Annihilating Terri Schiavo

Commentary Magazine ^ | 6-1-05 | Paul McHugh

[Goodgirlinred]

Since she was no longer receiving any rehabilitative treatment, she was continuing to decline. At least, they could say that. Could they get away with it, I don't know.

[ClancyJ]

This is the best article I have seen that presents the whole tragedy of Terri and all the precedents, the laws, the society drift and the dangers.

This explains the whole thing. Long but a very conscientious examination of what Terri's death represents and why it was so heart-rending.

[ClancyJ]

I think the medical profession has more than a few bad [ethical] eggs in it. Probably more than the author wants to admit.

Exactly what I was thinking. Very scary thought - made me question the counsel of the physicians in my mother's case. Was it the truth or had they decided she was not worth saving and were broaching their medical opinion to have me conform to their goal.

Another result of the Terri debaucle. I think it will probably make the elderly forego visiting doctors as they will fear they are not going to help them but to see that they depart this life.

And, another thing that makes me mad. Now, all disable, deformed and especially the elderly will end their lives wondering if instead of relatives and doctors "helping" them, they are in truth, "killing" them.

[ClancyJ]

I heard that once she was in the hospice, her funds were placed in a "trust" and she was getting Medicaid to pay for her stay. After her death, the "trust" funds are turned over to Michael.

Which is legal in the State of Florida apparently.

[ClancyJ]

Maybe that is where the fraud comes in that is being investigated.

They keep people outside the time frames and just alter the records continually to show decline. Or something to do with receiving the medicare funds.

[planekT]

...Maybe that is where the fraud comes in that is being investigated...

Exactly.

[planekT]

Hm....

In the state of Texas, which is where we live, Medicaid will only kick in once a beneficiary's assets are "spun down". That is, the beneficiary can only have so much cash, property, etc. At that point, Medicaid may be used to pay for custodial care(such as nursing home placement), but to my knowledge, Medicaid does not have a separate benefit for hospice. Hospice is a Medicare entitlement, although some commercial insurance plans do provide some type of hospice benefit, but it is usually not as rich as what Medicare provides. I am not sure about Florida law, but I don't think she would have qualified for Medicaid in Texas given the size of her trust fund. However, I am not an attorney, so I supposed there could be a loophole somewhere.

My understanding was that she was in a hospice and had been in a hospice for 5 years. I am not sure how she qualified to be placed in hospice in the first place since the feeding tube was already in place which was the source of her nourishment. I personally do not think the hospice should have accepted her since with a feeding tube in place and given her age and physical condition, it was reasonable to assume that she would live longer than 6 months.

In hospice, a beneficiary may receive some physical therapy, but it is not going to be enough to maintain a beneficiary at their current functional level.

Here are my thoughts, if indeed Michael Shiavo did apply for her to receive disability benefits under Social Security thereby qualifying her for Medicare, and if indeed she was receiving hospice benefits under Medicare, then I suspect that she continued to qualify for hospice benefits because she was not receiving enough physical therapy to maintain her functional status, therefore she showed a steady decline. If this basic supposition is true, then I think it would also be logical to conclude that at some point in time, she bottomed out, that is did not continue to show decline and her hospice benefits were either denied are were under scrutiny. At this point, her trust funds would have been fully at risk for her continued care. The level of custodial care that she was receiving would probably cost anywhere from $5000 on up per month. Her trust funds would not have lasted long at that rate. I think Michael Shiavo figured this out and then began petitioning to have her feeding tube removed. Once her feeding tube was removed, she actually did qualify for hospice at that time.

It is horrible to think that this scenario is really what happened, but it is plausible. I am an RN with 25 years of experience and the last 12 being in managed care(working with health insurance). I understand how hospice under Medicare works because it is truly a wonderful benefit for those individuals who truly need it. It is sad to think that this wonderful benefit is now being abused by greedy individuals willing to sign that an individual has 6 months or less to live when that is not the case, as in Terri Shiavo. It is murder, but a very slow murder that takes place by depriving a patient of what they need to maintain their health, and it is being done for money.

Mrs. PlanekT

[ClancyJ]

I am glad to hear that you were impressed with hospice care. I was beginning to wonder if they were a front/sham with the real goal of escorting people to the other side.

I have used them here and was totally impressed until all the Florida mess - then I wondered.

Appreciate your input as a nurse - it will be very helpful in understanding all the dealings of the medical industry.

[Goodgirlinred]

Well, that should be just plain illegal. That just gives the guardian a good reason not to take proper care of the patient.

[tutstar]

I'm about to get off FR for the night.

If you haven't read www.theempirejournal.com please do, there is a lot of info there re Terri.

A doctor never signed the papers admitting her to hospice.
MS lives in a $240,000 home, drives a mercedes and he's an RN. I guess they put it all in the mistress name so it couldn't be counted as part of Terri's income.

In order to get on medicaid you have to fill out an application, provide copies of utilities, rent/mtg, bank statements, vehicle titles or payment book, and I don't see how Greer was able to authorized placing her on medicaid. It's not fair to those who are in between jobs and could use the help. MS could have taken care of her bills if he hadn't been paying lawyers to get her death ok'd.

Terri was walking with help and use of parallel bars at one time. After the lawsuit settlement she was neglected.

[ClancyJ]

Agree. But seems there was an option for funds to go into a trust. Therefore the patient had no funds and medicaid jumped in. Not clear on this but I do remember something about her funds being in a trust and therefore medicaid/medicare was paying the bill. Maybe Medicare pays for any hospice stay from what another person said. Not clear on it. Maybe someone on this thread knows more about the details.

[Goodgirlinred]

I remember that Judge Greer helped Michael get the money put in trust and helped him get her on Medicare or Medicaid so that her hospice was paid for by that. I think that was wrong. Her settlement money should have been used for her care. That was what it was for.

[planekT]

I hadn't been to the empire journal site in a while. They have some new stuff there that I hadn't seen, including a piece on medicare and medicade.

Really, it seems that fraud is a very, very real possibility here. Mrs. planekT realizes it. The Empire Journal realizes it. A hell of a lot of freepers realize it. Why has this not been resolved yet? For that matter, where are the autopsy reports we were supposed to have "in a couple of weeks"? Do the Schindlers still not know what became of Terri's ashes? Didn't Judge Greer order Michael to tell them?

All of this is totally outrageous, and so is the silence from Florida officials. They bow to an uncertified judge instead of attending to their duties. It seems that they all want it to just go away.

Maybe it will, but I will never forget.

Thanks to all FReepers who continue the fight for Terri. Thanks also to Mrs. planekT for putting up with me and for sharing her insight on this forum at my request. She is a tower of strength, wisdom, and compassion. I am very lucky to have her.

[Earthdweller]

Never forget ping.

[Palladin]

Bravo! You're doing very well for your first week at FR.

Don't let the naggers get you down.

[T'wit]

This Newsmax piece from a few days ago, Doctors Doube Darwinism, may be of interest. I don't know if it has been posted. What caught my eye is this point of view quoted below -- surely one that directly addresses the callous treatment of Terri Schiavo:

"Why is this issue important to patients treated by doctors? If a doctor believes human beings and other creatures do indeed show evidence of intelligent design, those same human beings are due significantly more reverence and respect than if they simply reflect natural selection working on a pointless series of chance events.

If a person is due no more respect than a chicken or lump of clay, he is as easily disposed of should someone more powerful (such as the doctor or a government agent) decide he has outlived his usefulness. That anti-human attitude isn't science fiction. It's the stated position of some contemporary bioethicists."

[EternalVigilance]

The problem is that 80% or more of persons who execute "advance directives" revoke them when they are sick (i.e., they change their minds). If people under 40 all made advance directives, this number would be 95%+.

Therefore, respecting someone's "wishes" without regard to the clinical scenario is incompetent at best, if not negligent.

It is not obvious that brain-injured persons (who cannot "change their mind") should be held to the letter of their "prior wishes", since those prior wishes in expressive patients have almost no substance.

Very good, very important post.

[EternalVigilance]

The hospice in which Terri lived acted very un-hospice like in the end IMO. And I recall reading that there was some funny business with the hospice, that it had an affiliation with Felos, and others not very objective, nor interested in the POV of the Schindler family.

Throughout the vigil, there were very few pro-Michael protestors...mainly 2 or 3 that showed up regularly...literal friends of his...and one incident where about 2 dozen drooling liberal haters, the kind you would see at an ANSWER/anarchist march, came and caused trouble for about 2 hours.

But on a couple of occasions, I saw pro-Michael people, with signs, COME OUT OF THE HOSPICE ITSELF...obviously hospice staffers.

They casually strolled through the area that, if a pro-Terri person had walked a foot into, they would have been in danger of being arrested, tasered or worse.

Surreal...

[Jim Noble]

Thanks very much.

I should also point out that the Feds and other interested parties are very anxious for healthy young people to execute advanced directives (it may become mandatory soon).

The universal healthy young person advanced directive is, "If I'm ever sick, kill me" (it's a cultural thing).

You can bet that the payers, including the Feds, are going to want to "respect the patient's wishes", expressed at age 25, when they are old and sick.

[EternalVigilance]

Yep. You got it.