Guillermina Freniche Gómez would never have wanted to look like this: with a probe in her nose, whining, extending an empty life, her children say. A judge has ordered to feed her through that tube, because she, with an advanced Alzheimer’s disease and 78 years of age, can no longer swallow. “She was a fighter, a leftist,” says her daughter Astrid, and “she is like this due to the order of a judge, who did not hear her screaming and crying when she had to endure the end of her mother, my grandmother…” That’s what Astrid wrote in a poignant Twitter thread.
The doctors at the sisters’ residence of Torremolinos (Málaga) where Guillermina is hospitalized went to court when the children disallowed what they considered an intolerable therapeutic cruelty. Her son and legal guardian, Ricardo Freniche, fights in court so that the probe is withdrawn and has presented a verdict from the Andalusian Public Health Ethics Committee against her mother’s artificial feeding.
Astrid crudely tells us on the phone about the situation that took place at the beginning of July: “My mother has been calm for the last few years, although as a vegetable. But she had stopped swallowing. On July 10, the doctors at the San Carlos de Carmelitas Misioneras private residence gave us two hours to authorize them to catheterize her. They said that otherwise she would die of hunger and thirst with much pain. We refused and requested palliative care, so she wouldn’t suffer.”
Guillermina doesn’t have a living will. She has “lived” the last six years in that residence, “where they have looked after her wonderfully,” the children agree. “But we were aware that when this condition would turn up, we would have problems,” says Ricardo. On July 15, the abbess director presented a document asking the court to order the mandatory feeding of Guillermina, given that the medical team insisted. The doctors’ report attributes to the Alzheimer’s course her inability to swallow and justifies their request because “the patient shows clinical stability”. A residence worker has refused to talk about the case: “It is in the hands of justice. We just take care of Guillermina.”
On the 18th, the judge assigned to the Torremolinos Court of Instruction Nº 2 authorizes the insertion of the catheter because it is a “palliative treatment that will prevent the painful death due to the starvation referred [by the residence doctor] or the death due to suffocation described by the coroner,” says judicial decree. “But the court’s doctor did not examine my mother,” says Ricardo. On that same day, she is transferred to the public hospital Virgen de la Victoria in Malaga to insert her the catheter. They inserted her two different catheters. “All the doctors who saw our mother concluded with the same phrase: ‘I would never have inserted a catheter to a patient in such a state.’ In the end, after reading her entire saga, the last doctor took pity and made some considerations that we will be grateful for a lifetime,” says Ricardo. “I deem appropriate [to make] a reassessment of the judicial order to insert a nasogastric catheter for the enteral feeding of patients having evolved to a terminal situation after two years,” writes this emergency physician.
The strenuous insertion of the catheters has altered the inane life of Guillermina, always prostrated in a bed or an armchair. Ricardo visited her this Friday afternoon: “She is complaining, at times agitated. Before we perceived her much quieter.” “We have seen her with grimaces of pain, with gag reflexes, tears falling off,” Astrid grieves over. She remembers her mother as a tenacious woman, “a small-scale political animal”. So she describes her in the beautifully written Twitter thread: “When she was 19 years old she went to work in England, fleeing the misery of a bloody postwar period that was especially cruel for young women. She studied at night,” she writes. Then she moved to Switzerland, and returned compelled by her husband. “She ended up being the first female entrepreneur in Malaga, in the especially male chauvinist sector of construction,” continues the daughter, who works as an interior designer. “With an eternal smoky Ducados at the corner of her lips, she drove a red mini when women did not drive; she divorced when women did not divorce, even at the cost of losing everything she had created.” She started again as a city hall secretary when Torremolinos broke away from Málaga. She continued feeding with books the shelves of her house, and she worked until retirement when Alzheimer’s began to blur her mind: the same disease that killed her mother.
Ricardo, who now runs the family business created by Guillermina, has appealed the court order, but the magistrate has ordered to keep feeding her “for a humanitarian reason and maximum respect for the right to life”. This week, the son has included in another appeal a decision of the Costa del Sol Healthcare Ethics Committee discouraging the use of the catheter: “In this case, we consider that this patient should not be fed artificially, thus respecting both the medical knowledge in this field and the will of her legal representative,” they write. Specialists argue that artificial feeding is not part of good practices in patients with dementia and unable to swallow. “We consider that the life of the patient is coming to an end and thus it is the moment when the person needs more care to ensure a calm and painless death. Dehydration can be the natural mechanism for this patient’s death (as it happens in other cases), which is a consequence of her death process, rather than the cause of it. This does not mean that it should lead to suffering (…), the knowledge of palliative care ensures relief and wellbeing.”
Guillermina’s body “keeps being here, painfully twisted and connected to a feeding catheter that was ordered by a judge who never met or spoke to her,” the daughter laments, “a judge, a coroner and a medical team, fanatical and sectarian, at the service of a religion that she, despite respecting it, did not professed.”
Source: El País
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