posted
This should prod me to get back to the list of articles I want to write. I've mentioned to several people that there's a consistent break in how the starvation deaths of people are viewed in the media - depending entirely on context. This hit me last year when the Florida legislature passed a law to prevent Terri Schiavo's death through starvation and dehydration. There was an awful lot of commentary - "end of life" specialists and editorials - describing the death she escaped that time as a "peaceful" one. At about the same time, there were, I think, two cases in Michigan in which relatives were charged with neglect and manslaughter for starving and dehydrating their own relatives at home - the acts being described as "barbaric" and "cruel."
Someone else has gone and written that piece, unless I find the wherewithal to do a more comprehensive piece suitable for journal submission.:
In April of 2004, prosecutors in Pittsburgh, Pennsylvania laid first-degree murder charges against Kimberly Loebig for allegedly starving her disabled brother to death. Her brother, Scott Olsen, was an incapacitated young man who was made a ward to Loebig following a significant brain injury in 1996. When Mr. Olsen’s 6’ body was found, he weighed just over 60 pounds. Loebig now faces life in prison, or the death penalty, if found guilty.
In October of 2004, a Rialto, California woman by the name of Delores Johnson was sentenced to 29 years - to life in prison for the starvation death of her autistic brother, Eric Bland. Johnson received an additional sentence of 14 years for dependent abuse. Eric Bland, a 38 year old man, was only 70 pounds when police found him dead in his sister’s home. Deputy District Attorney, Tristan Svare told the press: “To see a helpless, developmentally disabled man being starved to death - photos of him on his deathbed, sinking in his bed and his clothes hanging off him - it was like seeing a Holocaust victim.”
Yet, in October of 2003, a simple gastric feeding tube was ordered by the courts to be removed from a disabled woman by the name of Terri Schiavo. Because of a mysterious anoxic brain injury in 1990, Ms. Schiavo is unable to care for herself independently. Because of an ongoing denial of rehabilitation by her husband and guardian, Michael Schiavo, her condition has not improved. She is not on life support as we know it. Rather, she relies only on a feeding tube to deliver life-sustaining nutrition and hydration. The removal of this delivered sustenance, without the appropriate therapies to restore Ms. Schiavo’s ability to accept table food, will produce precisely the same outcomes as the Loebig and Johnson cases.
Terri’s case has one thing the other two do not – a court order that mandates the removal of food and fluids. Because of that fact alone, outrage over her situation seems to be rather sporadic.
In November of 2003, Michael Schiavo, Terri’s estranged husband and still guardian, told Larry King that a starvation and dehydration death was a “peaceful, natural and painless” way to die. Yet, in a published report titled “Life Cycles”, we see that nothing could be further from the truth.
Citing a number of reputable physicians, Life Cycle’s report on withholding food and fluids paints a macabre picture of senseless torture:
“Dry mucous membranes (mouth, nose throat and genital organs), Constipation, Impaction (buildup of stool in the body), severe abdominal cramping and bloating, nausea and vomiting, Electrolyte imbalances (salt and water problems in the blood and tissues), Arrhythmias (heath problems); myalgias and malaise (muscle pain and marked fatigue), Cough and shortness of breath, Severe depression and confusion, severe agitation and fear, delusions, Dry, cracked skin, Urinary, vaginal and bowel infection, Bronchitis and pneumonia, Blood in the bowel, stomach, kidney and lungs, kidney failure. General systemic collapse and death”
This begs the question: How is it that a court order – a simple cooperative of paper and ink - magically transforms the experience of dehydration and starvation into a ‘peaceful’ or ‘painless’ one?
posted
I can think of three reasons that people would have differing degrees of disgust. One is the phenomenon called susceptibility to authority.
Because MSS's starvation was mandated by a court and presumably to be carried out by medical professionals, a lot of people wouldn't question the morality of it. There is the classic study, parodied in Ghost Busters, of students being ordered to give shocks to others and being willing to give highly painful even "lethal shocks" if ordered to by an authority figure. It's dispicable but nonetheless a real problem that I have to watch in myself.
Another, related reason is that if something painful has to be done, a lot of people might think it would be better done by an objective stranger than by one's own family members. This is the principle that justifies warfare. Shooting a stranger is immoral depending on the circumstances. Shooting a family member would require some kind of really bizarre circumstance to be justifiable. It is why the Civil War is more haunting than other wars. Or maybe it was the higher casualties. I don't know.
Finally, I think a lot of people would see MSS as a vegetable, whereas someone who is mentally disabled is more like an animal. I can't really put a lot of effort into this final justification. I mean, if the court ordered a dangerous animal to be put down using starvation, the outcry would be enormous.
So that is probably the type of thing people are thinking. I do think it is right for people to be disgusted by all three starvations. There is actually something more terrifying, to me, about Mr. Schiavo using the courts and the medical establishment as tools in removing the inconvenience of his wife'e existence.
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Thanks, but I think the paradox is deeper. It isn't just that one is considered "OK and legal" and the other a "crime."
The nature of the act itself changes. When done at home, it's barbaric and cruel. When done in a hospital, legally it's a peaceful death.
Here's an analogy. If a woman has an abortion, she is terminating her pregnancy. In some places, if a woman is shot and the fetus within her dies, it is a murder. But neither is described as pleasant for the fetus. So while the legal stance on the two circumstances change, very little else in terms of public perception does.
What's happening with death through starvation is even weirder.
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posted
I suspect there may actually be a difference in the “peacefulness” and “painlessness” of starvation by neglect and starvation by withdrawal of a feeding tube under medical supervision.
But I suspect it has more to do with the presence of morphine than the presence of a court order.
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posted
I certainly don't agree with these starvations. I don't have time to read all about this right now, but I DID want to make some medical comments.
Dying from dehydration CAN be be relatively painless or it can be a terribly painful death. It depends partly on how fast the kidney failure occurs. We only need 10% of our kidneys to be working in order to have normal labs and to appear to be normal. The older a person is, the less functioning kidney the person has left. So if you took a healthy appearing 95 year old woman and withheld water, that person would probably have kidney failure much, much more quickly and as the kidney failed the person would become sleepy and calm and less aware. Little pain or discomfort would be involved. Death would probably be faster, too. Same result with a 65 year old woman with chronic diabetes, heart failure, and hypertention. She probably would have similarly fragile kidneys. As the waste products build up it can act similar to sedatives and the person is more likely to just quietly fall asleep and fade away.
Compare that to someone being starved to death with strong healthy 30 year old kidneys. That person would have to struggle through several days of dehydration before the kidney failure became severe enough to cause the same effect. Much more pain, more discomfort.
Sounds terrible. I never thought about how awful that would feel. I'm sure that the IV morphine/sedatives can do a good job handling some of that.
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posted
Interesting. "Humanely" starving someone in a vegetative state because a court orders it is "good", but lethally injecting a convicted murderer is "bad".
It is all subjective I guess.
I found that an interesting thought.
Thanks for the articile
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What if a person committed several murders, was caught and convicted, and sentenced to die. Then got involved in a prison uprising and had his neck broken so he was mentally a vegestable.
Would it be wrong to put him to death still or would it then be ok?
An interesting thought indeed.
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Morphine use would account for part of the public perception except for one thing...
It's not highlighted much in cases like Terri Schiavo's. Even if they do give her morphine, talking about it in public opens the door to what she actually experiences. Since Michael Schiavo and others are arguing she doesn't experience anything, one can question why morphine has to be used. So it's more common to see open discussion of morphine use of people who vuluntarily refuse food and fluids than it is those who are presumed to lack consciousness.
Cessation of eating and drinking is probably a different experience for people in the final stages of cancer. With organ function failing, food and fluids don't actually promote life or comfort. And the cause of death usually isn't dehydration or starvation, but the disease itself.
Then there's the way in which press coverage of the home-based starvations details the physical deterioration of the person who died. That deterioration is the same whether it's at home or the hospital, morphine or not.
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posted
Well, Stephen, I for one am glad that Ms. Hennessy wrote this, despite the fact that you wanted to, because at least it is out there now and being read, because you have been so overwhelmed with work you haven't had a chance to yet.
Now she just opened the door for further articles, more in-depth, along this very line, and it seems to me you're the perfect person to do the more detailed follow-up to kill anyone's argument or objections to what she wrote.
Pam Hennessy has a time machine. She travelled into the future and picked up a copy of the article I intended to write, only I'd, like, actually written it by then.
Then she took down the main ideas and wrote her own article.
In the process, it looks less likely I'll write that article, which creates a paradox and is generally not considered healthy for the space-time continuum.
Some people have no sense of integrity - of the personal kind or the kind relating to the structure of the fabric of reality. Posts: 4344 | Registered: Mar 2003
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posted
She actually walked over to a neighboring reality where you'd already writen the article and brought back a copy to work from. Not so much a paradox of time, but one does wonder how our reality will react to the sudden addition of a few grams of newspaper.
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quote:Interesting. "Humanely" starving someone in a vegetative state because a court orders it is "good", but lethally injecting a convicted murderer is "bad".
Well, Chad, wrap your brain around this...
Liberals trust judges and juries, but not with decisions of life and death, so they want the death penalty outlawed.
Conservatives trust judges and juries, but not to make judgments about damages in malpractice awards, so they want legal limits on those.
At least some people in the disability community just plain don't trust judges or juries when it come to dealing fairly with people who are uneducated, poor or just plain devalued. Especially when there's a life on the line. That would mean we're not real trusting of the judicial system in either death penalty cases OR cases like Terri Schiavo's.
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posted
but you did write it! you on that other plane! and she had to get past a bunch of ant earths to find it. heck, i'd think it would have been easier for her to have just thought up her own article at that point.
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posted
I don't think it's possible, when you really think about it, to determine that a death by dehydration and starvation would be painless.
Heck, I feel awful when I go for several hours without drinking anything...can you imagine the torture of a days old thirst? I guess there is some point when that shuts down...but still...I would think it would be a most horrible way to feel and to die. The muscle cramps alone would seem to be a form of torture - the sharp pain of a cramped muscle is not something I'd want to endure for a long period of time.
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posted
Belle, both of my Grandmothers died in situations where feeding tubes / IV fluids might have extended their lives. Both of them were periodically conscious and able to communicate at least a little until the day they died, and one of them was on no pain medication at all. I was with both of them when they died, and for the days and nights leading up to it, and given the same situation, it is the choice I would make for myself.
Both of them were, as sndrake mentioned, experiencing organ failure for other reasons, so I don’t consider their choice not to use feeding tubes and artificial hydration suicide, though they almost surely could have prolonged their dying by choosing to use them.
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posted
Several years ago, my grandmother suffered a serious stroke and was in a comatose state in the hospital. She was being fed intraveniously and her children had to make the decision of whether or not to continue this form of life support. Her situation was different from that of Terry Salvo because she had left a living will and had discussed the issue with her doctor and it was clear that she did not want to have her life sustained in this fashion when her chances of recovery were minimal.
My reaction was exactly like those expressed in this article, that dying of starvation and dehydration would be a painful arduous death, but I actual did some research on the issue. At the time, my mother-in-law was the head dietician in charge of all tube feeding at LDS hospital in Salt Lake. I discussed the issue at length with her, she directed me to a number of resources and assured me that my response was in error. She had observed hundreds of deaths (similar cases to my grandmothers) where the family of the patient had chosen to stop intravenious hydration and feeding. This is a common occurance in hospitals dealing with elderly or chronically ill patients who have expressed a desire to end all forms of life support.
In most cases the patients die within 1 to 2 days of when artificial hydration and nutrition is stopped. Their deaths are peaceful. Those who are conscious at the beginning do not complain of thirst or hunger, after a while they simply drift to sleep and never wake up. My Mother in Law is one of the most compasionate people I know. I trust her assessment of this issue.
This is not a slow starvation. The patients die of dehydration which happens very quickly when all fluids are stopped. The long list of ailments that accompany chronic dehydration don't happen. When patients are too ill to either eat or drink they frequently have a severly supressed appetite and do not experience hunger of thirst normally. Even if they do, IV fluids keep one hydrated but do not wet the mouth or satisfy the thirst. To compare this to the slow starvation of a conscious individual is simply inaccurate.
If you have any medical evidence or can find me one medical professional who has overseen such a death that says the patients suffering is in any way similar to that of a person who is slowly starved, then come back and post your complaints. Until then, I have to believe that you are simply comparing apples and broccoli.
[ October 21, 2004, 06:25 PM: Message edited by: The Rabbit ]
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posted
Oddly enough, Rabbit. That kind of info is hard to find from sources on the web.
However, when Terri Schiavo's feeding tube was removed in October 2003, her husband's lawyer was telling the press it would take a week to ten days for her to die.
As it was, she was off the tube that provided nutrition and fluid for six days.
I realize that contradicts what you've heard from other trusted sources, but do a news search on Schiavo and you'll see that the 6 days off is factual. It's a matter of public record.
So it is still hard to see how to distinguish between this "slow" starvation (do we really know how slow it was?) in the community and what happens in a medical setting.
Six days with more to go seems pretty slow to me.
But if this is a matter of "belief," this discussion won't mean much, anyway.
posted
One of my grandmothers took three weeks. She was getting minimal moisture and food -- as much as she wanted, which amounted to a few spoonfuls of applesauce, ice cream, and/or pudding a day, and her mouth moistened with a sponge-on-a-stick – but everyone was surprised by how long she lasted.
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