I don´t believe in any right to die. I believe in a moral obligation to live and make the best of your life. I´m not religious, but I can´t understand how anyone would want to die. Given the fact that 1. you have only one life, and there is no great afterlife whatsoever and 2. there is always a slight hope of a cure for whatever disease you might have, how can one choose to die? I mean, you will die anyway sooner or later, so why rush it? What´s 10 years spent in a coma in a hospital compared with an infinite amount of time not existing at all?

Well, first of all, let me say that I am studiously attempting to avoid discussion on the substance of the issue because I want to enlist liberals as regards the really horrific procedural and evidentiary problems in this case, which is where I think persuasion can occur.

But to answer your question: yes, as a general proposition, 'tis better to fight on, but then, few of us have had to live with excruciating pain and the guarantee of imminent, though not quite quick, death.

Hope doesn't always spring eternal. And while there may be some chance of a miracle cure, most severely-ill people probably stop believing in that possibility eventually. Cures take time.

Pain and anguish are immediate.

I'm not really offering a real opinion on the matter. Just sayin'-- here's why some might disagree with you.

Am I off in thinking that this is routine stuff in Olde Europe (tm)? Euthanasia at the request of a financially conflicted relation?

The dirty secret is that a lot of very old sick folks are quietly and unofficially euthanized, often after off-the-record consultation with the family. There are ways to subtly kill the very old, weak, and sick that won't draw attention and don't require a judge's order.

And they, too, are probably financially conflicted. But if they all agree, and the person is dying anyway.... I think a few doctors or nurses have let patient's expire when they deem it hopeless, and the family doesn't want to drag things out.

But putting aside that sketchy scenario, the family here -- her REAL family, not the husband who's shacking up with a honey and a couple of out-of-wedlock kids -- want to keep her alive. So that on-the-QT euthanasia thing doesn't even apply.

Great post Ace. I wanted to write up something like this, but now I can just link to yours.

I'm absolutely stunned by the lack of discussion in the media of the possible impure motives on the husband's part. Really, how hard is it to imagine that when a guy has TWO KIDS with another woman, he might not be the best source for an objective take on his vegetable wife's wishes?

Since this case hit the media, I have felt that I am in the twilight zone, sitting many times in front of the boob tube with my mouth agape at this shameless attempt at legal murder and the plight of poor Terry's family.

I feel sick again today, but at least now, maybe the poor woman will get her MRI!

I'm thinking that maybe we should consider giving Florida "back" to whomever might want it. There's something seriously funny in the water down there.

Thank you Ace for laying out the facts about Michael Schiavo and the dumbfounding behaviour of our judiciary and elected officials!!!

Hey, PSF, there are a lot of people here in Florida who don't want Terri to be killed. Do you want us to be "given away" too? Don't be a jerk.

@ace: Most people may be able to imagine a situation in which they suffer so much, that they don´t want to go on. But if you are in such a situation, you are not able to make rational decisions. You can´t see the opportunities that may lie beyond your immediate situation. So one shouldn´t be given the right to choose for death, as long as there is a change of improvement. And there always is.

The reason why most people are so eager to argue for a right to choose suicide, is that they got a flawed vision of what death means. Some believe they get to some magical afterlife paradise. Less religious people may think that they get into some not clearly defined state of peace and calmness.
I don´t want to get too philisophical here, but death has nothing to do with calmness or peace or whatever other psoitive attribute might come to mind. It is simply irreversible non-existance. So, once again, as life inevitably leads into this state anyway, why rush it?

Judge Greer ruled there was clear and convincing evidence of Terri Schiavo's wishes based on the testimony of THREE, not one, witness.

The other two were related to Michael Schiavo ( His brother and sister in law) and spent time in Terri's presense. The two testified that Terri Schiavo had, as an adult, made a comment in their presense that she did not want to be kept alive artificially.

All attempts (and there have been several) to overturn the ruling that there is clear and convincing evidence of Terri's wishes have failed.

Due process regarding Terri's wishes has not exactly been skipped.

Most people opposed to withdrawal of the feeding tube would still object if Terri had made her wishes known, and her own parents said, even if Terri were competent and wanted to remove her feeding tube, they would have amputated their daughter's limbs to prevent her from doing so.

"The other two were related to Michael Schiavo ( His brother and sister in law) and spent time in Terri's presense."

Oh well there you go, unimpeachable witnesses. Say no more!

"her own parents said, even if Terri were competent and wanted to remove her feeding tube, they would have amputated their daughter's limbs to prevent her from doing so."

Right. Sure. You got this from where -- the same unimpeachable source as the other thing? Some links, some proof that this isn't just something you pulled out of your own ass, would help. And in any case, assuming the statement you claim the parents made was made, no one who is in generally good physical health (except for being brain-damaged and neglected) should be allowed to starve themselves to death.

"Most people opposed to withdrawal of the feeding tube would still object if Terri had made her wishes known..."

SarahW, can you support this through poll data or does this thought just give you comfort for your troubled conscience? Keep telling yourself its just those pesky pro-lifers again and you won't have to give this matter any serious consideration at all.

It's just a fact that two other people besides Michael Schiavo stated in court, with their relationship to Schiavo known to the court, and all interested parties. I thought Ace should correct for accuracy.

I have no personal opinion about their testimony and it's accuracy beyond my opinion that the testimony of others was indeed given. The testimony was put before the court, and the court had the opportunity to give it weight in context of the proceedings, and those opposing the message had an opportunity to "impeach" it.

This is pretty much my beef with the Schiavo controversy:

"No one who is in generally good physical health (except for being brain-damaged and neglected) should be allowed to starve themselves to death."

A lot of persons hysterically proclaiming "Save Terri" have an agenda that goes beyond the facts of that case, and have a doctrinal objection to refusal or withdrawal of medical care allowed under Florida law.

As for the "amputation" comments, your point is well-taken.
A guardian ad litem appointed for Terri by Jeb Bush, named Jeff Wolfson, discussed in a written report. I understand the parents testified that they would attempt to keep Terri alive "at any and all costs". They would take extreme measures to prevent Terri's death, up to and including amputation of each and every one of Terri's limbs.
Were she to be diagnosed with heart disease, they would tell doctors to perform open-heart surgery.
The Schindler family stated that even if Theresa had told them of her intention to have artificial nutrition withdrawn, they would not do it.

I have to go look for a link to actual tesetimony or a pdf or the report, but I'll try to bring one back here.

Arrgh. Posted before previewing. Hope you can make sense of above post.

Here is a link to *JAY* Wolfson's report. It's a pdf.
here

Google will provide an HTML version for that link.
excerted below:

Testimony provided by members of the Schindler family included very personal statements about their desire and intention to ensure that Theresa remain alive.
Throughout the course of the litigation, deposition and trial testimony by members of the Schindler family voiced the disturbing belief that they would keep Theresa alive at any
and all costs. Nearly gruesome examples were given, eliciting agreement by family members that in the event Theresa should contract diabetes and subsequent gangrene in
each of her limbs, they would agree to amputate each limb, and would then, were she to be diagnosed with heart disease, perform open heart surgery. There was additional,
difficult testimony that appeared to establish that despite the sad and undesirable condition of Theresa, the parents still derived joy from having her alive, even if Theresa
might not be at all aware of her environment given the persistent vegetative state. Within the testimony, as part of the hypotheticals presented, Schindler family members stated
that even if Theresa had told them of her intention to have artificial nutrition withdrawn, they would not do it. Throughout this painful and difficult trial, the family acknowledged that Theresa was in a diagnosed persistent vegetative state.

Ace,

I have written about this before at other blogs, but I'll say it again here.

There are to my mind, three issues of fact concerning this case. All of which have been adjudicated repeatedly, and with the same results.

1) Terri Schiavo is in a persistent vegetative state.
2) In the absence of an advance directive for health care, her husband is the appropriate person who "knows her mind" and is in authority when it comes to using "substituted judgment."
3) The "substituted judgment" is that Terri Schiavo, if she could at this very minute, tell us her wishes, would opt for removal of hydration and nutrition.

In this case, and as an expert neurologist (I have authored textbook chapters on the neurological examination and on coma), and someone who has seen many thousands of brain injured patients, Terri Schiavo does not appear to be in a PVS.

This is terribly troubling, but does not, in and of itself, exclude the possibility that Ms. Schiavo would not want hydration and nutrition, at this time.

In other words, the fact that the court, in my opinion, has come to an incorrect finding of fact with regard to Ms. Schiavo's current medical state, makes be believe that the court may also have incorrectly found to the other two facts.

First off, end-of-life care does not typically mean removal of all care, just those that are believed to be futile, or contraindicated.

Terri Schiavo, may have said, as many people have said at one time or another in their lives, "I don't want to be hooked up to machines," or "I don't want to be alive but a vegetable," or "I don't want to be kept alive artificially."

These are common and understandable comments. But whether or not these comments would apply to this set of circumstances, i.e., severe and likely permanent, but not imminently fatal brain injury, with the "artificial" life-support being a feeding tube, is difficult to say.

And yes, there is great controversy as to her husband's neutrality as her guardian.

But again, the court has repeatedly found in favor of her husband, time and again, with regard to these questions of fact.

One of the problems with this case, is its potential to undo many years of excellence in end-of-life care, for the benefit of no one.

The issues involved in end-of-life care are complex and are given the greatest thought and commitment.

Withholding hydration and nutrition can, and often is, clinically correct and merciful when people are dying.

It can also be ethical when someone has declared their intentions vis a vis an advance directive for health care.

You DO NOT want the State to tell you, or anyone else, how to comport yourself or others when it comes to dying comfortably.

And you are right, Ace, this issue transcends political part affiliation. This tragic case, may be even more tragic for the population at large.

Sarah W.

I'm pro-choice, non-religious, and believe there should be a right to die. But I think you are way off base here, and letting your dislike of the family and some of the "save Terri" people color your judgement on this situation. To me the right to die doesn't mean getting to starve to death. It means a quick painless death. If she was on a life support machine and this was a simple matter of pulling the plug I'd be with you. But removing someone's feeding tube and letting them waste away? No way. And that's leaving aside all the issues about her husband, and the fact that she didn't have a living will.

SarahW,

An important point,

"Within the testimony, as part of the hypotheticals presented, Schindler family members stated
that even if Theresa had told them of her intention to have artificial nutrition withdrawn, they would not do it.

The issue of "substituted judgment" here, if what is quoted is true, would be violated.

The notion here is that it is not for those left behind to make the decision, rather, they would be speaking and, therefore acting, as if they were the other person, even if that meant they would decide and act in a way contrary to their own mind.

Again, I am not taking sides in the Schiavo debate, as it were, but am troubled to see that the process of difficult and painful medical decision-making, is being conflated with "right-to-life, right-to-die" controversies, and potentially harmed, by persons (ON BOTH SIDES) acting in their own self-interest, and not in Terri Schiavo's.

SarahW,

I confess I had not heard of, or had forgetten, the claim that Terri had made similar no-artificial-life-support statements to Michael's brother and sister-in-law.

However-- look at the chronology and read that first judge's opinion.

Doesn't it seem odd that the first mention of Terri's claimed statements occurred only years after she'd been stricken, with Michael seeking to pull the tube, and with $700,000 remaining in the trust fund?

Doesn't it seem odder still that the brother and sister-in-law reported their claims of similar discussions still later, after a judge had deemed Michael conflicted in interest?

I have no "dislike" of the Schindler family. Their wishes and Terri's, have been determined by the courts to be at odds. THe decisions made have survived every challenge.

I think there is a lot of emotion going on about "starvation" .
In fact, Florida law specifically addresses refusal/withdrawal of artificial nutrition. Persons have a right to refuse or withdraw that treatment, even if it will result in death.

See the comments from the neurologist above about withdrawal of nutrition. Are you not overlaying your own fears about what, as a conscious person, you would feel?

"I think there is a lot of emotion going on about "starvation" "

SarahW, I think you, for whatever reason, have decided to be a troll this morning. I see no other purpose to that comment and being naive I don't believe you find the intentional starvation of a person to be something that can be considered without emotion.

Wuzzadem also has a great take on this:

http://wuzzadem.typepad.com/wuz/2005/03/about_terri_sch.html

There are nearly 50 neurologists out there who think killing Terri is premature.

Ace, battles over Terri began with the settlement of that malpractive lawsuit, it's true.

Doesn't it seem odd that the first mention of Terri's claimed statements occurred only years after she'd been stricken

I don't want to get into the postion of advocating for anything but the fact due process has been given to all the contrary claims made in this case.

However, it does color my view about how "odd" that delay is, that there was hope in the begninning and less hope, and then no hope, later on. A reasonable person might have hope, yet lose hope later on when the prognosis becomes more grimly certain.*

And it is reasonable that if what was sufficient testimony as to Terri's wishes is challenged, that other witness corroboration would be sought/offered.

*M. Schiavo did take Terri to California for some experimental
deep-brain stimulation treatments, and they didn't work.
Doctors revised their opinion of her prognosis the utility of
rehab treaments.

I thank Terri Schiavo for my living will. No one is going to give my husband that kind of grief for yanking my feeding tube when hope of recovery of consciousness is lost.

You know what. I am not even going to bother with SarahW anymore. I don't care what her motives are; the whole subject of what her opinions are just bores me. She drops this emotional stuff in here about Terry Schiavo's parents saying they'd OMGCUTOFFHERARMSNLEGZ and it turns out to be nothing more than saying they'd agree to amputate her limbs in the case that they became gangrenous, not for her being all rebellious and going against her parents wishes and er, yeah, it's "gruesome." Jesus.

As for you, MeTooThen, I do think that just about everyone in North America knows that you feel just awful about this whole thing. Now can we talk about something else besides your feelings?

Brewfan,
I was responding to another comment accusing me of letting emotions about the Schindler family color my views.

That person said "To me the right to die doesn't mean getting to starve to death. It means a quick painless death".

In Florida, the right to die DOES include the right to refuse artificial nutrition. If you think the law should be changed, move to Florida and lobby for change.

And I DO think that some of the reaction to removal of the tube is irrational, if completely human and understandable.

Based on medical opinions I've read, I don't think Terri will suffer what many people assume she will - they imagine what Terri will feel by imagining their own pain and discomfort if they themselves were denied food or water. In Terri's case, I don't think that emotional response lines up with actual reality, which in Terri's case will include palliative mesures, and can not be compared given her own lack of conscious awareness.

I pointed him to the comments of the neurologist above, thinking his words might carry a little more weight that my own medical opinion.

Sarah W.,
"I think there is a lot of emotion going on about "starvation" .
In fact, Florida law specifically addresses refusal/withdrawal of artificial nutrition. Persons have a right to refuse or withdraw that treatment, even if it will result in death.

See the comments from the neurologist above about withdrawal of nutrition. Are you not overlaying your own fears about what, as a conscious person, you would feel?"

"Artificial nutrition?" What kind of semantic nonsense is that? Food/Drink whether it goes in by eating, through an IV into your veins, or thru a feeding tube is all the same thing. If you take it away you are starving/dehydrating the person to death, regardless of what euphemism you wish to employ to conceal this fact. Of course I'm thinking about what a conscious person would feel. Neither you or anyone else knows for certain what she feels in her condition. In the absence of a living will, assuming that a person in her state would rather die by starvation than live with a feeding tube is a huge assumption. Just because you would want your feeding tube yanked in a similar situation in no way means that she would. Her husband, who has already moved on with his life and appears to want her out of the way, is hardly a reliable witness as to her wishes.

SarahW
What is it that hinders you from seeing Michael's motives? He said on videotaped testimony that Terri could feel pain, express discomfort, experience the sensation of falling, causing a willful and obvious concern, during taped testimony for the malpractice suit which he won. Then, money in hand, so to speak, he refused even the most basic care, allowing her to endure suffering, discomfort and physical damage for years, while he would exclaim, "When is that bitch gonna die?" And upon hearing that she was ill, "I'm gonna be rich!" This according to sworn affidavits of two different health care workers, Carla Iyer and Heidi Law.

Would you rather have loving, caring parents making decisions for you or a husband who was currently abusing you? This is the issue in this case. Not right to life or right to die.

Ace, those sick fucks over @ KOS are have a blast with this poor woman. sorry about that.

SarahW
You mentioned that the courts have consistently ruled. You are right. Consistently Judge Greer has ruled in favor of Michael Schiavo. Greer has demonstrated a total disregard for ANY evidence in favor of the Schinders point of view or Terri's life. Greer, in fifteen years has never seen Terri. EVER. He has dismissed the testimony of every witness in favor of Terri's rehabilitation, dismissed the guardian ad litum who said Terri should be rehabilitated and appointed himself guardian ad litum.

Meanwhile, Terri has been kept imprisoned in a room for four and a half years by orders of her estranged husband, who through court order prevented her parents from visiting her for 6 months at one time despite the fact that Terri responds with smiles and laughs at their visits, and according to sworn testimony of neurologist William Hammesfahr (who did a two day examination of Terri), "she totally ignores Michael when he is present in the room, turning away from the sound of his voice".
Put yourself in her place for a moment. Would you want Michael making decisions for you? Would You? He was her husband.

Why would he be so interested in making sure she gets no therapy? Tell me what the motives could be.

Money? Her parents have offered to take on ALL expenses. No, money cannot be his motive.
Morality? A moral duty to see that her wishes are carried out? Morality doesn't live with several other women during his wifes illness. If he is so concerned about keeping his word to Terri, what about the words, "in sickness and in health"?

What motives are left?

The only motive left is destruction of evidence that can be used against him.

Ace:

Thank you for the link to LCM. I have debated whether to post about this on my blog. I try to avoid overt politics there, but you and LCM have helped me to see the bigger picture.

Have a great weekend!

"Artificial nutrition and hydration" is a term commonly employed on both sides of the end-of-life debate to mean artificially supplied food and water. I meant nothing by it, certainlly not that the food or water was artificial.

Thank you, Ace.

SaraW - Very good, thoughtful posts! I agree with you if there is one great benefit to come out of this it will be that millions of Americans are getting Living Wills together so their final days or dealing with their final medical condition will not be hijacked by the Religious Right.

You can see the vehemence of such fanatics in the writings of Brewfan.

It is wise to realize that Schiavo is just a stalking horse for them. They want control of all end of life situations. Even if they have to cut your limbs off to save your life! Give your permanent coma'd body chemotherapy to forestall the cancer that hits in year 42 of your coma to hopefully stretch things out to year 43.

MeTooThen -

From my review of the Court papers, I read no one disputes most or all of her cerebral cortex died and liquified away. They had the CT scans posted showing her damaged brain.

I am not a neurologist like you. But I have to ask.....you state that she is not in a classic vegetative state - but is there any chance that she could ever regain conscious thought without regrowing the cerebral cortex? Has that ever happened? If she did regrow the higher order part of her brain somehow...though I understand this is not how CNS tissue works....say from cloning or stem cell implants.......would it have anything of Terri's memories, personalities, or would it just be empty gray tissue with nothing of Schiavo's imprinted on it?

Anyways, I do thank you for your contributions and informed speculations. Like with SaraW and ACE, it was not written to push an ideology.

ANDREAHARRIS, wrapped up in her own feelings so much that she doesn't understand it - rudely told you to stop discussing your feelings. Sorry, folks like Andrea are highly emotional and praying and so on right now. I think you just gave the facts as you see them.

"They want control of all end of life situations.."

Bwaha! Bwahahahaha! All of your end-of-life decisions are belong to us!

p.s. but don't worry, when its your turn there will be nobody trying to keep your tube in. But thats the consequences of being a sad little troll.

Cedarford:

"From my review of the Court papers, I read no one disputes most or all of her cerebral cortex died and liquified away. They had the CT scans posted showing her damaged brain."

Ask this question: Where is her MRI?

To those new around here I offer some advice. Don't ask cedarTARD questions because he has not the slightest interest in facts. The best you can hope for is some hate filled screed about the religious right, Jews, women, neocons, Chinese, the disabled, etc. etc.

The only thing I've noticed in your frequent exhortations for others to ignore this or that poster, SpewFan, is though this is not your Blog, you presume to try and control it.

There is an easy answer to satisfy your control fantasies on only posters showing your like-mindedness being allowed comment.

Get your own Blog.

That way only the choir you like is allowed to speak.

Bearing Blog -

I also wish that an MRI had been done. But the doctors that examined her all said the CT scan was all they needed to make a diagnosis of massive, irreparable brain damage. The scans clearly showed the cerebral cortex had died from lack of oxygen 15 years ago, rotted, and liquified away.

The cry for an MRI was started by the quack who always introduces himself as "Nobel-nominated"
omitting that real Nobel nominees are blind-nominated, generally not informed unless they win..The quack was nominated by his Congressman for osteopathic medicine "as Christ would approve". Love to see the Nobel folk's reaction when they got a Florida evangelical Congressman's letter.

But the hue and cry went up in the Religious Right that an MRI would prove the Schindler's edited videotape they believe in so much was right. The MRI would find her brain parts.....they must be hiding somewhere!

They should have just done the MRI to satisfy the fence-straddlers. Though her whole head could be completely empty and it wouldn't affect the True Believers one Iota. An MRI is fast and would show the half brain left in even better detail than the CT scans the doctors evaluated as conclusive.

The above post by cedarTARD is all lies. Read the article at NRO linked by Ace. Expert neurologist disagree with the eminent cedarTARD, but once again, lets not let facts get in the way, right cedarTARD.

Great post, Ace. We are all praying for Terri. I am disappointed that the more popular blogs (except for Michelle and Captain) are not flooding their site with posts from this. The folks at polipundit for example need to cancel their weekend plans and at least blog for this girl like they did on election night.

"ANDREAHARRIS, wrapped up in her own feelings so much that she doesn't understand it - rudely told you to stop discussing your feelings. Sorry, folks like Andrea are highly emotional and praying and so on right now. I think you just gave the facts as you see them."

*Stares*

*Yawns*

Andrea Harris,

Huh?

My feelings?

My comments were intended to show that those who are now interested in this case, may cause terrible harm to patients and their families in the future, acting out of their own indulgence, and not out of care for Terri Schiavo.

This case is the worst of all worlds.

A husband whose motives are easily impuned, and a family who reportedly would violate the ethic of "substituted judgment."

Neither is tenable.

Ace's post was intended to bring readers of all political affiliation into this discussion. To this end, I tired to show how this case truly transcends party lines.

How you came to the conclusion that my comments were about my feelings, is strange.

Really.

Is this not the "Comments" section?

Did I stumble into the wrong blog?

I will try again.

Terri Schiavo, is in my opinion, not in a persistent vegetative state. Other neurologists seem to agree.
For what it's worth, an MRI brain, will do little to advance our understanding of Terri's clinical state. She appears to be intermittently conscious, and will likely remain brain injured to some degree, no matter what her brain "looks like." The physical examination and other tests of brain function, e.g., EEG, would be more instructive here.

But in this case, it may not matter as Terri Schiavo's previous statements reportedly made to multiple people, at different times, in opposition against "artificial life-support" have been repeatedly judged to be inclusive to these circumstances, at this time.

Having said that, the failure of the court to come to the correct conclusion as to her medical state, should make everyone concerned that the court incorrectly judged on the other facts, i.e., the suitability of her husband as guardian, and whether or not, Terri's prior statements would be inclusive to her circumstances at this time.

More to the point, the intervention of the legislative branch of government, could prove disastrous for sick and dying patients, their grieving families, and the health care professionals who care for them.

I will say this, if you have ever once had to sit in a family conference, in a hospital chapel, either as a health care professional or family member (or clergy), discussing end-of-life, hospice, or other terminal care for a sick and suffering patient, you know how heart wrenching and difficult these discussions can be.

If you have been in many hundred such discussions, perhaps you would understand that this case is not about your feelings, but rather, the well being of your community and beyond.

And difficult and complex matters such as these are best left to the individuals involved, and neither to the legislature or judiciary.

It will be contentious cases such as this, that may be ruinous for everyone.

"Again, I am not taking sides in the Schiavo debate, as it were, but am troubled to see that the process of difficult and painful medical decision-making, is being conflated with "right-to-life, right-to-die" controversies, and potentially harmed, by persons (ON BOTH SIDES) acting in their own self-interest, and not in Terri Schiavo's.

I thought these comments helped to further others' understanding and that these points were clearly made.

Perhaps not.

Or perhaps you just wanted to be unnecessarily hostile and snarky.

Just sayin'.

Fantastic post... as they say...That which is most personal is most universal...And in this case it really should be about justice and ALL the facts getting out...not just the McStory that has been swallowed for far too long...you know..back when there weren't so many bloggers.....