Skip to comments.Terri’s ‘Exit Protocol’
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 wifes feeding tube. His appearance was only days after the Florida legislature intervened to have Terris 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: Its 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, Terris 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. Terris 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 Terris 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. [Editors note: The protocol, in bold print, is followed by Fords 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 nurses 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 And its premeditated murder, because look at the dates notes were prepared the day before the tube was supposed to be withdrawn.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 Their bodies are already shutting down, and their tube feedings are withdrawn when their body systems can no longer handle it.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 thats what bothers me. Shes 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 Terris 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 havent eaten in a while, Ford said. You start to get that gnawing feeling, almost a burning in your stomach. Most people dont extend themselves into the depths of hunger. They grab a cracker or bread if theyre out shopping for a while just to make themselves feel better.
Terri would not have this option, however. Within several hours, shell 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. Shes 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, theyre 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 theyre going to do is use a nebulizer the way you might use for asthmatics only instead of giving a histamine to help her breathe, theyre going to give Terri morphine sulfate, which only suppresses respiration more. In the later phases shell 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 cant 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. Shell start to twitch. You dont see this in an oncology patient because theyre 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 Terris not terminal, Ford said. What theyre doing here is starving a healthy person to death. This is the only reason why shell 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 wont make this easier, it will just help to bring her to death faster, because she wont have the ability to fight her way out of it, Ford said. Her body will not be in good shape at this point. You wouldnt look at her and say she was comfortable. Shes been without food and water for a long time. Shes pretty much withered, her skin is broken down, her metabolism is broken down, her kidneys havent 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 its still hot in Florida in October. This is not a painless or dignified way to die, Ford said. Its 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 firstname.lastname@example.org or (215) 965-4615.
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.
I'm curious - who's paying for her continued treatment?
Tears and prayers here...
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.
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.
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!
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.
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.
Torture in America.
Useless eaters is what ADOLPH HITLER called the disabled. He exterminated them before he started murdering people for their ethnic or religious beliefs.
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
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.
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.
You, the taxpayer.
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.