotten to the point that she was no longer able to swallow and could not be woken. We kept trying to get the thickened liquids and pureed foods in her but hospice said if she can't wake up she can't eat or drink and we must stop giving her anything by mouth. We (I mainly) then had to make the decision of a feeding tube and/or an IV. I talked with a number of doctors, nurses, hospice and every one said not to do either one. The feeding tube would just make her lie there in a vegetative state for many years since she had a strong heart and lungs. The IV was really hard for me but hospice kept telling me that it would only make her more miserable as when people are dying they cannot move fluids around their body like they should and they just end up in the lungs and she would be air hungry and miserable if she had one. Also there are anesthetic chemicals the brain produces in a dehydrated state that are not there when hydrated and she would experience more pain. Even though I knew all these things it is still incredibly hard to see them basically thirsting to death. We kept the eyedrops going and the water mouth swabs. I don't think my mother ever had a conscious moment and don't think she had really had one in a long time. I still went home and cried, feeling like the meanest person in the world, but I know she was trying to die and I would have just been interfering with that process. There was nothing to bring her back to - her brain was too diseased.

All that to say that it is actually a very common process in hospitals and nursing homes to let people die this way. I saw several people in my mother's nursing home go like this. I know other people on this board that have been through the same experience. I think it is a different thing if there is cognitive function and it is a much trickier question. But it is hell for the families.

[mlawson]

34. To a lesser degree, so did I in April.

Mother was 88, and had dementia (hardening of the arteries). She had pneumonia twice because she refused to stay out of bed, and a mild stroke in February. She had gradually, deliberately starved herself for 5 years since Dad died. NO one could get her to eat; she would chew food up and spit it out. She was 5'6" and weighed 75 pounds at the end. The assisted living home did everything they could to get her to eat, including high powered appetite stimulants, but no go. They asked me if I wanted them to insert a feeding tube into her stomach (from the outside, not swallowing it!). I said, under no circumstances, will I allow her to suffer that!!!!!!! They agreed immediately.

Finally, Mother was saying over and over, "I want to go home", and she was NOT talking about her house. She looked at me and said it again one night. I finally told her that it was her decision, I wouldn't insist on her staying there any longer. She smiled and told me to 'go back to campus'. The next morning I got 'the call'. The staff said that there had been no crisis; she simply 'turned loose'.

My point is, that at some stage, some terminal patients seem to know how to just 'let go'. If the woman in the original post wanted to die, perhaps she could, on her own. The fact that she hasn't *might* mean that she is not ready. Or, it may be that some people can do this, and others can't or won't.

[LizW]

70. My mom made the same decision with her mother

in a nursing home. She had broken her hip, and never was able to sit or stand or even turn herself over in bed again. She was in significant pain. She still had some cognitive function. She didn't carry on conversation, but would answer yes or no to questions. She either wouldn't or couldn't eat or drink anything, though, and this was really hard on my mom.

My grandmother got pheumonia and was very dehydrated and "altered", as they say. My mom had her moved once to the hospital and they rehydrated her and got her lungs cleared and she got a little better. When they got back to the nursing home, the doctor there suggested to my mother that she sign a request that my grandmother not be moved to the hospital again. A DNR was already on file.

Refusing hospitalization, tube feeding and an IV is very hard, and my mom and her sister agonized over it. But it was the right thing to do for their mother.

[Coventina]

33. My mother died from dehydration this summer

my father refused her an IV when she could no longer swallow due to her progressive, terminal illness.

It was HORRIBLE to watch.
She went into convulsions brought on by the dehydration. All the medical personnell would give her was a mild seditive.

I will NEVER let that happen to me. I am going to go juicy to my grave.

Yes, I definitley have "issues" but they are valid ones. And based on personal, painful experience and every bit as valid.

Staving/dehydrating my mother to death is going to be one of the major guilts I carry forward into my life.

[Woodstock]

44. please don't share your feelings with your father

he made the decision he thought was best for her

[Coventina]

47. Don't tell me what I should or should not share with my father

Do I believe that he had my mother's best interests at heart?

Yes, I do.

Do I believe he made the right decision in this case?

I don't know. I don't judge his decision. All I know for sure, is that I don't want to die like my mother did.
If I get diagnosed with dementia, I'm going to eat the barrel.
But just in case I meet with some other sort of accident that leaves me "incommunicado" with the world, I'm not going to be starved/dehydrated to death. Because I've seen it. And there was nothing "peaceful" or "dignified" about it.

[Woodstock]

50. it was a suggestion

I know someone who is responsible for a car accident that killed her baby. A relative feels she is to blame, and while she doesn't tell her in so many words, the woman who lost her child gets the message loud and clear. And I'm afraid this will push her over the edge - she's already living with a lot of pain.

I'm really sorry for what happened to both you and your father.

[Clark Can WIN]

74. Screw THAT

One of your parents kills the other with INHUMANE treatment that would put you in JAIL in most states if you did it to a DOG? And he's not supposed to "share his feelings" phuck that.

[Woodstock]

81. once again you are assuming and wrong

"Fools rush in where angels fear to tread."

Please do not cause Coventina any more grief by making such truly cruel and horrible statements. What decisions were made within her family is none of my business and it's none of your business, either.

[carpetbagger]

53. It's a tough situation, but look at the alternative...

She would have continued on artificial feeding and hydration, and unless or until an infection took her life, she'd have gotten progressively more bedbound, unable to move. Her skin, even with turning, would have broken down, progressively going through skin, then fat, then muscle and tendon. She would gradually become weaker, and the secretions would build up in her throat, giving her the sensation of drowning in her own spit, unable to cough effectively. She would have continued to lose weight, and the pain of the contractures, immobility, and ulcers would have been significant.

Sure, it's easy to second-guess. I'd have given a stiff shot of lorazepam at the onset of the seizure, and started phenobarbital by suppository, but in my experience, as well as the medical literature, death with artificial hydration is every bit as rough.

[Woodstock]

42. Well said again, Clete

and agreed.

[marigold20]

12. I need to get a living will TODAY

I informed my husband of my wishes but we all know that means nothing without explicit directions in writing and witnessed. Think of the advances to come in keeping corpses alive. We baby boomers can live forever in big warehouses, feeding tubes and ventilators keeping us going. Sorry, but this really freaks me out.

[Nikia]

14. I'm appalled by all of this

I don't know. I don't really consider a feeding tube life support. To me, it is just like feeding any other sick or disabled person. If we remove some people's feeding tubes, should we withhold food from other sick or disabled patients if their families want them to die. For example, if this woman broke many bones in the accident but was fairly mentally intact, wouldn't it be considered wrong to not to give her food? She would be unable to get out of bed and get food for herself and thus could die without "life support".
I don't know what this world is coming to. Maybe hospitals shouldn't treat anyone who doesn't (or can't) demand that they need treatment. Maybe, we should just let everyone with disabilities die because they don't have a good quality of life like all of us perfectly abled healthy people. Maybe, they should die because having them around makes us suffer and waste money. Health care is an investment and when the person in question is not going to get better enough to pay us all back or perhaps has some special sentimental value to someone, we might as well leave them to die. Just as our ancestors did, we will let the weak be eaten by the lions. Better them than us.

[Malva Zebrina]

16. in my experience

I have seen much of this--babies who are not expected to live because, well because their brain is on the outside of thie skull and they cannot survive much more than a week, and maybe they were born without a mouth and one eye that can never be opened--these types of anomalies need to be confronted and addressed. Our doctors and nurses are saddled with confronting this and indeed are so brave and so tuned in to the horrors of these things. People die-that needs to be accepted--babies born without a mouth die--babies born with a brain outside the skull are indeed doomed to die in days. There is nothing human being can do about this--these are not human beings==they are accidents of birth. These things need to be addressed logically wihtin the facts--and not within some religious fantasy world.

[maveric]

20. But this woman is aware of her surroundings and can smile when I

crack a joke, show joy when her children visit her, and distess when in pain or frustrated. She sheds tears at times when she is alone in her room. She cant speak, swallow or, ambulate but can respond to voice and visual stimuli.

I personally do not want to kept alive in that type of a state, but thats just how I feel. She may feel differntly. Her young children may also feel differently.

[Clete]

22. So ask questions before you butt in where you may not be

welcome. You could lose your job for nothing. It could be there is nothing more that can be done for this woman and it is crueller to keep her alive artificially than let her die.

[maveric]

29. And I'm conflicted over that Clete.

I ask myself is it really any of my business. This is an order from a municipal judge art the behest of the family who has power of attorney. And the loss of a job could be just the beginning of recourse against me.

[janx]

56. Maveric, please see my post #54. It may comfort you.

It also may explain what is going on. I hope it does.

[Malva Zebrina]

28. I am sorry for your dilemma

it would pay to understand ,fully, the neurological signs and symptoms--this can come from your own personal research and can come from years of experience and education observing these poor people in their state---people in this state at times do appear to be smiling when they are, indeed , grimacing. And the reason they are grimacing is a physical reaction or reflex, a reflex and a neurological event, not a cognitive event. I do not mean to diminish your perceptions and your concerns, but I am sure that if this person is indeed alive and responsive,able to discern and needing to comunicate, that the experienced medical personnel would know of it and not pursue a course of action that would be harmful.

[Woodstock]

45. Her husband knows more than you

What she wanted when she was of sound mind.

Why instead is this your decision to make?

I sympathize, and don't want to diminish what you are going through. But this is nothing compared to what the husband is going through. And you must consider what the woman wanted when of sound mind. Again, I'll just throw out that perhaps a transfer to a different kind of care unit would be good for you, since keeping emotional distance under these circumstances seems troubling for you.

[Old and In the Way]

66. You must be real conflicted.

"I personally do not want to kept alive in that type of a state, but thats just how I feel."

But you are motivated to keep someone in a condition that you yourself wouldn't want to be in?

I don't know...all I know is that I won't delay any longer in getting my living will done. I'm not going to let someone else dictate that I should live in a no-quality-of-life state because it makes them feel better or fits their religous worldview.

I'm watching the Sciavo special on Nightline. I think it's pretty scary when the State does play GOD by deciding they will decide who must live, irregardless of those that are closest to the person.

[OHdem10]

23. On the surface it sounds horrible

butbraindamaged persons have involuntary tics twitches and such that
give the illusion they are trying to communicate. This is sad because families think they are trying to communicate and it makes it difficult for them to make decisions. To keep someone in existence year after year when they are unaware of their of surroundings can be just as cruel as letting them pass on. Not to sound crass, but how many families can afford 20.000 and up a year
to keep a person alive on a machine. Feeding tubs are considered unnatural means of keeping aperson alive. The reality is we are all going to die and think how and what you wish for yourself. Do you want to existence unaware year after year in a vegetative state?

The situation in Fla gives me problems. Having politicians getting in on family decisions is somewhat frightening to me. If there was not money to pay for her care would these same pols be overturning a judges ruling. If she were on Medicaid--they would be going in the opposite direction. Pardon my cynacism.

[maha]

27. Does she still have a brain?

The Florida's woman brain has shrivled away and been replaced by fluid. She's not coming back. I don't know if that's true of your patient.

[juajen]

71. "Shriveled away and replaced by fluid?"

Do you have a link? This is the first I've heard of this. If this were the case, I find it hard to believe that five doctors would have testified that she could more than likely get better with therapy.

[kentuck]

32. I think Kevorkian's method is more humane than starving....

Just put them to sleep rather than let them suffer thru starvation...
If the immediate family unanimously agrees.

[brook]

35. It's my experience that,

many endstage patients have no appetite, no feelings of hunger. The body starts to shut down organ by organ. The "suffering of starvation" is, imo, more a product of our own cognitive/emotional processes than reality.

I would prefer that families and doctors be the final arbiters in such matters. Everyone should have written orders or, at least, verbal agreements to guide those who must wrestle with the decision. Florida and those who lobbied Bush have just given their hallowed theocracy a new sense of legitimacy. They will nibble away until we live in an unrecognizeable country unless they are stopped in 2004 - and are marginalized forever.

[Woodstock]

46. agreed, just like abortion they seek to legislate

personal matters until one day, we will all be property of the state

[loudsue]

36. OMG!!! DON'T LET THEM W/HOLD WATER!!!!!

NO MATTER WHAT they decide to do about her food, PLEASE PLEASE PLEASE don't let them w/hold water!!!

I PROMISE YOU THIS WITH EVERY FIBER OF MY BEING....there is NO PAIN greater than starving of thirst. The mental torment, alone, is the worse kind of hell a person can go through.

The lack of food, you become more accustomed to that after a few days, with the proper mental preparation. But when your body is SCREAMING for water, it is the worse kind of hell.

DO SOMETHING!!! Send me a private message with the woman's name, and I'll call everybody this side of the Nile River Valley to get that woman some help....AT LEAST WITH THE WATER ISSUE!!!

:kick:

[Clete]

39. In my experience the IV saline solution provided water

along with the morphine. I can't imagine why they would withhold the saline drip solution.

[brook]

43. Agreed.

That would seem extreme. I'm thinking back to my mother. She wasn't on IV's - just oral morphine on demand.

Hard to explain to anyone who hasn't been there -about the shutting down, etc. If my Mom had been in a hospital instead of at home, they'd have coded her. I just held her hand.

[sistersofmercy]

48. Hey Maveric, do me a favor would you? Look up persistant vegatative

state and common characteristics, read some case studies, and post them please. It is my understanding that reflexive emotional display is common. There was a really famous case here in MO, the parents of the girl fought to take her off a feeding tube it took years b/c nurses were testifying to the same thing type of emotional display that you are describing.

[janx]

54. I'm not Maveric, but I found the most wonderful essay...

I read other things, and then this; it seems that Terri Shiavo is a textbook case of persistent vegetative state.

But this essay (lecture?) calmed me. I recommend that everyone read it. It's marvelous.

http://seeingthedifference.berkeley.edu/schneiderman.html

Here is an excerpt:

Now, just a brief lesson in neurology. You have in your brain the cerebral cortex, which is actually a very thin structure on the outer surface of your cerebral hemispheres. Four to six minutes of anoxia, lack of oxygen, destroys that completely. The rest of your brain, particularly the brain stem, can survive for fifteen or twenty minutes without oxygen. That disparity accounts for what we now see in as many as 30,000 to 40,000 people being kept alive in permanent unconsciousness. Usually the cause is failed CPR, or occasionally a stroke or a motor vehicle accident of some sort. What happens is that that part of the brain, the cerebral cortex, which is us, our personality, who we are, how we think--our capacity to experience, see, hear, think, emote--that may be permanently destroyed. Whereas the rest of us, the brain stem, which gives us the ability to breath, digest, all the organ functions, that could be kept alive, and in many cases has been kept going for decades. And so that has given us this condition which was first diagnosed in 1972. It's really interesting, that that's a very new disease as far as medicine is concerned, and, in fact, it's an iatrogenic disease. Vegetative state is the condition, as we call it, but persistent or permanent is what we do to keep that condition going. So in a sense, that's a very important notion.

Now, all of us who do ethics consultations, have had the experience, and I've had several, where families have insisted that their loved one be kept alive in a permanent vegetative state, permanently unconscious. And this is a clinical diagnosis. If someone, for example, has persistent vegetative state, where their eyes may open and close and they have all sorts of reflex capacities, that's because that part of the brain stem, the reticular activating system that's responsible for sleep/wake may be temporarily impaired, but then recover. And so they're unconscious. Their eyes may open, and they sleep, but they're completely unaware. Families will sometimes demand that physicians keep such patients alive--and it's very simple, a feeding tube and good nursing care will do it. There's nothing more that has to be done, if that's the condition we're talking about.

Now, I've either been involved in or heard of cases where families have demanded that this be done, and the patient has been kept alive for eighteen months although there is no realistic chance that the patient will ever recover. I have to admit that today, hearing about embalming made me think of the parallel, that this was a family that needed to see that person in an embalmed state. It's truly nothing less than that, if you consider the person, the capacity of the person to interact.

I've also heard this described as a tragedy: "Oh," one says, "the person who had this happen to him, it's a tragedy." And I have to say that I'm with Martha Nussbaum on this, that this is not a tragedy: this is hubris, this is a failure to recognize our mortal limits. I refer here to a very rich and perceptive essay, "Transcending Humanity," where Nussbaum talks about Odysseus, whom Calypso was trying to tempt to stay with her. Calypso says, "You stay with me and you will have immortality and ageless love." What could be better? But Odysseus, even knowing that his waiting wife Penelope is far beneath the beautiful goddess in form and stature--and I'm quoting Nussbaum:

This guy not only defines PVS and the people affected by it (and farce!), but he tosses in a little Homer and Willa Cather as well!

It's worth reading the whole thing.

[brook]

55. Thanks for finding...

and sharing that. Excellent.

[janx]

63. You're welcome. I hope that many here read it.

.

[Clete]

57. What a wonderful essay. Thanks for posting this.

It certainly puts many conflicting ideas in perspective.

[janx]

62. And he's right--it is a farce! Just think of what a grand-scale

farce this has been!

[NNN0LHI]

64. Thank you for pointing me to this thread Clete

It is one really one worth reading. Thanks for starting this thread maveric.

Don

[sistersofmercy]

65. Thanks! Bless Nancy Cruzan & Christine Busalacchi may they rip.

[janx]

68. We do have a very unrealistic and unhealthy attitude re

death in general. That's what makes us do these twisted things.

[Bridget Burke]

51. Does your hospital have an Ethics office?

You need to talk to somebody since you are actually working with her. Not just somebody reading about this online & thinking "I woudn't want to live like that" or maybe "I wouldn't want to be bothered with a husband/wife who was in that shape." Are social workers or chaplains available?

There may be a Living Will. There may be reasons you don't understand.

Or, something bad may be happening. After all, this kind of care is quite expensive.

[KittyWampus]

58. Maveric, You Posted Conflicting Facts

You said she has no family in the U.S. in one post and then go on to talk about her Husband and three kids... so that seems a bit odd.

You may personally believe this woman has emotional responses but the doctors may have a better understanding of what's going on.

I have a great deal of respect for caregivers and nurses... but this is NONE OF YOUR BUSINESS. I can only hope that you don't intervene and make this family's life more of a hell than it is already.

[NNN0LHI]

59. kick for future reading

[gully]

67. My Great Grandmom died this way and they gave her morphine, they said she

didn't feel any pain? Were they full of shit? Gosh I hope not. She was 100 years old and I know would not have wanted to live on tubes but I don't appreciate them lying to us...

[carpetbagger]

69. They were probably right.

It's been studied pretty well, by both patient and caregiver pain and discomfort scales. If you keep the mouth moist, it's not uncomfortable.

Think about when you've been dehydrated. The general feeling is just being too tired to get up and get a drink.

The alternative with your grandmother was likely filling her lungs and trachea with fluid, or keeping her alive to suffer things worse than dehydration.

[diamondsoul]

73. I would imagine she probably didn't suffer, Gully.

Please don't get yourself upset over that. I believe my mother had morphine (though it's been a few years and I don't recall for certain). She was already severely dehydrated when she was admitted to the hospital, affects of a very bad systemic Staph or Strep infection, one of the two. I'm still convinced Staph, from a surgical procedure a few days prior to her becoming so sick.

Anyway, once she was on the morphine drip, they warned us her breathing would likely stop. The Doc said the choices were keep trying to treat the infection and leave her suffering, or stop her pain and expect her to die. We decided to stop her pain. She slept peacefully for hours, woke briefly, surrounded by everyone who loved her, smiled and left us.

That was, quite honestly, almost as amazing a thing to witness as child-birth. To see someone die with a smile on their face is...stunning and poignantly beautiful. It does happen, and a lot more often than people realize. Death is the natural and foregone conclusion to life, no matter when it happens.

[diamondsoul]

75. Two things I'd like to suggest, just for your thought-

One, she may be just as torn as you are. She may not want to be a burden to her loved ones, and yet she has young children she likely doesn't want to leave. If she isn't capable of verbal communication or written communication, it's impossible to tell the source of the apparent agitation you sense.

Two-it could just as easily be a reaction to YOUR and other caretakers emotional state. She may be sensing your anxieties over the situation and reacting to that. My mother hung on for hours after she should have passed away, and it was because she was waiting for something she needed. She anted all of her daughters with her, and she wasn't about to give up until we were there. Even then she didn't let go until I and my father told her it was ok if she was "ready to go". She was, and she did within 10 minutes of hearing those words.

Just something for you to consider, and I'm sorry that being a kind-hearted person sometimes brings this sort of pain on your shoulders. That's the hard part of caring, isn't it? :hug: :cry: :hug:

[CoffeePlease1947]

77. My worst nightmare would to be killed slowly against my will while I knew

that I was being killed.

If you are going to kill someone just put a damn bullet in the head. You don't need to slowly kill them in a horrible way. Even horses are shot and not allowed to stay there and just die.

Mike

[Malva Zebrina]

80. folks

we are only going through here once. Sooner or later we have to face the fact that we will die. We may choose to do things in our lifetime that will leave, we hope, to others who are coming up behind us, but for the most part, we must accept that we will die--and that we really do not know anything after death. Some will believe they go elsewhere and some will believe that after death they will indeed be a "nothing" and imo that is the most practical and logical. Nevertheless, one should not strap their children with this--make every attempt to make it easy on them and make it perfectly clear that any external efforts to keep one "alive" after they have actually died, is really a torture for those who survive you. Why should they be saddled with the decision? No==insist upon making out that will that says no to any outside attempts to keep you alive by artificial means--while you know that you will be dead and that the attempt to keep the physical body functioning is really a false hope.

[Valerie5555]

82. Why not e mail the Governor of your state and

have him/ her/ them do a Jeb Bush. If it worked for Terry Schiavo, why not?


I am actually *not* kidding about the idea.