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April 12, 2005

Email Message From Ken Mullinax on current situation: Late Night Update

Topics: News

I, along with a several other bloggers, received an email from Ken Mullinax tonight. After receiving the email, I later had two lengthy conversations with Ken, in order to be sure that I would be posting the very latest information about the current situation and about his intentions. The following message is from the updated email that Ken sent subsequent to our last telephone conversation at 11 PM ET.

- Email received from Ken Mullinax at 11:10 PM ET
My uncle and Mother are beside themselves about not being able to see Mae. Since we were the ones that advocated for Mae's life, we are amazed that we are now shut out of her care by the very person that sought to have her have quite a different outcome by being placed in a hospice. So I called our Ga. Attorney, Jack Kirby, and asked him to approach the court and Beth's lawyer, Danny Daniel, and see what their official reasoning for Beth's position is and to offer that if they would only allow Buddy and Mom to see Mae, I would be willing be denied access to Mae, although I failed to understand why Beth would wish to do so.

On the other hand, there is Beth's compromise for visitation:

Attorney Daniels, speaking for Beth Gaddy, told our attorney, Jack Kirby yesterday that Beth would be willing to allow us access to Mae Magouirk, if and only if, "Kenny would not give another media interview or speak to another blogger or do anything, either passive or proactive, which will give information or shed public attention to the case of Mae Magouirk."

Although I originally desired to get some input and suggestions on whether or not to accept Beth's offer, I have since decided late tonight that to accept Beth's offer would hinder my ability to be an advocate for Mae's life, and so must reject any such restrictions or conditions. Since we have signed over to Beth's side of the family - all financial rights regarding Mae, we feel that having no conflicts of interest of any kind in the matter, we should be included in Mae's medical care consultations, as family. Were we the ones with the guardianship position, a position that Beth now holds by agreement but the spirit of which she has since violated, we would be including Beth as an important participant in our family decision-making process. I intend to work toward an equitable solution with these issues in mind, with the sole objective being that my Aunt Mae receive the proper medical and loving care that she deserves from ALL of her family - together.

UPDATE: I wish to remind readers that BlogsForTerri has offered Beth Gaddy an opportunity to provide her side of these matters, for posting on BlogsForTerri. This message was given to Judge Boyd twice via telephone, with Judge Boyd agreeing to delever the message to Beth Gaddy. That offer is still open, but has not been met by Beth Gaddy.

Posted by richard at April 12, 2005 9:27 PM

Articles Related to News:


Looks like Judge Boyd may not be amenable to granting visitation after all . . . WorldNetDaily has an article http://worldnetdaily.com/news/article.asp?ARTICLE_ID=43763

Birmingham News http://www.al.com/news/birminghamnews/index.ssf?/base/news/111329760456660.xml

Posted by: purple_kangaroo_Angela at April 13, 2005 2:08 AM

Oops, part of my post got cut off . . . the Birmingham News said:

"Boyd said that Beth Gaddy would be within her rights as guardian to prevent visitors from seeing Magouirk. "If she thought it would upset Ms. Magouirk, she had every right," Boyd said."

Although, hopefully Beth's "conditions" on the visitation will show him that her reasoning is not because she thinks it would upset Mrs. Magouirk. He seems like a reasonable man . . . let's all pray that he will consider all the evidence thoroughly and make the decision that would truly most benefit Mae Magouirk.

Posted by: purple_kangaroo_Angela at April 13, 2005 2:12 AM

Just found another article . . . NBC news finally has an article online! http://www.nbc13.com/news/4373212/detail.html

Posted by: purple_kangaroo_Angela at April 13, 2005 2:19 AM

Someone will need to explain to me why getting his face on TV is more important than visiting his aunt and being kept updated on her condition.

Given that her condition is presumably stable now, seeking to have guardianship (shared or otherwise) would seem to be the primary concern, along with substantiating any financial abuse Beth might have comitted and get any rights she has permanently revoked, possibly following up with criminal charges depending on how severe the abuse was.

Sorry, but I've always been extremely sceptical of people who ride the spotlight since they're usually the ones with something to hide. So far, all the publicity they caused seems to only have worsened their actual position and has done nothing in their favour.

If I was being denied visitation, the first thing I'd do is contact the other side, or their lawyer. The second thing would be to petition the court and try to force it that way. If all of that proved to be futile I'd be screaming to third parties as well, no doubt, but it's certainly not the first thing and far from the only thing.
Ken seems to have his priorities mixed up bad.

Posted by: Vanessa at April 13, 2005 3:22 AM

Vanessa, we all just witnessed the court ordered starvation and dehydration of Terri Schiavo. While that case had lots of media attention and blogger attention, the attention came long after the death sentence was "encased in stone" for Terri.

I don't speak for Ken. I've never met or talked to him or even emailed him. This is all MY opinion. In the case of Ken Mullinax, there is a POSSIBILITY that his aunt may not have even been placed in the hospital had he not gone to the blogs and the media. This case is not finished yet. Since we know from Terri's case, the erring was on the side of death and not life, Ken cannot take the chance that the same thing may still happen to his aunt. To give up his ability to talk to the media or the blogs about this would mean giving up what could possibly be something that could save his aunt's life(my opinion). Or, if nothing else, the information from this case could be used to help someone else in the future who is facing a similar situation.

Furthermore, I find it interesting that Mae's granddaughter is adament about Ken being kept quiet. She is in my opinion using this as a "bagaining chip" to allow him to visit his relative. First, it is cruel in my opinion to deny family access to her. It is just as cruel as when Michael Schiavo denied Terri's siblings and Father Frank Pavone the ability to be with Terri when she died in my opinion. Second, if Beth Gaddy is doing everything in a morally acceptable manner, then in my opinion, she should not worry about anything Ken may say to a blogger. I suppose one could argue that this is a privacy issue. Well, George Felos continually discussed Terri Schiavo's medical condition with the press. Yet he denied the ability to bring cameras into the room for "privacy" reasons. We all know how Father Frank Pavone (a priest who would harm the pro-life movement and more importantly would gravely harm his eternal soul if he lied in public) has described Terri's condition just minutes before he and the family were ordered out of the room prior to Terri's death. Like Terri's case and most other cases, Mae's case has ramifications for others. It is important that Ken keep the public apprised of the situation in my opinion.

What could Ken possibly gain from staying in the public's eye - besides a little more time to spend with his aunt before God takes her home (in God's OWN time and NOT by human initiation)? The Schindlers were villified by many across the country. If they received such villification, Ken clearly will receive the same. There is obviously no money in this. In my opinion, Ken suddenly going silent now would possibly give up a needed avenue of assistance should the starvation and dehydration process suddenly begin for his aunt.

As to any kind of notoriety he may have, there will always be another Ken. There will always be another Bob and Mary Schindler. As the Culture of Death continues to claim victims, there will be so many names passed around that nobody is going to have much time to rememer individuals. About the most anyone can hope is that the individuals are remembered in prayer.

Posted by: cw at April 13, 2005 8:25 AM

Gee, "Vanessa" you seem to be making the rounds of all the blogs defending Beth Gaddy and demonizing Ken Mullinax -- all with some pretty odd distortion of the facts. You still never answered my question regarding if you personally know Beth Gaddy.

Posted by: Danny Carlton at April 13, 2005 8:32 AM

Ken is definitely right not to accept this offer. It is very dangerous.

"He that doeth truth cometh to the light."

I realize Beth thinks she's doing the right thing and just having her privacy invaded. But since she _isn't_ wanting to do the right thing, it's important that light be shed on this situation. That would be an incredibly sweeping promise Ken would have to give. If Mae were later moved back to hospice and dehydrated and were even verbally asking for water (there have been such cases), he wouldn't be able to tell anyone about it.

Posted by: Lydia at April 13, 2005 8:57 AM

This case needs to stay in the spotlight as it shows an abuse of power (again) of a guardian. If it wasn't for the heat of the bloggers and media, wouldn't Mae have remained in hospice to waste away? It also can happen in the hospital, so attention needs to be focused on her so that she can receive the proper care. Hospices are not the only place where care can be withheld.

Ken's priorities are right in line, as he ends all of his conversations that I have heard on the radio regarding the help given to his Aunt Mae, "Thank you, Jesus!"

Posted by: I hope at April 13, 2005 10:51 AM

Vanessa/Beth Gaddy---- I DO believe that if you're NOT her, you certainly KNOW her. Have you READ any of these materials that have been presented before you? Or perhaps you're really Judge Boyd, who just reads what he wants to read, and block out all of the rest.

Quoted from Jacklewis.net:
"Another aspect I find disturbing is that in the court filing A.B. McLeod claimed that Mae Magouirk told him, “Buddy, I have discovered that Beth is writing unauthorized checks on my account. I just can't trust her anymore at all. Would you please get with me and tell me what I need to do to have her removed from doing this. Also, I want to replace Beth and appoint you to have my power of attorney and to act on my behalf if I get sick.”

Mae's sister Lonnie Mullinax claimed that Mae told her, “Lonnie, I'm scared Beth is stealing money from my checking account. I have told Buddy already and ask [sic] him to please help me remove her from being able to do it. If you feel it's OK, I want to appoint Buddy as my guardian.”

Mae's nephew Ken Mullinax claimed that Mae told him, “Kenny, Beth is trying to make me give my car to Pat [Beth's mother] and I don't want to do this because I need it so my woman (her daily housekeeper) can take me to the beauty shop and my appointments. I told her no but she keeps bothering me about it and she's now treating me real mean. Charlie (Mae's deceased husband) and I bought Pat the house she lives in and even pay the property taxes on it. I would think that is enough but now this. What should I do?”

Also of interest is the run down of Mae's personal assets, totaling more than $120,000, which Beth and her brother stand to inherit if Mae dies.

While taking the time to schmooze his image with the press and bloggers, Judge Boyd has yet to cite Beth Gaddy for directly and intentionally disobeying his court order. Action speak much louder than words."
End quote

Are you truly illiterate? Or are you Judge Greer in disguise? You can put lipstick on a pig.....

Posted by: oldfitz at April 13, 2005 1:19 PM

Whether Vanessa knows Gaddy or not, is hardly the point. You don't 'need' to know or 'be' Kenneth to be sympathetic to him, do you? No one has endeavored to disqualify your opinions, based on a potential 'conflict of interest' either.

When you take your issues to the 'court of public opinion', you get just that...opinions. That's how it is.

Actions do speak louder than words...and so does in-action. Beth is still Mae's guardian, because the family has yet to challenge her guardianship.
Do you expect the judge to simply 'hand over' guardianship, based on unsworn hearsay 'testimony' contained in a blog? Thankfully, things don't work that way. I can only imagine the implications even in such cases as child custody, if they did.

Frankly, I don't know who's right and who's wrong. Unlike some of you, I prefer to read testimony under oath, and subject to cross-examination. We have one affidavit flying around, while missing the affidavits of both Gaddy and the physician. That's not good enough for me to start burning anyone at the proverbial stake...nor to involve blog commentors in a 'conspiracy theory', for having an opinion.

I have 20 years of nursing, and 10 years of family and estate law. I am the 'cooler head' advocate, not the 'hot-head' activist. I think you'll find that any effective and respected organization, requires both. This thing hasn't played out even ONCE in a court of law...and I'll reserve my opinions until it has. If anyone regards that as 'anti-Mae', that is unfortunate.

Posted by: Carol at April 13, 2005 2:32 PM

oldfitz, I think you're a little off the mark. First, Beth Gaddy's guardianship is temporary and expires in 45 days unless there is another hearing. Since Mrs. Magouirk seems to be getting her needed medical care, maybe the family (or their attorney) has advised them to focus their efforts on blocking the permanent guardianship application rather than maybe piss off the judge by fighting the previous order that they negotiated between themselves. (It's one thing to go to court and argue the judge made an error; it's another thing altogether to try to rescind a negotiated agreement that you yourself approved of.)

Regarding the statements allegedly made by Mae to her brothers, that's hearsay and is no more powerful than Beth saying "granmama said she wanted to go home to Charlie" (her dead husband.) What the family really needs is to find someone who is not a family member who heard Mae say those things.

Finally, the judge can't cite Beth for anything she might have said or has been alleged to have said or done unless there is a hearing where she can have her say (due process). Since the April 4 objection was withdrawn as part of the settlement, those allegations don't officially exist as far as the court is concerned. Standard procedure is for someone who has a complaint to file a petition, at which point a hearing is held. There are many reasons why the Mullinax's may not want to file a complaint right now, such as waiting to build a stronger case with more evidence than just 4 people making wild accusations at each other.

Posted by: Creatureofhabit at April 13, 2005 4:23 PM

Creatureofhabit. There's zero intolerance to revisiting or even rescinding a negotiated settlement, if it can be proven that one party has breached said agreement.

A temporary order can be sought in the interim...while they build up a stronger case for permanency. Even if unsuccessful, it's prudent to keep this situation in 'legal limbo'...thus providing the family with continued disclosure of Mae's medical treatment/status.

Why in God's name would they wait, given those simple legalistic truths?

On a side note...did anyone else notice, that on the Petition for the Appointment of an Emergency and Permanent Guardian, there are two petitioners? Beth Gaddy, and her brother Michael. Danny Daniel was the attorney for both petitioners...and the Petition request clearly states that Mae was currently in Hospice. So, everybody knew where she was.

Taken from the LaGrange Daily News:

"Danny Daniel of LaGrange, the attorney for Gaddy and another grandchild, said doctors made the decision to admit Magourik into hospice.

Gaddy has been taking care of her grandmother for 10 years, he said. “They’re following the doctors’ recommendations and they want to do what’s in the best interests of their grandmother,” Daniel said, adding that hospice is providing “excellent care” for Magourik, a widow with no children."

From the same source:

“I think all of Mrs. Magouirk’s family has her genuine best interests at heart, but fortunately they disagree on what they believe would be best for her,” said Jack Kirby of LaGrange, attorney for the patient’s brother and sister."

Do you think this could be a case of the woman's grandchildren (plural) making a decision for their grandmother, based on doctors'(plural) recommendations? Frankly, I don't see the 'plot' here...and interestingly enough, neither did the lawyer for Mae's own siblings. This issue belongs in Court.

Posted by: Carol at April 13, 2005 5:59 PM

"There's zero intolerance to revisiting or even rescinding a negotiated settlement, if it can be proven that one party has breached said agreement."

The problem is proving that Beth Gaddy refused to allow hydration AFTER a doctor recommended it. She was ordered to rely on the doctors, not on the advice of her aunt, uncle or cousin. In order to prove that Beth neglected to provide proper care, the family would have to subpoena the medical records from the hospice and find there a note on Mae's chart indicating that the attending doctor recommended some sort of treatment that was refused by the guardian. But since Beth is not a doctor, she cannot be held legally culpable for not reuesting hydration on her own.

Now, as I have pointed out in other comments, if the hospice had considered her dehydration medically significant, they had an obligation to provide hydration per the Living Will, even over the objections of the guardian. Obviously the hospice did not do that. I personally think the hospice is guilty of malpractice, and was content to let Mae wither away under the fiction that they were "offering" hydration. There may even have been collusion between the hospice and Beth Gaddy, but you will never see a shred of evidence of that, and Beth is "covered" so long as she never directly refused a doctor's order.

That leaves the Mullinaxes with the choice to break the agreement from their own side, which as I suggested and you seem to implicitly agree, would be unlikely.

Posted by: Creatureofhabit at April 13, 2005 6:25 PM

Hi Carol,

You talk about hearsay. I'm curious. If you do not like hearsay in this case, how did you feel about the hearsay in the Terri Schiavo tragedy? You know - the hearsay by Michael Schiavo and HIS family that Terri allegedly told them certain things. Judge Greer ruled in favor of such hearsay by Michael Schiavo and HIS family and issued a court order for Terri to be starved and dehydrated (Greer's court order caused CHILDREN to be arrested - remember, we're living in the United States of America in 2005, not NAZI Germany between 1933 and 1945). Of course, contrast Michael and his family's hearsay evidence with a statement Michael made on CNN about this (link to transcript available upon request)... Since Greer's excuse was "this is the law" then I don't see why hearsay isn't just accepted everywhere. Afterall it was acceptable to cause an innocent disabled human being to be starved and dehydrated by court order. In my opinion, it's like there's a double standard if one is trying to PRESERVE life.

Posted by: cw at April 13, 2005 10:58 PM

I'll answer you first cw, and then I'll get back to Creatureofhabit.

cw, I was a huge blogger for Terri Schindler. You're barking up the wrong tree, if you think otherwise. I hated and spoke out against hearsay in her case...and I'm doing the same now.

I approached Terri's case, in the same methodical way I have this one. I threw out all of the conspiracy theories, and looked completely at facts I could validate. I honestly don't think there is one court transcript from the Schiavo case, I have not read.

My conclusion was this:

1. Mike Schiavo was inconsistent in his versions of Terri's "wishes". Too much so, to be considered a reliable source of information. The other 'witnesses' to her alleged "wishes" all had undeniable conflicts of interest.

2. The media did a horribly irresponsible job of the case coverage. Allow me to give you an example. Medical pundits absolutely GUSHED that Terri had received wonderful care, as evidenced by "zero bedsores in 15 years". That was a blatant lie. If you consider the malpractice trial transcripts (Michael Schiavo's deposition), Terri had already had a toe amputated by 1992 due to 'decubitus ulcer' (bedsore)...and was in danger of losing another at that time. That's astounding for one so young, without diabetes, nor any diagnosed circulatory impedement.

3. Terri's image, was displayed as a product of her 'disease process'. Indeed, she had no disease process at all. The vast majority of her ailments (contractures, amputations, tooth extractions, hyperextension of the neck, limited ROM, etc) were all due to neglect...therapy, dental, etc. Miserably inadequate polls basically said, "Would you want to live like this?"...with no explanation given.

Therefore, the polls were lost proportionately to the courage of the politians.

I could go on for hours, but I hope you understand what I'm saying. I like facts, and I do search for what's right and just. People may not like what I have to say, but you'll find I'm consistent.

Posted by: Carol at April 13, 2005 11:21 PM

Carol, I appreciated your last post. I can really relate to your words.

I've seen people (not necessarily here) "defending" Terri's case and others by repeating unfounded rumors, using insults and name-calling to substitute for reasoned argument, ignoring any fact they don't like, and attacking any messenger who mentions it--even if that messenger is staunchly on the same side of the cause they are. I don't think that type of approach is helpful to the causes they are trying to further, and may cause more harm than good.

To be truly effective and to have our voices heard and respected, we MUST operate on a higher level. We need facts, logic, common sense and courtesy (even toward those who disagree with us) on our side. We must be fair and give adequate consideration to any facts or arguments that could possibly carry some weight, whether we agree with them or not--even if they are wrong, how can we effectively refute them if we refuse to take an honest look at them?

We must care more about the truth than about bending facts to make them what we want them to be.

We simply cannot allow ourselves to do anything that would give fuel to those who would portray us as a bunch of kooks who aren't interested in and don't know the true facts. Of course, we are going to have detractors and people who think badly of our motives, methods and attitudes no matter what we do--but let's not let it be because we did or said something deserving of such criticism.

Posted by: purple_kangaroo_Angela at April 13, 2005 11:59 PM

First off...Forgive the typos in my last comment. I get sloppy sometimes.

Creatureofhabit, let's trim the fat if we can. As soon as I hear words like "collusion", "plot", or "conspiracy"...I start to inch away very slowly.

You're throwing around alot of supposition, but I don't see the facts to validate any of it. I won't deal with hearsay...particularily when only one side is talking. I understand Beth has been invited here, but you know as well as I do, no self-respecting attorney would ever let her 'testify' publicly, without representation.

Ken can shout from the rooftops. He isn't, and never was a Court recognized party in this.

These are the only facts I can find, thus far:
1. Beth and her brother did admit their grandmother to a hospice, at the recommendation of doctors.
2. Nourishment and hydration were not withheld (and I keep telling you folks, we in palliative care don't do that)...but artificial methods of introducing those elements were not employed. (IV, NG tube)

Therefore, it is apparent that Mae was sent there to die. I don't dispute that, and never have. Was that wrong, given her Living Will? I don't know...I'd have to be in their situation, and hear what the doctors advised them. For example, the Living Will only addressed coma/vegetative state...what about excruciating pain from an inoperable tumor? In that case, I'm hopeful my family would be able to translate my wishes, beyond those expressed in writing. I'm just saying, we cannot possibly foresee every eventuality in our written directives. I have no idea what prognosis they were given...and I'm not arguing the point one way or the other.

What I do argue, is that a minimum of four people went into that decision-making process, and only one has endured a smear campaign. To me, that's wrong. Slander, harrassment, name-calling, finger-pointing, obligatory death threats, or any other guerilla-type tactics are not what I consider to be honoring Terri's memory or legacy. If you can't make a point, without slinging unsubstantiated feces or creating elaborate conspiracies...then maybe you don't have a point to make at all.

Give me the facts...show me that she ever refused an IV for Mae, after the Court order, and I'm sold. But, if you're telling me that the family can't make a case of her alleged impropriety in court...then maybe we shouldn't be making one, with no access to any facts at all.

Along with what Purple Kangaroo said above (and thank you for that very well-written post by the way), if you want to really effect change...don't get caught up in some loose-cannon, Area 51-type mentality. Choose how you can be most effective, discover your strengths and God-given talents, and organize.

Posted by: Carol at April 14, 2005 1:13 AM

Hi, Carol:

I'm not antagonistic to your general attempt to be level-headed, but I do have a lot of comments on what you've been saying and may not fit them all in here as I'm writing on the fly. Please don't misunderstand my tone, as it's in part the result of working quickly. I can only be super-polite when I have time to put in a lot of extra words. :-)

First, you keep saying that people in palliative care "don't" withhold food and water. Now, you _know_ that food and water were withheld in a hospice setting from Terri herself--even ice chips, for goodness' sake.

I know you may say that was an isolated case, done on court order, but I think the evidence is that the only thing isolated about it was the refusal to provide the mouth comfort of ice chips, etc., and that, at a broader level, people dehydrating in hospice because of far-from-sufficient amounts of hydration is not at all uncommon.

Now, please don't get angry, because I know that you are a palliative care nurse, or so I gather. But there is plenty of evidence on this. I don't have time right now to look up the URL, but there is a hospice watchdog group whose representative was quoted in the first WND story on this. I'd already heard of his group. It's evidently not at all uncommon to find people who aren't going to die very quickly from an underlying condition but who are taken to hospice nonetheless. Either they are out of it from their underlying condition and/or they are given a lot of morphine and Atavin which makes them out of it. I'm not claiming this is some huge plot to prevent them from saying what they want, but I have no doubt that it is in part to ameliorate their pain *from the anticipated dehydration*.

Perhaps your hospice is different. I do realize there is probably a tremendous amount of variation.

Now, did Beth have to be refusing a doctor's order here to be negligent? From what I can tell, *not at all.* My evidence: When the hospice looked into the legal situation and told the Mullinax "group" that there'd been a mistake and they were in fact the default decision-makers, they were able to order IV hydration *immediately.* It started that night, by their order by phone. The next day they were going to airlift her out, and they were demanding an NG tube. The hospice then told them that she wouldn't be a candidate to be there anymore if she had an NG tube. Now why? I know, and you know, that hospices certainly can _handle_ NG tubes. It's not like there's never anybody with an NG tube or a G-tube in hospice. Practices vary here, but it's not impossible. Obviously what was going on was that she would no longer be expected to _die_ if she was getting thorough hydration, so they couldn't keep her in hospice on the theory that she was "going to die shortly." Furthermore, Mullinax says (and why should he be lying) that when they showed up at the hospice, the nurses, etc., there tried to talk them out of hydrating her and suggested that they "let her go." They resisted that pressure. Beth could have done so, too.

Finally (for the moment), I strongly disagree, and I suspect others here would disagree as well, that it would be okay to give an old lady only ice chips and jello until she died from dehydration in a situation not even named in her living will, because one was--what was that phrase?--"translating her wishes." Heaven knows, some of us think it's bad enough to go along with someone's wish to be dehydrated to death (and let's face it--that's what's happening when you're just getting itty bitty bits of jello for a couple of weeks) in the situations they _have_ named. But to "translate" that and do that same thing in an entirely different situation they haven't even mentioned is not good *at all.* Some of us have even questioned if it's legal, and given the seriousness of what we're talking about--a matter of life and death--I think that's a good question.

Posted by: Lydia at April 14, 2005 8:16 AM

Hi Lydia I'll try to take your comment in parts, and answer it as best I can.

All forms of sustainance were withheld from Terri, by court order, and subsequent physician's order. I'm not sure why that would be regarded as proof that Hospices withhold nutrition and fluids. If anything, it should be proof that they do not. Consider this, if hospice facilities required only the legal guardian's request/order...why did Schiavo spend years in Court to obtain an order commanding the measure?

Non-substantial nutrition/hydration are not uncommon in a hospice setting. I never would claim otherwise. What seems to be misunderstood, is that either guardians, or the patient themselves have asked that no artificial means of introducing those elements be implemented. This is not a case of not providing/offering fluids or food. They are offered and damned frequently ...and no request for either, would ever be denied. The natural process of the terminally ill, is that they lose their appetite and ultimately their thirst. I have begged ...literally begged patients to drink something for me. They refuse. We go out of our way to find something they like to drink, often spend our own money to buy it, get Dr's orders for alcoholic beverages, if that was the patient's favorite thing...anything we have to do. It works for a while, if we're lucky...then the patient just won't take anymore. They not only refuse, they're damned adamant about that refusal. I've been yelled at, and even hit for annoying them too often with my offers of fluid. They just don't want it, and by law, I can't force it. They have the right to refuse.

Morphine is given for pain. Ativan is an anti-anxiety medication. They're not given in conjunction to 'knock people out'. Morphine can retard respirations, ativan relieves the anxiety that creates. I've given pain medications prophylactically, after someone has started their self-imposed starvation...but I've never given it preemptively. That's just unheard of.

As for the watchdog group you mentioned. I'm hopeful it has some health care professionals in it, who know the drugs and their appropriate usage. I'm sure it does. I can't claim that nothing ever goes wrong in a hospice...just as hospitals are not immune to error...I just know they are not "death camps", nor is there any conspiracy to murder the helpless.

Terri had no terminal, underlying condition and she survived the "death camp" hospice for 5 years. She'd still be alive, if not for the judiciary. Hundreds of AIDS patients came to hospice for the purposes of dying. With the introduction of new medical advancements, they were discharged and are now leading productive lives. There is no attempt to 'speed-up' nor manufacture death. Terri alone should have been proof of that.

Your next paragraph gets into more of what Ken says, and it's hard for me to address that without any validation. I've already conceded that Beth and Michael had placed Mae there to die. I don't believe they've ever denied that either. Maybe Mae wouldn't have fit that particular hospice's criteria of 'dying', were she fitted with an NG tube. I'm not sure.

As for the "jello, ice chips, and whatever else she would eat" (not quoted exactly, I'm afraid) statement...that's pretty common. There is a point where, unless people die suddenly, individuals tend to 'shut-down'. As I stated above, they have no appetite nor thirst. This is the time every family must make their decision...to either allow this situation to take its natural course (which incidentally doesn't guarantee death...I've seen lots of people rebound from such a condition, and live several more months or years)...or to implement artificial means, such as IV's or tube feeds. This is the crossroad every family will have to face...and this particular family was divided on which road to take. I don't see it as any more complicated than that, given my limited facts to the contrary.

I think what I was saying, is that I hope my family can translate my wishes beyond the scope of any written directive. No one can pre-determine every possible eventuality...as such, I am hopeful that no agency, activist group, or religious organization will interfere with the broad powers I have given MY family to interpret my wishes. I have a right to live, but I have an equal right to die naturally if that is my choice...or, quite frankly, their choice if I am incapacitated. If my Living Will only dealt with coma/vegetative state, but neglected excruciating pain caused by an inoperable source...I would be grateful if no one intervened in my family's rejection of any written directives. That's entirely about me, and has no bearing on the case at hand.

In Mae's situation, I have no idea what the doctors informed/recommended/advised to Beth and her siblings. I just don't know what was said to birth the conclusion they collectively arrived at. I wasn't there, and cannot argue the point one way or the other. I'm not suggesting that Mae's outcome is in any way wrong...I'm merely saying that a rush to judgment about people who may well have thought they were 'doing the right thing', could be premature...and naive, without all the facts.

I hope I've answered at least some of your questions.

Posted by: Carol at April 14, 2005 3:11 PM

Okay, I understand what you're saying, Carol. (I'm not sure I agree with all of it, but I think I'm following it.)

But suppose the person himself _isn't_ refusing hydration. Maybe he can't even communicate at all. He might just not be able to take much at all by mouth because of being, say, sleepy or "out of it"--perhaps from medication or perhaps from the condition that was there when admitted. This need not at all be the same as "shutting down." Wouldn't the guardian be able to say, "In that case, give Grannie an NG tube?" And speaking in general terms, at least if nothing Grannie had said or written seemed to _reject_ a tube under the circumstances she was in, wouldn't you think the guardian would be _obligated_ to order that rather than being resigned to Grannie's getting insufficient hydration and nutrition?

Finally, don't you think it's possible that some hospice personnel get so much into thinking about people who don't eat much by mouth as "shutting down" that they jump to that conclusion when the person is just unable to take much by mouth for some other reason?

Posted by: Lydia at April 14, 2005 4:11 PM

Excellent points Lydia. You have to understand that it is very difficult for health care staff to jump to any conclusions. We have a complete file of the patient's or guardian's directives, diagnoses, allergies, medications, and history.

It's not like someone fell off their bike out front, were brought in unconscious and we say, "oh this person isn't eating...they must be in 'shut-down' mode".

Hospices are not a diagnostic facility. By the time a patient is referred to us, we are already well aware of their prognosis. Either they have applied to stay with us, or their family (hopefully in agreement) has decided to admit them. Either way, they must be referred by a physician. No one can bring their mom, for example, and say, "we say she's dying". Only a physician can make that determination...and our staff physician would have to concur with that determination.

People have asked how Terri wound up in a hospice, when she was not terminal. My only answer to that would be, given Schiavo's success in his Application to have her G-tube removed...she was scheduled to 'be' terminal. That's a legal loophole, people might want to look into changing.

Did the daughter have an obligation to request an NG-tube? I've heard somewhere, but don't quote me on it until I find the transcripts, that the physician who submitted Mae's report to the Court, said he was prepared to override the Living Will. I still don't know why, as I can't find his report to determine what his diagnosis was. If that's true, he must have had some very passionate feelings about Mae's prognosis. That's why I want to see what he told Beth and Michael, before I make any comments on her culpability.

Unpopular as it may seem, I try to see a loving (maybe sometimes misguided, and all too human) family before I jump to conclusions. When I worked at a nursing home, we had elderly people brought in who were terribly bruised. Some hadn't eaten in days. Some were filthy and covered with feces. Once a car pulled up, an elderly woman was rolled out like a 'mob hit', and the car sped off. She suffered from dementia, and didn't even know her own name. We didn't know her history, medications, diagnoses, allergies...very frightening situation. And, sorry to say, not at all uncommon. Nevermind the rest, who are just left to die and rot at home. I don't know, maybe I've just seen too much garbage to start handing out 'black hats', before I know for sure.

Posted by: Carol at April 14, 2005 5:49 PM

Hey, Carol: I actually _agree_ that Beth was probably fed a line by some medical personnel before admitting Mae to hospice. My suspicion is it was somebody at the hospital. Maybe this Dr. Stout, maybe somebody else, maybe several somebodies. But I tend to hand out, shall we say, _purple_ hats :-) for what seems to me culpable stupidity. I mean, if the doctor's shtick was based on "quality of life" considerations (and I'm not as hesitant as you to accept the quotations I've read from the court materials, esp. since I don't have any choice because they won't load on my computer), then Beth should have had a little light bulb go off in her head that something was wrong rather than just repeating the whole line about how "no one would want to live with these disabilities."

The thing is that you are quite right about hospices already having a diagnosis that a person is "dying" or "going to die" _when_ they get the person. So they operate on that basis from then on. And you also are right to acknowledge the "legal loophole" about someone "scheduled to be terminal." But don't you think that happens more often than just in Terri's case? And mightn't that make hospice a rather dangerous place, even though the people involved at various levels aren't actively bad?

I certainly think it does, especially since a lot of passing the buck could go on very easily. Suppose Grandma is just very frail and confused from something she's just been through at a hospital but isn't actively dying right at this moment. Doctor A thinks she doesn't have much of a life to look forward to with her most recent problem and therefore puts together some spiel for Granddaughter about how now it could be time to "let Grandma go." He influences her to check Grandma into hospice. He casually declares Grandma to be "terminal," using that loophole where she's "going to die" because he can be pretty sure nobody is going to order a feeding tube and he knows she'll die without one in a relatively short time. Granddaughter doesn't order one, because Doctor A has filled up her head with the whole "letting Granny go" mode of thinking. Nurses can't put one in without a doctor's orders. The hospice doctor can't order one without the consent of the guardian (Granddaughter). And around and around it goes, but everybody (except perhaps the original doctor who made that fatal diagnosis that she was "terminal") can say, "It wasn't me. _I_ didn't go against any doctor recommendation" or "I couldn't order a feeding tube without the guardian's consent," or whatever. So Granny dies, when she wasn't actually terminal from her underlying condition.

I hope this doesn't sound insulting, but I bet something rather like that happens a fair number of times around the country.

Posted by: Lydia at April 14, 2005 9:49 PM

Carol, my apologies. I think I probably just popped off when I saw the hearsay comment in light of the trolls that occasionally show up here. And yes, I agree we have to carefully consider everything and not appear to be lunatics while still focusing on preserving life (ie - I do not believe in a "right to die" as a Catholic and I do not believe there is anything in the secular U.S. Constitution guaranteeing one either, particularly looking at the Fourth Amendment). Tonight I don't have the time to read through the discussion here carefully. Hopefully I'll get time over the next few days to at least read through (even though the discussion will have likely moved on to newer threads by then).

Posted by: cw at April 14, 2005 11:46 PM