[lit-ideas] Re: Right to Life, Right to Die

  • From: Carol Kirschenbaum <carolkir@xxxxxxxx>
  • To: lit-ideas@xxxxxxxxxxxxx
  • Date: Fri, 25 Mar 2005 09:30:45 -0800

> Has anyone read, as I have, where on occasion a person is denied a
> transplant because she can't pay?

ck: Veronica, this is quite common in the US. Without health insurance, a 
transplant is pretty much out of the question, as are relatively routine 
surgical procedures.

> Also, the society ought to have a say in some of this.
ck: By "society" do you mean Congress?

  Health care is
> already rationed to some degree to those who have good insurance.

ck: That's an understatement.

>How long> is society responsible for maintaining persons on life support at 
>incredible expense, while others are denied relatively cheap medical care?

ck: This is one reason that the Schiavo case was seized upon by 
conservatives. Terri Schiavo's medical care was not, until recently, 
dependent on any state or federal health program. (Shhh--don't tell Bush, 
who wants to put a low cap on medical malpractice cases...)

At any rate, I completely agree with you about basic health coverage for 
all, but that's unlikely to happen. Far more likely, people who had been 
covered (even by Medicaid) will be denied medical care based on what others 
perceive to be their value to society. Their perceived "worth." How to 
measure "worth"? In this capitalistic society, by return on investment. 
People with disabilities measure low on that economic scale, which is why 
the disability community figures they'll be among the first to have their 
access to medical care scaled back, as usual.

But as you say, society believes it should have a say in all this 
technology. However, I doubt that a feeding tube is a very costly piece of 
technology.

A couple of points in the Schiavo case:
Terri has been swallowing her own saliva, according to medical reports. (She 
doesn't drool.) Swallowing reflex can be increased, with training. Terri 
didn't have such training, and the courts refused it. Please note: The 
courts are not medical experts, nor are lawyers trained in interpreting 
medical information. The courts that have ruled in favor of Michael Shiavo 
have looked specifically--and almost solely--at the rights and obligations 
of a legal guardian. Charges of abuse remained just that--informal charges 
to nobody. The documents backing up the family's accusations are part of the 
Schindler family's records. Michael Schiavo has not been brought up on 
domestic violence charges. Btw, Veronica, I'm currently working as a 
counselor at a shelter for battered women, so don't lecture me.

You may not know that people have become fully conscious years after being 
in PVS and minimally-conscious states. Just a couple of weeks ago I attended 
a lecture on this by the physician who runs the local "vegetable patch" 
here--a coma unit. You'd think it'd be a quiet place. Not with this doctor. 
He believes in stimulating his comatose and near-comatose patients to the 
max--anything to wake them up, including flavoring the liquid in their 
feeding tubes. (What, it's gonna hurt?) His point is, you've gotta try to DO 
something with these folks or you might as well put them all to sleep 
permanently--which he has no intention of doing. So his ward is anything but 
quiet. Radios, TV, massages, vibrators, varying lights, families reading and 
picnicking...you wouldn't believe it. This ward has an extraordinary record 
of wake-ups, compared to others of its ilk.

And for 15 years, Terri Schiavo has been locked in solitary confinement, 
with infrequent, monitored visits from her parents. No outdoors, nobody 
talking next to her or around her. Radio tuned to the same station for 
years...It's enough to make someone feel brain dead.

But I'm curious: Would you deny feeding tubes in all cases of minimal 
consciousness? Would you allow a feeding tube for a certain number of weeks? 
Months? Years? Never? You've probably read or heard about people being fully 
conscious but "locked-in"--the Poe terror. This can continue for a long 
while, for years, if nobody's watching that patient very carefully for signs 
of alertness. Stinting on the feeding tube would kill them off. Is that okay 
in the rationing hierarchy? Should expensive healthcare be reserved for 
people above a certain IQ level--and withheld for, say, people with mental 
retardation living in institutions?  Just curious. Very curious.
Carol







----- Original Message ----- 
From: "Veronica Caley" <vcaley@xxxxxxxxxxxxx>
To: <lit-ideas@xxxxxxxxxxxxx>
Sent: Friday, March 25, 2005 8:50 AM
Subject: [lit-ideas] Re: Right to Life, Right to Die


> Carol:<The
> possibility that Michael, the guardian, was an abusive husband--who may
> have
> caused this injury--is terrifying.>
>
> I agree Carol that the situation is very complex.  But whereas you see the
> complexity in how Ms. Schiavo got into the condition she is in, I see the
> complexity as a possible abuse of technology.  That would be the feeding
> tube. If it is inserted in the body with hopes that the person will
> improve, return to consciousness, or in some way show brain driven
> responses, then it is a wonderful thing.  If it is used in cases where the
> person has undergone extensive gastrointestinal surgery, it is also a
> wonderful thing.  If it is inserted and left in there while the person's
> brain function is minimal to non-existent, then it's a different story.
> Also, the society ought to have a say in some of this.  Health care is
> already rationed to some degree to those who have good insurance.  How 
> long
> is society responsible for maintaining persons on life support at
> incredible expense, while others are denied relatively cheap medical care?
>
> Re the alleged brutality of Mr. Schiavo re his wife, I heard that several
> times judges have ordered an investigation into this before they made 
> their
> decision when the court cases started.  They have found no evidence of
> this.  Twenty judges have read the results of the allegations besides the
> one that ordered it.  I wish I could tell you for sure where I heard it.
> My best guess is on the Lehrer news hour
> on PBS.
>
> By the way, I am a card carrying feminist.  I don't take violence against
> women lightly.
>
> Veronica
>
>
>> [Original Message]
>> From: Carol Kirschenbaum <carolkir@xxxxxxxx>
>> To: <lit-ideas@xxxxxxxxxxxxx>
>> Date: 3/25/2005 11:21:08 AM
>> Subject: [lit-ideas] Re: Right to Life, Right to Die
>>
>> Veronica wrote:
>> > And we know why he needs punishing.  He
>> > stuck with Terri waiting for her to wake up, recover, speak, whatever.
>> > Somewhere along the line, when he decided that wasn't going to happen,
> he>
>> > found a woman with whom he has been living and with whom he has
> children.
>> >  > The parent's view was that he ought to divorce Terry and give up a
>> > million> dollars obtained in a malpractice settlement.  I have read
> that
>> > this is> mostly gone. >
>>
>> ck: Veronica, the situation is much, much more complex than you present
>> here, though this is pretty much all the media has reported. Terri
> Schiavo
>> did not receive the medical care or the rehabilitative care during the
> first
>> few years after her injury. Indeed, the cause of her heart stopping is
> only
>> a guess.There's no medical history of her supposed eating disorder; that
> was
>> something the media seized upon over the last two years. When Terri was
>> admitted to the hospital, she also had broken bones. Nobody has come up
> with
>> a reason for this, but Jeb Bush found the hint of domestic violence (more
>> than a hint, from those who knew Terri and Michael) very disturbing. The
>> possibility that Michael, the guardian, was an abusive husband--who may
> have
>> caused this injury--is terrifying.
>>
>> Then there's the mysterious matter of Michael never having mentioned
> during
>> the malpractice trial--no, not even once--that Terri would not have
> wanted
>> to be kept alive like that. The idea popped into his head only after he
> had
>> the money. Now the money's mostly gone, spent on Michael's court costs.
>> Money earmarked for Terri's benefit went towards fighting to end Terri's
>> life. Now, why doesn't that sit particularly well?
>> And that's not the half of it. The whole thing is damned sad and awful.
>> Marlene's right, though, about the fears of the disability community.
> Those
>> fears are not unfounded.
>> Carol
>>
>>
>>
>>
>>
>>
>>
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