You are hereOne Physician’s View on the Terri Schiavo Case.

One Physician’s View on the Terri Schiavo Case.

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By Mick - Posted on 25 March 2005

by Mickey Denen
I feel a need to comment on the Terri Schiavo case, as I am listed among the columnists of Planet Preterist. My qualifications for commenting are that I am a Board Certified Internist and Board Certified Pediatrician. I have been awarded the title of Fellow of the American Academy of Pediatrics and am eligible for the title of Fellow of the American College of Physicians. I feel a need to comment on the Terri Schiavo case, as I am listed among the columnists of Planet Preterist. My qualifications for commenting are that I am a Board Certified Internist and Board Certified Pediatrician. I have been awarded the title of Fellow of the American Academy of Pediatrics and am eligible for the title of Fellow of the American College of Physicians. I have been involved in pro-life ministry for more than 10 years as either a member of the Executive Board or the Medical Advisory Board of local crisis pregnancy centers. I have spoken publicly and written in the local newspaper on pro-life issues from both a medical and Biblical perspective. Although I am not familiar with the medical facts surrounding her case, there are some important principles that all of us should draw from the case. The three issues I perceive are: 1) make your desires known in a legal document, 2) what do we call an act that takes a person from the state of life to death and 3) what rights does the “husband” have in the case when he is scripturally divorced from his wife.

First, if you do not have a Living Will and a Durable Power of Attorney for medical decisions (the names of these documents will vary from state to state) you need to do this now. These documents allow everyone to know what you wish to be done in the circumstance where you are unable to make medical decisions for yourself and designate a person to make decisions for you in the circumstances that are not spelled out in your Living Will. This likely would have kept the case out of the courts and the national press. These documents would have left this case in the hands of medical professionals and family members, where these decisions need to be made, not in the hands of lawyers and courts. In my experience, medical decisions are best made by medical professionals and families, not lawyers, courts and elected officials. If you get nothing out of this article except this point, it will be a blessing to your family.

Second we must be intellectually honest. If Terri Schiavo is not brain dead or dead by any other standard, then she is alive. If someone acts in some manner that leads to Terri Schiavo’s death, then she has been killed. I am not a lawyer, but this seems to be murder, homicide or manslaughter. Having said that, I will tell you these situations are very difficult for families and all of the medical professionals involved. It is not unusual to be at the limits of what humanity can do for a patient. I will continue to argue there is a distinct difference between not doing something that seems to be medically futile and denying a patient food and water. Again these decisions are best made by families and medical professionals on a case by case basis. In the last month I have found myself counseling patients and their families on the limits of modern medical knowledge twice. As someone who has been trained to do something when illness is diagnosed, the decision to leave things in the hands of God and do nothing except pray is hard.

Finally, I have a great deal of difficulty with the rights of Terri Schiavo’s “husband”. My understanding of him is that he has a common law wife and children with this common law wife. If this is true, it would seem that Terri is scripturally divorced from her “husband”, Matthew 5:32. By this standard I would argue that he would have no rights to contradict the wishes of other family members who want her to stay alive. I can relate stories of family members who have asked me, “Was there anything else we could have done for (their loved one's name) that they might be alive today?” In my experience it seems to be just as difficult for family members to “give up” as it is for medical professionals.

As of this writing, unless Governor Bush or President Bush intervenes using the protective powers of the State to save Terri Schiavo’s life, she will die in the next few days. Hopefully, we Christians can enter into this debate in such a way that honors God. This may be the first major ethical debate of the post-modern era we are entering. If this is true, we need to have an answer that can shape the era we are moving into. Maybe the answer lies in the words of Jesus, “Abba, Father, all things are possible for you. Remove this cup from me. Yet not what I will, but what you will.” Mark 14:36 (ESV)

Seeker's picture

I know some people did not like the Federal Government getting involved, but from what I understand it was their constitutional right.

Also doesn't our constitution say we have 3 separate BUT EQUAL branches of govt? Why does everyone think the other two must bow to the judiciary. Don't we have two branches (the legislative and the Executive) that agree on this case, but somehow the judical branch still gets their way.

Seeker

Seeker

Jamie's picture

The three branches of the government are not equal..that's a liberal myth.

Jamie's picture

Thank you for sharing this Dr Denen! I wish more people would wake up to the fact that if she is not brain dead,she is alive. Thats the thing that keeps coming back to me.

Erick's picture

Amen kfiech, the debate is much more than does Terri's "husband” have a right to starve Terri to death, but if Terri would have a right to starve herself to death via a living will. It is a bit creepy that it was (as I understand it) an eating disorder that supposedly got her to this state in the first place. May God help this poor family, and our country. Nevertheless, these are some conclusions we can draw from this case so far based on the various debates:

1) Food is an “extraordinary measure” to keep a “vital organ” (stomach?) functioning.

2) Murder is wrong, but suicide would be o.k. (if Terri actually said this was her wish)

3) Adulterous men can kill their legal wives but only when a judge approves of denying her of life, liberty, and the pursuit of happiness.

4) Republicans can be just as spineless as Democrats.

5) Starvation is a form of mercy, and death by dehydration is dignified -- flaky skin, cracked tongues, emaciation, and even stomach bloating is good for the hopeless, so aid for Africa is no longer necessary.

6) Quality of life trumps the sanctity of life.

7) If only we killed more unborn babies for their stem cells we might not have to starve brain damaged women to death.

8) The right to life is not God given, but man-made, and dependent upon our ability to communicate, and assert it.

9) Withholding food from a living, breathing, conscious, patient is neither a sin of commission, nor of omission, but simply the fulfillment of the Hippocratic oath, a Husband’s duty, and American justice.

Seeker's picture

Amen Erick!

Seeker

Englewood's picture

I believe the first of the doctor's points is the big lesson learned in this case. It's what separates it from the hundreds of similar situations each year. The husband and parents happen to be sharply at odds as to what should be done for her.

But if this first point is valid, then it negates the second point. What if Terri did have a living will that stated if she were to end up in a "persistent vegetative state" that she didn't want to be kept alive, then shouldn't she be allowed to die and not be artifically nourished? How could it then be deemed murder?

As for the third point, I must admit I am perplexed as to why, even if he were still biblically married to her, why he wouldn't allow her parents to take custody and provide for her care, considering all they have done to keep the feeding tube intact. He could wash his hands of the matter. Some believe the fight is over money and that he would receive an insurance settlement of some kind. I don't know. I understand that money is the source of the division in this case. Michael Schiavo and Terri's parents got along very until Michael won a malpractice case three years after Terri's incident and he didn't split the money as the parent's had wanted. ????

Englewood's picture

"What if Terri did have a living will that stated if she were to end up in a "persistent vegetative state" that she didn't want to be kept alive, then shouldn't she be allowed to die and not be artifically nourished? How could it then be deemed murder?"

It wouldn't be murder. It would be suicide, which is still illegal. There is no right to die by your own hand nor by another's. Only God has the right to take life.

Englewood's picture

God would have taken her life if man had not intervened.

Erick's picture

Consider the following based on your logic:

God would take the life of every baby if its feeding tube (i.e. nipple) were taken away. Should we just let nature take its course and let babies die? They can't survive on their own. God would have let thousands more Americans die by terrorists if man had not intervened. God would have given murderous thieves more money if the cops had not intervened (do I really need to go on?)…

…O.K. one more… God would have taken all our lives if Christ had not intervened, so since the crucifixion was an "extraordinary measure" (and faith in Christ as well) that supposedly thwarted God's will, we should probably reject his sacrifice and go to hell as “nature” (albeit fallen) takes it course.

You’re missing the point in all of this - the lady is alive! Her eyes are open, she may even be able to talk, she is conscious, and none of her vital organs require artificial means to keep them working (unless you consider food an extraordinary measure for the stomach, and feeding the hungry a heroic means?) Why has it taken so long for her to die if her death was so imminent? If she’s just a vegetable with no feelings why on God’s green earth have they started to give her morphine for THE PAIN? You seem like you’re a pretty liberal guy, so do you favor capital punishment by starvation? Why not? Because you’re against “murder,” or because your against cruelty? If murder then let Terri live, if cruelty than let Terri eat. Either way let this disgraceful travesty of justice and ethics end right away.

BTW, Do you have a pacemaker?

Mick's picture

Kfiech,
Since early in my training as a physician, I wished we had a device I called a "soul-o-meter". This device would make medical decision making in cases like this much easier. We could wave this device over the patient, discover that their soul had left their body and know that the patient was dead. Many times a patient is "brain dead" yet their heart and lungs continue to function with man-made support. It is just such cases where a living will works very well.

Indeed our technology is not perfect and our decisions will never be perfect, but we must have a mechanism to stop man's intervention when we have reached a point of futility and are actually doing harm to the patient with our technology.

Many times as physicians we intervene to “save” a persons life in a critical situation. We do not know ahead of time if the process taking place in the person is reversible, that is later the patient will be able to survive without the technology in place. What we do know though is that if we do nothing the patient will die at that time. Weeks go by and the patient is “stuck” on the technology that we have put in place. Without the guidance of a living will or consensus from the family, the patient continues on and the courts get involved when one family member sues to have their way imposed on the patient over the wishes of the other family members (as in Terri’s case). A living will makes your wishes known. If your conscience guides you to believe that withdrawal of a particular form of support is suicide, then you specify that you do not want that support withdrawn. The point of the living will is to remove one level of pain from those that survive the patient by knowing what the patient wanted.
Mick

Mickey E. Denen

Jamie's picture

...on the side of LIFE. No need to play God in "ify" situations as you describe, Mick. Choose life and you will be all right with God and man.

Be that as it may, as JL states, we have no such "ify" hypotheticals in Terri's case. She can breathe on her own and only needs to be fed. Enough said.

JL's picture

To add to the confusion, occasionally (but rarely) people who are brain dead but kept "alive" on life support suddenly wake up.

However, in the Shiavo case, she's not on life support and is not brain dead.

JL

Blessings,

JL Vaughn
Beyond Creation Science

Seeker's picture

You're right. You can starv a dog in most states without being thrown in jail. You can't starv and Iraqi prisoner - you can't even put panties on their head without going to jail.

Seeker

Seeker

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