Death from Dehydration Is Usually Serene

March 18, 2005 — -- Though the legal wrangling in the Terri Schiavo case has been loud and contentious, the brain-damaged woman's physical response to having her feeding tube removed is likely to be very serene.

"The process of starving to death seems very barbaric but in actuality is very peaceful," said Dr. Fred Mirarchi, assistant clinical professor of emergency medicine at Drexel University College of Medicine in Philadelphia.

"The patient's experience is really pretty benign," said Dr. Joanne Lynn, a hospice physician associated with Americans for Better Care of the Dying, a group working for improved end-of-life care. "Overwhelmingly, what will happen is nothing."

Lynn, who has worked with numerous families facing end-of-life situations, said most patients who are removed from life support will die within a matter of a few days or weeks.

"Some people can last four or five days -- some people can last 20 days," she said.

Schiavo's feeding tube was removed March 18 following a contentious battle between her husband, who said his wife would not want to live in a vegetative state, and her parents, who wanted her kept on life support.

Schiavo's feeding tube was removed twice before, in 2001 and 2003. The second time, the tube was replaced after six days when Florida Gov. Jeb Bush signed a hastily passed law allowing him to intervene in the case. "Terri's Law" was later ruled unconstitutional.

The physical process of dying after life support is removed follows a pattern familiar to hospice workers. And the fact that Schiavo is in a vegetative state will likely make her death faster and less painful, Lynn said.

"It depends on whether she has the ability to swallow anything -- and if that anything is offered," she said. "If she's unable to swallow anything, the course toward dying, so far as anyone can tell, is fairly comfortable."

Most patients who cannot eat or drink will enter a physical state known as ketosis. During ketosis, the body begins to use fat and muscle as a fuel source.