Proverb for Today

This entry is long, heavily linked, and will take time and strength of mind and heart to read. It is not (I mention for the benefit of a private party and you-know-who-you-are-I-hope-and-bless-your-heart-things-are-all-good-between-us) directed toward a specific person, but rather addresses, again, a specific situation.

It really did come up on its own, without reference to any thing else. I was innocently reading one of my regular blogs and was sideswiped, and now I’m returning the favor for my readers. Please get a cup of java or tea and sit back and read on. You might need a helmet for the ride.

It was never our intention to make this a blog about hard, serious, and heartrending, heartbreaking, and really emotionally difficult topics. We meant to be funny, lighthearted, trivial, and occasionally erudite- but never serious. The Common Room isn’t meant to be a soapbox.

However, neither is it meant to be a collection of mythological ostriches burying our heads in the proverbial sand and ignoring the grim world outside our doors. We do have a severely brain damaged child, and the Terri Schiavo case is personally disturbing to us because the way most people argue about it would directly threaten her life if their arguments were made law. People flinch from statements like that (although, not, oddly enough, from foolish statements like “I wouldn’t want to live like that so let’s deny her food and water”). It’s too emotional. It goes too far. It smacks of hyperbole. That dismisses my tone, but not the substance.

I would say that 90 percent of the Schiavo discussions I’ve seen and participated in end up with somebody saying “I wouldn’t want to live like that, would you?” as though somehow that clinches things, and we should all starve Terri to death right this minute. In fact, if we had a nickel for every time we’ve heard or read that argument, well, the Common Room household of nine would have more than one bathroom, because all those nickels would more than cover the cost of renovation.

Nobody chooses to live like that, but that is not the issue. The issue is that others should not be choosing for Terri to die like that. Once we make such a subjective standard a basis for denying another human food and water, we are on an icy ski slope diving straight down- and we’ve thrown away our poles. Nobody would _choose_ to live in our daughter’s condition, either. That is irrelevant to any discussion of the ethical treatment of human beings who already do live ‘like that.’

I could go on. And on. And then type more. I could do an entire month of postings only on this issue. You see here one of the reasons I wasn’t ever going to blog about issues like this, but Equuschick started it, and it seems like every day I come across some new information, and that new information always makes the story even more disturbing than it already is. So, since I have carefully absolved myself of all responsibility and placed it squarely on Equuschick’s short shoulders, here’s more.

For instance:

Over at Patterico, we have another blogger with a similar dilemma to my own- he intends not to post on this case, but something new always comes up.

He shares more quotes from Terri’s former nurses. Things like:

Every time I made a positive entry about any responsiveness of Terri’s, someone would remove it after my shift ended. Michael always demanded to see her chart as soon as he arrived, and would take it in her room with him. I documented Terri’s rehab potential well, writing whole pages about Terri’s responsiveness, but they would always be deleted by the next time I saw her chart.

Please read it.

Then there’s John at WuzzaDem, who’s about as angry as I am about the way people voice opinions sans information and facts, and is even blunter than I (but he kept his language clean, thanks, guy!). He also addresses a long list of false information and faulty reasoning that’s been making the rounds. For instance:

Terri’s husband doesn’t stand to gain financially, because any money he might receive when she dies will probably go toward medical bills.

Michael Schiavo stands to gain another $1.6 million dollar when Terri dies. How much would go toward medical bills? Via Sue Bob’s Diary, we find this interesting article from The Empire Journal, which informs us that Michael Schiavo, after moving Terri to a hospice, placed Terri on Medicaid. Empire Journal also questions the legality of Terri being placed in hospice, and addresses a serious conflict of interest on the part of Michael Schiavo’s attorney…”

But please, go read the whole thing. Again.

One of my very, very favorite blogs to read, the Captain’s Quarters, asks some important questions and gets some disturbing answers. I especially appreciate the good Captain for his open mind.

(note: if the above link does not work, try this one.)

Formerly, he says,

“…my inclination was to consider this an unfortunate case of dueling experts and bitter family feuding. Now I think this is something more. The people who want the feeding tube pulled all seem to have vested interests outside of Terri’s well-being — Cranford wants to push an agenda for euthanizing people who he finds inconvenient, and Michael Schiavo appears to have a long history of neglect, or at least disinterest in pursuing the proper testing for his wife’s condition.”

The question he’s asking?

Did Terri ever receive a fair examination?

The answer?

According to a number of board-certified neurologists, Terri never got the requisite testing to certify her as suffering from persistent vegetative state (PVS), and the doctor who has testified to her diagnosis has a long track record of right-to-die activism.

You know what the Deputy Headmistress is going to tell you, right? Go Read The Whole Thing. The Captain is worthy of your time. So’s Terri.

One of the above blogs directed us to Suebob’s blog. Suebob claims to be is an attorney representing Medicare/Medicaid providers who also serves on the ethics committee of a Hospice. I say claims because I don’t know this of my own personal knowledge. This being cyberspace, people can claim to be things they are not. With that caveat in mind, Suebob says that

“… to qualify for Hospice care, one must be suffering from a terminal disease that will end the patient’s life within six months.

Let me share something else with you. Hospice receives a bigger rate of reimbursement from Medicare or Medicaid than does a nursing home. Further, a nursing home is subjected to greater regulation than a hospice. I assert that Terri was put in a Hospice because the state survey agency exerts greater scrutiny regarding a resident of a nursing home than a Hospice resident. I know this because I have defended both nursing homes and hospice providers against the government regarding regulatory issues.”

But Go. Read. The. Whole. Thing. It’s short.
Updated by Deputy Headmistress: I am not sure how I managed to single out SueBob’s Diary for its very own caveat other than a bad combination of caffeine, passion and weariness, but I am more than convinced she’s not only legit, she’s got a highly worthwhile blog

Suebob and others pointed out the Empire Journal.

Here we read extensively of Medicaid and Medicare fraud allegations as well as conflict of interest, complete with documentation, reference to the state laws, and more. I don’t even know where to begin quoting, it’s all strong on information and facts.

How about this?

Although money having been specifically earmarked by the court in the 1992 malpractice suit for Terri’s rehabilitation, and despite Michael Schiavo having received well over $1 million, in 2002 he petitioned the court and Greer for permission to place Terri on Medicaid and permission was granted.

IMPROPER CERTIFICATION

Both federal and state hospice law provide that for each period of hospice coverage, the hospice must establish written certification from a physician including that the recipient is terminally ill and has a life expectancy of six months of less.

The initial certification must be signed by the medical director of the hospice AND the recipient’s attending physician.

Under federal law, in order to qualify for hospice care and Medicare benefits, there must be a proper certification of terminal illness which is lacking in this case.

A review of the initial certification of Terri Schiavo for hospice care, the terminal diagnosis listed is “vegetative state”. Victor Gambone is listed as the attending physician who made the diagnosis on March 3,,2000, that “based on patient’s diagnosis (vegetative state) and the current condition,, she had a limited life expectancy of less than six months or less. That was five years ago.

Read it all. There are links to more.

Finally, today there is the bitterly aptly titled starving For a Fair Diagnosis at the National Review, an article by a reverent Robert Johansen.

Terri has had no attempts at therapy or rehabilitation since 1992, and very little had been done up to that point. Terri has not even had the physical therapy most doctors would regard as normative for someone in her condition. The result is that Terri suffers from severe muscle contractures, which have caused her body to become contorted. Physical therapy could remedy this, but husband Michael has refused to provide it.

Headmistress: Over at Patterico’s blog, referenced above, I read that one of the nurses tried to simply put a rolled up towel under Terri’s fingers to keep them from contracting, and Michael insisted that was therapy and ordered it removed.

I have spent the past ten days recruiting and interviewing neurologists who are willing to come forward and offer affidavits or declarations concerning new testing and examinations for Terri. In addition to the 15 neurologists’ affidavits Gibbs had in time to present in court, I have commitments from over 30 others who are willing to testify that Terri should have new and additional testing, and new examinations by unbiased neurologists. Almost 50 neurologists all say the same thing: Terri should be reevaluated, Terri should be reexamined, and there are grave doubts as to the accuracy of Terri’s diagnosis of PVS. All of these neurologists are board-certified; a number of them are fellows of the prestigious American Academy of Neurology; several are professors of neurology at major medical schools. Terri’s diagnosis was arrived at without the benefit of testing that most neurologists would consider standard for diagnosing PVS. One such test is MRI (Magnetic Resonance Imaging). MRI is widely used today, even for ailments as simple as knee injuries — but Terri has never had one. Michael has repeatedly refused to consent to one. The neurologists I have spoken to have reacted with shock upon learning this fact. One such neurologist is Dr. Peter Morin. He is a researcher specializing in degenerative brain diseases, and has both an M.D. and a Ph.D. in biochemistry from Boston University.

In the course of my conversation with Dr. Morin, he made reference to the standard use of MRI and PET (Positron Emission Tomography) scans to diagnose the extent of brain injuries. He seemed to assume that these had been done for Terri. I stopped him and told him that these tests have never been done for her; that Michael had refused them.

There was a moment of dead silence.

“That’s criminal,” he said, and then asked, in a tone of utter incredulity: “How can he continue as guardian? People are deliberating over this woman’s life and death and there’s been no MRI or PET?” He drew a reasonable conclusion: “These people [Michael Schiavo, George Felos, and Judge Greer] don’t want the information.”

The doctor who has diagnosed Terri has being unfit to feed and hydrate has a history of similar diagnoses:

In cases where other doctors don’t see it, Dr. Cranford seems to have a knack for finding PVS. Cranford also diagnosed Robert Wendland as PVS. He did so in spite of the fact that Wendland could pick up specifically colored pegs or blocks and hand them to a therapy assistant on request. He did so in spite of the fact that Wendland could operate and maneuver an ordinary wheelchair with his left hand and foot, and an electric wheelchair with a joystick, of the kind that many disabled persons (most famously Dr. Stephen Hawking) use. Dr. Cranford dismissed these abilities as meaningless. Fortunately for Wendland, the California supreme court was not persuaded by Cranford’s assessment

I could quote the entire article. It’s that worth reading. Please follow the link and read it yourself.

If you’ve read this far, you’re probably wondering about the title. The Proverb for today is:

Prov 24:11-12
Deliver those who are being taken away to death, and those who are staggering to slaughter, O hold {them} back.
If you say, “See, we did not know this,” does He not consider {it} who weighs the hearts? And does He not know {it} who keeps your soul? And will He not render to man according to his work?
(NAS)

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