GOP Principles regarding life

[TexasTiger 13,005]

March 8, 2005, 12:33AM

Hospitals can end life support

Decision hinges on patient's ability to pay, prognosis

By LEIGH HOPPER

Copyright 2005 Houston Chronicle

Bill Olive / Chronicle

(L-r)Mario Caballero, Spiro Nikolouzos Jr. and Jannette Nikolouzos. St. Luke's notified Jannette Nikolouzos in a March 1 letter that it would withdraw life-sustaining care of her husband of 34 years, Spiro Nikolouzos, in 10 days. A patient's inability to pay for medical care combined with a prognosis that renders further care futile are two reasons a hospital might suggest cutting off life support, the chief medical officer at St. Luke's Episcopal Hospital said Monday.

Dr. David Pate's comments came as the family of Spiro Nikolouzos fights to keep St. Luke's from turning off the ventilator and artificial feedings keeping the 68-year-old grandfather alive.

St. Luke's notified Jannette Nikolouzos in a March 1 letter that it would withdraw life-sustaining care of her husband of 34 years in 10 days, which would be Friday. Mario Caba-llero, the attorney representing the family, said he is seeking a two-week extension, at minimum, to give the man more time to improve and to give his family more time to find an alternative facility.

Caballero said he would discuss that issue with hospital attorneys today.

Pate said he could not address Nikolouzos' case specifically because he doesn't have permission from the family but could talk about the situation in general.

"If there is agreement on the part of all the physicians that the patient does have an irreversible, terminal illness," he said, "we're not going to drag this on forever ...

"When the hospital is really correct and the care is futile ... you're not going to find many hospitals or long-term acute care facilities (that) want to take that case," he said. "Any facility that's going to be receiving a patient in that condition ... is going to want to be paid for it, of course."

Patient showed emotion

Caballero said he believes the hospital wants to discontinue care because Nikolouzos' Medicare funding is running out.

Spiro Nikolouzos, a retired electrical engineer for an oil drilling company, has been an invalid since 2001, when he experienced bleeding related to a shunt in his brain. Jannette Nikolouzos, 58, had cared for her husband at their Friendswood home, feeding him via a tube in his stomach. Her husband couldn't speak, she said, but recognized family members and showed emotion.

On Feb. 10, the area around the tube started bleeding, and Nikolouzos rushed her husband to St. Luke's for emergency care. Early the next morning, she said, the hospital called and said he had "coded" and stopped breathing and had to be placed on a ventilator.

A neurologist told her, she said, that he is not brain-dead and the part of the brain that controls breathing is still functioning. Although his eyes were open and fixed when he first was placed on the ventilator, he has started blinking, she said.

A missed opportunity

Dr. Marcia Levetown, director of palliative care at The Methodist Hospital, said moving Nikolouzos to a nursing home or other type of facility may not be an option if his body is dependent on several types of technology, such as mechanical ventilation and kidney dialysis.

Levetown said when families and hospitals take their disagreements to court, it often means the hospital has missed an important opportunity in the family's emotional healing.

Often missing from aggressive medical care is empathy for family members and acknowledgment of grief, she said.

"The acknowledgment of 'You clearly love your husband very much. You've done the good fight' " makes a difference, she said. Levetown also tells families, "Whatever might be beneficial, you've made sure he's gotten that. We all wish he could get better ... How can we best honor this man ... as we accompany him in his next journey?"

Law allows removal

State law allows doctors to remove patients from life support if the hospital's ethics committee agrees, but it requires that the hospital give families 10 days to find another facility.

A similar case is still in the courts. Texas Children's Hospital wants to discontinue life support on 5-month-old Sun Hudson, who was diagnosed shortly after birth with a fatal form of dwarfism. His mother, Wanda Hudson, wants her son's care to continue at the hospital.

On Wednesday, a judge will consider whether Harris County Probate Court judge William McCulloch may remain on the Hudson case. Caballero, who represents Wanda Hudson, filed a motion that McCulloch remove himself from the case after making what Caballero said were biased statements.

http://www.chron.com/cs/CDA/ssistory.mpl/m...politan/3073295

Guess who signed this bill into law?

[Auburn85 432]

So obviously, it has to be an all or nothing thing, just like with abolishing the death penalty to minors?

So cases shouldn't be dealt with on an individual basis?

The person in the article is on a ventilator, Shiavo isn't. She blinks, smiles, follows objects around the room, makes noises.

[Piglet 0]

So obviously, it has to be an all or nothing thing, just like with abolishing the death penalty to minors?

So cases shouldn't be dealt with on an individual basis?

The person in the article is on a ventilator, Shiavo isn't. She blinks, smiles, follows objects around the room, makes noises.

More to the point, Nikolouzos's next of kin wants him to live, and no one's even suggested that the man communicated a preference to be removed from life support.

You're not seriously gonna argue that ending someone's life for reasons of the company bottom line is better ethics than the values raised by the Schiavo case, right?

[DKW 86 7,440]

Cant wait for the "Bash Bush for being too pro-life" thread.

We can then compare it with this "Bush is too pro-death" thread here.

[BamaGrad03 0]

Thats RIGHT...Liberals only think its okay to murder babies...

[TexasTiger 13,005]

Thats RIGHT...Liberals only think its okay to murder babies...

152292[/snapback]

Unprincipled, rank hypocrisy by your own guy doesn't even register with you guys, does it?

[TitanTiger 20,510]

Thats RIGHT...Liberals only think its okay to murder babies...

152292[/snapback]

Unprincipled, rank hypocrisy by your own guy doesn't even register with you guys, does it?

152431[/snapback]

I am one who finds himself torn on this particular situation (Terri Schaivo). In principle, I side with the husband. I think the spouse is the one who should make these kinds of life and death decisions. They are more likely to know what their spouse would want to have done in the event that a "living will" isn't present. I wouldn't want my wife to have to fight my family to allow me to go be with Christ if I had told her that I didn't wish to be artificially kept alive.

The troubling thing in this particular case is that there is a lot of suspicion surrounding Mr. Schiavo's actions and possible motives. So I think it is appropriate to question him and ask whether this is really what Terri wants.

Now to the specific question about this bill, I don't like it and I'm disappointed that Bush would sign such a bill into law. This should not be something a hospital can decide for a spouse or family.