Artificial nutrition and hydration should normally be withdrawn, says doctor

BioEdge ^ | 3/2/12 | Michael Cook

[wagglebee]

An American doctor argues in the latest issue of the leading journal Bioethics that artificial nutrition and hydration should be withdrawn from all patients in a permanent vegetative state – unless there is clear evidence that they want to be kept alive.

Dr Catherine Constable, of New York University School of Medicine, studied bioethics at the Ethox Centre at Oxford University. She argues that the current presumption in favour of maintaining ANH is misguided. It is not in the interests of the patient nor, because of its cost, in the interest of society.

However, her argument is not based upon cost, but upon Peter Singer’s analysis of what it means to be a person. An individual in a PVS has no consciousness and therefore no interests. In this case, whether or not he or she is alive is irrelevant.

“Excluding any known wishes of the patient or family to the contrary, a decision to preserve the life of a patient in a state of permanent unconsciousness based on respect for life itself is morally no more sound than a decision to take that life.”

Furthermore, surveys have shown that most people would not like to live as Terri Schiavo did. Therefore, in the absence of a living will, “we have arguably committed a worse violation of autonomy by treating the [PVS] patient than if we had not treated him against his wishes.”

What about the remote, but real, chance of recovery from a permanent vegetative state? Isn’t that hope an reason for keeping people alive? No, says Dr Constable. Even if they recover, it will be all but impossible for them to return to normal life. Instead it will be “some state of middle consciousness; a life, quite possibly, worse than non-existence”.

[wagglebee]

Few people are as inspiring as this wonderful woman!

Thread by SeekAndFind.

Joni Eareckson Tada on Wilberforce Award, 'Better Off Dead Than Disabled' Mentality

A disturbing belief is spreading within the hearts of many around the world and within America: that a person is better off dead than disabled.

But a leading advocate for people with disabilities is fighting that notion and looking to educate the world and the church about the precious lives and rights of "those who seem to be weaker."

The Christian Post spoke to Joni Eareckson Tada on Thursday, the founder and CEO of Joni and Friends International Disability Center, about her countless achievements for the disabled community, unwavering faith in God, battle with breast cancer, and her latest recognition by Breakpoint and The Chuck Colson Center for Christian Worldview.

The 62-year-old evangelical author, who became a quadriplegic at the age of 17 due to a diving accident, just recently learned that she would be honored with the prestigious Wilberforce Award – named after the British parliamentarian who fought for 26 years to abolish slavery in Great Britain – during the annual Wilberforce Weekend held at the end of March.

CP: First of all, how do you feel to have gotten this award? Were you surprised, shocked? How did your husband react?

Tada: I was completely stunned by the news that I would be receiving this year's Wilberforce Award. I had actually nominated someone else, and when I received the first notification, I thought the committee had accepted my nominee. Imagine my surprise when I read it and discovered I was the recipient. My husband? He was just plain proud!

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CP: Why do you think they chose you to receive this award?

Tada: For many years I have worked hard to promote a biblical worldview on disability, whether in churches or in the community. I served on the National Council of Disability and helped spearhead the effort to draft the original Americans with Disabilities Act. Most of all, it's been my heart's desire to see the church carry out the mandate from the Gospel of Luke, the 14th chapter where Jesus says to go out and find the disabled and bring them in. My life goal is to see the world's one billion people with disabilities embraced and encouraged by the church.

CP: What do you believe is the greatest achievement you and your organization have accomplished for the disabled?

Tada: I believe we have brought the plight of the world's special needs families before the church, reminding them that "those who seem to be weaker" are actually indispensable. Whether through the 25 U.S. family retreats we sponsor, or the thousands of wheelchairs and Bibles we've distributed in developing nations, our passion is to make certain these disabled people and their families find a place in the fellowship of the church.

CP: What do you believe is the foremost important problem right now facing the disabled and how is your foundation working to fight and overcome this?

Tada: There is a growing premise in this country and around the world that a person really is "better off dead than disabled." This premise reflects a fundamental fear that people have about disability and, unfortunately, it has influenced social policy, such as the legalization of physician-assisted suicide and the destruction of human embryos for stem cell research. Just this week a couple in Oregon were awarded $2.9 million because doctors did not diagnose their unborn child with Down syndrome. When we disregard the rights of the weakest and most vulnerable among us, then the rights of all of us are in jeopardy.

CP: How is your health right now? I know you were battling breast cancer. Have the treatments finished? Are you now in remission?

Tada: My health is great! It's been nearly 20 months since my battle against Stage 3 breast cancer and I have a little under four more years to go before I can be declared cancer free. As long as I take my daily medication, I feel I'm on the right and best track!

CP: With another obstacle to overcome, how do you continue to look to God for strength and reason that everything that He has planned for your life is for His glory and for your good?

Tada: My weakness, that is, my quadriplegia, is my greatest asset because it forces me into the arms of Christ every single morning when I get up. As long as I come to God with my need, I am promised more than enough grace to help me smile, not in spite of my disability but because of it. And that's good!

CP: Is there any words of advice you would like to give those who continue to fight injustice throughout the world?

Tada: The Bible is replete with commands to persevere, especially in the face of injustice. The God of the Bible also heartily commends those who strive for mercy and justice in this world. God is truly on the side of those who work for social justice, especially when we accompany that work with the giving of the Gospel!

Joni Eareckson Tada is the senior associate for Disability Concerns for the Lausanne Committee for World Evangelization and has authored nearly 50 books on disability and Christianity including her best-selling autobiography Joni.

For more than 30 years, she has worked to accelerate Christian ministry in the disability community through her wide array of life-affirming ministries begun by her organization including Wheels for the World, Christian Institute on Disability, the International Disability Center, Family Retreats, and her television and radio programs geared toward encouraging people with biblical insights.

She and her husband Ken Tada are currently traveling around the Bay area, speaking at different venues to energize and inform people about their disability ministry.

To learn more about Joni and Friends International Disability Center and keep updated on their status, click here.

[wagglebee]

Wesley J. Smith offers a chilling reminder of the horror that began seven years ago today.

Thread by me.

Wesley J. Smith: Should Dehydration Be the Default Decision for PVS

Bioethics exploded into the headlines over the last few weeks after the Journal of Medical Ethics published an article promoting “after-birth abortion,” that is, the right of parents to have infants killed if the child’s presence in life did not serve their (or society’s) interests.

But hidden by the sturm und drang over infanticide, Bioethics published another radical proposal that received virtually no attention—but which, if adopted, could result in thousands of persistent vegetative state (PVS) patients being dehydrated to death.

The question concerns whether or not to provide such patients with food and water. Tube-supplied sustenance—called artificial nutrition and hydration (ANH)—is considered a form of medical treatment that can be withdrawn or withheld like any other medical care, such as antibiotics, chemotherapy, and indeed, aspirin. Of course, unlike withdrawing other treatments, ceasing to provide ANH results in the patient’s death in every case—usually over a 10-14 day period.

(Withdrawing such medically efficacious sustenance should not be confused with situations in which a patient’s body is actively shutting down during the dying process and the body can’t assimilate food or water. In such cases, ANH is medically inappropriate. The patient dies of their disease, not dehydration.)

Currently, in the absence of an advance directive to the contrary, benefit is given to life in PVS and other catastrophic brain injury cases—with surrogate decision makers able to order that such treatment cease if they think it is in the patient’s best interests. But that would change if Catherine Constable, the author of the Bioethics article, gets her way.

She argues for a policy in which ANH must be withdrawn once a patient is diagnosed to be permanently unconscious unless the family orders otherwise. In other words, dehydration would become the default position for patients diagnosed in PVS.

How does she justify such a harsh measure? First, she denies PVS patients have an “interest” in living because (quoting Princeton bioethicist Peter Singer) “life cannot benefit them.” That being so, money rules:

We need not label these patients as already ‘dead’ or claim that withdrawing care is not the same as ‘taking life’ in order to find that it is difficult to apply any sort of ‘right to life’ argument to a patient who would not now or ever choose to exercise that right. In view of this conclusion, other considerations, such as the cost to the health care system . . . would seem poised to be deciding factors.

Of course, such an argument could also be voiced in support of killing these helpless patients by harvesting their organs. Indeed, it already is—as I have discussed previously.

But what about the people who unexpectedly wake up? Constable says most of these weren’t truly PVS—even though some had been so diagnosed. (In fact, studies show that PVS is misdiagnosed about 40% of the time.)

But that doesn’t matter because “the new life gained” by the “miracle patient” is “far less likely to resemble what he lost than to be some state of middle consciousness;” a life “quite possibly, worse than non-existence.” Moreover, the potential benefit of living to be a miracle patient “is not sufficient to trump the public interest in allocating resources to patients more likely to benefit.”

In typical bioethics style, Constable then puts in a hedge, allowing that families of PVS patients should “be given the last word.” That would still put at immediate risk of dehydration the thousands of existing PVS patients without families.

But even Constable’s bow to family intimacy seems political and hollow. Thus even though she states that families “should be encouraged to consider whatever factors they deem useful,” families would be made to believe that dehydration is right:

We should discontinue the practice of putting families in the position of having to justify a decision to withdraw ANH by making assertions about what the patient would have wanted . . . To put the onus on a family to justify the decision to withdraw ANH is to effectively treat them as would-be executioners who need to be checked . . . In the case of PVS, when in doubt as to a patient’s wishes, it is better to discontinue life-sustaining treatment.

But if it is true that families now have to justify choosing to dehydrate, this radical shift would put families in the position of having to justify the continuance of food and fluids in the face of potentially hostile doctors, bioethicists, and the public policy of society.

Families often already face too many such pressures. Creating a “default for death” policy would not only make matters worse, it would establish the foundation for a veritable duty to die.

[wagglebee]

Day One

Congressional Intervention Fails to Spare Terri Schiavo

March 18, 2005, Day 1 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schindler Schiavo. The next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that at this moment, countless others are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 18, 2005 (WND) - Doctors removed Terri Schiavo's feeding tube carrying out her estranged husband's requested court order allowing the brain-damaged woman to starve to death over the objections of her parents. Barring an intervention, Terri Schiavo is expected to live another week to 10 days. (continue reading ...)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

[Alamo-Girl]

Thanks for the ping!

[wagglebee]

Day Two

Schiavo's Feeding Stops

March 19, 2005, Day 2 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schindler Schiavo. The next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that at this moment, countless others are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 19, 2005 (Tampa Tribune) - Even U.S. marshals armed with congressional subpoenas could not stop the removal of Terri Schiavo's feeding tube Friday. The fight to keep the brain-damaged woman alive, however, is not over, federal lawmakers and Schiavo's parents said. (continue reading . . .)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

Day Two

Schiavo's Feeding Stops

March 19, 2005, Day 2 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schindler Schiavo. The next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that at this moment, countless others are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 19, 2005 (Tampa Tribune) - Even U.S. marshals armed with congressional subpoenas could not stop the removal of Terri Schiavo's feeding tube Friday. The fight to keep the brain-damaged woman alive, however, is not over, federal lawmakers and Schiavo's parents said. (continue reading . . .)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

[BykrBayb]

It’s still difficult to absorb the fact that our government ordered the torture and execution of an innocent citizen, while a handful of vocal boot lockers cheered them on.

[wagglebee]

What's scarier is the realization that Terri's murder was nothing more than a "test case" to see how America would respond to mandatory death panels.

[BykrBayb]

And scarier than that is the fact that many of us failed the test. Not as many as the death mongers claimed in the polls they forged to drum up support, but still too many.

[Alamo-Girl]

Thanks for the ping!

[wagglebee]

Day Three

 

Senate Passes Bill That Could Save Schiavo

March 20, 2005, Day 3 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schiavo. The next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that at this moment, countless others are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 20, 2005 (FL Baptist Witness) - The U.S. Senate passed a bill Sunday afternoon that could save Terri Schiavo's life, sending it to the House, which is expected to vote on it after midnight. (continue ...)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

[Alamo-Girl]

Bump!

[wagglebee]

Day Four

House Passes Schiavo Bill

March 21, 2005, Day 4 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schiavo. The next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that at this moment, countless others are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 21, 2005 (CNN) - Following more than three hours of passionate debate on Capitol Hill, the U.S. House early Monday passed a bill on 203 to 58 vote that transfers jurisdiction of the Terri Schiavo case to a U.S. district court for a federal judge to review. (continue reading . . .)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

[wagglebee]

[Alamo-Girl]

Thanks for the ping!

[wagglebee]

Day Five

ABC, CBS and NBC Evening News Coverage Favors Those Who Would Stop Feeding Disabled Woman

March 22, 2005, Day 5 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schiavo. The next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that at this moment, countless others are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 22, 2005 (Media Research Center) - A new Media Research Center study finds the three broadcast network evening newscasts have tilted their recent coverage of the Terri Schiavo case in ways that bolster her husband Michael’s arguments that the severely disabled woman is in an irreversible vegetative state and had clearly expressed a desire to die. But network reporters have attempted to debunk arguments made by her parents — namely that some doctors believe she could be helped and that Mrs. Schiavo, a Catholic, would not want her feeding tube disconnected. (continue reading . . .)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

[Alamo-Girl]

Bump!

[wagglebee]

Day Six

U.S. Judge Rejects Feeding-Tube Appeal in Schiavo Case

March 23, 2005, Day 6 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schindler Schiavo. Over the next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that as we speak, countless people are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 23, 2005 (New York Times) - A federal judge refused Tuesday to order the re-insertion of Terri Schiavo's feeding tube, denying an emergency request from the brain-damaged Florida woman's parents. The ruling by U.S. District Judge James Whittemore (pictured) came after feverish action by President George W. Bush and Congress on legislation allowing her contentious case to be reviewed by federal courts. The judge said the 41-year-old woman's parents had not established a "substantial likelihood of success" at trial on the merits of their arguments. The tube was disconnected Friday on the orders of a state judge in Florida. (continue reading . . .)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."

[Dante3]

Jeb Bush could have save her but refused to do it.

I apprecaite the efforts of everyone here to keep her memory alive.

[Alamo-Girl]

Bump!

[wagglebee]

(I won't be around tomorrow, so I'm posting this early.)

Day Seven

Schiavo Parents Appeal to U.S. Supreme Court

March 24, 2005, Day 7 of Judge George W. Greer's court ordered death by starvation and dehydration of Terri Schiavo. Over the next two-weeks, Terri's Network will post stories of the events that occurred on each of those 13 horrific days. We offer this not only in regard for Terri's memory, but as a reminder that as we speak, countless people are suffering slow, agonizing deaths in hospices, nursing homes, and hospitals in America and around the world.

From March 24, 2005 (CNN) - A lawyer for Mary and Bob Schindler - who are fighting to have their daughter Terri Schiavo's feeding tube reinserted - filed an appeal late Wednesday with the U.S. Supreme Court, which in the past has refused to hear the case. (continue)

"We will not be silent.
We are your bad conscience.
The White Rose will give you no rest."