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April 10, 2005

Wizbang: Mae Magouirk Update - The Contrarian Edition (UPDATED 4/19 - 08:15 ET)

Topics: News

(LATEST UPDATE)
I spoke with Judge "Donald" Boyd by telephone early this morning. I read the following comments from this post to him:

"One of the conditions of her guardianship is "To see that the ward [Magouirk] is adequately fed, clothed, sheltered and cared for, and receives all necessary medical attention, including placement in a nursing home, if appropriate." A nursing home is not a hospice - in a nursing home you are suppose to continue living, in a hospice you are suppose to continue dying(if AND ONLY IF, you are dying in the first place)."

Judge Boyd agreed with our version of his order and with our comments regarding the difference between nursing home care and hospice care. Judge Boyd seems to believe that things fell apart between the families AFTER they left his courtroom and that Beth may have acted upon information from her grandmother's doctors - that the two doctors in LaGrange must have told Beth that Mae should go into the hospice - else Beth could not have put Mae in the hospice. As to the issue of feeding and hydration, Judge Boyd said that it was testified in his court that Mae "was" getting nutrition and hydration. As to whether or not it was adequate, that may be the issue(my comment not Judge Boyd's).

Finally, Judge Boyd has agreed to provide BlogsForTerri with his views and opinions in the matter(not legal opinions but his personal opinions) on Monday. We have promised to post them on BlogsForTerri, Hyscience, ProLifeBlogs, and at the discretion of all other bloggers of the BlogsForTerri team.

Todays Birmingham News Article on Mae

The issue seems to be narrowing down to "SUFFICIENT AND SUBSTANTIAL" nutrition and hydration - not starving and dehydration. But if left in the hospice - Mae would have died. Upon arrival at UAB Med Center, Mae was so dehydrated that the physician believes it will take at least two days of hydration to bring her back to normal - according to nephew, but easily verified. Nephew providing BlogsForTerri a full updated email today for posting.

END OF LATEST UPDATE - begin original post.

As Paul at Whizbang notes, multiple people have made the argument that some things about Mae's case don't add up. As for me, there does seem to be conflicting information from the different sides that are involved in the case. But there is one thing that 'seems' for certain, and that is Mae Magouirk was not dying unless she was withheld medical care, nutrition, and hydration. Medical care for an aortic dissection is not, cannot be, provided in a hospice. Someone, reportedly the granddaughter Beth Gaddy, decided to put Mae in the hospice, saying ""Grandmama is old and I think it is time she went home to Jesus. She has glaucoma and now this heart problem, and who would want to live with disabilities like these?" Well, I do believe that Jesus is everywhere but I don't think that this was Beth's meaning in her comment - Beth thinks that Granny is "disabled" and therefore unworthy of life. We've all seen this before!

So the granddaughter 'seems content' to let her grandmother starve to death, dehydrate, or expire from lack of medical attention, or all three. If not, why put her in the hospice?

As for the hospice stating that all is well in their facility, I would probably believe that Bill Clinton didn't have sex with that woman, before I'd believe anything a hospice has to say - especially one that takes in a woman to die that really isn't dying at all, is not PVS, is not in a coma, needs medical attention, and isn't going to get it by order of the patient's ward.

Ergo, Mae was suppose to die in the hospice and not receive medical care for her condition. As for Probate Judge Donald Boyd, he does appear to have set himself apart from Judge Greer(in the Terri Schiavo case) by stating in his court order that Gaddy is to continue as Magouirk's temporary guardian, but in a formal letter attached to the order stating that her powers were limited. One of the conditions of her guardianship is "To see that the ward [Magouirk] is adequately fed, clothed, sheltered and cared for, and receives all necessary medical attention, including placement in a nursing home, if appropriate." A nursing home is not a hospice - in a nursing home you are suppose to continue living, in a hospice you are suppose to continue dying(if AND ONLY IF, you are dying in the first place).

Paul at Wizbang had an informative post Saturday on the matter. Here is what he had to say:

Update(From Wizbang): No matter the arguments, Mae is out of the hospice and on her way to UAB. I spoke to Ken for about 12 seconds and he promised an update when it was available.

Multiple people have made the argument that this case just doesn't add up. That we don't know all the facts. So, I'm presenting the contrarian arguments as best I can find them. (WIth my opinion of course.)

The Commissar, emailed the hospice where Mae Magouirk was admitted and they emailed back a reply I had seen elsewhere. I had not run it before mostly because I did not realize it was complete. The Commissar says that this is the full reply and for the sake of discussion, I'll keep the Commissar's bolding.

Federal (HIPAA) regulations prohibit us from speaking publicly about the treatment or records related to individual patients. However, we can say that we do not deny nutrition or hydration to any patient.

The staff of West Georgia Hospice/Hospice LaGrange provides compassionate and quality care to each of its patients, which includes offering food and water at frequent intervals.

Perhaps I lived too long in the Bill Clinton "non denial denial" era but that seems like completely worthless legal doublespeak to me. What is most telling is that they have steadfastly refused to confirm or deny repeated inquiries as to whether Magouirk is on a feeding tube.

They say they can't because of patient confidentiality. OK, fair enough. But certainly the granddaughter can give them the right to make a statement. Hospitals make statements to the media every day. All they need is permission from the guardian. In this case, the granddaughter, Beth Gaddy. Apparently Gaddy has not given them permission. Further, Gaddy has refused to talk to the media herself. This is itself probably significant.

But let's look at the bolded sections of the statement:

Continue reading at Wizbang ...

Posted by richard at April 10, 2005 6:11 AM


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Comments


What I want to know, and will keep insisting upon knowing in each of these cases until I get a straight, consistent answer from you BlogsForTerri folks WHO I HAVE SUPPORTED CONSTANTLY FOR THE PAST TWO MONTHS, is "Why is food and liquids by mouth not an appropriate treatment at the end of life?"

I realize that part of the decision hangs on whether a person is at the "end of life" or not. We do not have information on Mae's own wishes. We do know that her living will asked that she be given food and hydration unless she were in a vegetative or comatose state.

But I repeat, in different words: How was the hospice ignoring her living will if it was providing food and water by mouth? How can anyone say she was being dehydrated and starved if she was offered food and hydration by mouth?

This is a very important question to me, because it touches on decisions my family made when our mother said she did not want a feeding tube or any more hospitalizations, after fighting to recover from a stroke for about seven months. At that time, she decided she did not want to fight any longer. As I understand my own Catholic faith, her decision was not immoral. Our decision to respect her and not have her hospitalized and not have a feeding tube inserted was not immoral. We continued to provide her with maximum nutrition and hydration delivered by mouth.

The thought in this discussion seems to be that if one is not on a feeding tube, one is being starved and dehydrated. This is, to me, contrary to my understanding of food and water as normal care, that may be given by mouth if the patient is able to receive. If this is what was happening to Mae Magouirk, how can we say she was being starved and dehydrated?

Rae

Posted by: Rae Stabosz at April 10, 2005 7:37 AM

Well, I can only give you what I know: The issue with both Terri Schindler and Mae Magourik, as far as I and many others were concerned, wasn't tube/no tube, but food/no food. A lot of us were yelling, as loudly as we could, that Judge Greer should have allowed a trial of feeding Terri by mouth, since at least one of her nurses swore an affidavit that she could, in fact, swallow and did not need the tube to be fed. Judge Greer and Michael Schiavo said no to both the tube reinsertion and giving her water and food by mouth.

What I understood from Ken Mullinax's earlier messages is that Mrs. Magouirk was being given *no* food or water at all, either by tube or by mouth. Apparently it's more accurate to say that she wasn't being given *enough* water or food by either means, which is borne out by the statement of the hospital doctors that it's going to take two days to rehydrate her completely. She was apparently being drugged so heavily while in the hospice that she couldn't eat normally.

Terri should have been fed by mouth. Given the evidence that she could swallow her own saliva, I think it's quite likely that she never needed the tube at all -- that it was purely a matter of convenience, specifically Michael Schiavo's convenience -- but now, thanks to her killers, we'll never know.

I hope this helps, at least a little.

Posted by: Mary in LA at April 10, 2005 11:48 AM

Rae
I hope this addresses your question.
I am sure that the answer to your question does vary depending upon the medical specifics of each person.
In the case of Terri, as you know, she was paralyzed, unable to feed herself and Judge Greer ordered that "NO ONE FEED THAT GIRL".
In the case of Mae,she was being treated in a hospital originally. I imagine that many ill patients are either heavily medicated, or need to curtail physical activity so getting nourishment orally is not an option. If the individual lacks strength, can not sit upright, or has difficulty swallowing...then a feeding tube is a nutrional necessity. It could be that the individual is in need of a "temporary" tube (nasal) until they are stronger or more alert and better able to chew, swallow and ingest sufficient nutrition. The focus is on the need for sufficient nutrition/hydration in order to maintain healing...the quality of nutrion determines whether the patient just survives or thrives. The patient who can still take a little food orally but not enough to become strong..would be in need of a feeding tube in order to get their full nutrition/hydration needs met. Digestion of solid foods is a strenuous cardiovascular activity...(the adage of "do not eat right before sleeping"is so the cardio system can rest too))My mother died of a "weeping" aortic aneurysm and resulting unstablized blood pressure..sitting upright, swallowing, speaking...were all overwhelmingly strenuous for her weakened condition....Had the aorta been attended to in time...it all would have reversed, and regular eating would have resumed. She died of the aneurysm. It was discoverd in the autopsy. It was 1988...medical science did not know how to treat itsuccessfully back then.

In a weakened condition, a patient often will require a feeding tube until they are better able to manage sufficient oral feedings. I hope that this addresses your question.I am not a physician but I grew up in a medical home..so some knowledge has rubbed off....To my understanding, tube feedings are considered a "phase" with resumption of regular oral eating always being the ultimate goal(long or short term).

Posted by: JoJoFox at April 10, 2005 12:07 PM

Rae, I went back and read your posting in the thread below this one, as well. I think that what you did was right, proper, and respectful. You honored your mother's wishes, which were clear and unambiguous, with regard to the feeding tube.

Terri Schindler's wishes were not known, except by the highly dubious hearsay evidence of her husband. Mae Magouirk's wishes were clearly known, but not being honored by the hospice staff or her guardian. So their cases are different from your mother's in that regard.

My mother has a living will with "no food, no water" instructions if she becomes comatose. I have promised her that my sister and I will follow her instructions to the letter, as painful as that will be for us, if that comes to pass.

Posted by: Mary in LA at April 10, 2005 7:22 PM