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.
To us, it may not look like the patient is in pain. However, the patient may be so exhausted from lack of food and water that he/she cannot muster the strength to express how much pain they are in.
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.
I understand they are giving her morphine. You have to wonder why, since she can't feel pain. Hmmmm...
So if she is unable to process pain and discomfort, then in her present state of existence before the feeding tube was withdrawn, she was not suffering.
Which begs the question, then how can they say they are withdrawing her feeding tube to "end her suffering" when she can't "suffer" in the first place.
I understand they are giving her morphine. You have to wonder why, since she can't feel pain. Hmmmm...
the claim that she's "suffering" is used quite freely by her husband and his lawyer. They speak of her as if she's elderly and in advanced stages of cancer. And the MSM-believing public digests their crap.
Prayers for Terri and her family. It's looking like that's all we can give them.
I wonder why no one in the MSM has elected to interview others who have experienced starvation and dehydration and been close to death?
Veterans of Japanese and Vietnamese POW camps, Holocaust survivors, persons who have had to abandon vessels for a raft and not been picked up for days....there is a vast data base for the MSM to "mine".
But then they would have to get out of the office and stop taking the secretaries out for long lunches. Too, too much of a burden. Easier to rely on the say-so of doctors who also belong to the Hemlock Society
Psalm 79.
Jim Caraway, 21, kept a suicidal Florida woman online for 11 hours early Wednesday until rescuers could find her.http://www.dmregister.com/apps/pbcs.dll/article?AID=/20050319/NEWS08/503190324&SearchID=73202950703867
pukes
"Amazing how she can survive a week without food and water but goes into cardiac arrest simply by being bulemic."
Her bulemia was a condition that went on for more than a week, along with the fact that she was an active adult, expending what little nutrition her body took in between binging and purging. The potassium imblanance that the malnutrition caused led to the heart attack. Lying in bed with only some reflex movements, requires far less energy, therefore a longer period of time before any systemic shutdowns.
But is it being alleviated, in this case? Judge Greer has been relentless in preventing Terri from receiving anything by mouth. He did not even allow her to receive last rites until the priest agreed to put the couple of drops of consecrated wine in her feeding tube rather than on her tongue, shortly before the tube was removed.
You were looking at evil lurking behind those eyes.Scary to know that there are so many people around who feel so comfortable executing an innocent woman to an excruciating death,on the word of an adulterous estranged husband.
At least now we know,and a lot of them are judges.
Wow!Very good point.
What a bunch of nothing it is neither true in medical terms nor factual terms.There has been no finding regarding the cause of her collapse.
So now it has begun, has it? Stupid, ignorant idiot Americans will be told that we need a strong euthanasia policy in order to keep their grandma from suffering like Terri. Let's just give grandma a shot and save all that money for her care, so we can give it to the illegal aliens. They are strong, healthy and work hard. Grandma is a drain on society. I can see it now: Idiot Americans lined up in Washington begging for a strong euthanasia policy.
They could go to Holland where sick babies are murdered and teen agers, who are crippled or ill, are regularly killed by the medical profession. They have been killing the elderly there for many years they don't even think about it it is so common.
Yeah, we need a strong euthanasia policy like Holland.
Yes.... I have never been this depressed. Ans I am embarrassed for our country. Our politicians are spineless fools.
I don't think bulemia would be the only cause of a potassium deficiency. I had an aunt who was hospitalized a couple of times for extremely low potassium. She was in her 70s, definitely not bulemic, just wasn't eating right. After her bouts I always have bananas in the house.
Given Terri's history of serious dieting, I can see how the low levels might occur by just erratic eating, not necessarily bulemia. imo
How about just asking for the "right" to give Terri ice chips and popsicles by mouth?
Ditto
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