Jewish World Review Nov. 7, 2003 / 12 Mar-Cheshvan, 5764

Drs. Michael A. Glueck & Robert J. Cihak

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Consumer Reports

Avoiding the Schiavo Scenario: Readers Speak Out With Life-and-Death Comments | Today it is our turn to thank YOU, the readers, for the scintillating thoughts and comments in response to last week's column, "Death by Dehydration."

We were somewhat overwhelmed by our e-mail - and even more stunned that almost 100 percent of you basically agreed with our comments. We were prepared for some less-than-kind responses.

Many readers thought we were too kind to Terri's husband. They opined that her husband's actions reflected a desire to keep the malpractice settlement money for himself. We had decided not to comment on this so as to keep focus on the main issue: Terri is alive - and has the right to live even though she is unable to speak for herself.

Whether or not her husband is good or evil is an important but different moral and legal issue. At the same time, his actions betray little respect for Terri or her rights; therefore, he should not be her guardian.

Several readers related their own experiences to Terri's situation. For example, Betty G. wrote about her own husband, who "is happy to be alive and he knows I was by his side along the way. He thanks God every day. He was so drugged on medication that he could not talk. One year to the day" after being released from therapy he "piloted an airplane."

Dr. Joan E. wrote: "We have a daughter with DS [Down Syndrome] and know of many loving parents who have to use a feeding tube for their child due to heart defects or other oral motor issues. How many babies with DS will be denied feeding tubes by some relative who thinks it best to get the court to act and go down that path?"

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Kirsteen W. wrote, "This young woman has every right to stay alive and die when it is her time to die not one minute sooner."

C. B. wrote: "Because a person can't speak, move a muscle, a limb, ... it doesn't mean they aren't there. ... Thanks again for speaking out [for] one who cannot."

We also received some helpful suggestions for avoiding the Schiavo Scenario in your own family's lives.

In the absence of a living will, we would "err on the side of life - it's just the civilized thing to do," to quote reader Frank G. Zavisca, M.D., Ph.D., Director, Obstetric Anesthesiology, at LSUHSC, Shreveport, La. Dr. Zavisca also writes that he is all for a living will. We are too.

If you don't write your own will, your state almost certainly has written one for you to provide an orderly process for deciding these life-and-death issues. Putting down your own desires, in writing, in your own will and other directives largely pre-empts these "one size fits all" laws.

Reader Dan E. of Costa Mesa, Calif., sent these suggestions to avoid the Schiavo Scenario:

  • Establish an Advance Health Care Directive (AHCD) for yourself, and insist on it for all members of your family who might confront you with that dilemma.

  • Carefully specify in the AHCD exactly what you want done - and not done - when you are unable to express yourself adequately, such as when you appear to be at death's door, or when your chances of being restored to a functioning state are small (e.g., after a massive stroke).

  • Be sure your designated Agent for Health Care fully understands your intent.

  • Then, be sure, if you or any of your family members must go to a hospital, for even the most trivial treatment, that you/they always take a copy of the AHCD with you and show it to the hospital admissions or ER person.

A good attorney can help you and your family enhance rather than restrict your own rights and freedoms.

Beyond the Schiavo case lies a volatile issue that is rarely addressed directly as a single issue: What should be the role of the civil state in determining, as a matter of law and legal procedure, who lives and who dies?

We're talking "across the board," from capital punishment (the taking of the life of the heinously guilty and irredeemably evil) to abortion (the taking of the life of the absolutely innocent). America's laws on both are a pastiche of ugly contradictions.

Then there's the whole issue of "When is life not worth living?" - usually expressed in end-of-life scenarios, but increasingly, a la Peter Singer, in terms of killing infants because they "aren't fully human."

And let's not kid ourselves. As the population ages, and if medical care for the elderly consumes ever more tax dollars, the pressure to terminate or withdraw medical treatment from the inconvenient innocents will only increase, as is already happening in the Netherlands and Great Britain. [See: Fitness, Fatness, Freedom - Who Decides?]

If the essence of limited government is limits ... where should those limits be? And why?

Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here.


10/31/03: The Terri Schindler-Schiavo Case: Speaking out for those who can't
10/24/03: Want health service — go on a diet?
10/15/03: The War on Legal Painkillers: Sen. Kerry owes an apology to the more than 48 million Americans who suffer chronic pain
10/13/03: Medicare defrauds itself
09/19/03: Politics prevents women from learning about abortion/breast cancer risks
09/12/03: Medical mischief
09/05/03: Unholy medicine
08/29/03: The California Tea Party and West Coast Determinism; Voter anger coming your way soon
08/18/03: The outlaw prosecutors: A Justice and Civil Liberties Issue
08/08/03: "Toxic Teeth?"
07/25/03: Resuscitating the Constitution; CPR American Style
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07/11/03: Costly Medicare Changes, Without Real Reform
07/04/03: The Painful DEA II: War on legal drugs ensnares too many doctors and not enough dealers
06/20/03: The Medicare Mess: Will President Bush call Congress' Bluff?
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06/05/03: Soaring Medical Costs: Rational ignorance or rational enlightenment?
05/30/03: A Tale of Two Admirable Women: Jessica and Annika
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05/02/03: Medical Quarterbacking
04/25/03: CNN the "Conscience-Not Network"
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04/11/03: Are childhood vaccines shots in the dark?
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03/28/03: American conscience?
03/21/03: West Wimps or Wings: Treatment for Hollywood Hypocrisy
03/13/03: Worldwide schmaltz shortage looms --- all because of a featherless chicken
03/06/03: Legal metastases are killing us
02/28/03: Outside the Jury Box: Seeking Justice rather than a Lottery in Medical Liability
02/21/03: Workforce temperature rising; employer TLC in demand
02/14/03: Malpractice Insurance: They Reap What They Sue
02/12/03: Hawk, Dove or Groundhog: Diagnosis Critical List; Prognosis Uncertain
02/07/03: How about tax cuts for the "rich" and "poor"?
01/31/03: AIDS Bug Chasers
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01/17/03: It's not just 'sue the docs' anymore
01/03/03: A pox on the critics; diagnosis sour grapes
01/03/03: If protesting is good for your health; then at least let's root for the home team
12/20/02: Obesidemic (obesity epidemic) or not?
12/20/02: Time for voluntary informed smallpox vaccinations
12/13/02: The real reason the state opposes homeschooling?
12/06/02: Conscience of a former conservative: Portrait of a political metamorphosis
11/27/02: Thanksgiving dinner hazard?
11/22/02: Time to think outside the box and inside the nucleus
11/15/02: The military should be protected from abusive environmental laws in times of war
11/11/02: Does Kyoto Treaty pose more harm than global warming?
10/31/02: Deep thoughts on Baseball, the World Series and Life: How about them Anaheim Angels?
10/23/02: "Pediatric rule" guinea pigs
10/23/02: Once the World Series ends, we need to create a Donnie Moore Day of Remembrance: Sports and mental health
10/18/02: Congress to senior patients: Do as we say not as we do for ourselves
10/11/02: Using pollution "scare labeling" to political advantage
10/04/02: The Great Asbestos Heist: Did Litigation and Junk Medical Science Helped Bring Down the World Trade Center?
09/27/02: The imminent rise of civic feminism: A far healthier national alternative in war and peace
09/20/02: A Ray A Day" to replace the daily apple?
09/13/02: Beware of celebrities hawking drugs
09/06/02: Avoid 9/11 overdose: Give blood to begin "September of Service," SOS
08/28/02: From Doubleday to strikeday: Baseball's collective anxiety attack
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07/19/02: Medicare Drug Follies as in "now you see it, now you don't"
07/12/02: Anti-Profiling: A New Medically False Belief System
07/08/02: Don't procrastinate, vaccinate!
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06/21/02: Sex and the system: In seeking healthcare men are different from women
06/14/02: The FDA, drug companies and life-saving drugs: Who's the fox and who's the hen now?
06/07/02: Medical Privacy Lost: A hippo on the healthcare back!
05/24/02: To clean up America's game: A (soggy) ground rule
05/10/02: Free speech is good medicine
05/03/02: Medicine's Vietnam
04/26/02: Attack on alternative medicine could lead to alternative lawsuits
04/12/02: Insure the 'crazies'?
04/09/02: No Time for Litmus Tests: In War We Need a Surgeon General and NIH, CDC, and FDA Directors
04/02/02: The scoop on soot: A dirty rotten shame?
03/22/02: Too many beautiful minds to waste: The first annual Caduceus Movie
03/15/02: Terror and transformation: Defense essential for health & state of mind
03/08/02: Diagnosis: Delusional
03/06/02: The great matzah famine
03/01/02: Is new Hippocratic Oath hypocritical?
02/15/02: Why the recent moaning about cloning?
02/08/02: Searching for Dr. Strangelove
01/15/02: Score one for the value of human life
01/04/02: Medical-legal-financial wake-up call
12/28/01: Who's afraid of a 'dirty bomb'?
12/21/01: End of medicine?
12/14/01: More heroes: Docs deserve a little credit after 9/11
11/16/01: Do we need 'Super Smallpox Saturdays'?
11/09/01: Why the post-9-11 health care debate will never be the same
11/01/01: Common sense good for our mental health
10/26/01: Your right to medical privacy --- even in terror time
10/12/01: Failed immigration policy ultimately bad for nation's mental health: Enemy within leads to epidemic of jumpy nerves
09/28/01: Can legal leopards change their spots: A treat instead of a trick
09/21/01: Civil defense again a civic duty
08/30/01: Shut down this government CAFE
08/23/01: School Bells or Jail Cells?
08/15/01: Time to take coaches to the woodshed
08/10/01: Blood, Guts & Glory: The Stem of the Stem Cell controversy

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