Or at least it should have been.

The Guardian Ad Litem appointed as a result of Governor Jeb Bush's intervention in this case filed a lengthy and extensive report. It is worth a read by anyone who has an opinion in this case.

I submit that it carries more weight and validity than the winger radio hearsay that Larry has been spreading (and fabricating) of late.

The GAL is obviously qualified, unbiased, and thorough.

Exerpt....

A particularly disarming aspect of persons diagnosed with persistent vegetative state is that they have waking and sleeping cycles. When awake, their eyes are often open, they make noises, they appear to track movement, they respond to deep pain, and appear startled by loud noises. Further, because the autonomic nervous system those brain related functions are not affected, they can often breathe (without a respirator) and swallow (saliva). But there is no purposeful, reproducible, interactive, awareness. There is some controversy within the scientific medical literature regarding the characterization and diagnosis of persons in a persistent vegetative state. Highly competent, scientifically based physicians using recognized measures and standards have deduced, within a high degree of medical certainty, that Theresa is in a persistent vegetative state. This evidence is compelling.

Terri is a living, breathing human being. When awake, she sometimes groans, makes noises that emulate laughter or crying, and may appear to track movement. But the scientific medical literature and the reports this GAL obtained from highly respected neuro-science researchers indicate that these activities are common and characteristic of persons in a persistent vegetative state.

In the month during which the GAL conducted research, interviews and compiled information, he sought to visit with Theresa as often as possible, sometimes daily, and sometimes, more than once each day. During that time, the GAL was not able to independently determine that there were consistent, repetitive, intentional, reproducible interactive and aware activities. When Theresa's mother and father were asked to join the GAL, there was no success in eliciting specific responses. Hours of observed video tape recordings of Theresa offer little objective insight about her awareness and interactive behaviors. There are instances where she appears to respond specifically to her mother. But these are not repetitive or consistent. There were instances during the GAL's visits, when responses seemed possible, but they were not consistent in any way.


And link.....


GAL REPORT HERE


but then of course Larry says GAL reports are worthless and that he would be in a far better postition to decide....

jf


What do YOU think?

Really...this is worth reading. This guy is not a wingnut.

jf

Did you read the findings of the ORIGINAL GAL I posted earlier?

Yes, and I find nothing inconsistent.

jf

Nor did I.

Perhaps the fact that he recommended the feeding tube should not be removed?

The GAL is obviously qualified, unbiased, and thorough.[/b]

Is he unbiased? If you had cable TV so you could keep up with current events you'd know that one news story tonight dealt with just this issue, and it seems there is reasonable doubt as to whether the GAL was all that unbiased. A lot has come to light since then to cause one to doubt his thoroughness as well.

ROTFLMAO!!!!

This is a joke, isn't it Larry?

We have had years of litigation, extensive objective investigation, more legal and medical evidence presented than most trials get when any and all legitimate evidence could have and was introduced by all parties involved, the laws of the State of Florida fully followed and enforced, the spectacle of this being sent by special legislation to the federal courts who were supposed to save the day but the first ruling to come out says enough has been done....

And none of this matters and none of the evidence means anything because cable TV has found the truth!

And Larry, shame on you! You don't even tell us which network or show was able to see what everyone else has missed.

Forgive me for laughing, but your comment is simply too ludicrous to bring any other reaction.

No comment on the case at hand. I will just say that as a scientist/engineer, I am always amazed how frequently scientific "truths" fall apart.

It is my opinion in general that the only time life sustaining technologies should be removed is when the person in question has stipulated it, or a health care proxy has delegated the decision.

Word of mouth or heresay does not cut it. Get your living wills in place folks.

Unless the judge determined otherwise by "clear and convincing" evidence.

jf

"it seems there is reasonable doubt as to whether the GAL was all that unbiased. A lot has come to light since then to cause one to doubt his thoroughness as well."

Not at all surprising that the "keep Terri alive at all costs" faction would start to challenge the independence, integrity, and professionalism of the guardian ad litem. They have to do something to discredit him, because his report is pretty damn strong evidence of Terri's condition.

What you've said above is nothing more than innuendo, Larry. Do you have anything more on that, or are they simply spurious allegations that aren't rooted in fact? What is the "reasonable doubt" about the GAL's independence based on? What "lot" has come to light to cast doubt on his thoroughness? Please be specific, otherwise there's no way to attach any importance to those unsubstantiated statements.

For someone who claims that he's open-minded on this issue, you are repeating (without substantiation) a lot of things from one side of the debate, yet nothing from the other. It leads one to wonder how open-minded you really are.

With the appeals court having now ruled, I hope those who claimed they would accept the ruling of the federal Courts will now do so, that her husband, parents and family now focus on spending time with her as her return to God draws near and that AM radio and all the politicians and political activists stop exploiting all of them and give them the privacy they need and deserve.

If we need to have a national discussion on the issue of when to remove life support, let us wait a few weeks out of respect for Ms. Schiavo and her family and then have the discussion.

It is time to place Ms. Schiavo in the hands of God and let her rest.

I think an appeal to the US Supreme Court is inevitable. And remember, this ruling is only on the issue of the TRO (temprorary restraining order) to have the feeding tube reinserted. The ruling on the underlying case is still to come, although it may be moot by the time it is done.

I heard on the news this morning that Terri's parents are now hoping that the Florida Legislature will pass a bill outlawing generally the removal of nutrition and hydration from patients in a persistent vegetative state. Apparently, a similar measure fell short by just one vote previously.

jf

Let's hope not.

But I have heard there are two laws making their way through the Florida Legislature. One is the one you mention, Jack. The other would appoint Jeb Bush her guardian so he can make all decisions.

My elder law listserve with 3,000+ suscribers is abuzz with discussion on this case. Of interest is the fact that among this national group of elder law attorneys - probably the most compassionate group of attorneys you'll ever find, they *all* speak in favor of allowing Ms. Schiavo a dignified death. Several posted about their own personal experieces with removal of gastro-feeding tubes from family members and the peaceful deaths that ensued. There is also a blurb from a gerintologist underscoring the excruciating exsistence that Ms. Schiavo has while being forcibly sustained.

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*
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I just wanted to echo what Betsy and Christine wrote. My mother passed = away last year. We made the difficult decision to withhold a feeding tube = when my mother could no longer take food or liquid. We knew that she did not want artificial nutrition and hydration. She did have an advance = directive. She passed away without pain or suffering and under hospice care. Medication was available though it was evident that she could no longer "feel" anything. There was no longer that cognitive ability. She slept through the last few days pretty much as she had slept through days = before feeding stopped. Having been with my mother during those days, I am comfortable in saying that she did not "starve" or "suffer".

I hate "me-too" posts. But I hope this adds to the discussion. My = mother died in 1996. I was fortunate to spend the last week with her and = to be with her at her death. She had an advance medical directive that = directed the continuation of nutrition and hydration until death. It = also provided for comfort care and the administration of pain = medication. She had discussed the subject of nutrition and hydration = with me frequently in the years prior to her death. She was adamant that = she did not want food or water withdrawn under any circumstances. = However, she also made it very plain that she did not want to be in pain = or feel any discomfort. Mom had a feeding tube in her stomach during her last week. As I sat = with her, I noticed that at times she had difficulty breathing and = seemed to be in some discomfort. In discussing this with the nurses at = the facility, they said it was due to the inability of mom's body to = process all of the nutritional and hydrating fluids passing into her = through the feeding tube. The fluids were backing up into her lungs. = They said they would reduce the flow of the fluids and this would ease = her discomfort. Sure enough after the flow of the fluids were reduced, = mom's discomfort subsided. Later in the week, mom again began to bloat = and to exhibit signs of significant discomfort. The day before mom = died, the nutritional fluids were withdrawn because of the discomfort = they were causing. This caused me a great deal of anxiety because I = wanted to honor mom's wishes. On the other hand, I did not want her to = continue with the discomfort. The day of mom's death, the medical staff = came to me and recommended that the hydrating fluids also be withdrawn. = This put me into an emotional crisis that to this day is troubling. Mom = was drowning in the fluid backing up into her lungs. Her body had = totally shut down and was unable to process the fluids going into her = through the feeding tube. After a lengthy talk with the head of nurses, = frantic efforts to reach my siblings (to no avail), and a lot of = soul-searching prayer, I authorized the withdrawal. Within a half-hour = of the withdrawal of all fluids, mom began to rest peacefully. She was = no long in respiratory distress. Later in the day, there were times when I thought mom would die at = any moment. But she held on, with no apparent discomfort. That evening, = within 20 minutes of the arrival of my siblings, mom died peacefully. = She had been without nutritional fluids for less than 36 hours and = hydration for less than 12 hours. She did not starve or lack for fluid. = Her body simply failed. There are certain lessons I learned from the experience and which I = share with my clients when discussing advance medical directives. For = example, the importance of having "the talk" with family, the utility = and good that can flow from writing down last wishes, the conflicts that = may arise between two equally important final wishes when the time = comes, how medical conditions (anticipated and unanticipated) may impact = upon the ability of family to totally honor all final wishes, and the = ultimate futility of wanting to have total control at the end. Life is important. But we all will face death someday. Hopefully I = will do so with as much grace as my mother. Death is difficult enough = for family and friends who remain. It should not be politicalized. This post may have been more cathartic for me than informative for = you. If so, please accept my apologies. But I do hope it contributes to


Thank you Betsy. Your message confirmed everything that I have = learned about end of life including living through my own father's last days = after the decision was made to withhold nutrition and hydration. We have = learned from people who went on hunger strikes that starvation is not an = unpleasant experience after the first couple of days. When I first got into this business, I was told that continuing hydration was the more "humane" = option. That is no longer what medical professionals whom I respect without qualification are saying. In fact, I now understand that continuing hydration after systems begin to shut down is an incredibly difficult = way to die. I will spare you the graphic details. Suffice it to say that = it is not something that I would want to experience.

Thank you for the posts. Only people that have "been there and done that" really understand. Having litigated the first "right to die' case in Michigan, I am lucky enough to have not had to "make the decision" ( although my wife has had to twice--both her parents). It is not an easy or enjoyable position to be in. It is one in which the government does not belong. From your post it certainly sounds as if your mother was very wise-- she did her best to relieve you of a terrible burden -- by expressing her wishes to you, and you with honor and dignity carried them out.

For your group's consideration... For the record, I am appalled at the concept of Federal officials stopping work to "save" a patient who has languished in a persistent vegetative state for 15 years. Creating a new law for a single patient seems foolish beyond belief and potentially creates a moral and ethical dilemma for every family and health professional caring for a vegetative patient who is too profoundly impaired to ingest nutrition and has virtually no hope of improvement. As an expert in the care of people affected by Alzheimer's disease, I worry that this legislation will impact my patients' families right to choose whether or not to feed parenterally. The notion that the legislators are preventing suffering is ludicrous. With the pictures of Terri Shiavo pleasantly backlit; pink, cleaned, and brushed; body conveniently covered, we are kidding ourselves about the reality of a persistent vegetative state. It is not a pleasant dreamlike state. It is a constantly painful hell. Take a closer look. See Ms. Shiavo's hand contracted and curled about a hand board? It is "frozen" that way, contracted and painful. Her other hand, arms, and legs are contracted in much the same way. The reason for this is because the damaged brain produces what we call "upper motor neuron damage," producing crippling, ever advancing painful muscle spasms until the person is twisted into a painful fetal position, skin tightly stretched over the contorted limbs. You can not relax the joints enough to clean the skin. The palms of her hands can not be adequately cleaned or her nails cut-- which tend to grow down piercing her palms.. Look at Ms. Shiavo's head. Her neck demonstrates more crippling painful spasms. Imagine your entire body twisted into painful these unremitting spasms. Now imagine her lying in bed, her twisted body making positioning extremely difficult. Wherever there is a bony prominence such as her heels, knees, elbows, spine, shoulders, ears, there is the potential for painful skin breakdown. Preventing this breakdown is close to impossible, taking special beds, frequent painful turning. Moreover, she must be incontinent of urine and feces, thus must lie in excrement at least daily or have her feces manually removed. She probably has a urinary catheter, very uncomfortable. Both the urinary catheter and gastrostomy tubes are sources of continuing infections. The information we have on cessation of food and fluid is that after 24-48 hours suffering ceases. Ms. Shiavo is in a hospice, where it is most certain she will be given morphine for any pain or agitation. Her death would most certainly involve less suffering than her continued life. One can not fathom the depth of the anguish of Ms. Shiavo's parents and husband. They lost their daughter to an eating disorder and have been living in a terrible limbo ever since. Clearly the permanence of her death would replace their last shreds of denial with additional guilt. In my opinion, Ms. Shiavo's parents do not need legislators at this time. They need competent skilled grief counselors to help them face their loss so that Ms. Shiavo's awful suffering might be allowed to end.

Geri R. Hall, PhD, ARNP, CNS, FAAN Professor and Gerontological Advanced Practice Nurse University of Iowa

Raise your hand if you want to live in a society where dumbos in Washington think they have the right to invade your family and make life and death decisions for you. I am not talking about the dumbos drafting laws making kidnapping illegal, making hijacking illegal, etc. I don't want them having a say as to whether my wife can terminate a pregnancy, having a say as to whether I can make life and death decisions for MY family, etc. These dumbos scream about the sanctity of marriage, but then when they don't like a particular result, attempt to write laws that are "result" oriented, rather then taking the time to understand what's right and wrong. Of course this case is a tragedy, but that doesn't change the fact they these dumbos have no moral right to do what they did.

Good post Kathy... I watched my mother in law die recently.. While she was still lucid she begged me to kill her.. begged me -"You are the only one who can do it..PLEASE". She had Parkinson's and was often in pain.. couldn't move, had to be fed and changed... for months and months and months.. Her muscles were contracted. When she quit eating and drinking, the hospice nurse gave her some morphine and her body relaxed - she was able to lie on her back and her grimace faded... anyway - my point is that I know she did not want to continue living and many would chose death over the prolonged suffering of continued life.

Let us remember that the political posturings of this dicussion serve a purpose.. As much as we do not want the government to be able to mandate our private decisions, we also do not want a government that would allow the fickle disregard of human life.

apple: "we also do not want a government that would allow the fickle disregard of human life."

Some think that the actions of Bush and co show a fickle disregard for human dignity. The original court proceedings over the last 14 years show no such disregard towards Terri's life. This whole farce is just a ploy by the anti-abortion crowd, and one that is backfiring because it is inhumane what Bush and co are doing to this poor woman.

oh please... you know what I mean

You don't want your own self discarded when you can no longer contribute and we as a society decide we can no longer afford to maintain the disabled. Why discount that?. It is in all our interests that such decisions are made.

Zowie!

I just read this morning's appellate court decision. It ought to be required reading for those who complain about judges legislating from the bench.

To boil it way down, two justices agreed with the lower court that an injunction was inappropriate because the parents showed no "substantial likelihood of success on the merits." No big surprise.

But they also dealt with something called the "All Writs Act." This is, to paraphrase, a piece of legislation that allows an appellate court to issue an order in an extraordinary case to achieve some result in the interest of justice. Talk about a blank check for the exercise of unfettered power!

The appellate courts could take the All Writs Act and run with it, making all sorts of orders at their discretion. No, instead the appellate courts in the Fourth Circuit themselves decided not to run wild. They use the Act only rarely, and they don't allow litigants to sidestep the traditional requirements for an entitlement to injunctive relief.

Two justices didn't make a power grab. Good on them!

Oh, and one more thing. You know who really doomed the parents' case? Bill Frist.

The parents were arguing on appeal that Congress intended to require the federal courts to order the insertion of the feeding tube. The appellate court disagreed, saying that Congress expressly declined to include such a provision in the law. Based on the words of Dr. Frist.

Bill, Bill, Bill. Never assume.

Appellate Decision

Kluurs,

None of us know the whole story, none of us have a say in this one way or the other. But there *is* something that has come out of this that I want to talk about, and that's the way some of the lawyers here have acted.

The elements of this discussion are legal, moral, and to some, political. Any time the moral issues in this case were mentioned, the lawyers went into a frenzy. All they seemed to think that mattered was "the rule of law". That's scary. Oh, they loved to discuss the political aspects of it too, as long as it was a discussion bashing republicans and conservatives. If there was any push back on that part of things by the conservatives it was so weak and in such small quantity that it left no impression.

Jack, you in particular have been shameless in the way you have participated in this discussion, considering all the threads on this topic as a whole. Never mind the fact that every single point I brought up dealt with the moral issues of the case, and that every single thing I brought up was reported on major news outlets, never mind that this was pointed out to you on numerous occasions, you just can't stop taking jabs at me accusing me of being a fanatic who gets his information from "right wing nutbob" sources like the trash you dug up, something you did purposely to paint your opposition with.

Some who aren't lawyers showed their *** as well, such as RZ. The smug feeling of superiority that is this guy permeates every post he wrote like skunk smell. The lawyers are guilty of it too.

The "rule of law" has apparently won, and the moral issues have been stamped out of the equation as a result. Before you lawyers who seem to worship at the altar of legalese start thumping your chests too hard, take the time to read the opinion of the one judge who voted to have the tube put back. Then remember that 3 men made the decision, meaning that it all came down to one man's decision. And he could have easily voted the other way which would have meant that my "side" would have won, and this discussion would be on a totally different track than it is.

Furing the course of this discussion I have focused on the moral issue involved. If you go back and read the threads you'll find that I even switched my opinion at one point and agreed with you. But none of you smug lawyers ever noticed that, did you? Of course not. All you wanted to do was paint me as some kind of ignorant fanatic conservative bible thumping nutcase - and you just couldn't contain your built in belief that you, and your opinions, are superior to those who disagree with you.

I've got news for you. You've asked before why people view lawyers as lower than a used car salesman - you have all just given us a prime example of why that is. You fight dirty, every one of you believe that because you have a law degree that you are superior to others, and when the chips are down, the only side of things that matters to you is the legal wranglings of things.

I do not get my information from "winger" nutbob websites. Jack seems to be the only one who spent time digging those up. What really bothers a couple of you is that I wanted to talk about the moral issues involved, and to you that apparently is subordinate to the law. That's a sad way of looking at this world. All I have ever suggested, and all *most* of the people who think the feeding tube should be replaced have suggested, is that the issues that have made the news as of late should be investigated, and the woman needs to be alive for that to happen. All "my side" has asked is that the woman be given an MRI or a CT scan, to see if there's any merit to the arguments made that she *can* be rehabilitated. All we see from *your* side is a rush to let her die.

What I have taken away from this discussion is a clear picture of how some liberals and most lawyers honestly believe they are superior to others, and that the "rule of law" trumps moral issues. That's why, in my opinion, you lawyers are considered by so many to be such low life snakes - you look at issues that matter to people through a narrow lens that only captures the practice of law, any other issues outside of that such as the life of the person you may be deciding, morals, those issues - take a back seat to your black and white world of legalese, and you do it with the most disgusting air of superiority.

My only issue with this whole thing - she should have been fed at least long enough for the scans to be done (none have ever been done) for those medical professionals who claim she *can* be rehabilitated to work with her at least long enough to establish whether or not they are actually right in their claims, and then if after that she didn't improve, *then* let her die. Had they done this I wouldn't have a single issue with letting her die. But we'll never know now, because that great and glorious legal system that is supposed to serve its people has ruled, and we must all bow down to the god of legalism.

And once she's dead, we can all discuss the political aspects of it all, and watch the liberal lawyers who have such a high opinion of themselves as they bring out *their* winger nutbob websites and loony tunes sources to support their political views.

Larry, the rule of law is one-third of power base on which are nation was built - the executive, the legislative and the judiciary. If a mockery is made of the judiciary branch, the whole republic is left teetering on a two-legged stool. We lawyers are incensed about this *because* we have an intimate understanding of that particular leg of the stool.

If the people arguing as Larry is had taken the time to read the facts of this case (court opinions and GAL report), then it would be easier to take them seriously. To suggest that cable TV is what is needed to understand this case surely undermines one's credibility.

The rule of law is important. I am proud of the judges with the courage to make hard decisions in tough cases. If these decisions came down in conservative places like Florida and Georgia, and if the conservative Supreme Court doesn't intervene, then we'll all know there's no question that this was handled properly in the courts.

Oh, and if the decision had gone the other way at the appellate level, I'd say exactly the same thing.

...and just because I have come to the MORAL conclusion that allowing this woman to die is the most humane action to take does not AT ALL change one iota of my feeling about lawyers and the judicial system.

I stand 100% behind Larry Fletcher's remarks.

Thank-you, Larry.

Winger?

This coming from the same folks who laughed at W doing a Sieg Heil in a SS uniform?

Some of you ought to be taken out and shot, just on general principles....(for those of you unable, or unwilling to understand, the previous statement is hyperbole, and meant only to register sentiment, and not to condone, nor facilitate the actual actions, or actions. Even if the recipient of such sentiment tends to be a Leftist somewhere more politically rabid than Fidel Castro, swilling at the trough of human frailty, and enjoying the fruits of a Capitalist society.)

Y'all have a nice day, now, y'hear?

I don't recall anyone, on any wing, supporting those ads, Jolly. Not here, at any rate.

Lawyers are trained to be dispassionate. That doesn't mean that they don't feel deeply. It's just that in the day-to-day work of the law one's emotions tend to get in the way of zealously representing one's clients, which is what lawyers are paid to do. The legal ethics rules require such representation, and clients deserve it. It may surprise the non-lawyers here to know that law students are often given a side to take in an argument and are expected to present the best case for that side. It doesn't matter if the lawyer believes the argument or not because the lawyer's personal feelings and opinions are irrelevant to his or her representation of the client. The best lawyer is the one who can win either side of an argument, as the best football coach is the one who can win with either team.

Judges are usually lawyers themselves and are therefore susceptible to good legal arguments. It comes with the training. It's also what the laws, passed by the people's representatives, require. Sadly for the parents, they didn't have the best legal arguments to make. The fact finder (lower court) is given great deference in this country by appellate courts with respect to the facts of a case. And this makes sense, because the lower court sees the witnesses and can assess the evidence, whereas appellate courts read a bunch of paper and hear brief oral arguments. Appellate courts usually limit their review to the lower court's handling of the legal issues. In this case, the lower court did a thorough job of hearing the case and assessing the evidence. A perfect job? Of course not, but it should take more for an appellate court to reverse than because of insubstantial errors or because it doesn't like the result of the lower court's decision. There should be a legal reason for a reversal.

And would we want it any other way? People (and I include lawyers and judges in this category) muddle through, doing the best they can with what they've got. Every lawyer I know works hard trying to earn a living like everybody else. And if any thinks they know better than anybody else - and lord knows plenty of them are plenty arrogant, they must first answer to a higher secular authority - the law. This is the human construct that allows us to live together in a society.

I'm certainly open to hearing how the court system can be improved. It surely isn't fair that the lawyers on opposing sides can't be perfectly matched so that the legal issues are always aired fully and both sides are presented in the best light. It doesn't seem right that rich people can hire the best when regular folks get the guy in the store front office, or that the result comes down to one judge or one jury when, possibly, the vast majority of the country might rather have it come out another way. But I can't think of another way around these problems. I'd love to hear constructive solutions.

I'm sorry, but the common man has dropped most of the legal world into a pool of derision along time ago.

The next step is to reduce it to nothing more than something to laugh at, a point which I'm afraid we are rapidly closing in on.

The power of the Court only exists, when men will respect it, and obey it. It controls neither principalities or powers, and is weak without the ability to impose its will.

The beauty of the American troika, is that one leg of government depends on the others, in order to form a level governing platform. However, the power of the Judiciary has outstripped its designed role, and it must be reigned in, one way or another.

No matter how much I may agree with Mr. Franklin, the best avenue is not to begin hanging lawyers...