March 22, 2005

• I have told my family and friends many times to let me go if this type of situation presents itself. Since they tend to feel the same way about this that I do, I don't think it would be a problem. Difficult I'm sure, but I think they would cmply with my wishes. However, it certainly seems like a living will might be a good idea for just about everyone.
• Living Will Software
• this might be of interest (yes, i wrote this years ago and we're still discussing the case) anyway. interesting side note: my ex-husband had a 16-year-old sister who was severely brain damaged in a car accident. no hope for recovery, breathing through a respirator, etc., so they disconnected her. the decision nearly 20 years ago -- although the correct one for the family at the time -- still haunts him. to this day he insists if he's ever in that situation, he does NOT want to EVER be unplugged. it's a tough case. what if, for instance, the perfectly healthy terry did indeed say, "i wouldn't want to live like that," but now thinks, "i don't want to die." we just don't know how much she's experiencing. tragic.
• Here in Ontario, there are no such things as Living Wills. There are only Powers of Attorney for Personal Care. You can have a lawyer prepare one, or you can go to the Attorney General's website (http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/poa.asp) and download a kit from there. The POAs for Personal Care are general documents that allow the person or persons you appoint to make any medical decision on your behalf. The ones that we draw up typically have the clauses in there that a) if your death is inevitable and there is no hope for recovery, that you do not want to be kept on life support, and b) that you can be pumped full with drugs to make you as comfortable as possible, even if that means hastening the process. The kit from the MAG does not include these directions -- you would need to add them specifically. Seeing your lawyer to draw them up is the best way, but if not, the kits from the MAG will suffice just as well (as opposed to the Will kits you buy at the gas station, which generally are ticking time bombs of litigation). Most importantly, even if you have the POA, make it clear to the person you appoint what your wishes are. It happens often enough that although your attorney has that power, they're afraid to use it. Tell your attorney what you want, and tell other people as well.
• Oh -- the info I gave above is for information purposes only, and is not meant as specific legal advice. For that, you would need to consult your lawyer directly.
• I don't care if I have more tubes than a toothpaste convention, keep me alive.
• I don't know if we have Living Wills in New Zealand, but when #2 and I get around to writing our wills (which we should, what with having kids and a home and all those things), I'm going to request something in writing that says what I want, so no one can argue that it wasn't what I really wanted, or something. All I know is, I don't want starvation to be a last resort.
• On a personal level, I've got my POAs set up, and have made it quite clear to my family that they have full authority to pull out any feeding tubes, pull the plug, or even tilt my wheelchair to give me a close-up look at Niagara Falls. "Accidents" happen every day. Pesky things...
• Tracicle -- you pointed out a very common problem. Don't put these instructions IN your Will, as the Will has no effect until AFTER you're already gone. By the time people get around to looking at the thing, it's far too late. POAs or even a simple letter of direction to your family. (Again, info purposes only, please see lawyer, don't tell my insurer I told you anything.)
• A friend of mine had to order disconnection of a feeding tube for his father a few years ago-- he felt certain he knew that that was what his dad would have wanted, but he had to argue vehemently with his sister, and now the two have not spoken since. Thinking of that along with the front page Schiavo coverage got me to type out what I want (if need be), and sign it. I'm going to have it notarized by a friend of mine, and mail copies to my family, who are a mix of religious and medical folks... and tracicle, apparently the starving doesn't involve any pain for schiavo... fortunately, according to the overwhelming majority of medical experts, her condition has rendered her insensate.
• SideDish... I sincerely doubt terry is thinking anything, considering the majority of her cerebral cortex has dissolved into spinal fluid... It's just her brain stem that's operational... keeps the heart beating and lungs breathing but not much else... Still, while I don't see why this is even a newsworthy situation, (no dig at arch1) I would have to side with the parents on this one. Considering that she is technically "dead", with no real brain function, I doubt she's aware enough to care that she's hooked up to anything, regardless of her wishes in a previous "life." However, no parent wants to lose a child, so if I were the hubby, I'd just get a damn divorce and walk away from the whole thing. They'd run out of money to keep her alive eventually... As for me personally I couldn't care less... keep me plugged in, unplug me, whatever floats your boat...
• SideDish, wthe parts of her brain that control higher functions are liquid. We have a pretty good idea she's experiencing bugger all of anything. And that leads to what we've learned from this case: that if you're willing to spend enough money and tell enough lies, you can subvert someone's will, living or otherwise. If the lady had put on paper "if I have no hope of recovery, let me die" well, her parents have that covered with claims that she can get better. Also note, tracicle, that in New Zealand a simple power of attorney is cancelled if you become mentally unfit; you need an enduring power of attorney. In general, though, #2s wishes vis-a-vis you will be respected, and vice versa. The main risk is if both of you are incapacitated (a car crash, for example), or one dies and the other is incapacitated before you sort something out. Note that powers of attorney can be selective—you can specify limits on what a person may and may not rule on. Finally, keep them up to date. If the person you assign PPOA to joins a shiny new religious group, it might be best to find yout what their feelings on your right to die now are, for example.
• If you are going the Power of Attorney route, do not give the Power of Attorney to one of your parents. Give it to a spouse or sibling instead. It is incredibly difficult for a parent to willingly bring things to a dignified end on behalf of a child. All sorts of biological drives are arguing against it, and while it is never an easy decision for anyone, don't expect one of your parents to pull the plug. They just may not be able to do it. It's probably not a bad idea to write a letter to all members of your family, spelling your wishes out, so there's less room for argument later.
• When I prepared my will and POA with my lawyer, I asked him about the kits. He told me that the kits are perfectly legal, until someone in your family contests them, at which point they may become worthless. The extra cost of doing it properly with a lawyer is worth it, IMO.
• Debaser, as a husband, I'll honour my wife's wishes. If she doesn't want to be in a persistent vegetable state—and she doesn't—fuck her siblings, parents, whoever. My last responsibility as her husband is to make sure she gets to die and her remains disposed of as she wants. And bashi, you need a will now you have kids to make sure if you both die they get raised by the right people. Otherwise you could have an unholy battle between sets of grandparents, uncles, aunts, etc, over who gets custody. Not very nice for the remaining family members, and there's no guarantee the suitable rellies will get custody.
• I just don't want to end up like my friend Ed. Like Terri, he was tragically turned into vegetable by a horrible car crash. It' no way to go on living. Here's the last pic I have of Ed and his wife. It just makes me sad.
• I'd also have to 2nd the PPOA... Living Will DNR clauses only cover specifics.. i.e. (Respirators, feeding tubes, etc.) as such, you may be injured and comatose in which you don't need either, so it's best to leave the power to someone who is able to be fluid with the situation... That said, the reason I personally don't care (which I neglected to mention above) is that IMHO, tons of people (like in tracicle's post where she mentioned that she wouldn't want to starve to death) still have a misguided, though perfectly understandable, viewpoint of situations like this. If it ever came down to the wire, you wouldn't be aware enough to realize you were hungry, or slowly dying. The major pain and strife affects the surviving friends and family who actuall have to endure this situation... you're MIA, really... it's the people who care about you that are doing all the suffering... as such, whatever they want to do they can do...
• Why does everyone think Terri was injured in a car crash? (Several people at work also mentioned this today...) "She had a heart attack in Feb. 1990 caused by a potassium imbalance. According to testimony in Micheal Schiavo's successful malpractice suit against her doctors, Terri's collapse was brought on by bulimia and her drinking as many as 15 glasses of iced tea per day"
• Argh, HA!
• MSNBC has solicited stories from people who have had to make severe treatment decisions: http://www.msnbc.msn.com/id/7267499?GT1=6305 It's startling how many of them cite family that are under 50, and a few under 15 years old. And Debaser, while I know TerriTalk is stale, those stories gave me the heebies-- speficially because while the majority of them relate the hard decision to discontinue treatment, there are two or so that talk about keeping relatives alive, despite no cognitive function. ...While I believe my family would obey my wishes, I posted this because I have no guarantee that I would get my way. (And conversely, those who want all the tubes... how do they know they'd get their way?)
• And that would be "specifically"... apparently my cognitive function may already be questioned.
• arch1... I didn't mean to intimate that this post was not FPP worthy... I think it should be discussed now that it's splashed all over the internets and the tv screens (unlike the *shudder* MJ trial)... I was just pointing out that Terri's specific situation and the hoopla surounding it wasn't newsworthy... But, since the networks and politicians have decided to stick their noses in it again, I'll throw in my .02 and other monkeys should too (though I think I'm up to .08 by now) :)
• List of advanced directive information by state for American monkeys. Note the "talk to a lawyer" advice. Also really interesting, from the same person: lawyer board discussion of possible problems with the pleadings in federal court. I saw my mother go through the life-support ordeal with my grandmother in the 1970s. Grandmother had a stroke and the lights were on but nobody was home. It took her two years to die. This was before the question of pulling the plug was even on the table for most people. After seeing what it did to my mother, I can only imagine what it's like for the families in this case. My mother has medical directives drawn up by a lawyer. I'm the only child, so if it comes to that, it will be up to me to honor her wishes. Fortunately, what she wants and what I want in the same circumstances are at one, so if it comes to that for me, I expect her not to fight my husband when he pulls the plug on my twitching corpse.
• OK, devil's advocate here. suppose a healthy young woman told her husband she'd never want to be kept alive if she was in a vegetative state. then she was involved in a horrific car accident and, just before she lost consciousness forever, thought to herself, NO! I WANT TO LIVE! NO MATTER WHAT! I WAS WRONG! LET ME LIVE! that's what creeps me out about all this.
• rodgerd, you and I are thinking the same way. We've procrastinated too long about making a will, and I know exactly who I'd want my kids raised by if necessary - and that person would be the person I'd most trust aside from #2 to take power of attorney and do with it what I asked. Thanks for the NZ-related info. I'm going to get moving on this next week while it's still fresh in my mind. Right this minute, though, I'm off on holiday to the in-laws. See y'all next week. And don't be too depressed by the news. :)
• Close my eyes and I pray for Death.. Oh Please God kill me!!!!!!!
• of course also this begs the question, just what is quality of life? i have a cousin who has half a spine, lifeless legs and lower body, she's retarded and nearly blind, totally deaf, a cleft palate that makes eating difficult at best and a bad heart. they don't even have a name for whatever syndrome she has. and yet, she does indeed have a life -- although one far more different from the rest of us. just because someone does not experience life as a "normal" human does, does that mean they do not deserve to exist? don't get me wrong here, i think terry should be able to die. but the case gives us plenty to consider.
• *waves at monkeybashi!*
• You mean you guys haven't already given Tom DeLay Power of Attorney? I sent him a notarized copy of my living will yesterday.
• SideDish, the scenario you mention is perhaps not as scary as it seems. If the only thing keeping you alive is your brain stem, the part of you that would worry about being alive is gone... ergo, you may have wished to be alive, but there's no longer a "you" to know if you are or not. also, there's a reason that most of these decisions are made by people when they are "of sound mind and body", not terrified by the sudden approach of death.
• enough with this "living will" bullshit, lets just get down to brass tacks and look at the real motives... which side is it who is paying for her life support? or am i just being too cynical? also, something about being locked into a "hospice" with a security guard who's keeping your parents from feeding you, even giving you a lick from an ice cube to soothe your drying throat because some guy in a suit said, at the urging of some other guy who says he "speaks in your interest," that you werent to be fed.. i dont care how conscious or whatever you are, and screw all the legalistic mumbo-jumbo, something about it seems to speak to me a lot about where, as a societal organ, our... priorities... are. im not picking sides or anything here, since i dont know nearly enough to say, and besides, i think too many sides have already been picked anyway. im just you know, saying, is all..
• I believe niether side is paying for support. I thought she was declared indigent some years back, meaning that her support is coming from the public purse. And I'm sorry sykoze -- I have no idea what you're trying to say.
• the los angeles times had a great story, i'm leaving and don't have time to find it. it talks about the brain science, and how neurologists say there ain't no way no how she can live. that's what everyone should focus on -- the science, not the emotion.
• sykoze-- please read the thread. we're not debating the case. after that, please read the case... (no, there is no money left; no, the shell of Ms. Schiavo can't feel her own throat... etc., etc.) in other words, please take the trolling elsewhere.
• sykoze-- please read the thread. we're not debating the case. after that, please read the case... (no, there is no money left; no, the shell of Ms. Schiavo can't feel her own throat... etc., etc.) in other words, please take the trolling elsewhere.
• sorry for the double post... not that the emphasis is misplaced, but it wasn't intentional. )
• Over the years I have taken care of many people who are in a vegetative state, with no hope of recovery. They have no verbal communication, no reactions that aren't just reflexes. They are kept alive by feeding tubes, trachs, and respirators, They are unable to move without someone doing it for them. They aren't home. It is amazing to me how many of their DPOA's keep their code status full code and not DNR. They can't let go, denial rules the day. It is heartbreaking. Terry will starve to death without her feeding tube. She will probably not even know it or feel it. The ones who will feel it will be those who love her and those who take care of her on a daily basis. An advanced directive is a must in my opinion. Making sure your family understands clearly what your wishes are is imperative. I would suggest copies of your advance directive be sent to your family members and to your physician and always carry a copy with you in case you are in need of emergency care.
• If I am ever incapacitated (even briefly) I will be leaving a minor child alone with the next relative well over 1000 miles away. So while I can't remember exactly which specific documents I had my attorney draw up, I did it immediately after her birth. As I recall, I set up a revokable trust (funding it was a bitch), signed a living will, and (with permission) gave my sister durable power of attorney to execute my wishes. I made my brother my personal representative and trustee of my estate, and I set forth strict instructions about disposition. My attorney told me that I shouldn't put the same person in the position of ending my life and then managing my assets. I made both of them co-guardians of my child. I sent notice of this to everyone involved. My attorney said I should never send actual copies of wills or other instruments granting authority to anyone. The originals are lodged with my attorney, and my copies are locked in safe deposit. I have made my sister a co-signer on the deposit box, and have told her the location of the spare key. Hope this isn't too detailed, but my lawyer had seen some real nightmares in probate court. The process wasn't particularly inexpensive or simple, but I feel better knowing that (hopefully) my child and family won't be subjected to any additional pain.
• Cynnbad, perhaps I am wrong about sending copies, but some sort of communication, as to what your wishes are, is called for. :) I do carry a copy of my advance directives with me, so if I find myself in a situation where I am unable to make my wishes known, the first responders and emergency personnel will know what type of treatment is appropriate.
• I have my living will, and did send a copy of that to my sister (I don't think the will in itself conveys any legal power, only my wishes). However, the power of attorney is locked up; in the event anything happens, and issues arise, she will need to 1) contact my attorney or 2) get the actual documents granting authorities from safe deposit. This kind of stuff is very scary to think about. I can see why people put it off. That's why I pay somebody to tell me what to do! :)
• Oh, and I hope this isn't taken as a ghoulish question, but I really wonder: wouldn't Terri die of dehydration before starvation?
• Whatever your wishes are with regard to these matters, you need to make certain all members of your family are informed before the need for anyone to act on your behalf ever arises. And by all members I mean including your brother Hank whom no one's seen or talked to in twenty-odd years, or the father who walked out on you as a child and that you've never heard from again etc. Because these are often the very folk who will show up unexpectedly and in a fit of guilt/emotional excess throw a monkeywrench into your plans and disturb the peace of the whole family. If you can talk your wishes over with all parents/siblings/offspring beforehand it's much more likely things will run smoothly after you're incapacitated.
• Actually cynnbad, dehydration is more accurate as to what Terri will probably die from.
• And, to continue talking about things we don't want to think about, I'd urge any of you with assets (house, stocks, etc.) to set up a revokable trust, with yourself as trustee. It gives you the ability to deal with your assets as you wish while you're alive, but avoids probate when you die. Here, in California, I've seen a number of situations where probate ate up the estate assets before it was settled. And funding it involves transferreing title (like deeds) to the trust, with yourself as trustee. A little time consuming, in my experience, but no nightmare.
• Amen to that. When things get ambiguous, they get scary. I have first-hand experience.
• Tragic and ironic that extreme dieting and an eating disorder contributed to her current condition. Got a video recording of my desires in detail should I fall victim to "life" "support" machines tucked away in a safe deposit box and a copy with the folks and lawyer. Thinking of a DNR tattoo as well.
• Here's my living will: If any member of my immediate family wants me dead, that's fine. Do it. I'll be grateful. Not that I'm (evah) in my right mind.
• Switch. Me. Off.
• I note what people have said about starving (or dehydration) not causing any suffering in these cases. I still don't quite like it, though. There seems to be an idea that withdrawing the tube is more morally acceptable than giving a lethal injection - "Thou shalt not kill; but needst not strive Officiously to keep alive." - but I don't think so. If you've decided someone should die, I think it would be better to face up to the fact and get it over. Not in any way to endorse any form of Shipmanism, of course.
• bananas to cynnbad. a lot of thought went into your actions, and you've saved your survivors a heck of a lot of grief. good for you. also i like oklo's idea about a video. would that hold up in a court case like this? i should hope so.
• Where's Peter Singer on all of this? I'd imagine him flying down to hold a pillow over her face. As for me, I'd hope that I could be cloned. Or somehow get a new robot brain. And a new robot body. With lazer eyes. If none of that is possible, I'd like to be fired out of a cannon or something else spectacular that would be sure to kill me. Maybe I can even jump Snake Canyon on my rocket bike. Just tie my hands to the handlebars...
• There seems to be an idea that withdrawing the tube is more morally acceptable than giving a lethal injection - Unfortunately, yes. I'd prefer it personally if they could just give her a sedative and stop her heart as quietly and painlessly as possible, but the law doesn't like that 'round here. Letting someone die is okay. Speeding up that process to make it quick and painless is only okay if we're talking about a pet.
• I would really have to see her personally to get an opinion on the case. I keep hearing "Persistant Vegetative State" Thrown around, but yet in videos she seems responsive somewhat to her parents.
• apparently she is in a persistent vegitative state, but the parents and the pro-lifers are trying to convince the public that she actually does have awareness (somehow, even though that's totally scientifically implausible) by using video footage of her smiling when a family member gives her a kiss on the head or something... even the esteemed Dr. Bill Frist, a heart surgeon, tried to offer his own diagnosis, saying she seemed responsive to him. Rrrright.
• more on my previous statements here.