Terri's Starvation Commences: Terri's "Exit Protocol" Begins

Thrown Back ^ | March 18, 2005 | Fr. Rob Johansen

[sionnsar]

After a roller-coaster night and day, in which Congress first appeared to have abandoned Terri, then in which some Congressmen intervened in a last-ditch effort to prevent the feeding tube removal, and Judge Greer again demonstrated his singleminded intent to have Terri die, it comes to this.

According to reports at Blogs For Terri and from the Schindlers, Terri's feeding tube was removed at about 2:00 PM this afternoon.

Congress may intervene next week, but may not. What is certain is that from this moment on, unless someone can unsuccessfully undo the work of Michael Schiavo, George Felos, and Judge Greer, Terri begins dying.

Michael and Felos went on national television a few nights ago, and told viewers that Terri wasn't going to be starved to death, but that she was going to be "allowed to die". I suppose in some Orwellian alternate universe that might be true, but now, in regards to Terri, it is a monstrous, flat out lie. Michael Schiavo said that Terri would peacefully slip away. That too is false. Terri will die a horrible, prolonged death. The document I reproduce below demonstrates that.

The document I reproduce below was prepared by the hospice at which she resides, by their own doctors and nurses. It was produced in anticipation of the first time Terri's feeding tube was removed, in 2001. Anyone reading it with a rudmimentary knowledge of medicine will recognize that in Terri's case, and the cases of many others in similar situations, the so-called "treatment" that is given is in fact not treatment at all. It is a regimen of medication intended to perpetrate an illusion: the illusion that someone is peacefully "slipping away", when in fact they are dying in a painful and brutal way.

The document was given a name by those who wrote it. They called it Terri's "Exit Protocol".

I first published this document last September, when it first came to light. I republish it here so that all can see the truth of what is being done to her.

As I mention below, the document is not yet available on line. However, I will remedy that soon. I will try to have it available online in it's original form within the next few hours. As soon as it is, I will let you know where to get it.




Terri's "Exit Protocol" Discovered In Hospice Documents

Cheryl Ford, RN, a nurse from Tampa who has been very active in the efforts to save Terri's life, recently undertook, on behalf of the Schindlers, a review of medical records from when Terri was first admitted to Woodside Hospice. Woodside Hospice is run by Hospice of the Florida Suncoast. It is of interest to note that Michael Schiavo's attorney, George Felos, was a member of the Board of Directors of Hospice of the Florida Suncoast until the Terri Schiavo case began to attract widespread public attention a few years ago.

In her research, Ms. Ford found a document titled "Exit Protocol" in Terri's file. The document is on Hospice of the Florida Suncoast

"Patient Care Notes" stationery, and is dated April 19, 2001. This document lays out, in clinical detail, the procedures to be followed in bringing about Terri's death by starvation and dehydration.

I reproduce here, in entirety and verbatim, the contents of this document. It was sent to me in the form of an Adobe PDF document. It is not yet available on the web, but as soon as it becomes available I will post a link to it.

The text of the document is in black type, my comments and explanations will be presented in red type

Exit Protocolxxxxxxxxxxxx00038

Patient Care Notesxxxxxxxxxxxxx The Hospice
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxOf The Florida Suncoast

Date

4/19/01xxxxxxxxxxxxxClinical Pharmacy
xxxxxxxxxxxxxxRe: Medication review and symptom management


Pt. is a 37 yo woman in a vegetative state with no apparent signs of distress. Enteral tube-feeding to be discontinued on 4/20/01.

Current Medications:

1. antacid suspension 1-2 tablespoons prn [prn = "as needed"]

2. Naproxen suspension 375 mg Q8* prn menstrual cramps. [Q8* prn = "every 8 hours as needed". Naproxen is a pain-relieving and anti-inflamatory drug. ]

3. Vitamin liquid daily.

Upon discontinuation of enteral feeding the following signs/symptoms may or may not occur. The following is a brief list of symptoms for which to monitor and recommended interventions.

1. d/c ["discontinue"] antacid. d/c Naproxen suspension.

2. d/c Vitamin liquid

3. Monitor symptoms of pain/discomfort. If noted, medicate with Naproxen rectal suppository 375 mg Q8* prn.

Wait a minute! George Felos, Michael Schiavo, and all the other advocates of feeding-tube removal have been saying repeatedly that dying by denial of nutrition & hydration is "peaceful" and "painless". They've both said so in interviews and press conferences, such as on Larry King Live. So if dying by denial of nutrition and hydration is, as Michael said, "painless and probably the most natural way to die", then why is medication needed for pain and discomfort?

4. Signs of compromised skin integrity — continue vigilant skin care, provide moistener to lips, consult wound-care specialist if needed.

As the body dehydrates, the skin loses its tone and dries out. Left untreated, this will lead to cracking and bleeding. The lips are even more sensitive in this respect. "Vigilant skin care" is the liberal use of lotions and moisteners to mask these symptoms. The lips must be continually swabbed with special moisteners, and have lip balm applied to them. In the last stages, though, in spite of such measures, skin breakdown often occurs. Because of the body's debilitated state, normal healing mechanisms do not function. Hence the need to consult wound-care specialists to deal with ulcers and open sores.

5. Signs of dehydration
(A) dry lips, mouth. Swab saliva substitute inside mouth prn. (see next page)

After a few days without water, the body stops producing saliva, necessitating the use of a "saliva substitute" to avoid ulceration in the mouth, and a characteristic foul odor on the patient's breath. The cessation of salivation also leads to other complications which appear in the "pulmonary" section.



xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx00039

Patient Care Notesxxxxxxxxxxxxx The Hospice
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxOf The Florida Suncoast

Date

4/19/01xxxxxxxxxClinical Pharmacy Note — continued

xxxxxxxxxxxxxSigns of dehydration — continued

(B) decreased urinary output - no change in care plan.

While there may be "no change in care plan", one of the effects of dehydration is incontinence. The patient's diapers or "chux" pads will need to be changed more frequently, until such output ceases entirely.

6. Pulmonary
(A) Inability to clear secretions - reposition and swab mouth, consider scopolamine patch behind ear every 3 days.

Dehydration causes the natural mucus secretions of the mouth, nose, and throat to thicken, as the body struggles to protect these delicate membranes. The lack of saliva exacerbates this problem, preventing the normal swallowing of these secretions. These thick deposits can interfere with breathing. The use of the scopolamine patch promotes drying of these secretions, which prevents their build-up, but hastens the breakdown of the tissues.

(B) dyspnea ["difficulty in breathing"] — nebulize low dose 2-5 mg morphine sulfate Q4* prn.

In the last stages of dehydration/starvation, the patient's breathing will become difficult and labored. He or she may even begin gasping for breath, as even the lungs' ability to effect transfer of gases is compromised. Morphine nebulized into a fine spray relaxes bronchial passages and relieves these symptoms. However, because of the resultant decrease in respiratory efficiency, this may hasten death.

7. Multifocal myoclonus or terminal agitation (sometimes caused by electrolyte imbalance). Consider diazepam rectal administration 5-10 mg. May repeat in 4 hours if not resolved then daily - twice daily as needed.

Myoclonus is twitching or spasm of the muscles. Multifocal means "occurring in many different parts of the body". This is usually the result of imbalance in electrolytes, the chemicals, such as salt, potassium, and calcium, which make your bodies internal electrical "batteries" work. Nerve impulses and muscle contractions are governed by electro-chemical reactions utilizing these chemicals. Dehydration causes these chemicals to be out of balance, interfering with normal nerve and muscle function. This can result in nerves and muscles "firing off" uncontrollably, causing spasm. The patient will writhe and become extremely agitated. If you have ever had muscle cramps resulting from strenuous exercise (especially when you have sweat profusely), you have some idea what this feels like. Imagine having this happen all over your body, repeatedly. Diazepam (more commonly known as Valium) is a muscle relaxant

8. Grand Mal seizure, which is highly unlikely given current conditions and lack of contributing factors (meds). Recommend diazepam 15 mg rectally as indicated in seizure management orders.

In the final stages of starvation and dehydration, the same electrolyte imbalances which can cause muscle spasm can also lead to uncontrolled firing of neurons in the brain, according to a similar mechanism. This results in seizures.

Thank you for the opportunity to collaborate regarding this patient's care.

I would observe, in conclusion, that most of the "treatments" described in this Exit Protocol are in fact not directed at easing the patient's true condition, but in masking the symptoms of dying by starvation and dehydration. These treatments are designed to create the appearance of a peaceful "slipping away", when nothing of the sort is happening. The medications hide the fact that the patient undergoes a lengthy and painful deterioration, in which his/her body wastes away cruelly. Remember this the next time you hear or read someone say that Terri should be "allowed" to die.

[RansomOttawa]

just pull the plug There is no plug to pull. She is not on life support.

[JanetteS]

You get over it! If you aren't interested in fighting for life why are you participating on this site? If you want to denigrate life go play on the DU boards. They welcome your kind there.

[goldstategop]

A person's rights are not superseded by their limitations. I knew a friend whose last years weren't her best and she was on dialysis til the end of her life but she was full of warmth and grace and was the happiest person I've ever met. She taught me more about life that all the Ph.Ds in our universities and all the judges in our courts and for that matter all the politicians in this country. I still miss my friend and the one thing I take away from it is human life is precious. Death is the greatest teacher of all.

(Denny Crane: "Sometimes you can only look for answers from God and failing that... and Fox News".)

[BonnieJ]

You are trying to offend people by the way you're expressing yourself.
This is NOT euthanasia anyway...it is a slow torturous death, no mercy here at all.

[bjs1779]

She has been a veggie for years, just pull the plug, that shows true love.

And Charlie Manson loved Sharon Tate, too.

[maine-iac7]

I have this strange feeling that all this is coming down on this EASTER week for a reason....
We need to pray and trust in Our Father....How symbolic will it be if Terri is saved this week of all weeks? Not just the tube being reinserted, but saved from her husbands control and put into protective custody - gets the treatment and rehab she needs and eventually comes out of this enough to communicate?

What a victory for Terri and for countless thousands of others in the future.

God works His miracles, but sometimes He expects us to help - to earn them. WE must continue the fight - and the prayers. WE finally have the media all over it...albeit, they still need a lot of education on the facts!

"What Ye have done to these..."

[KingKenrod]

Those with nothing to say always trot out Hitler. Please stop embarrassing yourself by trivializing Hitler's Genocide of 6 million Jews and 5 million Christians. There is no parallel.

[isthisnickcool]

Get over it. Thats really the best way to deal with this. She will rest in peace.

I saw a dog on TV a few weeks back. The darn dog didn't have any front legs. Who would want a two legged dog? Well, some lady did and she got that defective dog as a puppy and my oh my that two legged dog grew up and learned to walk on two legs. Some folks wanted to kill that puppy. Go figure.

I knew a little girl named Abi Roland. See here and here.

Abi taught me a lot of things. One was to fight for life until the absolute end. She was the bravest person I've ever met.

At a point in time people knew Abi would die. People also knew that she was going to have a very tough time. And she did have a tough time. Some people would say that Abi should have been given a shot and been saved from all the pain she would go through. And she went through horrid pain. Abi may have been so young she may not have understood 100% what was happening to her as the cancer destroyed her little body. But she knew one thing. Fight for life, fight for life, fight for life! And she did, to the bitter end.

You might wonder what a two legged dog and a child with cancer have to do with Terri? Well, with a little love and care a two legged dog can adapt and have a good life. And maybe we should consider giving people like Terri at least a good a chance at life as that dog.

I mention Abi's story because I learned from her that life is precious. Abi told me by her actions that you never give up hope until there is no hope left. In the case of Terri Schaivo there is still hope. Until that hope dies why should she?

[BonnieJ]

The One Big Patriot has made a big exit it seems.
Probably one of those ACLU members who are in an outrage over terrorists with panties on their heads and atheists offended by Christmas trees and death row inmates without gourmet food, etc...But just fine with 3rd-term abortions and a beautiful soul like Terri facing a slow painful death. Just a guess though...

[kalee]

My stepfather died in a FL hospice last Aug. He was denied nutrition and hydration. He had a living will that declined extraordinary means but he and my mother were never told that nutrition and hydration and antibiotics were considered extraordinary care. The hospice lied to my mother about feeding him and when they thought she was giving him something to drink they screamed at her.
The clincher on this is that my mother even though she had power of attorney could not override the treatment hospice was delivering because my stepfather had a living will and had signed himself into hospice. She spent days trying to get him moved elsewhere but had no legal authority, hospice had his living will and signature for admittance. No other place would take him.
All this said, starvation and dehydration is NOT a pleasant way to go. It is not calm and peaceful. My family have seen it and been legally helpless to intervene.
My prayers are with Terri and her family.

[Ethyl]

This is so horrible, it is almost incomprehensible that a civilized people would do such a thing.

A criminal being executed is afforded more concern. This is trully shattering.



You are correct, convicted criminals get a lethal shot and they are dead in 2 minutes, even dogs and cats get lethal shots when they are too sick to continue living. Yet they are going to let this poor woman starve/dehydrated to death in 7 to 14 days, with just bandaids provided so the living watching this horrible death won't think she is suffering. Anybody who thinks that she will not suffer, don't have another drink of anything, and no food until Terrie dies, you will know what she is going through. We treat dogs better than this.

[NoControllingLegalAuthority]

Hitler killed six million. America has slaughtered 20 - 30 million in the womb.

[goldstategop]

Euthanasia means "mercy killing." To me, to slowly starve someone death is not a demonstration of mercy. Its a display of brute power and unfeeling barbarity. George Greer is a monster as well as a murderer. We won't forget.

(Denny Crane: "Sometimes you can only look for answers from God and failing that... and Fox News".)

[armymarinemom]

Those with nothing to say always trot out Hitler. Please stop embarrassing yourself by trivializing Hitler's Genocide of 6 million Jews and 5 million Christians. There is no parallel.

Hitler also euthanised or sterilized those who were mentally ill. They were nonproductive members of society who were a danger to a healthy gene pool as well as a drain of resources. Stop embarrassing yourself and ignoring history.

[wrathof59]

And the remains of all of them were incinerated in fire.

[bjs1779]

Those with nothing to say always trot out Hitler. Please stop embarrassing yourself by trivializing Hitler's Genocide of 6 million Jews and 5 million Christians. There is no parallel.

Not sure what you mean, but recent resarch estimates over 400,000 were victims of euthanasia.

[BonnieJ]

Sadly, the number is closer now to 40 million.

[Knitting A Conundrum]

Thank you for posting this...we all need to be aware of what it is.

Think about it. Have you ever been really thirsty? How dry your throat feels, how thick your tongue?

Now imagine laying there, not really able to move much, to communicate easily, and feel that thirst building up. There have been those who have come out of a state like Terri's who went through moments like this. They knew exactly what was going on, how the thirst builds up till it's an obsession before their eyes.

Can anyone guarantee that unless they are SURE via significant brainscan type testing that a person really has too low a consciousness to experience it, that people who are put down because someone else is horrified at their quality of life or wants to wrap up lose ends aren't merely in the "locked in" type condition and incommuncative?

A recent British study said that 40 percent of patients called PVS are misdiagnosed, and most get better.

Think about it. Laying there with a burning thirst and a body crying out for food. And you can't make anybody understand how much you need it.

I want to know how can torturing the vunerable, something you would be prosecuted for if you did to an animal, be done as an act of righteous love in the name of mercy?

And the King will answer them, `Truly, I say to you, as you did it to one of the least of these my brethren, you did it to me.' Then he will say to those at his left hand, `Depart from me, you cursed, into the eternal fire prepared for the devil and his angels; for I was hungry and you gave me no food, I was thirsty and you gave me no drink, I was a stranger and you did not welcome me, naked and you did not clothe me, sick and in prison and you did not visit me.'
Matt 25:40-43