Kevin, M.D. - Medical Weblog

I think it's probably irresponsible for him or Sen. Frist (who I admire very much) to attempt to try to make a clinical diagnosis of Terri using only snippets of video.

There must be a handful of doctor's who have cared for Terri and made the diagnosis that she is in a persistent vegetative state. It is not as if her husband, Michael, can make the determination to remove her feeding tube without physician consult under Florida law.

As well, Dr. Brinson's, the articles author, analogies seem ill founded:

"If recovery became the criterion to feed patients, which is a basic function of humanity, then we would be subjecting children with Downs syndrome, mental retardation and other chronic neurologic impairment to a premature death."

First, it could well be (only her physicians could make such an estimate) that Terri has suffered much greater neurological damage than a Downs syndrome child.

Second, the ethical dilemma here is the patient's wishes. It is both impossible for children or those born with mental defects to form or communicate those wishes. However, if Terri made it clear before she suffered her heart attack and stroke that she would not wish to live in a depleted neurological state (as Michael believes she did) then the matter is we should respect that.

It is not appropriate for Dr. Brinson to imagine that removing Terri's feeding tube is anything but a fight over trying to determine if that's what she would have wanted.

This does raise some concerns, however. For children who enter a persistent vegetative state, the government says that it is not their wishes (which they probably never contemplated, nor perhaps could, during their time of regular brain function) but the wishes of the parents. Perhaps there is a problem with such procedures and Dr. Brinson can argue so but these situations certainly don't equate with Terri Schiavo's case.

Finally, I'm certainly not well read in medical ethics but I know that hte general consensus is that removing a feeding tube differs nothing from removing the et tube of a brain dead individual. It seems ill founded for someone to take a contrary position to the matter based on a news story and their own personal beliefs. The fact more patient's than Terri Schiavo have had their feeding tubes removed and the fact that her parents have done well in, not manipulating, but drawing the media's attention to their daughter does not mean there is something overly special about her case.
 

Docs like the one in the acticle make such incredible ignorant and falsely based arguments that it is hard to disagree with them since there are no facts in what they state. Not only have numerous docs examined Terri, but all of the courts have sided with Michael in this case. All he is trying to do is fulfill his wife's wishes. These stories put forth by the right wing only serve to infuriate the medical profession, antagonize the conservative religious base and misinform those in the middle. Why can't we try to protect the interest of all Americans?
 

Neurosurgeons and other physicians assert, indeed, continually persist in claiming that, when someone's feeding tube and hydration are removed, the patient feels NO PAIN WHATSOEVER. This has been asserted continuously in the Schiavo case, considering, additionally, that Terri's cognitive cortex was liquified. Why, then, is Terri on a morphine drip "for pain"?

I would hope that, should anything similar ever happen to those all-knowing physicians in the future, their loved ones will be sure to keep them OFF the morphine drip.

Saint Louis University