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April 9, 2005

Schiavo neurologist views Alzheimer patients as physician-assisted "suicides"

Topics: News

- Canada Free Press
Years before he categorized Terri Schindler Schiavo in the persistent vegetative state, which led to her death by dehydration, neurologist Dr. Ronald Cranford was building the case for removing feeding tubes from society's vulnerable.

"...The United States has thousands or tens of thousands of patients in vegetative states; nobody knows for sure exactly how many," Cranford wrote in a 1997 Minneapolis Star Tribune opinion piece titled: When a feeding tube borders on the barbaric. (WorldNetDaily. Com, March 23, 2005). "But before long, this country will have several million patients with Alzheimer's dementia. The challenges and costs of maintaining vegetative state patients will pale in comparison to the problems presented by Alzheimer's disease.

"The answer, he suggested, was physician-assisted suicide."

More ...

hat tip - David Limbaugh

cross posted at Hyscience

Posted by richard at April 9, 2005 12:33 AM


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I don't know if anyone is going to like what I am going to say, but I'm going to say it anyway.

I am curious as to how many of the people involved here have ever volunteered in any kind of facility or board and care, hospice, whatever, where the elderly or disabled who are unable to care for themselves live.

In the many years I have served in my community I have found that people do the most good and are the most effective helping those who are nearby. Also, this is a very good way to show others what they can do and some may follow your good example.

That is not to say that it is not worthwhile to reach out beyond your own borders, so to speak. Sometimes that is very appropriate and necessary. I'm just pointing out the effectiveness of volunteering locally.

Also, it may give a greater perspective of the problems you are trying to deal with.

If you have not done this, you will be very surprised by what you are likely to find. People who are very lonely, some very depressed. Sometimes these people who no longer live the same lifestyle they were accustomed to are very depressed. They live out their days believing they have no purpose and spend each moment wishing to die already because they just cannot cope with their disabilities.

I will share an example. At one home where I volunteered there was a man named "Will". Will was about seventy and did not have dementia. He lived in a board and care with six others. Will was blind from glaucoma and had spent enough time in the hospital to weaken his ability to walk, so he spent all day and night everyday in bed.

Now, I have worked with many elderly and disabled people who continue to live purposeful and joyful lives, but not Will. Everyday he was laid up in his bed and would constantly say "help me, help me" at times he would yell. He did this everyday. He did this even when someone was with him caring for him, reading to him, feeding him. He had excellent medical care and nothing was wrong with him, except that he had become disabled.

I was very concerned for Will's state of mind (and everyone's who was in earshot, as it can be very annoying!)

I tried to get Will to talk about his life. This was very difficult. I told Will stories about other people who had faced suffering and loss, talked about sports, current events and read stories from the scripture. I was concerned that Will was going to spend his last days in torment and it occured to me what a terrible way that would be to go out of this world. So I decided that every time I saw him I would try to change his attitude about his life.

Over time, my (evil) plan worked(aha-ha!) and although Will was ready to go to heaven and meet Jesus, he became peaceful, sometimes he told jokes and he started to tell people about his life. By the way, I have found it fascinating to listen to the real life stories of the elderly!

Will stopped spending every minute in anguish because he was obsessed with nothing but his thoughts of dying.

I don't know if telling this little story helps anyone see what must be done, but it is really simple. We must care for one another better than what we may be doing.

It is a lot of work, it really is. But it is not only worthwhile, it is what we should be doing. Serving others. Instead of going on vacation, instead of going to the movies, instead of sitting around watching tv chanting 'tell me my opinion', instead of shopping. We can do these things too, but we should look at the excesses in our own lives and once we see them give them away. Willingly, lovingly.

We can find out what is going on in our own communities. If what concerns you the most is the elderly and disabled who may be mistreated or killed or who are simply lonely, go to the local facilities in your area and ask how you can help, ask all the questions you have learned to ask from getting involved in Terri's fight. Show up.

If some did this you could probably gather enough information about what is happening in your community on this issue to produce an excellent and insightful and compelling investigative news story.

You've heard the statistics, that this is common occurence, now go out there and find out, then report about it. Don't wait for someone to come to you, go out and find out.

This is not advice, just my thoughts, and they are not intended to insult anyone or tell anyone what to do or how to do it.

Posted by: that woman at April 9, 2005 2:09 AM

I have also had experience visiting with elderly folk at a nearby retirement village. I am not sure that I want to talk about my experience (not a bad one).

You have a point and what you suggest is good from the point of view of getting to know the people who are most in need of protection.

Are you familiar with the guardians issues that have been highlighted? You see there are unscrupulous people who go to those places and seek out the lonely to take advantage of them. Guess which county has the worst record.

I live in an area of Sydney where there is a very high proportion of retired people living in nursing home/retirement village style accommodation. My Church is very active in giving assistance to these people. We have a roster system to take them to Mass on a Sunday. I have many friends who are in this category. The local retirement village is huge. The staff includes physiotherapists, and occupational therapists. They have their share of Alzheimer's disease victims. One of my friends is an occupational therapist at the village. I used to take communion to people at a different village and they also loved the occupational therapy activities.

I will be having more to say on the material written by Cranford, when I get time to evaluate his material. Do expect me to take him to task over the sloppiness of the way in which he handled Terri Schindler, and the inconsistencies in his testimony, as well as afterwards.

Posted by: Maggie4life at April 9, 2005 6:09 AM

I have also been in a nursing home and assisted life home. I volunteered and my mom was put in one for rehab for 2 knee surgeries.

Nursing homes are places where elderly people are dumped off by people who can no longer take care of the person or just do not want to. I remember many asking me if they could go with me. I remember taking my mom upstairs to the rehab center. There were all of these elderly people in their wheel chairs by the elevator begging us to get them out of the place. It was very sad.

My mom is wheel chair bound, in a domestic violence relationship and severly depressed. I only call so often because there is only so much I can take.

Posted by: Julie at April 9, 2005 8:53 AM

I thought the Cranford death cult connection was already common knowledge or else I would have submitted the following long ago:

http://www.startribune.com/stories/779/23033.html

In case the link doesn't work; here's the article; it is written by Cranford himself so we can assume it very accurately depicts his attitude toward the disabled....

I happened to inadvertently get his contact information while search for his articles;

It's Hennepin County Medical Center
900 S 8th St, Minneapolis, MN 55404 | 612-873-6800 he's also a faculty associate at the University of Minnesota's Center for Biomedical Ethics. (not sure how up to date this is).

COMMENTARY BY RONALD CRANFORD M.D.:

Minneapolis St. Paul Star Tribune
Commentary: When a feeding tube borders on the barbaric
by Ronald Cranford May 28, 1997
Just a few decades ago cases of brain death, vegetative state, and locked-in syndrome were rare. These days, medicine's "therapeutic triumphs" have made these neurologic conditions rather frequent. For all its power to restore life and health, we now realize, modern medicine also has great potential for prolonging a dehumanizing existence for the patient.

We realize this, and we're starting to deal with it. In landmark legal cases from Karen Quinlan to Nancy Cruzan, society has come to see that it's sometimes sensible to stop treatment in patients lingering in permanent vegetative states (PVS). That progress has been hard-won and welcome. But anybody who thought that the dilemmas of PVS were troublesome hasn't seen anything yet.

The United States has thousands or tens of thousands of patients in vegetative states; nobody knows for sure exactly how many. But before long, this country will have several million patients with Alzheimer's dementia. The challenges and costs of maintaining vegetative state patients will pale in comparison to the problems presented by Alzheimer's disease.

Since women now live much longer than men, and since Alzheimer's is a disease of the elderly, most of these patients will be female. Many will spend their last years largely unaware of themselves or their surroundings.

If people really understood the reality of this dementia, I doubt they'd find it an acceptable lifestyle. Being in a state of wakeful oblivion for five to 10 years or sometimes longer is a degrading experience. The degradation is borne not so much by the patient, who may be completely unaware of him- or herself, but by the patient's family. They must endure the agony of seeing a loved one lying there year after year, often sustained only by a feeding tube.

Just as we've tried to come to grips with appropriate care of PVS patients, we've got to confront the dilemma of dealing with the demented. Comfortable solutions aren't easy to find.

So much in medicine today is driving the public towards physician-assisted suicide. Many onlookers are dismayed by doctors' fear of giving families responsibility in these cases; our failure to appreciate that families suffer a great deal too in making decisions; our archaic responses to pain and suffering; our failure to accept death as a reality and an inevitable outcome of life; our inability to be realistic and humane in treating irreversibly ill people. All of this has shaken the public's confidence in the medical profession.

People fear becoming prisoners of medical technology, and their fears are largely justified. When medicine and society refuse to face up to tough questions of treatment and honor individual values, physician-assisted suicide and active euthanasia start to look like the only open exits.

Consider, for example, the case of Jamie Butcher -- a young Minnesota man of 34 who spent half his life in a vegetative state. After tending his inert body for 17 years, his parents finally made the heartbreaking choice to let him die. You couldn't find two more loving, caring, intelligent parents than Jim and Pattie Butcher. Their decision to remove Jamie's feeding tube should have been relatively simple -- and entirely private. But right-to-lifers and some disability groups fought the Butcher family every step of the way, assailing their legitimate choice to withhold futile treatment as an act of euthanasia.

This is just the sort of inflammatory talk that threatens to drive society down the path towards physician-assisted suicide. Medical organizations, courts and other groups generally agree that there are some important distinctions between stopping treatment and acting to cause a patient's death. By insisting that withdrawing a feeding tube is akin to euthanasia, these special interest groups are undermining their credibility.

And they're creating unnecessary confusion for the growing numbers of families losing a loved one to Alzheimer's. Vegetative state cases are not nearly as numerous as cases of Alzheimer's. But both kinds of cases force families to mull over the same question: When the human brain is so badly damaged that its owner can no longer think or even eat, what should be done?

This is a question families should feel free to answer for themselves -- without fearing intrusion from outsiders. And when you really think about it, the idea of placing a feeding tube in a patient with advanced Alzheimer's disease makes no sense at all, medically or morally. It borders on barbaric and cruel. It's just the kind of dehumanizing medical intervention that the public finds so distasteful. It's the sort of practice that undermines confidence that doctors have the best interests of patients and families at heart.

In Europe, feeding tubes are rarely seen in nursing homes. Once a patient is so severely brain-damaged that only artificial nutrition can sustain life, many doctors and families rightly ask, "What's the point?" In many civilized countries, the question wouldn't be asked -- because placing a feeding tube in someone with end-stage dementia wouldn't even be considered.

But here in the United States, many caregivers wouldn't consider not placing a feeding tube in the same patients.

It's hard to understand why. If we want our loved ones to live and die in dignity, we ought to think twice before suspending them in the last stage of irreversible dementia. At it is, it seems that we're not thinking at all.

-- Ronald Cranford, of Bloomington, is a neurologist at Hennepin County Medical Center and a faculty associate at the University of Minnesota's Center for Biomedical Ethics.

© 2005 Star Tribune. All rights reserved.

Posted by: Anna_Nordin at April 9, 2005 10:50 AM

I too have volunteered, all my life, off and on in nursing homes or retirement communities with the elederly, that woman.

Since my youth, several of the churches I have been in have had either ongoing or intermittent outreaches to the elderly this way....I agree with you, it is one of the best ways to be involved and help to make a difference. It is a fulfillment of "do unto others as you would have them do unto you", and "as much as you did it unto the least of these.. you have done it unto me".
Thank you for posting it.

Posted by: juleni at April 9, 2005 2:33 PM

Dear "that woman", you are right, and I, for one, am not offended. I watched my mother and my aunts take care of my grandmother 24/7 for the last six years of her life. My first job, in high school, was at a nearby retirement home. My father died two years ago of complications of stroke, and my sister and I were heavily involved with taking care of him and getting home health care for him, to take some of the physical burden (sorry for that word) off our mother. My father wanted to live, and fought bravely, but in the end it was pneumonia that killed him. The strokes had impaired his ability to swallow, and he choked a lot, resulting in pneumonia. We had a battle with the hospital over trying to get him a feeding tube (does this sound familiar?) They dragged their feet too long, and he got too weak, and couldn't fight the pneumonia off.

So all these issues are very close to my heart. My sister and I want to take care of our mother when the time comes. She's still vigorous at 83 -- lives by herself, still drives, cooks, does everything -- but sooner or later, she will need our help. Like many of the WWII generation, she has a horror of "being a burden" to her children, one which the death doctors are only too happy to take advantage of.

Anyway, this is a long-winded way of saying that I agree with you. Our society would be much better if we didn't blithely assume that all was well behind the closed doors of Happy Sunset Rest Acres, but instead went to see for ourselves.

Posted by: Mary in LA at April 9, 2005 2:45 PM