Monday, March 28, 2005

Check Your Hypocrisy Scorecard

Score one: Tom Delay's personal hypocrisy, in pulling the plug on his father in 1988.

Score two: Then-Governor Bush's policy permitting medical industry to pull the plug over the objections of family.

And for a double whammy: eliminating all funding for traumatic brain injury treatment, while 60% of wounded soldiers returning from Iraq suffer from this sort of injury.


Blogger Management said...

Brain injury therapy being underfunded

March 18, 2005

According to doctors at Walter Reed Army Medical Center in Washington, D.C., 60 percent of the wounded soldiers coming back from Iraq have traumatic brain injuries.

Unfortunately, the Bush administration has recently completely zeroed out funding for the Federal TBI Act, which provides exactly this kind of help.

In Vermont, due to recent decisions concerning budgetary shortfalls, TBI survivors are now prevented from entering the Vermont TBI Medicaid Waiver Program, which delivers exactly this kind of help.

Please call the governor (802) 828-3345 and our congressional representatives and ask them to support the Vermont TBI Medicaid Waiver Program.

James Vyhnak Bristol

3:01 PM  
Blogger Management said...

DeLay's Own Tragic Crossroads
Family of the lawmaker involved in the Schiavo case decided in '88 to let his comatose father die.
By Walter F. Roche Jr. and Sam Howe Verhovek
Times Staff Writers

March 27, 2005

CANYON LAKE, Texas — A family tragedy that unfolded in a Texas hospital during the fall of 1988 was a private ordeal — without judges, emergency sessions of Congress or the debate raging outside Terri Schiavo's Florida hospice.

The patient then was a 65-year-old drilling contractor, badly injured in a freak accident at his home. Among the family members keeping vigil at Brooke Army Medical Center was a grieving junior congressman — Rep. Tom DeLay (R-Texas).

More than 16 years ago, far from the political passions that have defined the Schiavo controversy, the DeLay family endured its own wrenching end-of-life crisis. The man in a coma, kept alive by intravenous lines and oxygen equipment, was DeLay's father, Charles Ray DeLay.

Then, freshly reelected to a third term in the House, the 41-year-old DeLay waited, all but helpless, for the verdict of doctors.

Today, as House Majority Leader, DeLay has teamed with his Senate counterpart, Bill Frist (R-Tenn.), to champion political intervention in the Schiavo case. They pushed emergency legislation through Congress to shift the legal case from Florida state courts to the federal judiciary.

And DeLay is among the strongest advocates of keeping the woman, who doctors say has been in a persistent vegetative state for 15 years, connected to her feeding tube. DeLay has denounced Schiavo's husband, as well as judges, for committing what he calls "an act of barbarism" in removing the tube.

In 1988, however, there was no such fiery rhetoric as the congressman quietly joined the sad family consensus to let his father die.

"There was no point to even really talking about it," Maxine DeLay, the congressman's 81-year-old widowed mother, recalled in an interview last week. "There was no way [Charles] wanted to live like that. Tom knew — we all knew — his father wouldn't have wanted to live that way."

Doctors advised that he would "basically be a vegetable," said the congressman's aunt, JoAnne DeLay.

When his father's kidneys failed, the DeLay family decided against connecting him to a dialysis machine. "Extraordinary measures to prolong life were not initiated," said his medical report, citing "agreement with the family's wishes." His bedside chart carried the instruction: "Do not resuscitate."

On Dec. 14, 1988, the DeLay patriarch "expired with his family in attendance."

"The situation faced by the congressman's family was entirely different than Terri Schiavo's," said a spokesman for the majority leader, who declined requests for an interview.

"The only thing keeping her alive is the food and water we all need to survive. His father was on a ventilator and other machines to sustain him," said Dan Allen, DeLay's press aide.

There were also these similarities: Both stricken patients were severely brain-damaged. Both were incapable of surviving without medical assistance. Both were said to have expressed a desire to be spared from being kept alive by artificial means. And neither of them had a living will.

This previously unpublished account of the majority leader's personal brush with life-ending decisions was assembled from court files, medical records and interviews with family members.

It was a pleasant late afternoon in the Hill Country of Texas on Nov. 17, 1988.

At Charles and Maxine DeLay's home, set on a limestone bluff of cedars and live oaks, it also was a moment of triumph. Charles and his brother, Jerry DeLay, two avid tinkerers, had just finished work on a new backyard tram — an elevator-like device that would carry family and friends down a 200-foot slope to the blue-green waters of Canyon Lake.

The two men called for their wives to hop aboard. Charles pushed the button and the maiden run began. Within seconds, a horrific screeching noise echoed across the still lake — "a sickening sound," said a neighbor. The tram was in trouble.

Maxine, seated up front in the four-passenger trolley, said her husband repeatedly tried to engage the emergency brake, but the rail car kept picking up speed. Halfway down the bank, it was free-wheeling, according to accident investigators.

Moments later, it jumped the track and slammed into a tree, scattering passengers and debris in all directions.

"It was awful, just awful," recalled Karl Braddick, now 86, the DeLays' neighbor at the time. "I came running over, and it was a terrible sight."

He called for emergency help. Rescue workers had trouble bringing the injured victims up the steep terrain. Jerry's wife, JoAnne, suffered broken bones and a shattered elbow. Charles, who had been thrown head-first into a tree, was in grave condition.

"He was all but gone," said Braddick, gesturing at the spot of the accident as he offered a visitor a ride down to the lake in his own tram. "He would have been better off if he'd died right there and then."

But Charles DeLay hung on. In the ambulance on his way to a hospital in New Braunfels 15 miles away, he tried to speak.

"He wasn't making any sense; it was mainly just cuss words," recalled Maxine with a faint, fond smile.

Four hours later, he was airlifted by helicopter to the Brooke Army Medical Center at Ft. Sam Houston. Admission records show he arrived with multiple injuries, including broken ribs and a brain hemorrhage.

Tom DeLay flew to his father's bedside, where, along with his two brothers and a sister, they joined their mother. In the weeks that followed, the congressman made repeated trips back from Washington, his family said. Maxine seldom left her husband's side.

"Mama stayed at the hospital with him all the time. Oh, it was terrible for everyone," said Alvina "Vi" Skogen, a former sister-in-law of the congressman. Neighbor Braddick visited the hospital and said it seemed very clear to everyone that there was little prospect of recovery.

"He had no consciousness that I could see," Braddick said. "He did a bit of moaning and groaning, I guess, but you could see there was no way he was coming back."

Maxine DeLay agreed that she was never aware of any consciousness on her husband's part during the long days of her bedside vigil — with one possible exception.

"Whenever Randy walked into the room, his heart, his pulse rate, would go up a little bit," she said of their son, Randall, the congressman's younger brother, who lives near Houston.

Doctors conducted a series of tests, including scans of his head, face, neck and abdomen. They checked for lung damage and performed a tracheostomy to assist his breathing. But they could not prevent steady deterioration.

Then, infections complicated the senior DeLay's fight for life. Finally, his organs began to fail. His family and physicians confronted the dreaded choice so many other Americans have faced: to make heroic efforts or to let the end come.

"Daddy did not want to be a vegetable," said Skogen, one of his daughters-in-law at the time. "There was no decision for the family to make. He made it for them."

The preliminary decision to withhold dialysis and other treatments fell to Maxine along with Randall and her daughter Tena — and "Tom went along." He raised no objection, said the congressman's mother.

Family members said they prayed.

Jerry DeLay "felt terribly about the accident" that injured his brother, said his wife, JoAnne. "He prayed that, if [Charles] couldn't have quality of life, that God would take him — and that is exactly what he did."

Charles Ray DeLay died at 3:17 a.m., according to his death certificate, 27 days after plummeting down the hillside.

The family then turned to lawyers.

In 1990, the DeLays filed suit against Midcap Bearing Corp. of San Antonio and Lovejoy Inc. of Illinois, the distributor and maker of a coupling that the family said had failed and caused the tram to hurtle out of control.

The family's wrongful death lawsuit accused the companies of negligence and sought actual and punitive damages. Lawyers for the companies denied the allegations and countersued the surviving designer of the tram system, Jerry DeLay.

The case thrust Rep. DeLay into unfamiliar territory — the front page of a civil complaint as a plaintiff. He is an outspoken defender of business against what he calls the crippling effects of "predatory, self-serving litigation."

The DeLay family litigation sought unspecified compensation for, among other things, the dead father's "physical pain and suffering, mental anguish and trauma," and the mother's grief, sorrow and loss of companionship.

Their lawsuit also alleged violations of the Texas product liability law.

The DeLay case moved slowly through the Texas judicial system, accumulating more than 500 pages of motions, affidavits and disclosures over nearly three years. Among the affidavits was one filed by the congressman, but family members said he had little direct involvement in the lawsuit, leaving that to his brother Randall, an attorney.

Rep. DeLay, who since has taken a leading role promoting tort reform, wants to rein in trial lawyers to protect American businesses from what he calls "frivolous, parasitic lawsuits" that raise insurance premiums and "kill jobs."

Last September, he expressed less than warm sentiment for attorneys when he took the floor of the House to condemn trial lawyers who, he said, "get fat off the pain" of plaintiffs and off "the hard work" of defendants.

Aides for DeLay defended his role as a plaintiff in the family lawsuit, saying he did not follow the legal case and was not aware of its final outcome.

The case was resolved in 1993 with payment of an undisclosed sum, said to be about $250,000, according to sources familiar with the out-of-court settlement. DeLay signed over his share of any proceeds to his mother, said his aides.

Three years later, DeLay cosponsored a bill specifically designed to override state laws on product liability such as the one cited in his family's lawsuit. The legislation provided sweeping exemptions for product sellers.

The 1996 bill was vetoed by President Clinton, who said he objected to the DeLay-backed measure because it "tilts against American families and would deprive them of the ability to recover fully when they are injured by a defective product."

After her husband's death, Maxine DeLay scrapped the mangled tram at the bottom of the hill and sold the family's lake house.

Today, she lives alone in a Houston senior citizen residence. Like much of the country, she is following news developments in the Schiavo case and her son's prominent role.

She acknowledged questions comparing her family's decision in 1988 to the Schiavo conflict with a slight smile. "It's certainly interesting, isn't it?"

She had a new hairdo for Easter and puffed on a cigarette outside her assisted-living residence as she sat back comparing the cases.

Like her son, she believed there might be hope for Terri Schiavo's recovery. That's what made her family's experience different, she said. Charles had no hope.

"There was no chance he was ever coming back," she said.


Verhovek reported from Canyon Lake, Texas; Roche reported from Washington. Also contributing to this report were Times researchers Lianne Hart in San Antonio and Nona Yates in Los Angeles.

3:01 PM  
Blogger Management said...

President Bush's Proposed 2006 Budget Cuts Funding for Traumatic Brain Injury Programs

President Bush will unveil his proposed 2006 budget tomorrow (February 7, 2005). According to this New York Times article, (registration required), the President's proposed budget contains spending cuts for a wide range of public health programs, including several that deal with epidemics, chronic diseases and obesity.

Of importance to the readers of this blog, the proposed budget will include cutting a $9 million program for treating people with traumatic brain injury.

Once the budget is formally presented, we will be able to tell more about what other programs may have their funding reduced or no longer available.

3:01 PM  
Blogger Management said...,12271,1077219,00.html
Playing God

For 13 years Terri Schiavo has been in a coma - with her husband, her parents, the Christian right and now the president's brother locked in a bitter struggle over her fate. This week could see a final decision on whether she lives or dies. Suzanne Goldenberg reports from Florida

Tuesday November 4, 2003
The Guardian

The woman's eyes are open in the video. She slowly rolls her head along the pillow, keeping up a constant low moan, as a man's arm dangles a metallic balloon overhead. "Look over here, Terri," a male voice says. "Can you follow that at all?"

The medical community and Florida's courts are convinced that Terri Schiavo can't, and, indeed, that she will never be able to recapture even this degree of cognitive ability. So too is her husband, Michael Schiavo. Over the years, he has tried three times to remove her feeding tube.

But Terri's parents, Mary and Robert Schindler, say she can improve, and have collaborated with the Christian right in America to turn this very private tragedy into a national pro-life pageant. Using the internet, press and Christian radio and television shows, anti-abortion groups have turned Terri's catastrophic loss into a major political gain, expanding the parameters of the pro-life debate.

This week could provide the last act. After a decade of exhausting every legal measure - and all the furore the Christian right can rustle up - the Schindlers have arrived at the final round of their struggle with their son-in-law for control of Terri's destiny.

A judge is deliberating whether to strike down so-called "Terri's Law" - a last-minute reprieve pushed through the Florida legislature by the state governor and presidential brother, Jeb Bush, that forced the hospital to resume feeding Terri two weeks ago.

Terri's Law, condemned by civil libertarians, the legal and medical community, and queasy state legislators, was the Schindlers' last hope. If it fails, the feeding tube will be removed, and Terri will slowly starve to death.

None of this has penetrated through to Terri. In February 1990, aged 26, she suffered a heart attack, brought on by acute potassium shortage caused by bulimia. By the time the ambulance arrived, her brain had been deprived of oxygen for six minutes. She has remained in what doctors call a persistent vegetative state ever since. Her eyes are open, her limbs are contracted, she smiles and grunts occasionally, but without any sense of purpose, according to the majority medical opinion presented to the courts.

But even in that seemingly senseless form, Terri's parents were able to discern a remarkable power within their semi-comatose daughter. Over the years, as successive judges refused their demand to be put in control of Terri's destiny, the Schindlers have enlisted the support of the Christian right to challenge court verdicts that have gone in her husband's favour. In the process, they have turned her into an unwitting heroine for the pro-life movement, and a convenient foil for Governor Bush.

With a year to go before the 2004 elections, Brother Bush has been keeping a weather eye out for causes that would mobilise the pro-life movement. Earlier this year, he outraged legal opinion by intervening to prevent a severely disabled woman, who had been raped in a state institution, from obtaining an abortion. Terri's case has proved as enticing a cause - and the Schindlers are extremely cooperative.

From their rented camper van across the road from the hospice, they have presided over prayer vigils and power rallies, pumping up the emotions in the campaign to keep their daughter alive by smuggling out videos of Terri in her bed, and making them available on the internet. Although her father, Robert, claims that he hates the circus that has developed around his daughter, he seems well practised at delivering his pitch. The fight for her life, the argument goes, is the fight for disabled people across America.

"People are being executed every day. I don't mean by the law. I mean executed by being starved to death - mainly the elderly, and people with Alzheimer's," says Robert. "There is a big, dark secret out there."

His other daughter, Suzanne Carr, who is five years younger than Terri, is more expansive. "This whole notion of doing away with a group of people who don't contribute to society or who can't feed themselves or who are expensive to maintain, that is bizarre, that is crazy," she says. "You might as well put down handicapped people."

It is difficult to know quite what Michael Schiavo makes of all this. As the Schindlers sit in their camper van discussing TV talkshow schedules, he has been all but silent, granting one interview in two years. And so, while one version of Terri's life - the one peddled by the Schindler family - remains well known, there is nothing forthcoming from the person who arguably knew her best: Michael, her husband of six years.

To hear the Schindler family tell it, the trajectory that led to Terri's tragic existence can be traced to her years as an awkward, overweight teenager in the suburbs of Philadelphia. Suzanne produces a sheaf of pictures of a chubby child and teenager, smiling at the camera from behind large spectacles. In the family's authorised version of events, the extra weight made Terri painfully shy.

She emerged from her shell only after slimming down in high school, and was still not entirely sure of herself when she started at a local college in the Philadelphia area. Within a few months, she had met Michael and fallen deeply in love - although perhaps not enough for Suzanne's standards. "He was the first guy to pay attention to her, the first guy to say, 'I love you', and so she married him," she says.

Nowadays, the Schindlers can barely avoid mentioning Michael's name without writhing in hatred. They have reinforced their accusations that he is neglecting Terri by suggesting that he tried to murder her, and that she was a victim of domestic violence.

The Schindlers' lurid accounts of abuse and neglect don't seem to tally with past events. In the early years of their marriage, Michael appeared to be on good terms with the Schindlers. The young couple lived in the Schindlers' condo after settling in Florida in the mid-80s. After Terri's accident, Michael and the Schindlers shared living quarters and the burden of care for Terri.

Those family bonds snapped in 1993 - the same year that a court awarded Terri $1m in a medical malpractice suit, and granted her husband authority over the money to use for her care. Each party now accuses the other of trying to get their hands on the funds. The cash question became even more urgent four years later, when Michael arrived at his momentous decision to end his wife's life. If Terri died, he would inherit the funds remaining in the malpractice suit; so long as she lived, the Schindlers had a hope of challenging his guardianship over Terri, and his control of the money.

By 1997, when Michael was set to remove the feeding tube for the first time, the stage was set for an epic confrontation. It is unclear what led to the change of heart, but Scott Schiavo, Michael's elder brother, says he arrived at the decision soon after the painful death of his own mother. "It sort of woke him up when he was watching my mother die," he says. "One day he just stood up and said: 'I can't do this any more. I can't do this to Terri.'"

Six years later, it has come down to this: videos of a stricken woman on the internet, accusations of murder, and lining up television interviews in a rented trailer.

Today, the Schindlers are spending much of the afternoon with a crew from the Christian Broadcasting Network, operated by the evangelist Pat Robertson. There is no question which side the CBN is on. "There is a spiritual battle going on. There is a pro-death movement out there right now, and it nearly killed Terri," says reporter Wendy Griffith. "From our perspective, it is a spiritual battle. It basically comes down to good and evil, life and death."

Outside the Christian right, such clarity over Terri's fate - or indeed the best recourse for any person condemned to live for years with virtually no brain function - is generally difficult to obtain.

But, given the vehemence with which he has been fighting to prolong Terri's life, it is a little surprising to learn that Robert decided to turn off the life-support system for his mother. She was 79 at the time, and had been ill with pneumonia for a week, when her kidneys gave out. "I can remember like yesterday the doctors said she had a good life. I asked, 'If you put her on a ventilator does she have a chance of surviving, of coming out of this thing?'" Robert says. "I was very angry with God because I didn't want to make those decisions."

12:38 PM  

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