Monday, March 21, 2005

SAVING PRIVATE SHIAVO

Most of you have probably heard that George W. Bush has gotten Congress and the White House involved in preventing a loving husband from acting on his wife’s wishes (stated to him when she was uninjured and conscious) that she be allowed to die gracefully after 15 years in a coma. Bush and Tom Delay think that the Federal government should be able to tell this husband that his wife has to be hooked up to machines unnaturally keeping her alive for decades because, well, all life is precious and it would insult George Bush’s faith to restore this woman’s dignity. The woman’s name is Terry Shiavo.

The Republican Party’s "Talking Points" on the Shiavo case were leaked to the press today. They include these two disgustingly calculating "bullets":

1. The pro-life base will be excited that the Senate is debating this important issue.
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2. This is a great political issue, because Senator Nelson of Florida - has already refused to become a cosponsor and this is a tough issue for Democrats.

Add to these the fact that while he was Governor of Texas, George Bush signed a bill into law that gave hospitals broad discretion to "pull the plug" on patients who were on life support who had no hope of recovering. Why? Because, Bush argued back then, they were a needless economic drain on the Texas hospital system. How's that for a flip-flop?

Every day George Bush seems to top himself, revealing for us with greater and greater clarity what a vile human being he really is. I hope that even those of you who have supported him in the past will take a moment to imagine a moment where the White House tells you that their ideology supercedes your ability to let your spouse die with grace and dignity. But, listen, my good friend Jeff Wilson – like my wife Sue, an MD specializing in Family Medicine who has shepherded many family’s through the dying process – speaks with greater eloquence than I do about just how crazy this case has become thanks to right-wing ideologues. I’ll let him have the floor till the end:

Is anyone following the story of the women in florida? if not here is a quick update-15 yrs ago this lady had a heart attack leaving her in a coma. her husband says that she had verbally instructed him prior to the accident that she would not want to be kept alive with artificial means. her parents however, feel that she had/has a chance to improve and have pushed to keep her alive. the battle went to the courts and over that time period the 'feeding tube' has been removed THREE TIMES the most recent time a few days ago. each of the previous two times it was re-inserted after some legal maneuvering.

what has me so incensed at this story is the levels of government that have now become involved. the day before the tube was removed there were multiple motions in the house and senate (were talking in washington here, not in her state) to block this action. the motions/bills that they attempted to push through involved calling her as a 'witness' to various 'trials' involving end of life issues. this woman's daily life involves laying in a bed, unable to eat/drink or move essentially ANY of her body and is fed with what is called a peg or 'g' tube inserted into her stomach. her parents insist that she is able to respond by blinking and/or small hand squeezes and answers questions appropriately in that manner, however the truth to this is much up in the air.

IS THIS INSANE???? as of last night the president... that's right the actual president... now has cancelled a trip in order to stay home at the white house waiting to sign anything the congress can push through to 'protect' this woman and re-insert the tube. im so glad he has time to worry about this case in the middle of, oh, lets say a war, a major and horrible push to revamp and kill social security, crisis in medical coverage and insurance companies, record high oil and gas prices and lets not forget about all those heart-warming individuals in al-queda just itching for another chance to punch us in the face. maybe after signing the bill to open more drilling in alaska bush felt he could lay off on some of the 'other stuff' and help out another pet project.

as a doctor and a husband this story is eating at my soul. life is precious and god knows i work everyday to help it along but i also strongly believe in the idea of dying with dignity if someone wishes. i have sat at the bedside of patients and their families as they have let go peacefully and gracefully-it is really a beautiful thing. i have stood next to and participated in drawn out and dramatic codes where the patient SHOULD have been allowed to die peacefully but the family could not let go. my own family had to deal with this exact same issue when i was in college and, after a car accident, my aunt was left in a coma- six months later my mom and her sisters decided to withdraw support. to this day i applaud and am humbled by their courage and use it and that lesson to help other people through the same process.

if indeed this woman voice desire not to be kept alive under these means, and her husband should know- his story has not wavered from the start- this action is criminal. and now the president wants to get involved. to me, this reeks of a pet project for the religious right anti-abortion crowd to grab onto and flaunt and use to justify their misguided cause but instead they only cause more pain to the players and ultimately to the woman they are trying to 'save'. it stinks and shows how blind to the truth and divorced from reality they actually. some of them actually tried to bring the woman bread and water a few days ago... please excuse the detached nature of this next statement but actually i wish they had been allowed to give it to her,
maybe she would have choked and had her wishes fulfilled.

anyway, i really needed to get this out of my head. i picture myself in this position (my in-laws are awesome people, that is not what i mean!!!) of my most valued friend, lover and partner unable to speak or move and yet tortured for 15 years, made to endure a living hell that she did not want to be in. now put it in the media spotlight and turn it into a circus. if something good can come out of this PLEASE PLEASE talk to your partners and families and discuss these types of issues. it is not scary or depressing or macabre to do so, it is freeing and loving to your partner, kids and family to know what you want. how different is it from checking off the 'organ donor' box on your licenses?

i hope you are all very well, please know that you are all in my heart and thanks for listening.

Jeff Wilson


Peace and love from me too,

Michael

3 Comments:

Anonymous Joe V. said...

Mike:

Long time, no speak. Several weeks ago John C. sent me a link to your Blog. While I don't agree with everything on it, I respect your right to comment and admire your passion. But, I am having a hard time squaring some of the posts with the intelligent person I grew up with and went to college with. Instead, they read more like they were written by somebody who blindly follows whatever is supposed to be the liberal position, without any critical thinking or bothering to learn the facts. (Living in Washington, I have come to accept it as a fact of life that most liberals and conservatives spend little (or no) time actually thinking and being willing to listen to both sides before jumping to a conclusion. But, I would hope that you would be different.)

The one post that just drove me over the edge was the recent one on Terri Shaivo. As you know, I have spent my whole life in and out of hospitals with Cancer (most recently two years ago) and was, at one time (twenty five years ago) declared terminal (my still being here is a testiment to the fact that doctors are sometimes wrong). So, this is an issue that is near and dear to me. While people of good will can certianly disagree on the issue of euthansia or assisted suicide. Your post (and that of your friend) reveals an apparent lack of knowledge of the fact of this case. This is not a simple matter of honoring a woman's wishes on extraordinary medical care. This is a case of "he said, she said." The husband says that she would want to die. The parents say that he is lying. Even though this case has been tied up in the legal system for over 10 years, the parents have never gotten a chance to prove their case in court. The court has even denied any request to have an neutral guardian appointed. (The law, as interpreted by the rulling court, is that only the spouse has any rights.) Why should anybody be against a full and fair hearing on the merits (as opposed to merely on the procedural issues) to determine the wishes of the person to be starved to death?? It seems to me that this should especially be the case in a situation like Schaivo's, where: (1) the husband neglected to tell anybody about Terri's alleged verbal declaration until several (I believe, six) years after she had the attack (and, most notable, until after his malpractice suit was finally over); (2) her parents and siblings all strongly dispute that this was what she would have wanted; (3) the husband stands to gain financially from her death; (He serves as trustee to a trust that controls a $750,000 malpratice judgement that pays for Terri's care (which was in addition to the $300,000 he was personally awarded). If she dies, as sole heir to her estate, he gets the money left. If she is kept alive it continues to go towards paying for her care.); (4) the husband is clearly husband in name only at this point (for several years he has been living with another women, with whom he has had two children); and (5) there is conflicting medical opinion about the chance for any improvement in her condition. If this is not a case that cries out for a full judicial inquiry, I do not know what does. (Why does Bush's insistance that there should be one make him "vile." With all due respect Mike, I think you are being blinded by your hatred.) Below is what a liberal writer (Nat Hentoff, with whom you would certainly agree regarding the war and the Justice Department) in a liberal newspaper (Village Voice) had to say about the subject two years ago, before this became such a national political football.

Sincerely,
Joe V.
(John C. has my email address if you want to reply. I don't want to post it because it's a work address).

Lying about Terri Schiavo
By Nat Hentoff
The Village Voice | November 10, 2003

I have covered highly visible, dramatic "right to die" cases—including those of Karen Ann Quinlan and Nancy Cruzan—for more than 25 years. Each time, most of the media, mirroring one another, have been shoddy and inaccurate.


The reporting on the fierce battle for the life of 39-year-old Terri Schiavo has been the worst case of this kind of journalistic malpractice I've seen.


On October 15, Terri's husband and legal guardian, Michael Schiavo, ordered the removal of her feeding tube. As she was dying, the Florida legislature and Governor Jeb Bush overruled her husband on October 21, and the gastric feeding tube has been reinserted pending further recourse to the court.


So intent is Michael Schiavo on having his wife die of starvation that one of his lawyers, after the governor's order to reconnect the feeding tube, faxed doctors in the county where the life-saving procedure was about to take place, threatening to sue any physician who reinserted a feeding tube. The husband had immediately gone to court to get a judge to revoke what the legislature and the governor had done.


The husband claims that he is honoring his marriage vows by carrying out the wishes of his wife that she not be kept alive by "artificial means." As I shall show, this hearsay "evidence" by the husband has been contradicted. The purportedly devoted husband, moreover, has been living with another woman since 1995. They have a child, with another on the way. Was that part of his marital vows?


For 13 years, Terri Schiavo has not been able to speak for herself. But she is not brain-dead, not in a comatose state, not terminal, and not connected to a respirator. If the feeding tube is removed, she will starve to death. Whatever she may or may not have said, did she consider food and water "artificial means?"


The media continually report that Terri is in a persistent vegetative state, and a number of neurologists and bioethicists have more than implied to the press that "persistent" is actually synonymous with "permanent." This is not true, as I shall factually demonstrate in upcoming columns. I will also provide statements from neurologists who say that if Terri were given the proper therapy—denied to her by her husband and guardian after he decided therapy was becoming too expensive despite $750,000 from a malpractice suit—she could learn to eat by herself and become more responsive.


Terri is responsive, beyond mere reflexes. Having this degree of sentience, if she is starved to death, she will not "die in peace" as The New York Times predicts in an uninformed October 23 editorial supporting the husband. What happens to someone who can feel pain during the process of starvation is ghastly.


Increasingly, New York Times editorials are not as indicative of conscious liberal "bias" as they are of ignorance or denial of the facts, as I have demonstrated in my series on Judge Charles Pickering.


In all the stories on Terri Schiavo and her parents' determined efforts to save her life, the media continually report that the Florida legislature intervened because of many thousands of calls, letters, and e-mails from the Christian Right and pro-lifers. Those groups and individuals are indeed a major factor in rousing support to prevent Terri from being starved to death. But among the many others who sent urgent messages are disabled Americans and their organizations.


Except for the op-ed page article by Stephen Drake of the Not Dead Yet organization in the October 29 Los Angeles Times ("Disabled Are Fearful: Who Will Be Next?") and a letter in the October 24 New York Times, I have seen hardly any mention in the press of the deeply concerned voices of the disabled, many of whom, in their own lives, have survived being terminated by bioethicists and other physicians who strongly believe that certain lives are not worth living. The numbers of these "new priesthoods of death," as I call them, are increasing.


The letter to The New York Times signed by Max Lapertosa, staff counsel, Access Living in Chicago—told of "14 national disability organizations that filed a friend-of-the-court brief to support keeping Terri Schiavo alive." Lapertosa objected to a Times editorial calling for Terri to go gently into that good night because, said the moral philosophers of the Times, "true respect for life includes recognizing . . . when it ceases to be meaningful."


Max Lapertosa reminded Gail Collins's board of oracles at the Time's editorial page that "many would lump into this category [of meaningless lives] people with severe autism, multiple sclerosis or cerebral palsy who, like Mrs. Schiavo, are nonverbal and are often described as being "in their own world."


"The judicial sanctioning of such attitudes," Lapertosa continued, "moves America back to the days when the sterilization and elimination of people with disabilities did not merely reflect private prejudices but were embraced as the law of the land."


In the Los Angeles Times' October 29 op-ed piece by Stephen Drake, he writes: "I was born brain-damaged as a result of a forceps delivery. The doctor told my parents I would be a 'vegetable' for the rest of my life—the same word now being used for Schiavo—and that the best thing would be for nature to take its course. They refused. Although I had a lot of health problems, surgeries and pain as a child, I went on to lead a happy life." And clearly, his is a very articulate life. I have interviewed other such "vegetables."


Ignoring the facts of the case, the American Civil Liberties Union—to my disgust, but not my surprise in view of the long-term distrust of the ACLU by disability rights activists—has marched to support the husband despite his grave conflicts of interests in this life-or-death case. The ACLU claims the governor and the legislature of Florida unconstitutionally overruled the courts, which continued to declare the husband the lawful guardian. On the other hand, the ACLU cheered when Governor George Ryan of Illinois substituted his judgment for that of the courts by removing many prisoners from death row. In a later column, I'll go deeper into the constitutional debate over saving Terri's life.


In the October 28 weeklystandard.com, Wesley Smith, author of Forced Exit—who has accurately researched more of these cases than anyone I know—reports that of the $750,000 to be held in trust for Terri's rehabilitation, two of Michael Schiavo's lawyers pressing for removal of her feeding tube have been paid more than $440,000. Whom did that rehabilitate? Any comment from the ACLU? If the husband and the lawyers succeed, maybe the ACLU will send flowers to Terri's funeral.

March 22, 2005 at 6:24 PM  
Anonymous Joe V. said...

Mike:

I must amend one part of my earlier post. While I was correct to say that the court has "even denied any request to have an neutral guardian appointed," I should have mentioned that for a brief period, the Florida legislature was able to intervene and appoint a guardian ad litem. But, the law they past was struct down by the court and then the brief neutral guardianship was ended.

The guardian (Jay Wolfson) did prepare the independent report the former law (now struck down), but it was ignored by the court since his appointment had been made under the now invalid law. In his 38-page report, Wolfson said the best decision for Schiavo could be made only if both sides agreed to fresh, independent medical testing. If the new testing showed she couldn't swallow on her own and that Schiavo had no hope for improvement, then the feeding tube should be pulled. If the results were the opposite, then she should begin receiving therapy (which she had been denied for several years).

Both parties were on the verge of agreeing to these new conditions, Wolfson testified, but once the court struck down the law his efforts were moot.

Just wanted to clarify that point. Thanks.

Joe V.

March 23, 2005 at 2:03 PM  
Anonymous Joe V. said...

Mike:

I must amend one part of my earlier post. While I was correct to say that the court has "even denied any request to have an neutral guardian appointed," I should have mentioned that for a brief period, the Florida legislature was able to intervene and appoint a guardian ad litem. But, the law they past was struct down by the court and then the brief neutral guardianship was ended.

The guardian (Jay Wolfson) did prepare the independent report the former law (now struck down), but it was ignored by the court since his appointment had been made under the now invalid law. In his 38-page report, Wolfson said the best decision for Schiavo could be made only if both sides agreed to fresh, independent medical testing. If the new testing showed she couldn't swallow on her own and that Schiavo had no hope for improvement, then the feeding tube should be pulled. If the results were the opposite, then she should begin receiving therapy (which she had been denied for several years).

Both parties were on the verge of agreeing to these new conditions, Wolfson testified, but once the court struck down the law his efforts were moot.

Just wanted to clarify that point. Thanks.

Joe V.

March 23, 2005 at 2:04 PM  

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