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Terri’s ‘Exit Protocol’
The Catholic Standard & Times ^ | Jan 10, 2005 | Susan Brinkmann

Posted on 01/14/2005 1:09:55 AM PST by amdgmary

On Oct. 27, 2003, Michael Schiavo, the husband of the cognitively disabled Florida woman, Terri Schindler-Schiavo, appeared on Larry King Live to explain why he was fighting so hard to remove his wife’s feeding tube. His appearance was only days after the Florida legislature intervened to have Terri’s feeding tube reinserted for the second time in two years.

Michael Schiavo insisted that he wanted to help his wife “die with dignity.” He told King: “It’s painless, and probably the most natural way to die. It is a very easy way to die — probably the second best way to die, the first being an aneurysm.”

At the same time he was speaking on national television, Terri’s medical file contained a document prescribing for her a slow and painful death by starvation and dehydration.

Called an “Exit Protocol,” the document contains explicit instructions for how Terri will be treated during the grisly series of events that will occur should the courts decide to withdraw her feeding tube. Terri’s fate remains an active issue in both the Florida state and U.S. federal courts.

The nurse who discovered the Exit Protocol, Cheryl Ford, R.N., a Tampa nurse, was reviewing Terri’s medical file at the request of the Schindler family when she found the document. For the benefit of our readers, Ford agreed to explain this document in detail. [Editor’s note: The protocol, in bold print, is followed by Ford’s comments.]

• Patient Care Notes— The Hospice of Florida Suncoast — 4/19/01 — Clinical Pharmacy — Re: Medication review and symptom management. The patient is a 37-year-old woman in a vegetative state with no apparent signs of distress. Enteral tube-feeding to be discontinued on 4/20/01.

“This is a very critical piece of information from a nurse’s point of view,” Ford said. “We have a patient with no apparent signs of distress, yet enteral tube feeding is going to be discontinued on 4/20/01. This is murder. And it’s premeditated murder, because look at the dates — notes were prepared the day before the tube was supposed to be withdrawn.”

What would make the death more difficult is that Terri is a healthy woman, weighing approximately 138.5 pounds, which means she will endure longer than other patients who are in the midst of a natural-death process.

“I was an oncology (cancer) nurse,” Ford said. “These people are very weak and gaunt. Their bodies are already shutting down, and their tube feedings are withdrawn when their body systems can no longer handle it. But Terri is not a cancer patient — that’s what bothers me. She’s a healthy young woman.”

• Upon discontinuation of enteral feeding the following signs/symptoms may or may not occur. The following is a brief list of symptoms for which to monitor and recommended interventions.

• Monitor symptoms of pain/discomfort. If noted, medicate with Naproxen rectal suppository 375 mg. Q8 prn [“Q8 prn” means eight times a day as needed].

If someone in a persistent vegetative state cannot feel pain, as Michael Schiavo and his attorney, George Felos, have consistently told the world, why do Terri’s charts tell nurses how to treat her for pain?

According to Ford, that is because Terri can and will feel pain during this process — and a lot of it.

“Think about what hunger pains are like if you haven’t eaten in a while,” Ford said. “You start to get that gnawing feeling, almost a burning in your stomach. Most people don’t extend themselves into the depths of hunger. They grab a cracker or bread if they’re out shopping for a while just to make themselves feel better.”

Terri would not have this option, however. “Within several hours, she’ll start to feel this kind of hunger pain,” Ford said.

Dehydration would only add to the discomfort: “When she starts going into the dehydration stage, her metabolism will start to change. Her electrolytes will get imbalanced. She’s going to get uncomfortable and will start to writhe.

“Advance a couple days without food or water. Now her mouth is parched, her lips, her gums, her tongue will start to crack and bleed. The nasal cavities will start to dry, crack and bleed. The stomach will get dry and shrink, causing vomiting and heaving,” Ford said.

• Pulmonary (a) Inability to clear secretions — reposition and swab mouth, consider scopolamine patch behind ear every 3 days.

“When you first go into dehydration, your body will automatically compensate by making saliva. But when she gets into the stage where the stomach shrinks and nausea begins, they’re going to stick a patch behind her ear for the nausea. What the patch also does is dehydrate you by taking away this fluid.”

(b) Dyspnea — nebulize low dose 2-5 mg. Morphine sulfate Q4 prn [four times a day as needed]. “Dyspnea is when you have difficulty breathing. What they’re going to do is use a nebulizer the way you might use for asthmatics — only instead of giving a histamine to help her breathe, they’re going to give Terri morphine sulfate, which only suppresses respiration more. In the later phases she’ll start gasping for air.”

In seven to nine days, as most of her body fluids are lost, her blood pressure will go down and her heart rate will rise. The blood will be shunted to the central part of the body from the periphery of the body, so that usually two to three days prior to death, the hands and feet become extremely cold. They become mottled and have a bluish appearance. The eyes will become so dry the patient can’t move them anymore because there will be fluid in them.

• Multifocal myoclonus or terminal agitation [sometimes caused by electrolyte imbalance]. Consider diazepam rectal administration 5-10 mg. May repeat in 4 hours if not resolved then daily — twice daily as needed. Multifocal myoclonus means seizures taking place in various parts of the body. “Because of the electrolyte imbalance, Terri will begin to have seizures,” Ford said. “She’ll start to twitch. You don’t see this in an oncology patient because they’re already dehydrated. Even the elderly, who are going into the natural process of death, their bodies are doing what God created them to do — slow down.

“Our job as health-care professionals at this point is to understand the death process and to oblige the process God has given these people to help them in comfort measures — palliative care — not to enhance death. But Terri’s not terminal,” Ford said. “What they’re doing here is starving a healthy person to death. This is the only reason why she’ll go into multifocal myoclonus.”

• Grand Mal seizure, which is highly unlikely given current conditions and lack of contributing factors (meds) [medication]. Recommend diazepam 15 mg. rectally as indicated in seizure management orders.

“If she happens to make it into a grand mal seizure, they will give her 15 mg. of valium. … The valium won’t make this easier, it will just help to bring her to death faster, because she won’t have the ability to fight her way out of it,” Ford said. “Her body will not be in good shape at this point. You wouldn’t look at her and say she was comfortable. She’s been without food and water for a long time. She’s pretty much withered, her skin is broken down, her metabolism is broken down, her kidneys haven’t received anything. Her body is reacting to the lack of food.”

At this point, death is imminent.

During the Oct. 2003 tube withdrawal, Ford saw Terri before the process began.

“They started off by dressing her in wool sweaters and long pants, then wrapped her in a wool blanket — to ‘sweat her out’ — to make her deyhdrate faster,” Ford said. She was horrified, especially because it was only October and it’s still hot in Florida in October. “This is not a painless or dignified way to die,” Ford said. “It’s against the law to dehydrate and starve to death a prisoner on death row. Why should we allow it to be done to a disabled woman — or anybody?”

The cruelty Ford has seen Terri endure is “not even believable,” she said. “In this case, Dr. Kevorkian would be more humane than what they intend to do to Terri.”

Contact Susan Brinkmann at fiat723@aol.com or (215) 965-4615.


TOPICS: Extended News; Front Page News; News/Current Events; US: Florida
KEYWORDS: euthanasia; hospice; terri; terrischiavo; terrischindler; terrischivo; vegetativestate; wifekiller

1 posted on 01/14/2005 1:09:55 AM PST by amdgmary
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To: amdgmary
He told King: “It’s painless, and probably the most natural way to die. It is a very easy way to die — probably the second best way to die, the first being an aneurysm.”

If it is sooooo wonderful, perhaps Michael should try it first. We'll see how he does with it before using his wife as a guinea pig.

2 posted on 01/14/2005 1:11:56 AM PST by peyton randolph (CAIR supports TROP terrorists)
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To: floriduh voter; Republic; Ohioan from Florida; tutstar; pc93; BykrBayb; TOUGH STOUGH; ...

Ping


3 posted on 01/14/2005 1:14:01 AM PST by amdgmary
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To: amdgmary

I'm curious - who's paying for her continued treatment?


4 posted on 01/14/2005 1:15:44 AM PST by johnmilken
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To: amdgmary

Tears and prayers here...


5 posted on 01/14/2005 1:17:18 AM PST by EternalVigilance
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To: johnmilken

Medicare if paying for Terri's stay at Hospice. Her estranged husband, Michael Schiavo, does not pay a penny.

Terri is not terminally ill so she's being held at Woodside Hospice in Pinellas Park illegally. Hospice is making a lot of money off of a disabled woman who is not terminally ill.


6 posted on 01/14/2005 1:23:09 AM PST by amdgmary
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To: amdgmary

You see, I am undecided on euthanasia - mainly because I've never had to face a hard a situation where it's come up as a choice for anyone I know. But I'm wondering how many on this board will be content to see Medicare keep thousands of baby boomers alive indefinitely. I see this issue as becoming a lot hotter over the next 10 years.


7 posted on 01/14/2005 1:27:46 AM PST by johnmilken
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To: amdgmary

BUMP


8 posted on 01/14/2005 1:53:00 AM PST by nickcarraway
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To: johnmilken

It can be pretty expensive to pay for someone's medical care when they're disabled. Terri was awarded about $1.3 million, but most of that has been spent on lawyers to have her killed. A lot of other people have no insurance and no money to pay for their medical care. It would save us an enormous amount of money if we just starved and dehydrated them all to death. Useless eaters!


9 posted on 01/14/2005 2:28:52 AM PST by BykrBayb (5 minutes of prayer for Terri, every day at 11 am EDT, until she's safe. http://www.terrisfight.org)
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To: amdgmary
Thanks for the ping. I'll post this link on the January Terri Thread. If anybody wants to to there: go to search, put in Terri Schindler Schiavo January.

FV

10 posted on 01/14/2005 3:51:51 AM PST by floriduh voter (Visit www.terrisfight.org SEE TERRI'S VIDEOS AWARE AND ALERT)
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To: peyton randolph
He told King: “It’s painless, and probably the most natural way to die. It is a very easy way to die — probably the second best way to die, the first being an aneurysm.”

How does he know it's easy and painless? My guess is from these comments, this guy is brain-dead and doesn't know it.

11 posted on 01/14/2005 3:58:11 AM PST by aardvark1 (Something was seared in my memory but I forgot what it was.)
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To: johnmilken
You see, I am undecided on euthanasia - mainly because I've never had to face a hard a situation where it's come up as a choice for anyone I know. But I'm wondering how many on this board will be content to see Medicare keep thousands of baby boomers alive indefinitely. I see this issue as becoming a lot hotter over the next 10 years.

I expect that involuntary euthanasia will be widely practiced, albeit discreetly (religious sensibilities are too strong). Even now, nursing homes are full of people who rarely, if every, have a visitor, so who would notice, much less care, when they die?

Right now, we're spending money in this country like the proverbial drunken sailor on leave. The cost of supporting and providing medical care to the Baby Boomers will break the bank. I'm afraid that we'll go to the other extreme, involuntary euthanasia, in a desperate, and perhaps futile, attempt to stave off national bankruptcy.

A democracy inevitably destroys itself, morally and economically, and is replaced by a dictatorship. I think that this is where we are heading for within about 30 years.

12 posted on 01/14/2005 4:09:13 AM PST by Siamese Princess
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To: amdgmary

bttt.


13 posted on 01/14/2005 4:35:20 AM PST by floriduh voter (Visit www.terrisfight.org SEE TERRI'S VIDEOS AWARE AND ALERT)
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To: amdgmary; EternalVigilance

Torture in America.


14 posted on 01/14/2005 4:37:12 AM PST by floriduh voter (Visit www.terrisfight.org SEE TERRI'S VIDEOS AWARE AND ALERT)
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To: BykrBayb

Useless eaters is what ADOLPH HITLER called the disabled. He exterminated them before he started murdering people for their ethnic or religious beliefs.


15 posted on 01/14/2005 4:40:04 AM PST by floriduh voter (Visit www.terrisfight.org SEE TERRI'S VIDEOS AWARE AND ALERT)
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To: floriduh voter; All
Join: fight4terri@aol.com.

ALL STATES, ALL COUNTRIES.

TERRI DID NOT CHOOSE TO BE HELD CAPTIVE FOR 14 YEARS, BE ROBBED OF HER REHAB MONIES AND TO HAVE DEATH VULTURES SEEK TO MAKE AN EXAMPLE OF HER. TERRI CAN BREATHE ON HER OWN, IS ALERT AND AWARE OF HER SURROUNDINGS, KNOWS DAY FROM NIGHT. She's a person, not a vegetable. FV

16 posted on 01/14/2005 4:44:36 AM PST by floriduh voter (Visit www.terrisfight.org SEE TERRI'S VIDEOS AWARE AND ALERT)
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To: floriduh voter

Today's death squads aren't as picky as all that. They don't care what ethnicity you are. They don't care what your religious beliefs are. As long as you're weak enough to be easily exterminated, you qualify.


17 posted on 01/14/2005 4:45:40 AM PST by BykrBayb (5 minutes of prayer for Terri, every day at 11 am EDT, until she's safe. http://www.terrisfight.org)
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To: peyton randolph
Every one of the people who want to do this to Terri should have to suffer the same fate.

Dear Lord and most merciful Heavenly Father, please spare this innocent child of yours this fate. Lord, make it possible for her parents and family who love her to care for her. Father, remove her from the hands of the evil ones who want to kill her. I humbly ask this in the name of your Son, Jesus Christ who died on the cross for our sins and who rose on the third day to give us all everlasting life. Amen.

18 posted on 01/14/2005 5:29:08 AM PST by texgal (end no-fault divorce laws return DUE PROCESS & EQUAL PROTECTION to ALL citizens))
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To: johnmilken

You, the taxpayer.


19 posted on 01/14/2005 5:48:21 AM PST by newzjunkey (Demand Mexico Turnover Fugitive Murderers: http://www.escapingjustice.com)
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To: johnmilken

A "decision" on Euthanasia based upon personal convenience and money is suicidal for the culture - We will destroy ourselves. "Alive indefinitely" - that's how long we are all alive. Stop feeding us and we will die. These are all red herrings.


20 posted on 01/14/2005 5:49:53 AM PST by grassboots.org (I'm dead sometime after I stop breathing and my heart stops beating, not a moment before...)
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To: johnmilken
Forget the cost a moment. Having been a caregiver I can tell you there are worse things than death and that's the kind of unliving hell modern medicine can inflict in the name of treatment.

I have suspect some of those who troll the Terri threads are selfish bastards who don't know when to 'let go', suffer survivor's guilt, are inexperienced or refuse to recognize the point when treatment sucking away every last ounce of dignity, making the patient unrecognizable to friend or family and they to him or her.

My view is Terri's "dead" but her body hasn't caught up with this reality. There's no viable ethical argument, however, to starve a patient to death. So long as food, rather than artificial respiration or similar means, is all that keeps her from dying she should be fed.

She'd have been better off if she'd been killed by her original illness. Her parents are just as sick as her husband.

21 posted on 01/14/2005 6:04:51 AM PST by newzjunkey (Demand Mexico Turnover Fugitive Murderers: http://www.escapingjustice.com)
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To: peyton randolph
There's nothing painless about dehydration. I've been treated for that before.

This isn't death with dignity. It's murderous.

22 posted on 01/14/2005 6:12:13 AM PST by newzjunkey (Demand Mexico Turnover Fugitive Murderers: http://www.escapingjustice.com)
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To: peyton randolph
He told King: “It’s painless, and probably the most natural way to die. It is a very easy way to die — probably the second best way to die, the first being an aneurysm.”

My father died this way 3 years ago, but he made the conscious decision to do so after discussing it with the family. He had PSP, a rare form of Parkinson's and had been sick for years. His body was rejecting the feeding tube and the doctors said that they could put him on IVs, but it would only prolong his death. It was a nightmare...I have never recovered from spending his last 10 days with him, watching him slowly starve to death, but it was his wish.

23 posted on 01/14/2005 6:48:43 AM PST by ravingnutter
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To: ravingnutter
.I have never recovered from spending his last 10 days with him, watching him slowly starve to death, but it was his wish.

I feel for your loss of your father. The distinguishing characteristic in this case is that Terri doesn't have the ability to make the same choice as your father. It is an estranged husband with a monetary incentive who is trying to make the choice for her.

24 posted on 01/14/2005 6:53:07 AM PST by peyton randolph (CAIR supports TROP terrorists)
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To: BykrBayb

Terri's the HOSTAGE OF THE SUNCOAST. (at hospice of the suncoast).


25 posted on 01/14/2005 7:40:38 AM PST by floriduh voter (Visit www.terrisfight.org SEE TERRI'S VIDEOS AWARE AND ALERT)
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To: newzjunkey

Why so Hateful! Terri is not unrecognizable to friend & family (only to the eyes of those who love death and her adulterous husband.)

Who are you to say someone else is better off dead!

It is your kind who will destroy the culture!


26 posted on 01/14/2005 7:51:09 AM PST by grassboots.org (I'm dead sometime after I stop breathing and my heart stops beating, not a moment before...)
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To: peyton randolph
The distinguishing characteristic in this case is that Terri doesn't have the ability to make the same choice as your father.

I understand that fully, I was just responding to her husband's comments that this was a good way to die...when, from my experience, it is most definitely not.

27 posted on 01/14/2005 7:55:56 AM PST by ravingnutter
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To: amdgmary

But once she's dead, that lovely life insurance policy will kick in. Michael should sign the benefits over to her parents and go on with his miserable life.


28 posted on 01/14/2005 8:01:01 AM PST by hershey
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To: amdgmary

bump


29 posted on 01/14/2005 8:01:23 AM PST by tutstar ( <{{--->< http://ripe4change.4-all.org Violations of Florida Statutes ongoing!)
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To: amdgmary

Bump!


30 posted on 01/14/2005 8:53:25 AM PST by windchime (Won't it be great watching President Bush spend political capital?)
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To: amdgmary
"cognitively disabled..."

?

31 posted on 01/14/2005 8:57:14 AM PST by verity (The Liberal Media is America's Enemy)
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To: newzjunkey
My view is Terri's "dead" but her body hasn't caught up with this reality.

Have you seen the Videos of Terri obeying the commands of her doctor? How can the "dead" do what their doctor tells them to do?

Please go to her Web Site and watch her Videos! Go to www.terrisfight.org

32 posted on 01/14/2005 11:29:52 AM PST by Kitty Mittens
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To: verity
"cognitively disabled..." ?

it doesn't make sense to me either.

33 posted on 01/14/2005 12:40:13 PM PST by amdgmary
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To: All
This photo of Terri was taken in 1993 shortly after Michael Schiavo won over $1 million dollars in a medical malpractice lawsuit. He ordered the nurses and doctors not to treat Terri for infections. He also put a do not resucitate order in her medical files.


34 posted on 01/15/2005 3:57:49 AM PST by amdgmary
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To: amdgmary

The woman who was supposed to WATCH OVER this process is dead now herself, right?


35 posted on 01/16/2005 9:41:32 AM PST by Saundra Duffy (Save Terri Schiavo!!!)
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To: Saundra Duffy
"The woman who was supposed to WATCH OVER this process is dead now herself, right?"

The woman who watched Terri being starved in Oct 2003 was Jodi Centonzi's mother, Eleanor Centonzi. Eleanor died of ovarian cancer Sept 5, 2004 in Jodi and Michael's house. Also, the priest who testified against Terri in the 2000 trial, Fr. Gerard Murphy, was run over by a car in Tampa last year.

36 posted on 01/16/2005 1:49:10 PM PST by amdgmary
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To: amdgmary

I just read this again and it amazes me that so many will believe Felos and MS that this is a painless way to die. Freepers especially are known IMO to dig to the bottom, but many have failed to do that with Terri's situation. They call us fanatics or emotional when the opposite is actually true and it seems that more often than not they won't even take the time to educate themselves about Terri. I think that is must be a fear of becoming disabled that has paralyzed some from diving in and learning.


37 posted on 01/29/2005 8:56:02 AM PST by tutstar ( <{{--->< http://ripe4change.4-all.org Violations of Florida Statutes ongoing!)
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