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.

[supercat]

What would Jesus do? What would Jesus say?

Well, when Jesus was on the Cross, he said he was thirsty, and he accepted a wine-soaked sponge.

A damp sponge to keep Terri's mouth moist, however, would be too much to ask of the Monster.

[thinkingman129]

Do oyou know what the purpose of the vinegar soaked rag was?

Jesus was starved and deydrated, too.

He was killed, on the cross, for nothing He did wrong.

And still, He said, "Father forgive them, they know not what they do."

It is sad that there are two camps in Terri Schiavo's case and neither can see that there may be some 'right' in each, and plenty of 'wrong' in each. Again, villifying someone (MONSTER?) does not give credence to your position. It weakens it.

Father, forgive ALL the people involved in Terri Schiavo's case, for whatever wrongs they have committed, consciously, unconsciously, and subconsciously.

Same for ALL the people pushing one way or another.

[Churchillspirit]

Thank you for a very informative - and frightening - post.

[supercat]

Again, villifying someone (MONSTER?) does not give credence to your position. It weakens it.

Perhaps, though people need to recognize that Michael is not acting in good concience. He knows full well that Terri is concious, and is doing everything possible to conceal that fact. A man who is concerned for his wife's privacy does not discuss her gynecological problems on national television. On the other hand, abusers frequently try to restrict access to their victims on the grounds of "privacy".

Consider the hypotheses: (1) Michael is an honest person, and (2) Michael is a liar with murderous intent, and figure out the implications of each. Hypothesis #1 leads inevitably to all sorts of bizarre conclusions even a blue whale couldn't swallow. Hypothesis #2 leads to conclusions which are consistent with people's observed behavior.

[thinkingman129]

Mark 15:23 And they offered him wine mingled with myrrh; but he did not take it.

I remember reading that the wine/vinegar was something that would deaden the pain.

Did you note that Jesus did not accept it?


He had a mission. He was accomplishing that mission.

[thinkingman129]

Are Terri Schiavo's parents anymore honest, honest with themselves and others?

Or just consumed with their Catholic religion, with being right, with fighting what they deem evil.

Let God be the Judge. If He means for Terri Schiavo to live, then maybe a miracle will occur.

God works in miracles, even today. The miracle could be something we mortals don't dream of knowing.

God's ways are not our ways.

[supercat]

Are Terri Schiavo's parents anymore honest, honest with themselves and others?

I see one group of people who want evidence of Terri's true condition to be made available to the world. I see another group of people who want all such evidence buried. Which type of person should be deemed more credible?

[Ciexyz]

May God have mercy on their souls for doing this to Terri Schiavo.

[Ciexyz]

I think the spineless Republicans who voted against saving Terri, believe that this issue will die out, that it's only a blog thing. That we'll forget. Like with Elian Gonzalez, once it was a done deal, he was back in Cuba, then the issue basically died out.

Let's keep this issue alive every day!

[Smartaleck]

"Do you think she should to be taken off food and water for weeks to die even if you are right and no one knows exactly what the state of her mind is?"

Similarly, how long do you keep going?

[Smartaleck]

"Due to his court decision, could judge greer be charged with conspiracy to commit murder?"

What about the Supreme Court? They refused to even hear an appeal?

[Smartaleck]

"I see one group of people who want evidence of Terri's true condition to be made available to the world."

I've seen that too. Some people post only the info Terri's parents and their supporters want you to see.

For example they post the doctors lab report implying her husband beat her up yet don't post the full deposition that included observations from something like 8 other people.

They put out video's purporting to show here alert. They don't say that selectively edited the film.....according to some anyway. Nor, do they present the testimony of other doctors.......I think there were 6 in all who have presented opinions on her brain state.

From what I can tell the info is out there if they dig for it and not allow themselves to be manipulated by people that have an agenda.

These two sites seem to offer the greatest amount of un-biased info :

http://abstractappeal.com/schiavo/infopage.html#timeline

and the testimony on the condition of her bones....
http://www.hospicepatients.org/dr-walker-t-schiavo-bone-scan-deposition.txt

[thinkingman129]

Terri Schiavo's parents want *their version* of the truth presented to the media.

Have you read both sides of the issue, or have you just read their side?

Accuracy, bias, intent, and audience....

[GeekDejure]

Of course Terri's NOT vegetative !!!

All you need to do is LOOK at her !!!

But Judge Greer REFUSES to LOOK at her !!!

LOOK at her Judge Greer... LOOK at her !!!

I know you are legally blind, but just LOOK !!!

Terri is NOT vegetative... she's HOMOSAPIAN !!!

Now get off you ass and REVERSE your idiotic order !!! ;-))

[bvw]

Being charged with a crime is entirely different than the act of committing the crime itself. Here in that "Hospice" -- there's a murder going down. And a conspiracy to commit that murder which includes the Florida Judiciary and all participating law enforcement officers. Why do I include the police? The war crimes trials after WW II settled that issue -- if it hadn't had been already -- that perforimg a patently criminal act under color of a legitamate order is still a crime. Murder by starvation is a crime, no matter what legal paper and process may cover it up or even order it.

[AUsome Joy]

She is on a feeding tube, not a respirator. You eat to stay alive. She has that same right. To starve and dehydrate her is inhumane. It is not like she is brain dead or needs heroic means to keep her alive. She just needs what you and I need...food and water.

Imagine what it would be like to be in a cage and no one would give you food or water. That is the fate that she has been assigned to. Having had the experience of knowing a brain injured person come back after the doctor said to "pull the plug" I would continue to feed and give water to her. If I could see to it that she got stimulation which her husband forbids, I would do that also. She has been neglected to the point that she has deteriorated from the place where she was in the beginning.

[supercat]

Have you read both sides of the issue, or have you just read their side?

I've read both sides, and the undisputed actions of the Schiavo Triumvirate make clear that they are not honorable people.

Consider also that while the parents may report primarily that which is beneficial to their side, they do not try to stifle Michael's efforts to report his side.

Also, why is it that it takes a unanimous vote of twelve people to sentence a murderer to death, but a 3/5 vote is sufficient to sentence an innocent woman?

[Smartaleck]

"there's a murder going down."

It's definitly a sad situation and certainly got the country in an up-roar. There's been much written about "when life ends" and from what I can tell the legal precedents have been set to determine such (right or wrong.)

I think it rather shortsighted to lay the blame on the courts and police. The legislative bodies have had 15 years in this case to write laws spelling out what life or lack thereof is. If no one did anything isn't it a bit to complain now that the laws and judicial system is inadequate? Terri's case has been hrough the courts and by most if not all accounts has been subjected to the due-process. If the laws of that process aren't adequate to protect people is it the courts fault or the people who write the laws?

Curiously, feeding tubes are removed everyday but for some reason this case has generated interest where there was none before.......at least not of this magnitude.

[maine-iac7]

Let God be the Judge. If He means for Terri Schiavo to live, then maybe a miracle will occur. God works in miracles, even today. The miracle could be something we mortals don't dream of knowing. God's ways are not our ways.

God operates also with the natural laws HE made - which includes the need for food and water to sustain human life. He also gave us laws and commandments to follow.

His son told us that "As ye have done unto these the least of my children, ye have done it unto Me."

That means we are not to sit idly by and leave all up to God -

or mayhap you should test your theory and stop eating and drinking for a couple weeks and see if He intervenes?

[maine-iac7]

Wahoo! Tom Delay just ripped Michael Shivavo up good!

They are determined to see that Terri finally will have HER day in court