Culture of life update: Woman taken off ventilator *while conscious*

[KamaAina]

because she didn't have insurance. This happened last month in Texas. The reply from Bush**co:

(crickets chirping)
(tumbleweed blows down Main Street)
(saloon doors swing open and shut)

http://cbs11tv.com/topstories/local_story_348124802.html

Daniel Salvi and his family surrounded his sister’s bedside Monday at Baylor Regional Medical Center in Plano and watched doctors take the 27-year-old off life support....

Salvi believes this would not have happened if his sister had health insurance.

"If you don't have money in this country, you're nothing. You're not a human being."...

A hospital spokesperson the facility offered to hire an immigration attorney free of charge to help bring the woman's mother from East Africa.

Oh, East Africa! Now I get it! The late Tirhas Habtegiris was a black African! And here I was thinking the culture o'life crowd was gonna get all worked up about this like they did about doe-eyed, white Terri Schiavo! Silly me! :sarcasm:

[Critters2]

1. Baylor?!

Isn't Baylor Southern Baptist? Hypocrites!!

[ken_g]

2. She wanted to die in her mother's arms! How wrenching.

They coudn't wait for her mother.

[bluerum]

3. Not one of the "have mores"? No RW fundy connections?

You are SOL pal. See you on the golden shores.

[katsy]

4. Ya' know...

There are days, naughty shameful days, when I fantacize that every puke would wake up one day on ventilators & dems (me for instance) have the pleasure of pullings their plugs.

I know... not nice. But their hypocrisy astounds me.

[xchrom]

5. sadly --- ding, ding, ding! -- we have a winner.

isn't just too disgusting for words?

[cascadiance]

6. It's kind of like their selective approach at going after churches

who support anti-war positions and other more progressive philosophy to try and take away their tax exempt status and not pay attention to their flock's far more abusive political stands that would merit losing tax exempt status far more.

I still remember Terry Schiavo's passing well. It was about the same time that my father almost passed away from having an emergency operation then and not being able to ingest nutrients afterwards as well. He's recovered now, but he came pretty close to leaving us in the same way, and we were reminded daily about how Terry Schiavo was suffering the same things he was more visibly and consciously, though he is suffering from Alzheimers.

[sui generis]

7. I don't see where it says she was "conscious"

I certainly don't believe that medical staff would have unplugged her if she was conscious and responsive unless it was at her personal request. That detail is uncorroborated.

Those doctors had to make a choice: keep her on ventilation and using hospital resources to await the unknown, possibly weeks or months distant arrival of her mother (although unconscious), or use those resources for other patients who stand a better chance of recovery.

It's really sad, but also really unfair to the doctors and hospital who did their best for her. She did have family present. Personally when I die I'd like a flaming viking funeral complete with sacrificed virginians, but I'm not going to say "in this country you are NOTHING, you're not a human being . . ." if you aren't given a free flaming viking funeral with a bunch of sacrificed virginians. . . .

DISCLAIMER TO ALL OUTRAGED VIRGINIANS: lighten up. I CAN afford a flaming viking funeral. It just might be you . . .
:P

[KamaAina]

10. I actually saw that part on Kos, via Slate

http://www.dailykos.com/storyonly/2005/12/14/151930/63

No one here can forget the spectacle made over the death of Terri Schiavo, whose brain had died long, long ago. But in Texas, the law George W. Bush signed as governor allows doctors to inform the family that further treatment is hopeless (and costly) and Pull the Plug. Literally.

In the latest case to escape the Culture of Life warriors, Tirhas Habtegiris, a young woman and legal immigrant from Africa, was CONSCIOUS and responsive when removed from a respirator and allowed to die....

Let me rephrase that: She was killed by doctors who removed the ventilator keeping her alive. And this action was fully legal under Bush's "economic considerations" law. Her body was ravaged by cancer, but she was alert. She was responsive.

The Slate piece is so repulsive I feel oddly compelled to link it:

http://www.slate.com/id/2133518/

Here, for the edification of bloggers everywhere, is an example of an economic consideration: If you ask people—and especially poor people—what their most dire needs are, you'll find that "guaranteed ventilator support" ranks pretty low on the list. OK, I haven't actually done a survey, but I'm going out on a limb here and predicting that something like, say, milk, is going to rank a lot higher up the priority list than ventilator insurance.

In fact, I'll go further. The back of my envelope says that a lifetime's worth of ventilator insurance costs somewhere around $75. I'm going to hazard a guess that if, on her 21st birthday, you'd asked Tirhas Habtegiris to select her own $75 present, she wouldn't have asked for ventilator insurance. She might have picked $75 worth of groceries; she might have picked a new pair of shoes; she might have picked a few CDs, but not ventilator insurance.

:puke: :puke: :puke: :puke: :puke:

Commentators in Slate's forum The Fray point out that well-off people like author Landsburg can afford both milk AND "ventilator insurance", whatever that is. What a dork.

[sui generis]

12. I can't find that anywhere else

and the tone on KOS was sensational. What is his source?

Now, since she was on a ventilator, she was also on a paralytic to keep the tube in without esophageal spasm, which means that although she may have been "conscious", like had brain wave activity, it doesn't mean that she was awake and aware of her surroundings.

She was surrounded by family. It's sad that her mother couldn't be there for her too, but this stage of grief is denial and anger right now.

She had a deadly disease that killed her, and all the ventilator is supposed to do is get you through a rough patch, not keep you around indefinitely.

Technically, if she needed a ventilator, she was already dead in other circumstances. If they put her on a ventilator, it wasn't in the hope that she would get better, it was out of compassion for the family. When it seemed unlikely that the mother would be able to be there, they had to do the right thing and disconnect her.

How do you think the medical staff felt? Do you think doctors and hospital staff just sit around waiting for an excuse to kill someone?

[KamaAina]

14. By popular demand:

http://www.opendiary.com/entryview.asp?authorcode=C100144&entry=20084

12:33 PM CST on Wednesday, December 14, 2005
By JANET ST. JAMES / WFAA-TV...

Salvi was stunned to get this hand-delivered notice invoking a complicated and rarely used Texas law where a doctor is "not obligated to continue" medical treatment "medically inappropriate" when care is not beneficial.

Even though her body was being ravaged by cancer, this family says Tirhas still responded and was conscious. She was waiting for one person.

Greed on top of greed: the original link at wfaa.com has registration :puke:

http://www.bugmenot.com

[sui generis]

15. by medical fact

how was she "responsive" on a ventilator?

Just curious. The family says she was but that goes against fact. She had to have been on paralytic, anti-spasmodic, anti-anxiety and some serious pain juice to be on vent for multiple days.

The only thing she could have done to be "responsive" is for her heartbeat to speed up or slow down in response to conversation or a new visitor. Somebody that far gone on vent can't even blink or track an object due to what they have to do to keep the vent in her.

They need to let go. Does anyone here think she would have recovered? I completely agree with the decision to remove her from life support. It was the humane and responsible thing to do.

Even if the family could have afforded to keep her on vent the doctor and staff would have done their best to talk the family out of it, and that is the critical point that's not being addressed in this.

[KamaAina]

16. Wasn't Chris Reeve on a vent for years?

Just curious.

[sui generis]

17. he was on passive ventilation

he was able to move his head and had some autonomous function.

Her lungs were destroyed and probably the muscles in her diaphragm compromised as well. I imagine she was on full intubated monitored ventilation.

I think it is a nice thought to wait for the mother, but if I were the mother, I would rather my child had died in peace than suffered for weeks waiting for me to get there for a grand opera death scene.

I know I sound crass, but death is a natural part of living. When you're there, it's time to go. It would be nice if it waited for a sunny day or a trip to the beach or a visit from your mother in a foreign land, but that's not reality. She had family there, and no doubt also had compassionate staff there despite what we seem to think.

A mature parent would realize that was the best that could have been hoped for under the circumstances. Trying to blame her death on the medical staff is misplaced grief.

[mongo]

22. I've been on a ventilator

and was conscious and alert.

I'm not saying one way or the other what the hospital should or shouldn't have done, but just because you are on a vent doesn't mean you aren't awake and aware.

[sui generis]

25. forced ventilation unable to breathe on your own?

Well I've lost one ex on ventilator who was conscious the first 48 hours (between sleep cycles) - major organ failure after three days, and another friend who had metastasized lung cancer.

My ex died suddenly of heart failure, following acute renal failure, although his kidneys were perfectly normal going on vent and he was put on vent after developing non-specific breathing difficulty from chemo for melanoma.

My other friend was "brought up" when they disconnected him after four days, at his request to be conscious if possible when disconnected, but he was not conscious before then. It took him about 15 minutes to die too, although he was unconscious again after about five minutes.

My personal experience has been with far end stage, as I believe this woman was. Ten days is a long, long time on full vent. If it was my sister that far gone waiting on my mother to show up, I would not have agreed to keep her alive indefinitely on full ventilation.

[mongo]

28. Forced ventilation

For about the first 24-36 hours after open heart surgery.

[Thtwudbeme]

11. You might want to get used to the fact that in the medical profession in

the US you are NOTHING if you don't have money. Zero. Less than zero.

As far as removing a concious person from a vent; I don't believe that either, personally. That sounds like rumour run amok horseshit to me.

But, as far as your comments about money--you are dead wrong. I don't really care if you have enough money for your viking funeral or not---if you or someone in your family comes down with something really heinous...and I hope you are all healthy as horses....there is a great chance you will go broke. I doubt you are Bill Gates posting on DU---

Stephanei

[sui generis]

13. okay miss grinch

I understand what you are saying, but the issue isn't whether or not she received indigent treatment for her cancer, it is whether she could afford to be kept alive indefinitely on a ventilator.

My comments about money weren't meant to be insensitive - Other Mr. Sui and I regularly give money to the AIDS charities here and have hosted and attended more benefits than you probably have years. We KNOW exactly what not having money will get you in this society. I also know a woman (sister of a friend of ours) who has HIV who pays cash - $3000 a month for her meds. She had briefly been paying that amount waiting to go onto insurance and we picked up a payment for her.

The interesting thing is that after the insurance took effect and the copay was deducted out the pharmacy still charged her insurance company $3000.

No, Stephanie, the real problem isn't being poor, as you inadvertantly pointed out. The real problem is that healthcare, and pharma simply cost too much, whether you have money or not. Hospital costs of 20 dollars a pill to administer Tylenol three times a day?

Don't you think that if we controlled healthcare costs up front with draconian regulation that states could afford to provide healthcare to the insurance-indigent? The problem is NOT poverty. It is our lack of willingness to regulate. At the end of the day, as an unregulated service, it will be cut off for non-payment, until we regulate what makes it so expensive to begin with.

[Thtwudbeme]

18. How am I a grinch?

and why do you keep hinting at being rich? That's vulgar, and you haven't a clue as to how much money anyone on this board has.

Stephanie

[sui generis]

20. what on earth are you talking about?

are you reading something that I didn't write? I'm not hinting, I'm not claiming, I'm not doublespeaking. Are people around you usually dishonest? I'm not. I will tell it to you like it is whether you think it's vulgar or not, and you won't have to read betweeen the lines. Spare yourself the effort.

And accusing me of being vulgar is vulgarity itself. I thought we were on friendly terms, but apparently you are a bit full of yourself yourself today.

Here's a lecture. I am SHARING. If you have a problem with that then please feel free to keep your opinion to yourself. If discussions of money bother you I certainly don't see you lecturing people here who say they don't have money for being vulgar. I am being honest and open and sharing my experience and if I have to LIE to do that then I would truly be vulgar.

Now if you have anything to say about the points I made before you got all pissy with me about income, please feel free to elaborate on THOSE points.

[Thtwudbeme]

30. No, people around me are not usually dishonest, and

here are the comments you were asking about:

"I CAN afford a flaming viking funeral. It just might be you . . ."

"My comments about money weren't meant to be insensitive - Other Mr. Sui and I regularly give money to the AIDS charities here and have hosted and attended more benefits than you probably have years. We KNOW exactly what not having money will get you in this society. I also know a woman (sister of a friend of ours) who has HIV who pays cash - $3000 a month for her meds. She had briefly been paying that amount waiting to go onto insurance and we picked up a payment for her."

You were the one who referred to me as the "Grinch." I am quite sure that we are on friendly terms.

However, I read your comments about your money as bragging. No doublespeak, no inuendo there---just flat out bragging. There are posters here that are barely able to afford their heat this winter. I am sure that if you knew them personally, that you would host a lovely fundraising benefit---however, in the meantime, the best deeds are the ones done quietly.

Stephanie

Btw--could you refer to me as "Ms. Manners" instead of "Miss Grinch?" Thank you so much.

[sui generis]

31. (holds head, sighs)

Well, I wasn't bragging and you have it from me.

It was a poorly thought out attempt at connecting the cost of staying alive longer than ten days on a ventilator to the cost of a mythical viking funeral. It was intended to be in jest, not bragging. Plus sacrificial virginians really probably are outside my budget, but I'm sure I could scrape together a barbie yacht or something.

Yes, sometimes putting one's personal name, resources, and contacts behind a fundraising event raises more awareness of the event than not. That's a fact, not bragging, and I'm not saying that with any grinchiness myself, Ms. Manners ;).

However, I don't believe that anyone who relies on the proceeds of such an event can pick and choose whether they like the perceived deep humility and modesty of the host and therefore can accept the resources based on that judgement. Like as not I wouldn't hold a "lovely fundraising event" for the situation you described - that was an unnecessary jab. If I said I'd just give my friend the money you would say that was bragging, but it's not - but that's what friends are for. So I shouldn't say anything, worried about how it will be taken? I certainly wouldn't run an ad in the paper saying who I'd given the money to and how much. That would be bragging AND vulgar, and it would no longer be just between friends.

My point about the cost of that particular set of prescriptions was a comment on the cost of HIV drugs, as well as a comment on the state of pharma regulation, NOT bragging. I am not sure how I would have given personal credibility to that statement without lying, otherwise, so I told the truth, plus I was typing real fast.

My comments are not really open to judgement, Steph. Just as you assume that I'm "lording it" and being vulgar, which is negative, it's also a call to those of us on DU who CAN give to remember to do so. I realize that ANYONE in a position to do that is going to be accused of vulgarity if that's the way one wants to read it, whether they are urging a donation of 5 dollars or 5 thousand dollars. I posted earlier about going to the food banks regularly with Mr. Sui - this is what really IS important to us, not bragging. I posted it not for kudos from a bunch of strangers, but because I wanted to set an example and encourage other people to do the same if they were able.

Nonetheless, if there is a way to look at it negatively, someone will probably find it and I can't waste heartbeats worrying about it. We're all in this together. If I have to worry about being perceived as immodest and vulgar for being myself, I suppose I'll just have to live with being perceived that way. Anyway, everyone already thinks I'm immodest and vulgar, which I am, most days. ;)

:shrug:

[opihimoimoi]

33. We do live in a fucked up society if ya already didn't notice

Shit like this happens all the time.

Good health care is only for those who happen to have money/insurance....all others must eat it.

There is no village today...only selfishness and callousness.

[sui generis]

34. well if it is to be a village then the villagers

have to decide so.

I guess that's why we are here on this side. I believe in the village - but we have to overcome some monsters. This war drains every penny away from us and corporate welfare does the rest. We have to win on populist issues - we have all been screwed by the "me me me" boomer generation (the ones on the other side), and don't even know just how badly just yet.

Healthcare costs are outrageous, and our elected reps do nothing to regulate it in any meaningful way, because the pharma lobby insists that they have a greater right to profit than you or I do to exist.

Along with energy, water, transportation, the economy and the environment we HAVE to re-regulate healthcare.

We're giving away money to American Airlines and US Air to stay in business while Southwest has never not been profitable. We're allowing private companies to collude on the price of energy, costing us personally, at the gas station and in the environment of our own homes, we claim that each state has the right to regulate the levels of toxins in the water differently, we sell meaningless pollution credits in some monopoly money game that does nothing to really keep the air you breathe clean, and we allow big pharma and the health insurance industry to rape the people who can least afford to pay, because "they have a right" to profit. We allow credit card companies to charge userous rates and prevent you from declaring bankruptcy if you have ever been unfortunate enough to break an arm and have to go to the hospital and walk away with a 10,000 bill, and this village needs to gather round and pick up our weapons and slay these monsters and use their heads for trophies.

I believe in a mostly free economy - but I also believe that the government's core purpose is to provide for our mutual wellbeing, and you can't do that when you value the rights of a corporation over the wellbeing of individuals. Pharma and the oil companies do not have a right to exist in their current unregulated form.

[opihimoimoi]

37. I agree...the Peeps must call for the improvement themselves in

a way that succeeds.

The Solutions will soon become apparent as the problems evolve to that point...either we improve or we gp extinct.... We Humans will have no choice... to Solve and Live..OR..... to Deny and Die.

[lapislzi]

35. There's a flaw in your analysis

When you refer to health care as a "service." Health care in this country is not a service. It is a BUSINESS. And that is where the problem lies. There is a fundamental conflict between a corporation's directive to turn a profit and providing for the well being of humans. The two rarely, if ever, intersect.

Ask yourself: why is the insurance business involved in health care? There's only one reason, and it's because there's money to be made from human misery.

[sui generis]

36. totally agreed

I was referring to "service" in the "wellbeing is optional, we don't have to give it to you" sense, not the pure economic definition.

Absolutely both pharma and health insurance are parasites. If insurers had their way it would be mandatory for everyone to have insurance, but no claims would ever be paid beyond annual checkups, and then only the "reasonable and customary" $5.00 that it costs (sarcasm).

The insurance industry is just as corrupt and always has been, openly in collusion with private industry using various private non-profits to "consolidate" medical insurer records for statistical purposes. Mmmm hmmmm.

That's what needs to be torn apart and reregulated.

[liberalitch]

21. I'm thinking how much cheaper my burial would be if I were terminally ill

I'd sign up for your sacrifice..... only if I can be sacrificed in a bear suit (one native to Va. of course)

[sui generis]

23. I blew out some lung tissue

getting over a cold and that cracked me up!

:yourock:

[liberalitch]

26. I hate the "hanging snots".....

the globs that you can't blow out.... but you can't snort them down your throat

[Horse with no Name]

8. This is terrible

However, I worked for Baylor and can vouch that MANY times they brought family in from other countries at the hospital's expense to say goodbye to their loved ones.
It sounds--from the story--that there wasn't any hope of getting her mother here in time due to immigration laws.
"Relatives, however, said the East African process was too lengthy."
It brings to light the question again--just because we CAN prolong life, should WE?
The cancer had spread throughout this woman's abdomen and her lungs.
What suffering that must have been.:(

[oldcoot]

19. Why is it our decision?

Although I would not want to be kept alive under these circumstances, I do not have the right to make that decision for others. I believe that it should be the patient's choice if he or she is able to communicate. If not, the patient's next-of-kin should make the decision. I do not favor allowing hospitals to make this decision.

[Horse with no Name]

38. Terribly sad that it comes to this occasionally

When you have an end stage cancer patient who basically just wants to hold on for something that isn't going to happen--what other road do you have to go down? If the embassy says no--then she is not going to get to die in her mother's arms as heartbreaking as that is.
The Social Workers are generally very good about cutting through immigration red tape. One has to wonder why the East African embassy would not cooperate for this request? I am sure there is more than we know to this side of the story.

[BushOut06]

9. What, no Bill Frist intervention?

Well, I'm sure at least Sean Hannity was broadcasting his show from there, right? You mean the same people who went nuts over Terry Shiavo didnt' give a damned about this case?

[FreedomAngel82]

24. So sad

We NEED national health care in this country. And don't forget baby Son too. Poor little guy didn't even have a chance!

[Avalux]

27. In defense of the clinical team at Baylor -

from the perspective of a medical professional, metastatic cancer and ventilator means this young woman was terminal and was probably near death - they may have had medical reasons for removing her. We don't know because we weren't there. She may have only had hours to days - perhaps she made her treatment wishes known to her physicians and not her family? It's possible. Please take all these things into consideration before claiming it was because she didn't have insurance.

[bleedingheart]

29. agreed

[sandnsea]

32. It's TEXAS LAW

Please go look up the law. In Texas, an ethics team makes these decisions and it IS based on the fact that this care is expensive. Yes the woman was terminal, but they were trying to get her mother to her and her family was not ready for her to be removed from life support. That is the issue, the family should make these decisions and the cost of the care shouldn't matter. It is also my understanding that she was still alert. If she had had insurance, another facility would have taken her because it's just naive to believe that any facility would turn away money in a capitalist society.

[alarimer]

39. This law sucks

It is heartless and totally contrary to the "culture of life" the republicans keep spouting. If Terri Schiavo had been in Texas and poor, she would have been removed from life support long before she was. Oh, by the way, how come you don't see Frist and company making a law to keep this woman alive or that baby that was taken off life support months ago. I guess if they are rich and white (although I don't know how much money Terri's family had) you get s lots of press attention but if you are poor or black, hospitals can kill you no matter what your family might want.