No Mercy in Florida
SMITH, WESLEY J.
No Mercy in Florida The horrifying case of Terri Schiavo, and what it portends. BY WESLEY J. SMITH AT 2:00 p.m. on October 15, 2003, Terri Schiavo's feeding tube is to be removed, after which she...
...Robert D. Troug and Walter M. Robinson, from Harvard Medical School and the Medical Intensive Care Unit at Children's Hospital, Boston, want to discard the "dead donor rule" requiring that vital organ donors die before their organs can be procured, writing: "We propose that individuals who desire to donate their organs and who are either neurologically devastated or imminently dying should be allowed to donate their organs, without first being declared dead...
...This is a prescription for moral freefall...
...Given finite resources," the Ethics Committee stated in 1997, "institutional providers should define what constitutes inadvisable treatment and determine when such treatment will not be sustained...
...But so what...
...Rather, it would be to permit doctors to procure organs only from donors who have been declared dead in the traditional manner...
...If the order is carried out, Terri will die over a period of 10 to 14 days...
...This isn't a case where we have to believe one side's medical experts or the other's...
...If it is true that a nation is judged by the way it treats its most vulnerable citizens, a lot is riding on the Schiavo case...
...The authors urge that the relevant question about organ donors should be changed from the current query—is the patient dead?—to, "Are the harms of removing life-sustaining organs sufficiently small that patients or surrogates [e.g., Michael Schiavo] should be allowed to consent to donation...
...Troug and Robinson attempt to justify their homicidal proposal by claiming that we already take the organs of those declared brain dead but that such patients are really alive...
...The literature is brimming with advocacy that death be "redefined" to include a diagnosis of permanent unconsciousness...
...Rather than the funds going to pay for medical therapists to help her, as the jury intended, much of it instead paid lawyers that Michael retained to obtain the court order to end her care...
...Medical and bioethics journals have reported in recent years that futile care protocols are being adopted quietly by hospitals throughout the country...
...This case illustrates how utterly vulnerable people with profound cognitive disabilities have become in this country...
...Whatever Terri said or did not say, she certainly never asked to be denied the very treatment that might allow her to eat without medical assistance...
...People are often shocked at how Terri has been treated as somehow less than a fully human person by the legal and medical experts who are determined to see her dead...
...Not only are many routinely dehydrated to death—both the conscious and unconscious—but often the people making decisions to stop food and water, like Michael, have glaring conflicts of interest...
...But once the money was in the bank, Michael refused to provide Terri with any rehab...
...Terri Schiavo collapsed from unknown causes in 1990 and experienced a devastating brain injury...
...Michael brought a medical malpractice case in which he promised the jury that he would provide Terri with rehabilitation and care for her for the rest of his Wesley J. Smith is a senior fellow at the Discovery Institute...
...But Judge Greer, in a decision that elevated procedure over justice, won't do that because, he ruled, it would mean retrying the case...
...Not only do the authors strongly imply that some of us have less value than others but that those so denigrated can be killed for utilitarian ends...
...An article just published in Critical Care Medicine, the journal for doctors who specialize in treating the most seriously ill and injured patients, urges the adoption of an even more radical policy...
...The Schiavo case is only the most recent "food and fluids" case to make national headlines, after Nancy Cruzan (Missouri), Michael Martin (Michigan), and Robert Wendland (California...
...because their hearts have ceased beating without hope of restarting...
...But if I am wrong, it is a scandal of the highest order, for it means that society was sold a bill of goods about brain death by bio-ethicists and organ transplant professionals...
...The sad truth is, many practitioners of bioethics, medicine, and law no longer believe that people like Terri Schiavo are fully human...
...His most recent book is Forced Exit: The Slippery Slope From Assisted Suicide to Legalized Murder...
...He is engaged to be married and has had a baby with his fiancée, with another one on the way...
...The Schiavo case has drawn attention only because her family is in profound disagreement about the care she should receive...
...As a consequence, these patients are being systematically stripped of their fundamental right to life and, perhaps worse, are increasingly looked upon as mere natural resources whose bodies can be plundered for the benefit of others...
...If futile care theory takes hold, we may see fewer such cases, if only because the unilateral refusal of treatment will quietly take place without anyone speaking up for the patient...
...Adding to the suit's potential legal heft and credibility: Florida governor Jeb Bush dramatically signed on to the federal case, urging the court in an amicus brief to prevent Terri's dehydration until she received treatment to determine whether she could relearn to take food and water by mouth...
...Moreover, within months, he had a do-not-resuscitate order placed on her chart...
...Michael's second conflict of interest is deeply personal...
...But Terri's case has gone a step beyond all the rest: Not only are Michael Schiavo's conflicts of interest so blatant that he should be allowed no say over her care, but Terri is also being denied rehabilitative therapy that several doctors and therapists have testified could wean her off the feeding tube...
...life...
...Had she died then, Michael would have inherited all the money...
...Yet, in the ultimate injustice, Judge Greer refuses to permit Terri to receive rehabilitative therapy that could help her relearn to eat by mouth, even though several doctors and therapists have testified under penalty of perjury that she is a good candidate for tube weaning...
...District Court Judge Richard Lazzara ruled on October 10 that the federal courts had no jurisdiction and dismissed the case...
...They shouldn't be...
...To the contrary, the malpractice jury was told that Terri could expect a normal lifespan...
...Petersburg attorney Pat Anderson, who represents Terri's blood family, believed that denying food and water and potentially rehabilitative therapy that could have made the feeding tube unnecessary, reeked of discrimination against the disabled...
...The issue can be decided empirically by providing Terri with six months of therapy to see if she improves...
...This is to be done at the request of her husband, Michael Schiavo, and at the order of Judge George W. Greer of the Sixth Judicial Circuit, in Clearwater, Florida...
...The couple would like to marry, but Michael's wife, inconveniently, is still alive...
...But once again, the law turned its back on her...
...I don't believe this is true, assuming proper diagnosis...
...If true, this is bitterly ironic...
...She filed a civil rights lawsuit seeking a federal injunction against the dehydration...
...The answer to such a moral travesty would not be to expand medical homicide beyond patients who have suffered a total cessation of brain activity...
...Some of the worst such conflicts come not from family members but from a medical establishment eager to remedy the chronic shortage of organ donors...
...on October 15, 2003, Terri Schiavo's feeding tube is to be removed, after which she will slowly dehydrate to death...
...For the past three years he has been in litigation, opposed by Terri's parents and her other relatives...
...Advocacy in Critical Care Medicine for discarding the dead donor rule follows on the heels of the Ethics Committee of the Society of Critical Care Medicine's advocacy for legalizing "futile care theory," which would permit doctors to refuse wanted life-sustaining treatment—including "low tech" treatments such as antibiotics— based on the doctor's perception of the "quality" of the patient's life...
...This plan is currently being implemented...
...Judge Greer ordered Terri dehydrated based on dubious testimony from Michael, his brother, and his brother's wife that Terri told them she did not want to be hooked up to tubes—something he never told the malpractice jury when he sought a financial award...
...The jury in 1993 awarded $1.3 million in damages, approximately $750,000 of which was set aside to pay for her care and rehabilitation...
...In that unreasonable denial, it looked as if Greer might have crossed a crucial line...
...True, experts hired by Michael disagree...
...But he denies having a venal motive, claiming that the trust fund money is now exhausted...
Vol. 9 • October 2003 • No. 6
