Posted on 03/25/2005 2:16:36 PM PST by Southside_Chicago_Republican
Her skin is flaky, tongue dry and lips sunken. Doctors are saying Theresa Schiavo could survive another week without food or water, but she could just as easily die over the weekend.
But is she suffering? On that point, expert opinion varies widely.
Schiavo stopped receiving food or water last Friday. Because she is in a persistent vegetative state without conscious awareness, many medical authorities say she is unable to process or communicate pain and discomfort. Any reaction she shows is reflex, they say.
And as her organs fail, they predict that she is likely to pass peacefully, as if she was drifting off to sleep.
But other physicians — some of whom combine medicine and Christian missionary work — strongly disagree.
Dr. David Stevens, executive director of the Christian Medical Association in Bristol, Tenn., has worked in some of Africa's poorest nations.
He recalls watching people die of dehydration with symptoms that include thick saliva, severe cramps and dry heaving. As their mucous membranes and intestines dry out, they bleed from the mouth and nose, and begin to hallucinate.
Stevens says the quiet death that physicians often associate with dehydration comes to patients whose bodies were already shutting down from cancer or another terminal illness.
"That's a whole different thing than someone like this, whose body is in metabolic equilibrium," he said.
But in a statement, groups representing hospices said the Schiavo case has raised "erroneous medical claims" that stopping food and water causes terminal patients considerable discomfort.
"Most studies show that patients nearing the end of their lives do not experience hunger," said Ryan Walker, a spokesman for the Hospice and Palliative Nurses Association. "Dry mouth is the most common symptom, but it easily can be alleviated."
Other medical authorities say a case like Schiavo's is more difficult to analyze because researchers don't have a complete idea of what a vegetative patient might feel. They still have basic functions controlled by the brain stem, including sleep-wake cycles, breathing and some facial expressions. But she is not consciously aware and requires total assistance.
And, at 41, her case is rare because of her age. Nursing homes are full of geriatric patients battling serious diseases only to suffer a heart attacks and wind up breathing on ventilators while their families weigh sad and limited options.
But Schiavo was 26 and outwardly healthy when she collapsed and her brain was temporarily starved of oxygen. The courts have ruled that the episode left her in a persistent vegetative state, and agreed that her husband has the right to disconnect her feeding tube.
"Often the issues hardest to decide are when young people who are otherwise living productive lives are struck down by an unforeseen event. They do not have a lot of other medical problems and can live for years without succumbing," said Elaine J. Amella, associate nursing research dean at the Medical University of South Carolina at Charlestown.
Currently, Schiavo is not known to face a life-threatening infection like pneumonia, for which the family and doctors might agree to withhold antibiotics and let nature take its course.
Without a national euthanasia policy, physicians said nutrition is the only medical intervention over which Schiavo's surrogate decision-makers can exercise any individual choice.
"In this case there really isn't any in-between," said Dr. Michael Weissman, director of the palliative care center at the Medical College of Wisconsin in Milwaukee. "Of all the things we talk about stopping in these cases, nothing more emotionally laden than feeding. Antibiotics don't mean nurturing, but feeding does."
If nutrition is denied, there is a point when death may occur even if the tube is reinserted — toxin levels are too high and the body is in too much shock. Or the patient might survive, but with additional damage to the brain, kidneys or other organs.
Ironically, when the end of life draws near, doctors say that over-hydration may pose the bigger medical problem. As the kidneys and other organs fail, fluid builds up in the lungs and the legs. This increases stress and pain, and often requires aggressive intervention.
One frequent hallmark of approaching death is the "death rattle" as patients lose the ability to cough or swallow saliva and other secretions from their throats and bronchial tubes. When they breathe, air moves over the fluids, creating turbulence.
A study by the Medical College of Wisconsin suggests that death comes about 16 hours after the rattle's onset. But patients with brain injuries and lung disease might also produce similar noises without being close to death.
Dehydration leads to kidney failure and levels of toxins and impurities rise in the bloodstream. At some point the biochemical changes in the blood become severe enough to impair the electrical system that controls the functioning of the heart. Blood pressure drops. Consciousness wanes. Respiration slows, or even stops for longer intervals.
The heart slows, then stops beating. Finally, the brain shuts down from a lack of oxygen. Death might not be immediately apparent.
In a recent New England Journal of Medicine (news - web sites) study, hospice nurses rated the deaths of terminally ill people who voluntarily stopped eating and drinking. On a scale of zero to nine, with the highest number being "a very good death," their average rating was eight.
Because she is in a persistent vegetative state without conscious awareness, many medical authorities say she is unable to process or communicate pain and discomfort. Any reaction she shows is reflex, they say.
Yet, she knows that she really really wants to die this way.
This has not been reported as "euphoric" -- just the opposite. Take the Donner case: starvation pangs were so bad that people were so hunger-maddened as to reduce themselves to cannibalism.
However, the East German nurse gave it only a 6.2.
We're at a sick point in human culture.
"But other physicians — some of whom combine medicine and Christian missionary work — strongly disagree."
Sounds like a sly little way to automatically discredit them on this. Afterall, it's just the nutty religious right who's standing up for a living corpse, right?
Thanks for nothing Jeb. He can commute the sentance of a murdering rapist but he feel's powerless to save this womans life. By washing his hands of this unfortunate occurance, I see he is certainly keeping with the season.
Run for president, Jeb. You will get my vote when hell freezes over. Sleep well.
I notice that he cancelled his Good Friday prayer today. He just may have a concience. Then again, he has his image to protect and he may want to run for office or something.
I am not in his shoes, but if I were I would certainly not stand by and let this happen.
I'll give hospice a rating of zero.
Another attempt to place a fog over the heinous act of murder taking place.
Heard Bobby Schindler on Glenn Beck this am. Glenn asked Bobby if they were giving Terri morphine, but Bobby didn't know. Understandable-he must be absolutely speechless, in shock, and grief beyond belief at this point.
Wow; thanks for the reassurance! One can only speculate on the euphoria that awaits somebody who attains a nine.
The media is really falling over itself in its insistence that this process really isn't all that big a deal.
Amazing how she can survive a week without food and water but goes into cardiac arrest simply by being bulemic.
False Premise -> False Conclusion.
I've always tended to be optimistic about the human race. Not lately, though.
Good point.
I wonder how the ACLU would react if this became standard practice for death row inmates. You know, being how it is so "humane" and all...
No, wait! We've been repeatedly reassured that this was not euthanasia, that this was HER wish...surely there must be a mistake.
I saw a young pretty woman "expert" on TV yacking about this. She kept smiling and she made my skin crawl!! How can they discuss this topic like it's no big deal?! I couldn't understand what the heck she was saying - gobbledegook and kept getting distracted by how calm cool and collected she was. Like a movie star playing a role. And that creepy smile! It was CHILLING!!!!!!!
Lookalikes.
Bobby Schindler and Ben Stiller.
It reminds me of that song:
"The bubble-headed bleached-blonde comes on at five.
She can tell you about the plane crash with a gleam in her eye.
It's interesting when people die,
Give us dirty laundry."
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