Ron Panzer

Quoted by Ron Panzer

The pushing of DNRs on patients will only increase as the culture of death flourishes, making them mandatory in many settings, contrary to patients' wishes.  It was all a stepping stone to legalized euthanasia where the unwanted may be killed against their wishes (all in the name of patients' rights/autonomy!)

Is POLST already here in Canada

What happens if a patient changes his or her mind: like I was told when Randy alledgedly agreed to a DNR him not knowing what a DNR was, I was told that Randy can't change his mind whenever he talks to me. Simple solution get rid of all DNRs and Advanced Directives and make physicians technicians not instruments of quality of life budget constraints.We will all die in good time and we do not need the state to help us. Life is worth it no matter what.


NDY quoted in Pew Trusts’ Stateline: New End-of-Life Measure Quietly Sweeps the Nation

Posted: 21 Jun 2013 03:50 PM PDT

This week, the Pew Charitable Trusts’ Stateline carried an article entitled “New End-of-Life Measure Quietly Sweeps the Nation.”  The measure described is Physician Orders for Life-Sustaining Treatment (POLST), sometimes also called Medical Orders for Life-Sustaining Treatment (MOLST).  According to the National POLST Paradigm website, POLST originated in 1991, and 14 states had adopted it by 2004, when the National POLST Paradigm Initiative Task Force formed to expand the practice.
This blog has only covered POLST twice, once regarding the Illinois program and once regarding the New Jersey POLST bill.  A POLST is a medical order, signed by a physician, instructing a health care provider about what types of life-sustaining treatment to provide or withhold.  The instruction is supposed to be based on the wishes of the individual or their authorized surrogate health care decision maker.  The National Task Force “strongly recommends” that the patient or surrogate signature also be required, but not all states have adopted that requirement.
A primary concern about POLST is whether an individual’s POLST form actually reflects their wishes, and whether the individual’s wishes are based on informed consent.  Other forms of advanced directives in which people designate their health care wishes are not signed by physicians, so they need to be translated into medical orders to direct health care provider behavior, but POLST is a medical order that is effective immediately.  If you or someone else calls 911 in an emergency, the emergency medical technicians (EMTs) know to look for a POLST form and to do what it says.  If the POLST form says “do not resuscitate”, then the EMT’s are supposed to comply.
The Stateline article briefly but accurately reflects the disability community’s concerns as follows:
Some disability rights groups have focused on the issue of patient signatures. Without one, according to Diane Coleman, president of the disability rights group Not Dead Yet, “How do we know the POLST medical order actually reflects the desires of the individual?”  Coleman worries that depending on how POLSTs are presented, they can make life-sustaining treatments—such as the use of feeding tubes—seem unbearable, even though many disabled people are able to live full lives because of them.
The reporter, Michael Ollove, also interviewed Cathy Ludlum from Second Thoughts Connecticut, and noted that:
Disabled rights groups lobbied successfully against POLST in Connecticut this year.
I don’t know about you, but successful lobbying against a mainstream bill by a disability rights group is not something I read about every day.  Second Thoughts CT developed an effective flyer, researched with citations, to talk about the concerns they had with the bill.  Among other things, the flyer said:
While MOLST is intended for people with about a year to live, there is a real danger that people with chronic and severe disabilities will get swept in as well.  In California, nursing facilities pressured all patients to have a POLST, whether or not they were terminally ill.  Delaware recently suspended its MOLST for similar reasons.  People with years ahead of them are often considered “terminal” by medical professionals not familiar with the disability world.  … Many of these concerns could have been addressed if people with disabilities had been at the table designing Connecticut’s MOLST pilot.
Connecticut’s research was very helpful to me and led me to some additional resources.
The Stateline article was picked up by the Huffington Post, which received 78 comments, including several by Stephen Drake, who went toe-to-toe with other commenters, and myself.  As Stephen noted, “If the patient or surrogate signature isn’t required, this document is less about safeguarding the rights and preferences of the patient than it is relieving some perceived burden of uncertainty on medical providers.”
My comment passed on the information that I got from CT, and connected the dots between POLST concerns and futility policies:
Some problems with POLST implementation have come to light.  Delaware suspended use of its POLST form when it was found that it was being used for people who did not meet the state’s criteria for POLST eligibility in that they were not terminal.  In California, the state protection and advocacy agency issued a report documenting a case alleging that an individual’s physician revised his POLST form to say the opposite of the patient’s expressed wishes to receive life-sustaining treatment.    It is perhaps a little known fact that many states allow doctors to overrule a person’s choice to receive life-sustaining treatment under “futile care” policies.  (See http://medicalfutility.blogspot.com.)  A balanced approach to POLST policy development must take these realities into account.
That last sentence sums it up for now. – Diane Coleman

The following demonstrates that a woman was not in cardiac arrest.  Now it seems the cut off for dying from six months is now one year. The woman was 62 years old.

New End-of-Life Measure Quietly Sweeps the Nation

By Michael Ollove, Staff Writer

Joe Takach talks to his friend Lillian Landry as she spends her last days in the hospice wing of an Oakland Park, Fla. hospital. Many states have adopted a new end-of-life document designed to ensure that a patient’s wishes are respected as death approaches. (AP)

The emergency call came in at 10:47 on a Saturday night: “Woman in Overland Park with difficulty breathing. Code one closest.”
Angela Fera, a paramedic in Johnson County, Kan., and her partner raced to the house, sirens blaring. When they arrived, six minutes after the first dispatch, a man told them that his 62-year old wife had terminal cancer and was unconscious. The paramedics found her sitting upright in bed, ghostly pale with a weak pulse and shallow breathing. Death seemed imminent.
The woman was under hospice care, and had signed a “Do Not Resuscitate (DNR)” order. She had made her wishes clear: She did not want to be taken to the hospital if a life-threatening medical emergency arose.
But the woman was not in cardiac arrest, the situation specified in the DNR order. Protocol required that Fera try to save her life, probably by inserting a plastic tube into her trachea to restore breathing and transporting her to a hospital, where she’d be put on a ventilator. Fera guessed that was precisely what the woman did not want. But the husband felt that his wife’s children—his stepchildren—should be the ones to decide whether to withhold treatment.
“We were completely fighting all our instincts to jump in and save her, but on the other hand we really wanted to do what was right,” Fera recalled.

New End-Of-Life Document

A new end-of-life document, more explicit and binding than a DNR and advanced directives, is designed to clarify patients’ wishes—and spare caregivers such as Fera from facing such wrenching choices.
A “physician order for life-sustaining treatment” (POLST) is a medical order, signed by a doctor or other authorized medical provider. The product of a conversation between patient and provider, a POLST specifies a patient’s goals and desires as death closes in. Unlike a traditional DNR, it covers such medical interventions as resuscitation, hospitalization, use of antibiotics, hydration, intubation and mechanical breathing ventilation.

See POLST Form

Without much opposition or attention, many states have adopted POLSTs. This year, Indiana and Nevada approved legislation to allow their use, leaving only seven states and the District of Columbia without POLSTs in at least some stage of development.
They tend to come in garish colors—neon pink, orange, and green, for example—so they stand out among other documents in a home. People are encouraged to put them on their refrigerators, and paramedics are trained to look for them there. In Oregon, where POLSTs originated in the early 1990s, they are recorded in an electronic registry so first responders can access them online. Other states are moving in the same direction.
Research suggests POLSTs are effective in matching treatments to patients’ wishes. According to one study, patient preferences noted on POLST forms matched the actual treatment—or non-treatment—in more than nine out of 10 cases.

Vague or Irrelevant

Dr. Susan Tolle, one of the creators of POLST and director of the Center for Ethics in Health Care at the Oregon Health and Science University, said DNRs and other end-of-life documents tend to be vague or irrelevant to many medical situations. In many cases, they are signed by somebody whose authority may be in question during a medical crisis.
“We needed a portable system of actionable medical orders that would follow the patient and be consistently respected across settings of care, whether that was in a long-term nursing care facility, home, hospice, the ambulance or an acute care hospital,” Tolle said.
POLSTs are often confused with advanced directives, but they differ in significant ways. An advanced directive is often completed by a healthy person, and is purely hypothetical. It lacks the  medical authority of a physician’s signature.
By contrast, a POLST is completed by a medical provider in consultation with the patient. POLSTs are geared toward severely ill patients who are expected to die within a year. According to Tolle, the most common triggers for completing a POLST are when someone begins hospice care, is admitted to a skilled nursing facility or is discharged from the hospital where they had a DNR order.

Some Are Wary

All states require a medical provider to sign a POLST. In most, the signer must be a physician, though some states allow other medical personnel, such as nurse practitioners, to sign it. Most states also require the signature of the patient or a designated surrogate but some, such as Oregon and New York, do not.
Some disability rights groups have focused on the issue of patient signatures. Without one, according to Diane Coleman, president of the disability rights group Not Dead Yet, “How do we know the POLST medical order actually reflects the desires of the individual?”  Coleman worries that depending on how POLSTs are presented, they can make life-sustaining treatments—such as the use of feeding tubes—seem unbearable, even though many disabled people are able to live full lives because of them.
Disabled rights groups lobbied successfully against POLST in Connecticut this year.
In Texas, Wisconsin and Florida,  opposition to POLSTs has come from Catholic groups. Edward Furton of the National Catholic Bioethics Center worries that in cases where POLSTs do not cover the exact circumstances of the moment, denying care may be akin to euthanasia. “When you look at the POLST documents, they don’t take into account the circumstances that the person is in at that particular time and place,” Furton said.
Nonetheless, there is no monolithic Catholic position on POLST. POLSTs have received strong Catholic support in some states, including California and Louisiana.
“This is not about ideology or religious views,” said John Carney, president of the Center of Practical Bioethics in Kansas City, which has worked to bring POLST to Missouri and Kansas. “This is about dignity and making decisions about what I want about my own life.”

Fera’s Choice

At the scene of the emergency in Overland Park a year ago, Fera the paramedic had to act fast: She asked the husband of the unconscious woman to summon his stepchildren and a nurse from the hospice service. Then she directed the fire crew to use a bag valve mask to help the woman breathe for a short time.
When the woman’s children and the nurse arrived, they quickly confirmed that the stricken woman had repeatedly said she didn’t want to be revived in such a situation. With that assurance, plus approval via radio from an emergency room doctor, Fera and her partner left the woman at home in the care of the hospice nurse. They drove off, certain that the woman’s end was near, and fairly sure that they had acted according to her wishes.
Fera is grateful that she is less likely to face similar situations in the future. In the year since responding to the call in Overland Park, Johnson County has adopted POLSTs. “To say we like it,” she said, “is an understatement.”

Issues:

Health

13 June 2013

I went to the food bank this morning.  The story of my future life.  Food banks and the insecurity of rental housing.

1 400 grams of Ccheerios box
1 411 grams of Oroweat Cinnamon Raisin muffins\
2 bottles of water
1 Eastmore brocooli sprouts 60 grams
400 grams of Danone Silhouette yogurt refreshing apple flavour
1 can 540 ml dark red kidney beams
 106 g of Gold Seal small shrimp can
4 medium-small apples
2 medium onions
5 medium-small potatoes
candy canes from Christmas

I spoke to Randy today and he wasn't all that alert.  I showed him a $20.00 bill and he did not know what it was and he allowed it to fly away in the wind.  If Randy concentrates hard enough he can catch things with his right hand.  This I learned when I threw a small plush toy at him when he was in VGH so many years ago. the  months he spent in VGH in isolation with hospital acquired infections.

7:30 pm  Randy was anxious about something and so I gave him a letterboard.  He spelt JAC and then I remembered from yesterday I had washed his jacket and he wanted it.  I washed it but it was still in the washing machine as I forgot to take it out of the washer to put it in the dryer.  His memory astounds me at times.  At other times there is nothing there.  Like I asked him if he went to physio today and he couldn't remember.  

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Off to City hall

On Wednesday Randy and I ventured to City Hall on Cambie to pay the doggie liceences.  This City is so expensive.  It cost $88.00.  Randy had a good day yesterday and he was very alert.  I wish he was like that every day.  He wanted me to take him to see his lawyer but I couldn't as it was late in the day.  As we passed a medical supply store he kept pointing to a pair of crutches in the window.  I wish I knew for certain that Randy will never walk again but I don't.  During the three years Randy has been at GPC I only talked to Dr. Dunn three times.  Two being sixty second sound bites and another time he glossed over Randy's file neglecting to mention he had code blues and also a recent heart attack.  I suspect he isn't even familiar with Randy's medical condition.



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The medical establishment is in control

Doctors Deny Lifesaving Care for Canadian Patient, Say Quality of Life Too Low

by Wesley J. Smith | LifeNews.com | 6/6/13 10:59 AM
Bioethics pushed personal autonomy to the forefront of medical decision making, helping forge the legal right to say no to unwanted life-extending care. Today, if a person doesn’t want to be in an ICU or to be otherwise kept alive with medical treatment, the patient or family can say no. And that’s generally a very good thing. Indeed, without the right to say no, the hospice movement would never have materialized.
But what about patients who want to say yes to such care? Increasingly, patient autonomy is becoming a one-way street. If you want to die, fine. That decision is sacrosanct. If you want to live, well doctors and bioethicists get to make the final decision. This is sometimes called Futile Care Theory or medical futility.
Futile Care Theory is as much about money as it is about benefiting the patient. It is also about honoring the subjective views of doctors and care givers–even at the expense of rejecting a patient’s specific request for efficacious treatment, that is, treatment that would or could achieve the desired medical result of extending the patient’s life.
Now, in Canada (yet again), we see a case in which a patient stated he wanted to be kept alive but the doctors don’t want to comply.

This mindset trickles down to denying quality of life medical treatment to the rest of us when we become seriously injured.
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Victorious for Five

I felt victorious for all of five minutes today.  I went to see Randy and the curtains shielding Amy from human contact were open.  I could not believe it.  After all these years finally these dangerous curtains which provided a blind spot so Randy could not be seen by the nursing staff were open.  My victorious feeling only lasted a few minutes as I asked where was Amy and was told that she was at VGH and would be back and the curtains were only opened because housekeeping had just cleaned her space.

Randy is in a high risk open ward but he is mostly hidden behind curtains.  He has an ABI and he can't or won't use a call bell provided it is even given to him, he can't call out for help as he can't talk, he has a trach, and since the residents at GPC will  never to be productive members of society, care is cosmetic.

If you are of the 80% of the population that are currently in good health and have a future, you will be looked after by our health care system..  If you part of the 20% who are marginalized (i.e. not in good health and no quality of life), your care will be less than optimal.

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Read This

Public Comment by Marilyn Golden, Policy Analyst, Disability Rights Education and Defense Fund (DREDF) Before the Institute of Medicine Transforming End-of-Life Care Committee 
May 29, 2013
I’m Marilyn Golden, Senior Policy Analyst at the Disability Rights Education and Defense Fund. We’re a leading national law and policy center on disability civil rights.
We have many concerns – –the common thread is the many stories we hear from people with disabilities, again and again, illustrating that our lives are seen as less worth living than others——so much less that health care providers too often think death is the correct course.  They press this viewpoint on us, our families and sometimes even overrule us when we disagree.
Let me tell you a true story about a young disabled woman who worked for the Center for Disability Rights in upstate New York. At the age of 19, she’d had a car accident . . . . While lying in a hospital bed on a ventilator . . . doctors would ask her mother if she was ready to “pull the plug”.  ”Why would I want to do that?” she would ask. The doctors answered, “What kind of life will she have—she won’t be able to dance, walk, work, have a social life, or be independent.” Over and over.
Terrie had a rough time medically, but eventually, she was spending hours a day off the ventilator and the doctors were still asking if she wanted to live with this condition. If she chose no, they would keep her off the ventilator and she would die, with morphine for comfort.
When she returned a year later, with a power wheelchair and no ventilator, the doctors’ jaws dropped to the floor and their eyes began to fill with tears. They always meant well and thought they had been doing the right thing.
Today Terrie is still working for disability rights and has a darling young daughter. We’re so glad she had the wisdom to go against her doctors. 
A related problem we see in the end-of-life field is a deep misunderstanding that the only problem to be addressed is over-treatment at the end-of-life. A balanced approach would address something rarely acknowledged: that there is another problem, under-treatment at the end-of-life, and pressure against life saving treatment, resulting from health care disparities, discrimination, including discrimination against people with disabilities, and economic considerations.  
These issues come up in many ways:

• discriminatory “futile care” policies allowing healthcare providers to use quality of life judgments to overrule our decisions to receive treatment;
• discrimination in organ procurement and transplant practices; and          
• discriminatory rushing to judgment and denial of life sustaining treatment of newly injured persons based on hasty and unsupportable diagnoses of “persistent vegetative state” (PVS).  

Lastly, on another point, we and many disability organizations oppose the legalization of assisted suicide, which is just too dangerous.  It’s a prescription for elder abuse, and when legal,  it’s the cheapest treatment available, a frightening thing in our profit-driven healthcare system. Terminal diagnoses are too often wrong, the so-called “death with dignity” safeguards are hollow. Because the dangers so outweigh any benefit, the legalization of assisted suicide should be opposed.
Sincere thanks to Marilyn and DREDF for delivering this important message to the Committee.  Let’s hope the members and staff listen carefully. – Diane Coleman
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123975

Why Pro-Choice is Destroying Society

How legalizing euthanasia changed Belgium.

The following article was originally published on MercatorNet on May 17, 2013

By Tom Mortier & Steven Bieseman

In 2002, Belgium became the second country in the world after its neighbour, the Netherlands, to legalise euthanasia. Over the next decade our country has become a living laboratory for radical social change. With many other countries debating legalisation at the moment, now is a good moment to stand back and take a good long look at the results.

In 2002 Belgium was governed by a coalition of Liberals and Social Democrats. The slightly more conservative Christian Democrats had been excluded. With blue as the colour of the Liberals and red of the left-leaning Social Democrats, the press dubbed it the Purple coalition.

The Christian Democrats took a dim view of euthanasia, but they were in opposition. The Purple coalition was free to pass a euthanasia law based on the view that an individual should always have a “free choice” to end his life. In absolutizing individual self-determination the left and the right found common ground.

The law states that doctors can help patients to die when they freely express a wish to die because they are suffering intractable and unbearable pain. The patient needs to consult a second independent doctor; for non-terminal illnesses an independent psychiatrist must approve. In practice, however, this independence is irrelevant. Belgium is a small country and compliant doctors are easy to find.

A string of recent cases leaves no doubt that the euthanasia law has fundamentally and drastically changed Belgian society. Last year 45-year-old deaf identical twin brothers who couldn’t bear the thought of going blind were granted euthanasia. Doctors granted their request because they “had nothing to live for” anyway. According to the doctor who gave the lethal injection it was not “such a big deal”.

In another case, a 44-year-old woman with chronic anorexia nervosa was euthanased. Then a 64-year-old woman suffering from chronic depression was euthanased without informing her relatives. The doctors defended their decisions by explaining that these extreme and exceptional cases were legitimate because all legal conditions were met.

Euthanasia is hardening from a medical option into an ideology. Belgium’s euthanasia doctors even believe they are being humane because they are liberating people from their misery. Fundamentalist humanists go further and describe euthanasia as the ultimate act of self-determination. The opinion of the patient’s family has no weight whatsoever. A doctor is entitled to give the mother of a family a lethal injection without offering any explanation to her children. Euthanasia is being promoted as a “beautiful” and positive way to die. Doctors are transplanting organs from patients who die in the operation. (This is said to make their lives meaningful.) The law may soon allow children and patients with dementia to be euthanased.

Since 2002 opponents of the law (like us) have been marginalised as rigid and heartless conservatives who feel ill at ease in a post-modern, pluralistic and progressive society like Belgium. (1) The Christian Democrats have repudiated their traditional values and support the law. Questioning it has become taboo because the absolute right of the individual might be violated.

Herman De Dijn

There are still some significant critics, apart from the Catholic Church. The Belgian philosopher Herman De Dijn is an outspoken opponent. He describes Belgium as a “sentimentalist society” in which traditional values have been drastically minimized and replaced by subjective preferences. (2) A sentimentalist society no longer subscribes to ethical values other than those which are related to the search for individual happiness (autonomy and no-harm). Communal responsibilities and moral institutions are being discarded in the search for purely individual well-being; interdependence and connectedness are ignored.

De Dijn feels that this is the nub of the problem. A human being is not a bundle of individual feelings, opinions and preferences, but part of a species, a member of mankind, a vital link in the moral ecology where every individual has a unique symbolic value. Respect for human dignity includes not only respect for personal choices but also for connectedness to loved ones and society.

  

Supporters of the euthanasia regime repudiate this secular critique -- as well as the baneful influence of the Catholic Church. (3) However, their ideology of absolute self-determination has become so strong that it is morphing into a theology, a quasi-religious fanaticism. They have invented comforting symbols and rituals to express their beliefs. A self-determination card describes a patient’s final wishes so that the social services know what to do in a terminal illness. There are centres where people can ask questions about how euthanasia can be performed. There is indoctrination in self-determination for doctors and volunteers who wear their euthanasia enabler certificates as badges of honour.

Nonetheless, we are hopeful. Surely it must be possible to convince the Belgian public that something is terribly, terribly wrong when politicians are debating whether parents can legally have their children put down. It is not humane and it is not scientific. There is no scientific scale of unbearable suffering. With advances in pain relief, euthanasia is not even needed.

The key insight of the green movement is that all living beings are interconnected – even us humans. Especially us humans. The job of politicians is to protect this connectedness. Otherwise, why should parents care for their dependent children? Why should children care for dependent parents? Once we lose the sense that each of us is bound to one another with invisible cords of fellowship, we will end by killing all those who are burdens on society. And at some stage, all of us are going to be burdens.

Euthanasia does not threaten religious dogmas. Churches will stay open no matter what happens in hospitals and nursing homes. What is threatened is humanism. Instead of standing strong, arms linked together as brothers and sisters, the dogma of self-determination separates us, places us in bubbles of isolation, and then offers to kill us – if we want.

In today’s Belgium all of us are at risk.

Tom Mortier and Steven Bieseman teach in Leuven University College, in Belgium. They would like to thank Emeritus Professor Herman De Dijn for valuable discussions and Sylvia Statz for advice about translating the text.

Notes

(1) Burms A. and De Dijn H., De sacraliteit van leven en dood, Pelckmans Uitgeverij nv, Kalmthout, (2011), S. 71-89.

(2) De Dijn H., Taboes, monsters en loterijen, Uitgeverij Pelckmans, Kapellen (2003), S. 23-25.

(3) Burms A. and De Dijn H., De sacraliteit van leven en dood, Pelckmans Uitgeverij nv, Kalmthout, (2011), S. 91-99.

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Time

It doesn't seem to make a sifference; no matter how I try I never get catchup to the times I have to do.  I do not even have time to blog.  Everyday a new prioritory presents itself.

This past week Randy was being difficult and I did not know why.  Finally, yesterday he pointed to an application which I picked up from the bank when we were doing the banking.  After much pointing last week and yesterday I finally gave him a letter board and he slowly spelled out C+R+E.  I knew then he wanted me to fill out the credit card application.  I asked him why would he want a credit card.  No answer.  I then asked him if he wanted a credit card in case of an emergency.  He nodded his head YES. We mailed the credit card application and he was happy. He amazes me at times with his memory and determination. 

Since January 2013 Randy has been on strike against the RTs at GPC. He won't let them treat him.  Why, because he sees them as being the cause of him not having a passey-muir valve which would enable him to talk.  I was never told that he can't talk if it was attached to his trach, but rather that it was too dangerous...
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Terri Schindler Schiavo and Us

Need I say more about the dangers of advanced directives/DNRs ...see below letter dated May 10, 2013  This letter does not mention that from the time a patient knows of a DNR in Texas it is only a few day I think I read ten days to find another hospital to transfer to.  Good luck finding one on short notice. 

You might want to refer to the recent Kenny Ng 2013 BC Supreme Court decision which allowed his surrogate to starve Kenny to death and it was supported by evidence given that it was a medically appropriate decision. 

We live in a climate that many of us do not even have a family doctor who could (maybe) advocate for us. Just strangers who are under intense pressure to contain unproven cost savings and promote the mantra that quality of life is more important than life itself.  I was horrified when in January 2013 I was told by a young doctor that medicine was about quality of life. If newly educated doctors are taught this and they continue to believe it, we are lost.

Recently I spoke to a health professional who really did not understand advance directives but who told me that if he didn't honour a DNR that he could be sued.  What ignorance. What stupidity. You can't sue hospitals or hospital medical teams. As a further comment: do you think any court will $award anything for saving a life. Impossible.

All health is pro-life; otherwise, it is not healthcare. (Ron Panzer)


Dear Texas House Members,


My sister, Terri Schindler Schiavo, and the horrendous acts that took her life represent the tragic logic of the slippery slope of futile care policies, similar to the one enshrined in current Texas Advance Directives Law (Chapter 166.046 of the Health & Safety Code).

On March 31, 2005, Terri finally succumbed to dehydration and starvation because her estranged spouse and those entrusted to protect and care for her rejected her value as a disabled human.

Since Terri’s intentional death by dehydration, my family and I have established a foundation, the Terri Schiavo Life & Hope Network, through which we advocate for patients and families who fall victim to the same quality of life judgments to which our beloved Terri was subjected.

The hospitals and personnel and locations may be different than Terri’s, but the story is often the same: An unelected body of hospital or facility caregivers, strangers to the patient and deciding in secret, impose their own value judgments about a patient’s life and illness and then determine that continued wanted medical care should be withheld or denied. See the recent 2013 BC judgment of Kenny Ng wherein it was stated that it was a medically appropriate decision to starve Kenny to death.Search Vancouver Sun KENNY NG.

"Futilitarian ethics" seems to be growing in hospitals and care centers across America, and the powerful medical lobby has become more aggressive in codifying policies that jeopardize the lives of the disabled and dying.

Current Texas law is one such threat, and our foundation has been involved in helping a number of patients navigate through the futility review process and transfer to another facility. The alternative is a process of imposed death in which all power is in the hands of the treating facility.

Recently, I was made aware that proponents of a dangerous bill, Senate Bill 303, are using Terri’s photo to manipulate the truth about the bill and to confuse messaging about the dangers of SB 303.

I eagerly signed a joint letter opposing SB 303 that remains our firm opinion today. I have studied the legislation, and remain vehemently opposed to that bill. While recognizing that TADA needs reform, but I consider SB 303 to be worse than current law by expanding the power of hospital ethics committees over the lives and deaths of its patients by specifically authorizing imposition of DNR orders without consent of the patient or family, and requiring them to file a written appeal, this at a time of family crisis.

No one in my family authorized the usage of Terri’s photo or name in conjunction with SB 303. In fact, we urge you as legislators and protectors of the most vulnerable to oppose SB 303. In addition to further embedding the futilitarian mindset, SB 303 does nothing to restore any due process rights for patients. The hospital ethics committee is stacked with its own personnel and associates, yet they, with a clear conflict of interest, have the final say over a patient’s life and death with no outside checks and balances.

If you allow Senate Bill 303 to become law, the acts that led to the death of my sister will only increase in Texas. The decision to end my sister’s life unnaturally was based on quality of life judgments vs. clinical medical judgments. The calls to our foundation from Texas families feature the same conflict: value judgment on the patient has supplanted objective medical evaluations.

My sister lived for 13 days after the third court-ordered removal of her feeding tube. Texas SB 303 would sanction removal of artificial hydration and nutrition based on the following criteria—all of which were used to end Terri’s life. Under Section 7, Section 166.046(e), artificially administered food and water does not have to be given when the treatment—according to the hospital panel—would:

(1) hasten the patient's death;
(2) seriously exacerbate other major medical problems not outweighed by the benefit of the provision of the
treatment;
(3) result in substantial irremediable physical pain or discomfort not outweighed by the benefit of the provision
of the treatment; or
(4) be medically ineffective in prolonging the patient's life.

These criteria are broad and leave too much room for interpretation. “[N]ot outweighed by the benefit,” “substantial… pain or discomfort,” and “seriously exacerbate” are quality of life, subjective decisions imposed by the facility and physicians, not medical or clinical assessments.

Do not let what happened to Terri happen to patients in Texas. I urge you, State Legislators, to protect the most vulnerable, the disabled, and the dying from hastened death by rejecting SB 303 and the House version, HB 1444.

Respectfully,

Bobby Schindler
Executive Director
Terri’s Life & Hope Network

Mystery Solved

The mystery is solved.  A nurse telephoned me and said that that is what nurses on shift do.  She would do it whenever she had to write a letter ... before there were smart phones.  Now the puzzle of my banning is starting to make sense.  Staff doesn't want anyone around especially someone like me who visited Randy every day. 

So that is what Whilley has on the staff at GPC: I won't say what staff is really doing as long as no one objects to me sleeping at GPC on my own comfortable lounger (drapped in sheepskin). He was doing this for six years. I think this is a blatant example of corruption in full sight.

The banning of myself from GPC has had a devastating effect on me.  It was orchestrated by the staff on Ward 2 and Whilley.  I still remember Whilley telling me that a petition was being signed to get me banned from GPC.  I was terrified. I will never forget the injustice of it all.  Whilley is still there as well as the staff when I got banned.  No one spoke to defend me.  Even now no one speaks for  me.

Now I have become a monster:.  a true advocate for the disabled, the elderly, the ailing and for those that have been blind sighted to agree to any form of advanced directive. A proponent for the sanctity of  life. ..

Helpless

I went to see Randy during a group keep fit activity today at GPC.  Comparing his level of participation with other residents of the group, I felt so helpless realizing just how handicapped Randy really is.  He tried so hard to participate but could barely do so. It was painful to watch him.

I still haven't heard from the Ethics Committee as to why we were subjected to repeated DNR requests. 

What are they doing behind the curtains

When I return Randy back to GPC, I leave him in the hands of the nurses as they ready him to bed.  After watching vimeo.com/64462798 an interview with the daughter of a man who died of bedsores at Burnaby General, a thought raced back to me.  What are they hiding?  On Saturday I returned Randy and since he did not want to return to GPC I promised that I would wait until after he was put to bed and then stay with him until the visiting hours were over.  When returned I was told by his nurse to leave his bedside and I had to wait one hour before he was safe in his bed. Why should this have taken one hour; when it should have only taken 10 minutes; 15 minutes top.  What are they doing.  Hiding something I should see or alternatively texting on their smart phones  I have seen this man naked before, so why am I ushered out of  his "home" by the nurses...Randy can't even talk to tell me what is going on....of the ten residents on Randy's "open" Ward, only one can talk ...



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When did it Change

In the 1960, the 1970s and the 1980s society (medical industry) was doing everything to extend life and they did.  The sanctity of life was in tack. And it was not until the early 1990s that it was decided that the unproven financial  cost to allow everyone to live longer was too high.   In the 1990s it started to change to "quality of life" and the willingness of patients to end their lives sooner than they needed to.by being convinced/coerced that it was in a patients best interest and he alone made this decision. The method they used to triage patients was advance directives/levels of care... Who needs patients who are a burden on society and their families and difficult to treat and will never be productive members of society.  They are not only going after the elderly but others as well like those who were injured through extreme sports or have a long-term disease.They are targetting each one of us.  It is easy to postpone treatment for heart attack, stroke, pneumonia or cancer until a patient/resident has a sudden death. This is called a slow DNR.

I remember reading recently of an economist from back East saying that our medical system is sustainable and it is not necessary not to treat the elderly.......  The elderly are paying taxes on their pensions/income/assets/purchases and are a source of revenue for the economy.  When I went back to cite this article I could not find it but it made sense to me at that time.  So maybe all this about cost savings is not cost saving but rather to dispose of those of us who are not perfect and not in good health. And you might ask where do your assets go upon your death... 

All forms of advanced directives have to be banned. This to ensure that everyone has security of person i.e. life..

How to Solve the Health Care Problem

Decades ago I was told that to make money in the long-term you have to spend money.  And this is what the Province should be doing respecting health care.  No harm will result.   More jobs will be created thus more revenue will recirculate into the economy. And among the compounding effects will be that we will all have security of person. We will not have to worry about whether or not we are receiving optimal care because of budget restraints. Start medical training in Grade 10 so that upon graduation everyone is a LPN and those credits can be applied to a RN degree.  Look upon health care as a natural renewable resource and it will attract investment from around the world in the spinoff industries.

I did a terrible thing yesterday.  A man I assume was from India offered to share his over sized umbrella with me and Randy and I told him that it wasn't necessary.  I said that rain was good for the earth and also us humans.  I should have allowed the comfort of his umbrella and chat with him as we walked the two blocks in the pouring rain to the entrance of George Pearson Centre.  If I see him again, this tall elderly man from India, I will run after him and apologize. An offer of kindness has to be appreciated. (Randy was covered in a rain cape especially designed for wheelchairs)

I still haven't heard anything from the VCH's Ethics Committee on why Randy was bombarded with DNRs these past six months.  This discussion happened many times and each time we voted for full code and VCH seemed intent on voting for a DNR.  Caution:  if you do not have 110% confidence in the medical/legal system never agree to a DNR.  Do not believe the quality of life issues VCH will argue. Life is worth it no matter what. Too many mistakes can be made with DNRs, Advance Directives, Living Wills, etc. Research it on the web. Ask yourself why the push for DNRs...start with www.texasrighttolife.com...end of life care.


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Nothing Changes

I went for a short walk to GPC at 11:00 am.  I wanted to know Randy's status as he wasn't looking well.  He was lethargic, unhappy and needed a suction. Since no one was available after about twenty minutes I used the call bell.  Ten minutes later a staff member arrived and said to me that he doesn't have to talk to me as I am not a patient...
1.  Because of Randy's injury, he cannot talk;
2.  Randy isn't looking well as he has an infection and needs someone to be his voice and expects me to look after him..


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Aftermath of Hospital Report Card 2013

Referring to the B.C.Minister of Health's comment that 90% of the people are happy with the excellent care provided by VCH on CKNW on Thursday (Bill Good's show), .what about the other 100,000 people, (the ten percent) who do not share her view.  We are talking 100,000 people in the Vancouver area alone..

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