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April 18, 2005

Advance directives: Useless in most states

Topics: Studies

According to a recent study by the Robert Powell Center for Medical Ethics (an arm of NRLC), only in 10 states are Doctors required to follow the advance directives of patients when they call for treatment, food, or fluids.

The study finds that the laws of twenty-three states (and two territories), offer "no effective protection of a patient's wishes for life-preserving measures in the face of an unwilling health care provider." In the laws of another two, Texas and Virginia, the doctors must follow the directives of the patient, only while arranging for a transfer to a willing health care provider. If they can not find a willing health care provider within about two weeks (10 days for Texas and 14 for Virginia), then the doctors need no longer follow the patients advanced directive--but legally are allowed to let him or her die. The law in another 15 States, and in the District of Columbia, is so ambiguous that it means whatever is a most convenient interpretation at the time--or in other words, hardly anything. In ten states alone are their laws in place that would protect your directive for lifesaving measures.

The conclusion (according to the study):

Americans are being urged to set down their wishes concerning life-preserving medical treatment, food and fluids in advance directives to avoid the sort of debate over the wishes of a person no longer able to speak for herself that surrounded the case of Terri Schindler-Schiavo. To the extent those advance directives call for food, fluids, or life-preserving medical treatment in some or all circumstances, however, in the present state of medicine and the law there is no guarantee they will be honored in most states.

You can read the whole study, (with individual state statues in the appendix), by clicking here.

Cross posted at: Sounding the Trumpet

Posted by joshua at April 18, 2005 10:47 PM

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My knee jerk is, what else is new? I've said before that you can't stop a determined suicide. Now it would appear that you can't stop a determined homocide, either. Or can we???

Posted by: mary et. al. at April 18, 2005 9:57 PM

It is important for people to know, if they have a person who needs care, that they _can_ administer a feeding tube at home. This is particularly true for a G-tube, once it is established. So if a concerned relative or guardian runs into a situation with a patient who is said to need to feeding tube, but the healthcare provider doesn't want to keep doing the tube feeding (because of some "futile care" idea), then you _can_ take the person home and do it there, especially if that's the only "technical" thing the person needs.

People are sometimes told lies about this. I read a book excerpt in Reader's Digest some years ago glorifying dehydrating Mom to death (it was a very creepy article), and in it the woman said, "It was very hard to give her nothing. But if she had had to have a tube, she would have had to go to a hospital, and she didn't want that." This is balderdash. If the "loving" daughter who sat next to Mom while she died of dehydration had been willing to learn to use a tube, it could have been used at home. But she apparently was told differently.

Also, feeding tubes aren't always _really_ needed when it is _said_ they are needed. One coughing fit does not mean you "can't" eat by mouth. There is a tendency to exaggerate the danger of aspiration. I've even heard it said that "maybe" Pres. Reagan died of pneumonia caused by aspiration. My reaction to this is that I'm glad they were feeding him. If that conjecture can be made, then at least he didn't die of dehydration! But the idea now is that it's better to let someone die of dehydration than take the mere _risk_ that they will aspirate and get pneumonia. Those who might be caregivers or guardians should know about this exaggerated sensitivity so that they aren't gullible whenever some doctor says, "Well, your dad needs a feeding tube, and that would be artificial, and I think it would be futile care, so let's just let him die of dehydration." (Probably the doctor wouldn't be that direct, but that might be the point, however he put it.)

In any event, it's important to know that you can do a lot at home if a medical facility is unwilling to keep feeding the person.

Posted by: Lydia at April 19, 2005 10:23 AM

I think what's happening here bottom line is that people don't value other people. They feel is they don't meet their standards of what they consider to be "quality of life" then they feel it's okay to euthanized them... It's so scary to me to see the blatant lying going out through out our country now about "mercy killings" and how frequently it happens. Whatever happened to walking a mile in someone elses shoes? Whatever happened to compassion and taking care of someone until God called them home?

I'm at a loss of what to think anymore. Evil is running rampant...

Posted by: Sirena at April 19, 2005 10:31 AM

Apropos of can we? check out http://www.lawcasella.com/spooner/TrialByJury.htm

You have a good idea Lydia, which should be brought to a conclusion vis a vis educating the public. You are right, Sirena, evil is running rampant and you will see why and how at the above site.

Can we work on supporting Delay before they bring him down and any possible friends in high places we might get if we support them? Does anyone know how to place such a large item in a major newspaper; how to gather the signatures and dollars if this turns out to be our best idea. I think this should be very public so the enemy can't say Delay made it up.

Posted by: mary et. al. at April 19, 2005 10:44 AM

Count me in for supporting Delay. Can a paypal account be setup? Are there tax implications? Are there any website techies that know how to do this? How about Joni and Friends? Joni was very vocal about Terri's murder. Dobson also had a couple shows about the whole situation. I'd like to be able to see more of the momentum get started.

Here are a couple thoughts I had. They may have been mentioned in other comments.

Brochure - have a brochure to give to people telling how the euthanasia movement lies and deceives people e.g. "death with dignity", "right to die" and to give contact information for support
Bumper Sticker - Make our presence known daily, maybe listing a website for further information
Crisis Line - by phone or website.
Contacts - have this readily and easily available (by state?) State agencies, media outlets, organizations etc. with emails, phone numbers, faxes etc.
State Coordinators: Would people volunteer to be a state or regional coordinator? This would allow us to rally quickly on a more local level.

Lydia made a good point - that people need to know what their options are.

People just believe whatever they are told. If you tell someone a lie enough times they begin to believe it.

Now where do I send my money for the Tom Delay ad?

Posted by: kay at April 19, 2005 12:06 PM

Great ideas everyone.

I also had a thought this morning about monitoring Felos and his talks. It would help to be able to dispute point for point his fallacies and distortions. I would hate to financially support him, but to let him run rampant unchecked and (unsupervised) I think is dangerous. Kind of like, 'keep your friends close but your enemies closer'...People need to be made aware of how he is SO against God's teachings as to be considered, yes, evil.

Posted by: I hope at April 19, 2005 12:21 PM

Lydia, Sirena, Kay and I hope. Tim will have another blog site up approx. the end of this week for us to get on and get things rolling; actually take action.

The Tom Delay thing I see as very important and needing to be done quickly. I am stymied in the method of gathering signatures and dollars and getting it into a newspaper. I wish someone with some know how in this dept would take that over. I aam leery of pay pal and would rather snail mail that--I don't like other access to my bank account because of all the savvy thieves about.

Brochures, etc. we could do ourselves by setting up a central group for publishing info, creating the info and somehow financing it then sending it to a printer. It could be disseminated to those who request it by the same group. I would like to take such things to hand out at high traffic areas such as Walmart.

Remember the movie Field of Dreams, I think. If you build it they will come. I believe we will have volunteers, for all of this. I would like to see us present now, split into groups each group taking on one task and sticking with that one task until it is running.

In the meantime, would you check out the site I put in an above post re: trial by jury. It is book length, but if you just read the first section up to the Magna Carta section, you will be in a better position of knowledge to fight this. This paper outlines how "they" did this and what we are up against.

Posted by: mary et. al. at April 19, 2005 12:44 PM

I hope,
Regarding keeping tabs on Felos: I just signed up to receive email news from Roth Talent where Felos has signed on to be a speaker. Maybe when he comes to my town I can go and hear him speak UGH!! I better bring a pail with me and my tums. I agree that we need to keep tabs on him. He should not go unmonitored.

Posted by: kay at April 19, 2005 2:53 PM

WOW!! You go-getter gals! Kay, what a great list of things to work on! Lydia, thank you for that wonderful insight, which I will keep on hand for my own parents if they should need it in the future. You are so right, people do need to be informed! Sirena, you are right to that people are being fed lies, and we need to do something to educate people! And I HOPE! Wonderful idea - I also agree we need to keep tabs on Felos, and the others like him. I too, will sign up for the email news at Roth Talent (ick), per Kay. Great idea. I have added all these ideas to my growing daily list of ideas.

TIM WHO BLOGS HERE IS MAKING ANOTHER WEBSITE FOR ACTION, JUST FOR US TO BEGIN WORKING ON THESE THINGS! Stay posted, as Mary and Tim will let you know more! I'll post my daily list of ideas, next.

Posted by: juleni at April 19, 2005 5:24 PM

Here is my daily update, with the noted suggestions I have recorded from the Blog here:

1. Campaign to END ANY AND ALL NOTIONS that a. human lives should ever be litigated or b. that killing someone is ever a choice. We have to be very
loud that all forms of killing and suicide are cruel, and the true kinder
path is instead solving the reasons people seek suicide and c. fight any notions that food and water are ever “optional” for human beings (nutrition and hydration). Promote everywhere legally, culturally, constitutionally, that everyone deserves to eat and drink.

2. Put page-sized or half page-sized thank you notes or thank you ads to legislators who take a stand for life (such as Tom DeLay) in the Washington Post, signed by all of us and any other groups we could get to join us. Each person could contribute a dollar along with their signature to help pay for these ads.

3. Prayer. - Establish “Prayer warriors” with 24/7 ongoing prayer, with people signing up to pray on a continual hour by hour basis. (Especially during times of getting another specific person through a situation of getting nutrition and/or hydration restored to them – and during times of persuading specific legislators or sponsoring/voting on a specific bill?)

4. A Brochure - have a brochure to give to people telling how the euthanasia movement lies and deceives people e.g. "death with dignity", "right to die" and to give contact information for support

5.Develop Shelters. - a. Guardians (medical powers of attorney) in the form of those who stand for life, and are willing to take on guardianship for those without such a trusted guardian available among their loved ones. These would be a group of pro-life professionals – doctors, clergy, lawyers who have taken an open stand for life and are willing to be named a guardian for someone who is in need of a trusted pro-life guardian. As people committed to life they would be loving; as people who have no agenda they would be impartial; as people with no financial interest in you they would have no temptation; and as people who are trained in life issues and not under emotional stress they could make the best human decisions possible.

b. Develop a "pro life seal of approval (award)" for specific nursing homes and long-term care facilities that do not starve or dehydrate people to death, willing to act as transfer facilities, voluntarily. Useful for when the person concerned is mentally competent enough to check themselves into one, or when a guardian (medical POA) would want the person concerned to go there (speaking for the person concerned).

c. Tax shelters of some sort (were mentioned)?

d. We, the bloggers are a current 'shelter' of sorts - at least a life raft of a kind - for those brought to our attention, such as Terri, Mae and Clara!

6. Create a Bumper Sticker - Make our presence known daily, maybe listing a website for further information

7. Crisis Line - by phone or website.

8. List of Contacts - have this readily and easily available (by state?) State agencies, media outlets, organizations etc. with emails, phone numbers, faxes etc.

9. State Coordinators: Would people volunteer to be a state or regional coordinator? This would allow us to rally quickly on a more local level.

10. The states have been allowed to decide for themselves what is “clear and convincing evidence” in a ‘right to die’ or ‘right to life’ case. So, put forward legislation in states where allowing "clear and convincing" evidence has not become a watered-down thing (as it has in Florida where just one person’s hearsay testimony is now accepted as evidence of desiring removal of a feeding tube), for mandating that *strong* evidence, absolute (written) evidence to be required before such a thing as removal of nutrition and hydration be allowed – in the form of a written statement by the person concerned while they were in a lucid and conscious state, if possible *with* knowledge of the possible pain involved in starvation and dehydration (informed consent).

11. Put forward legislation for *juries* to be involved in any and all such so-called "right to die" cases, so that the people may be involved in deciding the case.

12. Legislation at a national level for absolute protection of the disabled and incapacitated.

13. Discredit Felos et. al.

a. Monitor Felos and his talks. It would help to be able to dispute point for point his fallacies and distortions. Do not let him run rampant unchecked and (unsupervised). As in 'Keep your friends close but your enemies closer'...People need to be made aware of how he is SO against God's teachings as to be considered, yes, evil.

b. Sign up to receive email news from Roth Talent where Felos has signed on to be a speaker. When he comes to town, go and hear him speak (UGH!!) Know what he is saying. Keep tabs on him.

c. Have a presence in the media and also on the speaking circuit to try to minimize the damage that they (Felos, M. Schiavo, etc.) will do in the upcoming future.

Posted by: juleni at April 19, 2005 5:25 PM

Good list, Juleni. Have you had a chance to read the trial by jury paper? Now I don't know what to do re: the nomination of judges. I wish someone would 'splain that to me.

We might try educating people on the major media, as well.

I went to Washington Post site and found where one can inquire about ad rates, then quietly slipped away before I got myself into something I couldn't handle.

Posted by: mary et. al. at April 19, 2005 5:40 PM

Mary, and everyone:

About a newspaper ad. I went back to the very start of Blogs For Terri, and found that they ran a full page ad in the Sunday, February 27th edition of the Tampa Tribune for Terri. It cost $10,000.00 and they were able to raise the money for it. Tim, you blogged about it.

They were going to procede from there with an ad in USA Today, but I haven't read enough of the old blogs yet to see if that happened (Tim?)...

This was a great venture! And Tim and Richard and Beth, who started blogging this blog in the first place, I am sooooo proud of what you did back then! I am only sorry I hadn't even yet found out about Terri Schindler at that point. I didn't even know about her or your blog...only because of your blogs did I ever find out about her, about the euthanasia movement, everything. Look at what you did!

The USA Today paper ad was going to cost $20,000.00 for a full page, and Blogs For Terri put up a place to collect donations for it at the time. The collection of the money was being made by:

Franciscan Brothers of Peace
1289 Lafond Avenue
St. Paul, Minn. 55104

Here is what Blogs for Terri said about the donating:

"The Franciscan Brothers of Peace will be accepting and managing the funds for the BlogsforTerri. They are a 501(c)3 so the donations will be tax deductible, they will charge no overhead, and they will be distributing the funds directly to the newpaper. There are two ways for you to support the advertisement campaign. The first is to spread the word to your readers and friends. It made a HUGE difference when our member blogs began to publicize the first campaign. The second way to support the campaign is to pledge using the form below so that we can make commitments. Then, either send in your donation using Paypal or mail checks to: Franciscan Brothers of Peace 1289 Lafond Ave. St. Paul Minn. 55104 Please be sure to indicate that your donation is for the BlogsforTerri Advertisement Campaign."

So, they used both PayPal and checks.

You can see the original pledge form here:


You can see the original newspaper ad that went into the Tampa Tribune at:


and at:


and at:


The blogger, that lovely lady Crystal Clear (her name :) is the one who digitized the ad for Blogs for Terri so that it could be put into the paper. She can be contacted at her email here:


Also, another blogger helped with the digitizing, who can be reached here:


OK, that is just a start. (By the way, at my work, one of the things I do is call in and have set up classified ads for our firm, so perhaps I could help out with a call or two to newspapers.)

I found all this information just by clicking on the right side of the Blogs for Terri website page, in the gray bar area, where it says ARCHIVES, and clicked on FEBRUARY 2005. The archives of this Blog are good to see and I think we should all go back and get a look at how much Tim, Richard and Beth did from the very start of this blog (Tim, Richard, you must be EXHAUSTED by now!!). And the archives also had tons of contact names and numbers, and are a good source of those.

Now, I am looking into the brochures.

Posted by: juleni at April 19, 2005 5:50 PM

Mary, I have printed off the article you posted regarding the rights of Juries and Trial by Jury and will try to read it some, tonight. What are you meaning about not knowing what to do about the nomination of judges? I may understand better once I read the paper on juries.

Where is the Washington Post site to inquire about rates? I can search for it. Mary, could you try to contact the Franciscan Brothers of Peace in Minn. to see how they handled the fundraising for the USA Today ad for Blogs for Terri (or how they were setting up to handle it)? Also, maybe ask if they'd be up to doing so, again?

Obviously, a full page ad might be over the top for us to afford, but if enough people would pitch in maybe a smaller ad could be run - ?

I may not be back on the Blog this eve., as I have to run...

Posted by: juleni at April 19, 2005 5:59 PM

Will do, Juleni, and thanks for the action suggestion. I seem to be very stuck in the trial by jury issue, awaiting some intelligent feed back. I'm on my way to the Franciscans, etc. Oh, yeah, just type Washington Post in your search line and go fish.

Posted by: mary et. al. at April 19, 2005 6:53 PM

what's happening with Terri's autopsy. will it be on the news when its completed? please don't stop the fight for Terri , file a civil law suit for million so Michael and Jodi can not get rich on killing Terri

Posted by: msTChamberlain at April 27, 2005 1:32 PM