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Although the specifics of the cases involving Andrea Clark and Terri Schindler Schiavo are different, the key issue is the same----should government be the one who makes the decision whether a vulnerable, incapacitated person should live or die and whether or not it's "futile" to treat them.
A significant point to the Andrea Clark case in Texas, where a Houston hospital ethics committee has unilaterally made the decision to terminate the woman's life support because they have determined continued treatment of her would be "futile", is that the hospital and ethics committee are ignoring the wishes of both the patient and their family.
So what's the point of having a living will, a health care proxy, of placing advanced directives in writing if those wishes are going to be totally disregarded and the government is going to make the decision if the person lives or not?
In the Terri Schindler Schiavo case, the young woman hadn't left a living will. At age 26 and at a time when feeding tubes weren't legally considered medical treatment or artificial life support, she had taken no steps to place her wishes in writing. But her husband, who consistently testified under oath at deposition and trial that he didn't have a good memory, could explicitly remember an off-handed remark allegedly made by Terri during a train ride 15 years after it allegedly happened when he was trying to convince the court to issue an order to allow him to kill his wife. And on the basis of that "clear and convincing" evidence, Terri Schiavo was dehydrated to death---even though the government, at least the executive and legislative branches, tried to save her life.
Michael Schiavo is now continually touting the resulting poll results that he claims are determinate of the people's will---that they don't want government involved in decisions of such family matters as whether their loved one should live or die.
But in the case of Andrea Clark, that's exactly what's happening. The state of Texas is dictating that Andrea should die, ignoring her wishes and those of her family, ordering her death. The government has got their feet planted solidly in the middle of the Andrea Clark case.
What's even more ironic is that the central figure in both of the cases is none other than President George W. Bush, then Governor of Texas when he signed the Futile Care Bill. In Andrea's case, and others in Texas, Bush is actually advocating their death. What happened to his "presumption in favor of life"?
Bush tried to save Terri but has decreed Andrea's death. What's happening in Texas could soon be the norm across America---the killing of the vulnerable, the Bush legacy---a throw-away society.
Andrea has private insurance. Terri had been placed on Medicaid by her husband and attorney George Felos after her husband had expended virtually all the money in her trust fund on attorneys such as Felos to kill her, money that had been earmarked for her treatment and rehabilitation. Although Michael Schiavo is now claiming that he used 98% of the trust fund for her medical care, that is just another one of Michael Schiavo's false statements as the open court records in the Pinellas County clerk's office will substantiate that even minimally Schiavo spent well over 60% on attorney's fees.
The common denominator in the two cases is that the state---in Terri's case Judge George W. Greer, and in Andrea's case, George W. Bush, have made the final decree that ends the lives of these disabled individuals, to stop the flow of Medicaid and Medicare funds to keep vulnerable adults like Terri alive and in the case of Andrea, to insure that insurance companies and the Social Security system will not have to pay to maintain the disabled and incapacitated.
Should the state be able to play God? Decide who's worthy of keeping alive and who's not? Isn't that a violation of the Establishment Clause of the Constitution? Should the state have the final say whether a person's life is worth saving? Should the state and George Bush be able to remove a human being from life support?
The role of George W. Bush in the Schiavo case and in the Texas Futile Care Law is significant. George W. Bush rushed back to the White House from his 2005 Easter vacation in Texas, no less, to sign the emergency legislation passed by Congress and earmarked to save the life of Terri Schiavo. Had Terri been in Texas, for one thing she wouldn't have been subjected to the judicial tyranny of George W. Greer.
"In cases like this one, where there are serious questions and substantial doubts, our society, our laws and our courts should have a presumption in favor of life", Bush said in a statement after signing the bill as Texas governor.
So why did he sign the 1999 Texas Futile Care Law that allows hospitals and ethics committees to end the life of an adult, later amended in 2003 to end the life of a child, if that patient's care isn't transferred to another physician or facility within 10 days of the decision?
Ironically, at virtually the same time that Terri Schiavo was dying by court order, Sun Hudson, a nearly six-month old infant at Texas Children's Hospital in Houston, diagnosed with a fatal congenital disease, against his mother's wishes was removed from the feeding tube that was keeping him alive because a Houston court had authorized the hospital's action, thanks to George W. Bush. Had the mother been able to pay for his medical costs or been able to find another facility to care for him, his death would not have been hastened. The baby died shortly thereafter but there was little press given to the Futile Care Law even though it was reportedly the first time in the United States that a court had allowed life-sustaining treatment to be withdrawn from a pediatric patient over the objections of the child's parent.
In the Hudson case, although the statute under Chapter 166 of the Texas Health and Safety Code doesn't mandate that a court order be obtained by the hospital to kill a patient, the Children's Hospital took the extra step. There was no separation of powers to kill baby Hudson. All three branches advocated his death.
On Monday, the Texas Futile Care Law may be in the Texas courts again as the attorney for Andrea Clark says that she won't rule out seeking an injunction against St. Luke's Episcopal Hospital to stop them from removing Andrea Clark's life support.
Under the Texas Futile Care Law, if an attending physician disagrees with a surrogate over a life-and-death treatment decision, there must be an ethics committee consultation with notice to the surrogate and an opportunity to participate. In a futility case such as Andrea's in which the treatment team is seeking to stop treatment deemed to be non-beneficial, if the ethics committee agrees with the team, the hospital is authorized to discontinue the disputed treatment after a 10-day delay, during which the hospital must help try to find a facility that will accept a transfer of the patient.
Andrea Clark, 54, has been a heart patient at the hospital since November. In January, she underwent open heart surgery and in February, she developed bleeding on the brain. She was born a "blue baby" and has combated medical issues her entire life but has led a full life. She is a widow and has a 23-year-old son. According to her family, Andrea has expressed a clear desire and strong will to live.
As of late Friday afternoon, St. Luke's had reportedly agreed not to remove the life support from the disabled woman until at least Tuesday while the search continues for a facility where she can be transferred or the ethics committee decision is revoked.
Andrea's attending physician, Dr. Ronald Giveon, made the decision to remove Andrea from life support and then left for vacation. His decision was supported by the hospital's ethics committee and the respirator and dialysis keeping Andrea alive were scheduled to be removed from Andrea on Sunday, April 30.
The family and their supporters were breathing a sigh of relief early Friday after learning that a facility near Chicago had agreed to accept Andrea as a patient but 20 minutes before the ambulance was to start the transfer process, the family was told that the facility had notified St. Luke's that they did not have the medical equipment available to sustain Andrea.
Jerri Lynn Ward, the Texas attorney who is representing the disabled woman, says that efforts are still being made to transfer Andrea's care to another physician or facility.
The hospital has not responded to The North Country Gazette's request for information and hospital officials will not indicate how they plan to proceed in Andrea's case.
Melanie Childers, Andrea's sister said that St. Luke's had "played hardball" with them on the issue when the hospital told them of their choice to move their sister to the Glenshire Nursing and Rehab Centre in the Chicago suburb of Richton Park. Melanie said that they were told that if they made the decision Thursday, the hospital would pay the entire amount of $14,000 of transfer costs but if they delayed a day, the hospital would only pay half of the cost and if made the following day, the hospital would pay nothing.
The deal was canceled Friday after Glenshire officials said that Andrea's condition was too complicated for the level of care that they provide and that they did not have the necessary medical equipment.
The case has become high profile with protests conducted at the hospital and the facility receiving numerous phone calls and emails from individuals around the country furious about the hospital's plan to end Andrea's life.
It is anticipated that a meeting will be held Tuesday by Clark's doctors to reassess her case. Dr. Matthew Lenz, a doctor of internal medicine may take over her case and is supported by the Texas Right to Life group. The hospital could decide to revoke the ethics committee's plan to end Andrea's life support or could grant an extension until a facility could be found where she could be transferred.
According to her sisters, Andrea is quite ill still, but there seem to be signs that she's on a path to getting at least slightly better. Her white cell count is normal for the second day in a row, and that hasn't been true in a long time, according to her sisters. Her blood pressure is still too low, a sign that her heart is pretty weak from the infection and all, but her meds have been lowered, which is a good sign. Her lungs are also finally clear for the first time in months. In other words, she's still very ill and in the intensive care unit but doing much better than she was doing even just three days ago, they say. She has endocarditis which her sister says takes about four months to resolve.
Efforts had been underway late Friday to transfer Andrea to a Michigan hospital but that hope was apparently dashed when a social worker from St. Luke's told an internist from the hospital that she didn't feel that Andrea was stable enough for the transfer.
Michael Schiavo didn't want government involved in his decision to kill his wife and the polls presumably support that position.
What will be the role of government in the fate of Andrea Clark? 4-30-06
© 2006 North
Country Gazette
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