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An emotional diatribe driven by a media which does not believe in God, therefore believes that this one lifetime existence we all must have is precious. There is also playing out here the culture of victimhood. The Liberals want to give everything to the poor -- and who can be more poor than a dieing person -- so spend the millions of dollars to preserve the "life" of a vegetable. So, on this one the mad-dog media can seem (like the stupid Jesse Jackson) to be on the "side of right" while denying YOUR right to leave a tortured body.
Many "famous figures" are out there, on the wrong side of this issue, including Mel Gibson,
Will The Pope Die Under "Different" Criteria?
As the Pope approaches a state similar to Terri Schiavo, who will make the decision there, to "reduce" the medical care -- they certainly could never admit to "pulling the plug." The Pope, or "someone," in fact, has "been announced" as "refusing the medical treatment" of the hospital, "someone" preferring to be in the Vatican where almost all Popes die! There is absolutely NO difference between Terri and the Pope. (This was written on April 1, 2005, finished in writing just an hour before his death, then published on April 6th. Even the Catholic Church has been taken over by the precepts of psychology.
What is Natural Death? There is NO trauma in it!
Do you have the Right To Die? I hope so, because I sure want it!
What is Life? According to non-believing doctors a "living vegetable" is all it takes.
Karl Note: What no other news source has seen in this
current debate is that "psychology is being used as the criteria!"
Psychology is based on the premise that "man comes from the mud -- and has no
spiritual existence." When that premise is accepted as true, there is no
"life after death."
Even those who loudly proclaim the existence of God, and
Heaven, like Jesse Jackson, have no
clue as to the nature of the soul, or the
spiritual being which is "man." The media, like Jesse, simply
turn on the opinion to suit their evil agenda. There was nothing so
revealing as the so-called Sean Hannity playing cozy with Rev. Jesse over this
ugly affair of the parents who seek only headlines and turmoil for Terri.
Man is a spiritual being occupying a body made of meat. The body dies, the spirit does not. This Schiavo case is, despite the terrible bitterness and perverse nature of the ongoing news coverage, can bring America to finally confront some basic questions about existence:
What is life?
What is death?
Does a person have a right to refuse medical care?
Does a person have a right to trust another to make decisions of this type without the government (courts) insisting that THEY must make the decision?
What is the cost of death?
These are fateful questions -- my own wife, just six months ago, decided that the cancer treatment was so painful that she would rather die than continue. That was not a "pleasant" decision by her, but my love for her includes granting her the right to make that decision, and insisting on that decision being honored if she is not able to advance her cause. It troubles me that some impersonal court could deny her that right to die.
When my wife informed the oncologist, Dr. Karo Arzoo, she would take no more chemotherapy, he had a special certified letter delivered, by overnight mail, indicating that my wife needed psychological counseling because she had made so obviously a poor decision. He is driven by the arrogance of stupidity on matters of life and death.
If you don't have answers to those questions -- answers you are certain about -- it is time to explore alternative philosophies!
Yes, I have an "Advanced Directive" covering my wife, but it was stunning for me to read (below) in the Wall Street Journal that many times "living wills" are ignored by doctors and hospitals.
I have downloaded the California Form from www.caringinfo.org and will be VERY carefully re-doing my own Advanced Directive. I know EXACTLY who I want to speak for me if I cannot, and it is NOT Pres. Bush, any Republican, any Politician, any Court, or ANYONE other than the one I trust! That choice is none of your business! Nor anyone's business!
I can't imagine the type of bitterness in my
family that was revealed in the Schiavo case -- example below.
The polls suggest that the great majority of Americans believe you have a right to die -- it appears to me that many are trying to take that right away from you. Why? Because I don't think they have answers to those above questions -- they don't have a reality that can sell in public -- so if they are "public figures" they figure they have to take the "politically correct" position.
The "politically correct" position is, "No man has the right to kill another being! Even if that person asked for death in extreme circumstances." "Further, no man has the right to FAIL to intervene, if necessary, to prevent another from dieing!"
You may not see it, but these concepts are driven by psychology!
Psychology USED to be "the study (ology)
of the soul (psych)." Many hundreds of
years ago churches gave up trying to understand the "soul" and now pays
lip-service to it while taking in the new form of psychology. That new
form is described in great depth and detail in
my article here.
If YOUR church uses "psychological counseling" then it does not recognize the truth of spirituality. It would be time to find a REAL church.
Psychology still believes, and teaches, that the "mind" is in the brain -- they have no room in their belief system for the spirituality of man, so must find all manner of "brain reasons" why you have a religion or feelings of love. Bosh!
Psychology failed to understand "soul" so started teaching that the soul does not exist -- instead man is considered to be an animal without a soul, a piece of meat that arose from a sea of ammonia. They won't admit this publicly, but that is their core belief.
With this belief they KNOW that man lives but once and thus every minute of that life is precious -- even in a vegetative state! They also KNOW that you are not capable of making important decisions yourself, and that "someone" (the State) must accept responsibility for you -- even to intervene in how you get treated in health and death.
Even most churches have adopted this psychological concept -- paying lip-service to "life in heaven" but acting like "this only life you will ever have is precious -- stretch out every possible second of 'life' because 'God might perform a miracle.' "
When you finally understand that "life" in a human body is a
type of hell -- one to be escaped from -- through a succession of more bodies,
perhaps, until you can be free of the "earthly bonds" that tie you to a body
made of meat -- until you understand that you are stuck with, but can disagree
with, the claim that "you
do not have the right to die!"
Will the great majority of common sense Americans speak out for life as a spiritual existence which is never ended by death?
I hope so!
Watching Schiavo's family fight over her fate on national television -- and learning of her 15 bedridden, tube-fed years -- inspired many Americans to have uncomfortable kitchen-table discussions on how they want to live their final hours and how much they want the government involved in them.
"Those are valuable conversations to have about something that isn't discussed often in our society," said Robert Brody, a professor of medicine at UC San Francisco and chair of the ethics committee at San Francisco General Hospital.
"The most valuable feedback from this is that people are realizing that they have to have a written advance directive and discuss it with their family -- unless they want to have Tom DeLay make that choice for them," said Brody, also a board member of Compassion in Dying, an advocacy group for end-of-life issues. (Source)
One final an vital note: How much money can we afford, as a society to spend on the medical care of people in their last year of life?
Figure 2 [below] shows that in the last 6 months of life most terminal cancer patients (63.5%) received no hospice services. While most cancer patients who used hospice benefits did so only at the very end of life, only 16.1% of patients dying of cancer received hospice services for more than 30 days. (Source)
My own wife had terminal cancer in 2004 and entered a hospice to die. When she was then free of the terrible effect of the radiation and chemotherapy she actually started to recover. Within a few more months she recovered completely and was pronounced "cured" of esophagus cancer. In her case she lived, but the great majority of people with similar types of cancer DO die as expected and very few of them take advantage of hospice care -- the cost of providing acute hospital care to such people is large and growing. Perhaps the true evil here is that so many people continue to put their faith in traditional medicine which, in fact, causes death in these cases. (Hospice care is not allowed, by law, to provide "curative treatments" to a patient. Thus, Hospice care could not include the devastating chemotherapy or radiation which my wife received -- and which would have killed her had she not decided to stop taking it before the end of expected treatments.)
The morals of keeping vegetables alive for decades must give way to the economics, at some point. Morals, of course, must be based on the maximum survival benefit for the maximum number of people. When a culture evolves which spends 20% of the entire Gross Domestic Product on medical care that doesn't truly prolong life or improve quality of life, someone is going to be more willing to "pull the plug," whether patient of public.
Karl Loren
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A
Living Will Won't Guarantee After Josef Weissberg suffered a heart attack in 2001, following a battle with cancer, his son Ted was comforted that his father had prepared a living will. But as Ted soon discovered, a living will can't prevent a loved one from trying to pursue passionate beliefs. When it became clear Josef would die unless doctors intervened, Ted's uncle, Norbert Weissberg, began appealing to doctors to save his brother. "He just couldn't let his brother go," Ted says. At the time, "I was unaware that anyone other than my brother's wife had consented to" the advanced directive, Norbert says. "It wasn't clear to me that the children had given their consent."
In the end, Josef's "do not resuscitate" directive was followed, but "it was a very difficult moment and at the time there was a good deal of anger all away around," says Ted of Brooklyn, N.Y. Since then, the family members have resolved their differences. While living wills detail the type of medical care individuals want in the event they become incapacitated or are near death, it doesn't guarantee that a patient's wishes will be followed. It's not uncommon for family members -- or doctors -- to disagree on the appropriate course of action, which may go against the guidelines in an advance directive. Among the factors that are taken into consideration when deciding on whether to abide by a patient's stated wishes are the prognosis and quality of life, as well as the wishes of family or friends, according to a study from the Loma Linda University Medical Center, in Loma Linda, Calif. "Advance directives are used in decision making, but in practice probably not as absolutely as the document might imply," says Steve Hardin, an assistant professor of medicine who oversaw the study. As a result, families can find themselves battling health-care providers, or each other, amid already devastating emotional anguish. But there are ways to ensure a patient's wishes are followed without resorting to legal battles. This week's Fiscally Fit looks at what family members can do when doctors, or other family members, aren't abiding by or disagree about a patient's last wishes. Going Beyond the Documents Most living wills describe typical scenarios involving catastrophic care, such as whether or not to resuscitate or use life-sustaining technologies. "But because you can't predict what type of illness or injury you'll face, advance directives can be open to interpretation," says Patti Spencer, an attorney who specializes in estate-planning law in Lancaster, Pa. Unfortunately, interpretation can lead to family conflicts, and a situation like the Terri Schiavo case can wind its way through the legal system. "Sometimes, if it's a large family and there are long-standing differences, the loved one's care becomes the catalyst for which to bring those differences to a head," says Barbara Filner, director of the training institute at the National Conflict Resolution Center in San Diego. Instead of working together to resolve the conflict "families end up dealing with each other as enemies," she says. Since advance directives generally don't cover all contingencies, it's critical to name a health-care agent -- a spouse or other family member or friend you designate by health-care proxy or durable power of attorney to make decisions on your behalf if you are incapacitated. The agent should first determine whether health-care providers are aware of the living will, and be sure that its directions are explained to all staffers providing care. The rules for advance directives vary by state. Become incapacitated in Colorado, for example, without designating an agent with a health-care power-of-attorney and by law your doctor is required to round up a committee of "interested family members" to determine who shall make decisions for you, says Albin Renauer, a legal editor at Nolo.com, a Berkeley, Calif., publisher of books and software for nonlawyers. Read more about state rules on advance directives and living wills11. An ombudsman program run by Kaiser Permanente, a health maintenance organization that operates in California and other states, focuses on just this type of conflict in its training courses, says Carole Houk, an attorney and consultant in Alexandria, Va., who oversees the ombudsman-training program for Kaiser in hospitals around the U.S. "We deal with the family conflict in a neutral ombuds setting, where family members and physicians meet and explain everyone's concerns," Ms. Houk says. Many hospitals and nursing homes have ethics committees or ombudsmen on staff to mediate problems. If your hospital doesn't have an ombudsman, families can turn to clergy, a neutral third-party friend, a local family counselor or mediator to help find consensus. Mr. Renauer of Nolo.com says the best way to avoid this kind of conflict is for the drafter of the living will to recognize the potential for conflict within your family, and to make your wishes known to the rest of your family. "If you have a family member who is deeply religious and who may have problems with your desire to forgo life-sustaining care, make sure you make your wishes clear to the person now," he says. "It will save the person you name as your agent a lot of headaches during what will obviously be a very emotional situation." Make Your Loved One's Case If a patient's wishes aren't being followed, the health-care agent should ask the doctor why he or she is taking the course of action. If you still want to, request that the advance directive be followed, says Alan Meisel, professor of law and psychiatry at the University of Pittsburgh School of Law. If the doctor or hospital refuses, obtain copies of the living will and meet with the hospital or nursing home administrator, he says. "It helps to drop 'by law' and 'legally' into the conversation, so the administrator is aware that you know the patient has rights," he says. But be aware that some hospitals base decisions about advance directives on religious beliefs. The U.S. Conference of Catholic Bishops state in its Ethical and Religious Directives for Catholic Health-Care Services12 that its institutions "will not honor an advance directive that is contrary to Catholic teaching," such as an act that would result in death in order to alleviate the patient's suffering or the withholding of food and water. If the health-care provider continues to balk at the patient's wishes, contact your state oversight board and ask that officials intervene on behalf of the patient. Once the state is contacted, it's rare that loved ones will be forced to involve the courts when directives are not being followed, says Mr. Renauer. "In most states, by law, the hospital is required to move a patient to another facility if the doctor or hospital refuses to provide the care as directed by a living will," he says. A Change of Heart Sometimes, it's the patients themselves who decide that their failing health warrants a change in their own advance directives. The desire to have "all heroic measures" taken to save your life may fade after suffering through a protracted, painful illness that drains your loved ones' finances. That can result in a situation where it's just as important for a patient struggling with an illness to make clear to the family members, as well as the health-care providers, about a change of heart. A patient who wants to revoke an advance directive can do so verbally, conveying the decision to the physicians, says Prof. Meisel. However, convincing family members that is your true desire, and the best course of action, can be far more difficult. "In these cases, it's always best to have the original directive destroyed and have the facility draft a document that states you want your living will revoked," he says. Often, in situations like these, where a change in treatment could result in the end happening in hours or days, "people generally are so emotionally distraught that it's tough for family members to make decisions with a clear head," he says. By putting your desire to revoke a living will in writing, you can help to ease your family's suffering by providing proof the decision was your own. * * *Write to me at fiscallyfit@wsj.com13.
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| Copyright 2005 Dow Jones & Company, Inc. All Rights Reserved |
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| This copy
is for your personal, non-commercial use only. Distribution and use of
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If Terri Schiavo had been shot
THE TERRI Schiavo case has struck a raw nerve in America. One would have to be
either dead or numb not to empathize with the sorrow and the agony of her
parents, the Schindlers, and of her reviled husband, Michael.
But we should not be moved by our feelings alone, we also have to use our minds.
The uncontroverted medical testimony is that Terri has been in a “persistent
vegetative state” since 1991.
Yes, she can look you in the eye, smile, move her head, close her eyes but there
is nothing else there. There is no functioning brain that can feel pain or that
can direct orders to any of the muscles.
When she was still conscious, Terri Schiavo told her husband Michael that she
would not want to live in a vegetative state, she did not want to be kept
artificially alive.
Michael relayed his wife’s wishes to her parents who either did not believe him
or did not feel that Terri had the right to make that decision. Since it wasn’t
written down in a living will, it wasn’t worth the paper it wasn’t written on.
For the last seven years, Terri Schiavo’s parents have sought to keep their
daughter alive by whatever means necessary, by prayer, respirator or feeding
tube. Over the years, the parents have been frustrated by the state courts which
have consistently sided with Terri’s husband.
After a state court issued an order on March 18 removing the feeding tube from
Terri Schiavo, the politicians intervened.
The U.S. Congress met in emergency session on March 19 and 20 and passed a bill,
quickly signed into law by President Bush, transferring jurisdiction over Terri
Schiavo from the local state court to the federal court affording Terri’s
parents another shot at obtaining a favorable court ruling after exhausting the
state court process.
But the federal court turned down the Schindler’s motion for a temporary order
to reinsert the feeding tube after the Schindlers could not prove that they
would likely prevail in a court proceeding. The Schindlers then appealed the
Federal Judge’s decision to the 11th Circuit Court of Appeals which affirmed the
lower court’s decision. The U.S. Supreme Court declined to take the matter up on
appeal.
As of Easter Sunday, the
Schindlers have given up on any hope of obtaining a favorable court ruling. The
countdown is now on for Terri’s last breath which may come this week.
But I believe Terri died a long time ago and her soul is already with God. I
believe that what separates human beings from animals or androids is our brain.
It is our ability to think and analyze.
We realize that with modern science, people’s bodies can remain artificially
alive for years, long after the brain stops functioning. But for all practical
purposes, there would be no “life” left in the body even though “it’ still
breathes, once the brain dies.
The most powerful man in the U.S. Congress, Majority Whip Rep. Tom DeLay
(R,Texas) spearheaded the congressional effort to interfere in the Schiavo case
after a Republican strategist had written a confidential memo that was
circulated to the Republican members of Congress: “The pro-life base will be
excited that the Senate is debating this important issue…This is a great
political issue…and this is a tough issue for Democrats.”
In a press conference surrounded by his Republican colleagues, DeLay denounced
Schiavo’s husband, as well as state court judges, for committing what he called
“an act of barbarism” in removing the feeding tube from Terri Schiavo.
But what DeLay advocated
for Schiavo, he did not espouse for his own father.
Like Terri Schiavo, DeLay’s father in 1988 was also severely brain-damaged,
incapable of surviving without medical assistance. Both had similarly expressed
a desire to be spared from being kept alive by artificial means. Like Terri
Schiavo, DeLay’s father also did not have a living will.
But Tom DeLay had no reservations in 1988 about joining in his family’s
unanimous consensus to let his father die.
“Tom knew – we all knew – his father wouldn’t have wanted to live that way,”
recalled Maxine DeLay, the Majority Whip’s 81-year-old widowed mother.
DeLay wasn’t the only hypocrite.
In 1999, then Texas Gov. George W. Bush signed the Advance Directives Act, which
lets a patient’s surrogate make life-ending decisions on his or her behalf. The
law also gives Texas hospitals the right to disconnect patients from
life-sustaining systems if a physician, in consultation with a hospital
bioethics committee, concludes that the patient’s condition is hopeless.
If the Schiavo case had occurred in Texas, her husband would be the legal
decision-maker and, because he and her doctors agreed that she had no hope of
recovery, her feeding tube would be disconnected in Texas.
In the same week that Bush signed the Schiavo bill, a Black mother in Texas was
fighting to keep her critically-ill infant on the breathing tube after the
hospital had disconnected it after determining that continuing life support
would be futile.
The hospital did this with the permission of a judge who followed the Texas law
signed by Bush.
But while Bush had lot to say on the Schiavo case, he had little to say to the
families of the 10 Native American schoolchildren and adults in Red Lake,
Minnesota, who were massacred by Jeff Weise, a Nazi-loving high school student
on March 21, the day after Bush signed the Schiavo bill.
As in Columbine, one student was asked if he believed in God before the
assailant shot him dead.
Bush’s response or non-response was based on his assessment of his core
constituencies. Conservative Christian groups pressured Bush to support the
Schiavo bill, while the National Rifle Association (NRA) and other gun-owner
groups pressured Bush to “minimize the relevance of political responses to mass
shootings”.
“The bottom line is the gun lobby is too important a constituency to the
Republican Party for them to do anything,” observed Kristen Rand, legislative
director of the Violence Policy Center, a gun control advocacy group.
“The sad reality is if Terri Schiavo had been shot, the administration would not
have lifted a finger to help her,” she said.
Send comments to Rodel50@aol.com.
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April 1, 2005 5:59 a.m. EST |
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Pope's Condition Is 'Very Serious'
Catholic Leader Develops High Fever
Brought On by Urinary Infection
Associated Press VATICAN CITY -- Pope John Paul II is in grave condition, the Vatican said Friday, but it said he is lucid and spent the morning celebrating Mass and receiving some top aides. Papal spokesman Joaquin Navarro-Valls, at one point breaking into tears, told reporters that the 84-year-old pope was "informed of the gravity of his situation" and decided to remain in his apartment overlooking St. Peter's Square. "The pope is still lucid, fully conscious and extraordinarily serene," Mr. Navarro-Valls said. He said the pope remained "in very serious condition" with unstable blood pressure. ![[Image]](../../images2/Pope_John-paul04182002224957.gif)
"He is fully conscious about the real gravity of the situation and he asked whether it was strictly necessary to go to the hospital. He has decided to remain'' at the Vatican, the spokesman said. "This is surely an image I have never seen in these 26 years," Mr. Navarro-Valls said. Choking up, he then walked out of the room. The pope suffered heart failure during treatment for a urinary tract infection on Thursday, the Vatican said earlier Friday, but it denied an Italian news report that he was in a coma. The Pope asked aides to read him the biblical passage describing the 14th and final stage of the Way of the Cross -- the path that Christ took to his crucifixion, Mr. Navarro-Valls said. In that stage, according to the Bible, Christ's body was taken down from the cross, wrapped in a linen shroud and placed in his tomb. Mr. Navarro-Valls said the pope followed attentively and made the sign of the cross. The pope's health declined sharply Thursday, when he developed a high fever brought on by the urinary tract infection. The pope's wish to remain in his apartment at the Vatican and not be taken to the hospital was respected, Mr. Navarro-Valls said. He said the Holy See's press room would remain open all night, an unusual step for the Vatican. Thousands of pilgrims gathered on St. Peter's Square to stand vigil for the pope, many tearfully gazing up at his third-floor window, and people around the world joined in prayer. The pope received the sacrament for the sick and dying on Thursday evening, the statement said. Formerly called the last rites, the sacrament is often misunderstood as signaling imminent death. It is performed both for patients at the point of death and for those who are very sick, and it may be repeated. The pontiff was attended to there by the Vatican medical team, and provided with "all the appropriate therapeutic provisions and cardio-respiratory assistance," the Vatican said earlier in a statement. The statement said that the pope was being helped by his personal doctor, two intensive care doctors, a cardiologist, an ear, nose and throat specialist, and two nurses. The Rome daily La Repubblica reported Friday that the sacrament was administered by John Paul's closest aide, Polish Archbishop Stanislaw Dziwisz, who serves as his private secretary. Archbishop Dziwisz had given the pontiff the same sacrament on Feb. 24 just before the pope underwent a tracheotomy to insert a tube in his throat at Gemelli Polyclinic, the newspaper said. Vatican radio said Friday that the pope's condition had stabilized and that he was reacting to treatment with antibiotics. Dr Paolo Nardini, a Rome physician who is not part of the pope's team, said "a heart attack, which is very serious, affects only the heart, while heart failure signals a breakdown of the entire system, basically uncurable." A urinary infection can produce fever and a drop in blood pressure as reported in the pope, said Dr. Marc Siegel, a specialist in internal medicine at the New York University Medical Center. The pope's risk of such an infection is heightened because of his age -- which suggests his prostate is probably enlarged -- debilitated and run down from the illness that recently sent him to the hospital, Dr. Siegel said. Urinary infections tend to respond well to antibiotics, and "I would suspect there's a very good chance he's going to recover well," Dr. Siegel said. Other physicians offered far more guarded assessments, given the pope's overall condition. The pope was hospitalized twice last month following two breathing crises and a tube was placed in his throat to help him breathe. When he appeared at his apartment window Wednesday to bless pilgrims in St. Peter's Square, he managed to utter only a rasp. Later that day, the Vatican announced he had been fitted with a feeding tube in his nose to help boost his nutritional intake. The use of the feeding tube illustrates a key point of Roman Catholic policy the pope has proclaimed: It is morally necessary to give patients food and water, no matter their condition. As Parkinson's disease and other ailments have left him increasingly frail, the pope has been emphasizing that the chronically ill, "prisoners of their condition ... retain their human dignity in all its fullness." The Vatican's attitude to the chronically ill has been apparent in its bitter condemnation of a judge's order two weeks ago to remove a feeding tube from Terri Schiavo, the severely brain-damaged woman who died Thursday. Vatican Cardinal Jose Saraiva Martins, reacting to Ms. Schiavo's death, denounced the removal of her feeding tube as "an attack against God." Although different, some see parallels in the two cases. Under Pope John Paul, Vatican teaching on the final stages of life includes a firm rejection of euthanasia, insistence on treatments that help people bear ailments with dignity and encouragement of research to enhance and prolong life. A 1980 Vatican document makes the distinction between "proportionate" and "disproportionate" means of prolonging life. While it gives room for refusal of some forms of aggressive medical intervention for terminally ill patients, it insists that "normal care" must not be interrupted. The pope set down exactly what that meant in a speech last year to an international conference on treatments for patients in a so-called persistent vegetative state. "I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory." Pope John Paul II's 26-year papacy has been marked by its call to value the aged and to respect the sick, subjects the pope has turned to as he battles Parkinson's disease and crippling knee and hip ailments. It is not clear who would be empowered to make medical decisions for an unconscious pope. The pope has no close relatives, but the Vatican has officially declined to comment whether the pope has left written instructions. Copyright © 2005 Associated Press
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ARZOO KARO K Address: 2601 W ALAMEDA AVE STE 210 |
IMPACT ORDEAL'S END
A very public death prompts many to have very private discussions
- Joe Garofoli, Chronicle Staff Writer
Friday, April 1, 2005
The morality play that swirled around Terri Schiavo's final weeks touched many who watched her life unwind on the 24-hour news cycle, from ordinary folks who shuddered at their own future foreshadowed in the Florida woman's helpless visage to politicians who trumpeted Schiavo as the tragic human by-product of "activist judges."While President Bush and conservative Rep. Tom DeLay, R-Texas, thrust Schiavo's story into the national spotlight two weeks ago with an extraordinary interruption of their Easter recess to call for federal action on her behalf, Schiavo's legacy may ultimately transcend political partisanship and the nation's ongoing culture wars.
Watching Schiavo's family fight over her fate on national television -- and learning of her 15 bedridden, tube-fed years -- inspired many Americans to have uncomfortable kitchen-table discussions on how they want to live their final hours and how much they want the government involved in them.
"Those are valuable conversations to have about something that isn't discussed often in our society," said Robert Brody, a professor of medicine at UC San Francisco and chair of the ethics committee at San Francisco General Hospital.
"The most valuable feedback from this is that people are realizing that they have to have a written advance directive and discuss it with their family -- unless they want to have Tom DeLay make that choice for them," said Brody, also a board member of Compassion in Dying, an advocacy group for end-of-life issues.
Those conversations resounded especially among older members of the country's massive Baby Boom generation, a bloc that is beginning to face its own mortality issues. Requests for advance directives soared, said Boyd and others, as people even circulated boiler-plate directives to friends and family on the Internet.
"People saw their own vulnerability in (Schiavo)," said Katherine Schlaerth, a Los Angeles geriatrician. "People see the demographic changes occurring in their future, and lot of older people feel very vulnerable. Some people saw that and didn't want live their life being fed through a tube."
Oakland Mayor Jerry Brown said Thursday that Schiavo's case provoked challenging questions about how "the medical-industrial complex is prolonging -- with extraordinary technology -- life beyond what any person at the time of Christ, let alone 50 years ago, could have imagined.
"It's a profound distortion to be taking these extraordinary technologies -- that have their place -- and then have government mandating them in a one-size-fits-all form for everyone who is facing the end of their life," Brown, a former seminarian, said on KGO-Radio on Thursday.
That decision "is not something that belongs to the doctors. It doesn't belong to the state. It doesn't belong to the president. For believers, we think it belongs to God. We shouldn't be calling in the technocrats to prolong what maybe isn't their business," Brown said.
Keeping government out of death decisions seems unlikely, at least in the near-term, as politicians will continue to sculpt Schiavo's life -- and now death -- to suit their own political perspective, said David Davenport, a professor of public policy at Pepperdine University and research fellow at the Hoover Institution at Stanford University.
Despite most polls showing that a huge majority of Americans -- more than 8 in 10 according to one poll -- said that government should not become involved in such private matters, Davenport predicted that Congress will continue to push for legislative solutions.
"What this case pointed out was that there are no federal laws on the books that gave Congress anything to act upon here," Davenport said. "There will be people who will try to address that."
That desire has its roots in the evangelical Christian community, which overwhelmingly supported Bush's re-election last fall and has helped build Republican majorities in Congress.
Evangelicals connected to the Schiavo case as it evolved into a round-the-clock crusade, with Schiavo as the human face for what Bush and other conservatives have called a "culture of life." It's a phrase which liberals question coming from Bush, who presided over dozens of executions as governor of Texas, and started the war in Iraq, which has killed thousands of U.S. soldiers and Iraqi civilians.
Minutes after Schiavo died Thursday, Bush urged "all those who honor Terri Schiavo to continue to work to build a culture of life, where all Americans are welcomed and valued and protected, especially those who live at the mercy of others.
"The essence of civilization is that the strong have a duty to protect the weak," Bush said. "In cases where there are serious doubts and questions, the presumption should be in the favor of life."
Efforts in Congress to take on the judiciary will be supported by a number of conservative combatants, including Jim Backlin, vice president of legislative affairs for the Christian Coalition.
Backlin said his group will use the case to argue for Congress and state legislatures to reduce the power of what he termed "activist judges," and leave politicians to determine the outcome of these kinds of cases.
"It was just so frustrating from our side to see the nonresponsiveness of the judiciary," said Backlin. "It just seems that, with the exception of two of the judges, the 20 judges or so involved in this didn't seem to reflect any common sense."
Randall Terry, the anti-abortion activist who had acted as a spokesman for the Schindler family, said the "tragedy and the injustice of Terri's death could be the impetus for hundreds of thousands of Americans and Floridians to reform the judiciary."
But not all religious people were of the same mind.
Bob Edgar, a Methodist minister and general secretary of the National Council of Churches, a progressive religious group, said the case provided a powerful lesson -- that Congress and politicians have no business getting involved at all.
He argued that the "international media circus" that blew up around the case stole the family's dignity, and that it became a convenient tool for the right.
"I think it's an absolutely absurd use of inappropriate political and conservative religious power to exploit an issue and a family for their gain," said Edgar, a former six-term congressman.
Without uttering a sentence, Schiavo scrambled the usual American political lineups. The Rev. Jesse Jackson found himself aligned with DeLay in taking up Schiavo's cause, although Jackson pointed out that he traveled to Florida for different reasons. "I was there as a minister," Jackson told The Chronicle Thursday.
Jackson pointed out that Schiavo was fortunate enough to have good medical care -- something many Americans don't have.
"There is a Terri in every congressional district," Jackson said. "I would hope that Congress uses this occasion to look at Medicare, Medicaid and provide the proper allocations for the health care system.
"It can't be just about Terri," Jackson said. Then, drawing on his civil rights past, he said, "You can't just support Rosa Parks and not support equal access to public accommodations."
San Franciscan Fran Johns hopes that the issue remains in the spotlight when the case stops being a cable news staple.
Next month, the author of "Dying Unafraid" and steering committee member of the Bay Area Network for End-of-Life Care will hold a seminar on creating advance directives.
Said Johns, "I hope people don't forget about all this by then."
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URL: http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/04/01/ASSESS.TMP
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Schiavo Case Underscores
Importance, and Limitations,
Of Having a Living Will
By ANDREA PETERSEN and RACHEL EMMA
SILVERMAN
Staff Reporters of THE WALL STREET JOURNAL
March 22, 2005; Page D1
As the case of Terri Schiavo, the severely brain-damaged Florida woman, winds its way through the courts, doctors and patient advocates are calling on people to create living wills, documents that detail the kind of medical care they would want in case they can't voice their own wishes.
Some doctors say living wills are only a good start. They can't cover all of the potential what-ifs and medical gray areas that can arise. Also, some recent research shows that doctors won't follow them to the letter. In a study published last year in the Archives of Internal Medicine, doctors were asked to consider six hypothetical medical cases. Overall, 65% of the decisions the doctors made were contrary to patients' advance directives.
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"Living wills don't reflect the complexity of the decisions," says Nancy N. Dubler, director of the division of bioethics at Montefiore Medical Center in New York.
Ms. Dubler recalls a patient at Montefiore who had a living will that stated that she didn't want to be put on a ventilator to help her breathe. The woman's daughter, however, wanted her to continue with the treatment. While the patient did have serious dementia, she was expected to recover. The hospital gave greater weight to the woman's prognosis and her daughter's wishes and decided to give the woman a ventilator. She did recover and lived for another two years.
Living wills are still important, however, especially since they can communicate your feelings about what kind of life is worth living to your family. It can be critical if family members don't agree on your treatment, as has been the case with Terri Schiavo; her husband has requested to have her feeding tube removed, while her parents have sought to keep her alive in a protracted legal battle. A U.S. District Judge in Florida said Monday that he wouldn't rule immediately on Ms. Schiavo's parents' request for an emergency injunction to keep her fed.
![[Schiavo]](../../images2/PJ-AE483_pjHEALTH03212005171340.jpg) Protesters in Florida who are against the removal of Terri Schiavo's feeding tube. |
Gretchen Brown, president and chief executive at Hospice of the Bluegrass in Lexington, Ky., says she has seen living wills convince families to stop futile treatment. Often it is out-of-town loved ones who initially are adamant about continuing therapies. "Someone remembers that the last time they saw Mom she was getting around and making pies," Ms. Brown says. "If you have a person's advance directive, there's no doubt."
Doctors say the more important decision, however, is creating a health-care-proxy or power-of-attorney document. This designates a person, such as a spouse or trusted friend, who can legally act as your agent, making medical decisions for you if you are incapacitated. Still, most Americans haven't done this. In a 2003 survey conducted by AARP, only two in five adults age 45 or older had a durable power of attorney for health-care decisions.
"The best thing you can do is designate on paper a surrogate decision maker," says Mitchell Levy, director of the medical intensive-care unit at Rhode Island Hospital in Providence. "I talk to my spouse, my significant other, my mother, and I give that person a sense of what I would want."
An advance medical directive typically includes both a health-care proxy and a living will. The living-will portion "spells out what you want or don't want when you are seriously ill and likely to die," says Charles Sabatino, assistant director of the American Bar Association's Commission on Law and Aging, Washington.
The laws governing these documents vary by state, including rules about who can and cannot be a witness when the documents are signed. For instance, New York requires two witnesses for health-care-proxy documents -- but the person you have named as your health-care agent or backup agent can't be one of them, says New York lawyer Bernard Krooks. (See some examples4 of state regulations on advance medical directives.)
Health-care-directive documents are generally available through hospitals or state medical associations, and the particulars vary. Some forms simply ask if a person does or doesn't want life-prolonging treatment if he or she is considered terminal or unlikely to regain consciousness. Some ask whether a person would want specific life-prolonging treatments, including ventilators, artificial nutrition, kidney dialysis and artificial resuscitation.
Before signing the documents, it is smart to check with a lawyer to make sure you know the proper witnessing requirements and that the document clearly expresses your wishes. Many people have religious considerations about end-of-life decisions or organ donations, for instance, that might not be reflected in a generic state form. Beginning April 1, the National Hospice & Palliative Care Organization will have all state forms available at the Web site www.caringinfo.org .
[Karl Note: I have downloaded the California Form from www.caringinfo.org and will be VERY carefully re-doing my own Advanced Directive. I know EXACTLY who I want to speak for me if I cannot, and it is NOT Pres. Bush, any Republican, any Politician, any Court, or ANYONE other than the one I trust!]
Sometimes the directives can contain nonmedical instructions. Stuart Zimring, president of the National Academy of Elder Law Attorneys, and a North Hollywood, Calif., lawyer, says some of his clients have had "specific instructions regarding grooming and fresh flowers in their rooms, and certain kinds of music being played," he says. He also talks with clients about whether they would want to take part in experimental procedures.
If you have homes in multiple states, check with your lawyer to make sure your medical directives comply with laws in all those states. Be sure your agent has authorization to access medical records under the Health Insurance Portability and Accountability Act (HIPAA).
Once the documents are signed, give copies to your doctors, your hospital, your agent -- and backup agent -- and other family members or close confidantes. Make sure to sit down and talk about your wishes with the person you have named as your agent, lawyers say.
Doctors encourage people to periodically refresh their health-care directives. If your health-care proxy dies, gets sick or moves away, you will need to designate someone else. Living wills also need to take into account medical advances that can turn what once was a terminal or irreversible condition into something treatable.
Tara Parker-Pope is on book leave, but still answers questions in Health Mailbox7.
• E-mail healthjournal@wsj.com8.|
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There has been derogatory, but intriguing rumor that the Pope, during a time of such poor health that an American Court might have found him "incompetent" to make such decisions -- during such time might appoint some Cardinals who would help sway the election of the next Pope in whatever direction the Pope wanted! Seems that there was truth to the issue of "recent" appointments, but not new Cardinals.
New bishops are appointedVATICAN CITY: The Vatican announced the appointment of a swathe of new bishops and archbishops as well as four papal envoys yesterday as Pope John Paul II hovered near death. The announcement bears the Pope's signature and were made at various times during March before the pontiff's health suddenly deteriorated. The 12 appointments will have no bearing on the election of his successor as they do not involve any cardinals, who alone sit in the conclave that elects the next head of the Roman Catholic Church. (source)
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Figure 2 shows that in the last 6 months of life most terminal cancer patients (63.5%) received no hospice services. While most cancer patients who used hospice benefits did so only at the very end of life, only 16.1% of patients dying of cancer received hospice services for more than 30 days. (Full Report)
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1
"Passion
of the Christ" producer-director Mel Gibson is blasting St.
Petersburg, Fla., Bishop Robert Lynch for "being quite
indifferent" to the plight of Terri Schiavo.