What is most puzzling to me in this Schievo case, is indeed the discrepancy of her swallowing capabilities.
Medical interventions that can be withheld as a result of a previously made advanced directive, only involve invasive things, and are normally clarified as "iv fluids; tube feeds, ventilator support" etc.
Now what bothers me the most are the reports from the nurses is that she made efforts to drink, but that offering it to her was forbidden. I'm assuming at some point someone decided via swallow eval that she was a high aspiration risk, but I've never heard that definitively. But still this is a askill that can be rehabed, and can certainly improve with training over time.
If thats not the case (abnormal prohibitive swallow eval), then how, legally, can someone be forbidden from offering po fluids? IF one argues that it was her desire to die, then doesnt her effort to drink supercede her previous decision?
The lack of info about her ability / inabilty to drink, even if just sips, to me is the missing data I need to make a conclusion about this case. If she really could make a drinking effort, and was denied this, and denied swallowing rehab, I believe that to be clearly criminal, regardless of what any implied advanced directive may have said.
ping
Having experienced a family member unable to safely take fluids by mouth (per os), this topic is not unfamiliar to me. My father was such a case. While he was designated npo (nisi per os) by the doctors, and we had to approve that order due to the risk of pneumonia, we nonetheless had to grapple with the question of discomfort. The mouth dries out and the patient greatly desires to drink. Some moist swabbing is a remedy, but it cannot take the place of a drink. At some point you have to decide if keeping the patient "safe" is better or worse than making him comfortable. Giving a little spoonful of coffee, for example, might not be a good thing for physical health, but when it is extremely appreciated by the patient, perhaps it is worthwhile. When the patient is in decline, and his days may be numbered short, how could a moment of great relief be a bad thing? The nurse doesn't have to know.
In Terri's case, the guard, the nurse, and the "husband" wouldn't have to know. Much more difficult. And it seems that the conspicuously deliberate prohibitions surrounding her were criminal acts. There were people who wanted to help but could not. And those who the court allowed to control her environment were bent on her death. I heard one report that said that only "dry swabbing" was allowed. That is an act of war. It's probably a good thing for me I was not there, because I would have made some trouble. I will not presume to pass judgment on those who were there and tried to help her, but we ought to remember that "trying to work in the system" only ended up with Terri slowly dying of unrelieved and torturous thirst. Perhaps a little confrontation would have done some good. It might have given other protestors some courage, too. The corrupt legal system has now made quite a name for itself, it seems to me. We no longer are inexperienced.
Remember Terri in your prayers.
One would think what one wishes today should supercede past directives. Apparently, in many of these situations THAT is not the case. Frightening to say the least.
You raised a pertinent question regarding Terri's swallowing abilities, so I thought I would fill you in on how the guardian's denial of her basic therapy and care contributed strongly to her declined state, declined from the gains seen in the 1993 videos.