The Terri Schindler-Schiavo Case: Speaking out for those who can't

http://www.NewsAndOpinion.com | The Terri Schindler-Schiavo case is not a "death with dignity" issue.

So comments Jane M. Orient, M.D., Executive Director of The Association of American Physicians and Surgeons (AAPS), who issued this statement in response to the emergency action of the Florida legislature to reinstate feeding and hydration of Terri Schindler-Schiavo:

"Terri Schindler-Schiavo has won a temporary stay from execution by a method too cruel to be used for convicted criminals. And yet her husband's attorney is trying to spin it into a 'death with dignity issue' with his comments on Tuesday last week."

Her husband says it's cruel to begin rehydration. The opposite is true — dehydration is a cruel, painful death. It is unconscionable that the state ordered removal of her feeding tube in the first place — — it's nothing less than state— sponsored euthanasia.

Terri is not dependent on advanced medical interventions. Nothing is mechanically pumping her blood, or forcing oxygen into her lungs. She is simply being fed through a gastrostomy tube.

This is a tube inserted through a very small opening, created in the upper left portion of the abdomen, directly into the stomach. This is not an exhuberant, extreme or extraordinary means of life support. Would we allow a retarded child to be starved to death?

Some physicians believe that Terri could be rehabilitated to some extent, at least so that she could swallow oral feedings and eliminate the need for the tube. She should be allowed to try, but so far her husband has blocked every attempt to see whether she can swallow. Doctors have offered pro bono treatment, if money is the barrier for her husband.

Although severely disabled, some believe that Terri does have the capacity to communicate a desire to live. Her husband has obstructed efforts at rehabilitation or independent assessments of his wife's true state.

Notes Dr. Orient further, "Where are the 'compassionate end— of— life' groups such as the Robert Wood Johnson 'Last Acts' initiative, and why aren't they weighing in on this?"

The ethical question for Terri's nurses and physicians — — prior to the Jeb Bush reprieve — — was whether they would cooperate in carrying out a death warrant. And the ethical question for all of us is whether we will allow the state courts to obstruct the efforts of people who want to provide the minimum of medical care to patients who should receive it but can't speak out for themselves.

If we go down that path, who's to say what treatment the state will prevent you from getting?

For the time being it boils down to the fact that Terri is still alive. Perhaps not well, but alive. Does she — or does she not — have the "inalienable right to life" proclaimed in the Declaration of Independence? Merely functional criteria and arguments, e.g., "How much is she contributing to society?" are utilitarian and very limited.

And ultimately, looking up the road to the future, wouldn't it be far better for the courts, legislatures, governors and lawyers to stay out of medical care and leave the difficult decisions to those trained in the healthcare professions and to their patients.

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

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