Tuesday, March 22, 2005

On the Terri Schiavo case

On the Terri Schiavo case, I post a question above and beyond its being taken over from clinicians (as seems to occur in healthcare more often in the past few decades) by politicians and lawyers:

In my medical training and experience, while feeding tubes may have been removed from terminal patients (e.g., with cancer or post-stroke), an IV with basic fluids was not.

To my knowledge, Ms. Schiavo is not receiving IV fluid hydration such as normal saline solution. If anyone knows differently, please correct me.

The body loses significant fluid each day from respiratory losses, perspiration, etc. Without replacement, death will occur via dehydration long before it occurs from starvation.

Dying of dehydration was considered inhumane, at least in the medical world I trained in. I ask, somewhat rhetorically, if this has changed in the past decade since I left clinical practice for Medical Informatics.

-- SS

1 comment:

Wallace Sampson MD said...

On what constitutes unusual or unnatural means of support.

I think the giving of IV fluids to terminal patients may have been optional or a function of local policies. I never did it.

In Schiavo's case, why not have left in the feeding tube and give fluids that way? The answer is that the experts on the case are convinced that she is unaware of discomfort.

That makes me a bit uncomfortable, although they are probably correct.

The case is being argued on the wrong grounds, seems to me. Even if Terri cannot recover, the husband morally and reasonably should give up authority to the parents and family who want to care for her. If they are willing to do so at no expense to the public, there is no compelling reason to remove nutritional support.

I write as one who gave patients large enough doses of stuff which I knew they would use to exit at their own decision, and who opposes unnatural life prolongation at great expense.