Medicine Flawed
Yes, it’s the countdown. Terri’s Schiavo’s last hours. I want to clarify that I am amazed at the media and energy which this case has generated, when our politicians and president should be focused on far more pressing issues. Perhaps it is a smokescreen against all of the planned cuts that the Bush administration has in mind? Bob Herbert, a NY Times columnist, had a great column about that a few days ago.
But what I find offensive in this instance is the “we know it all” attitude of many of the doctors making judgments about Terri. Many of the medical experts reassure the public that stopping Terri’s food and fluids will cause her absolutely no discomfort, because a person in a persistent vegetative state feel no discomfort from either dehydration or hunger.
Of course, these same medical experts used to believe that infants were incapable of experiencing pain. Many invasive and painful procedures used to be performed on infants (even surgery) without sedation or anesthesia. Does it seem possible? Well it was, and not all that long ago. I can tell stories that would make you cringe in horror. One example was a 1 year old who had brain surgery, and I had him as a patient fresh post-op. The baby was moaning, in obvious pain, but all he had was Tylenol ordered! Uh, would you like Tylenol after your head was cracked open–which is what I asked the resident who refused to give me an order for a narcotic.
It was only after I threatened to call the child’s parents that he came up to the unit and wrote me an order for morphine. Duh, the baby stopped moaning and his vital signs improved dramatically. The resident was stunned. I really didn’t think he’d be feeling pain, he told me. They’re not supposed to be able to at this age.
The NICU used to be a house of horrors for newborns, because of this attitude. Even today, babies are usually circumcised without any type of anesthetic because “they don’t feel anything.” I refused to participate in any way, shape or form in circumcisions during my last years as a nurse. Babies don’t howl because they “don’t feel anything.” I asked one doctor, who told me that very thing, how he would like it if I cut off his foreskin. Think it would feel good? He was a little stunned, then mumbled something about it being different for an adult.
Anyway, there are many changes in what was believed to be “scientifically true” over the years. Another example are tonsils, which were formerly believed to be a worthless mass of tissue in your throat. They were routinely removed from children without a second thought, much as you’d clip a toenail. Of course, then the discovery came that they play an important role in the immune system.
The doctors who preach that Terri Schiavo is not a sentient being, and therefore, does not feel pain or discomfort, really don’t have a clue. How do they really know what is going on in her mind? If you ask, they’ll bark a bunch of scientific gibberish at you, same as the docs who said infants don’t feel pain, or that women don’t need their uterus once they’re done having kids. Have you ever noticed how medical facts change from one day to the next? Have you ever noticed that there is often no concensus on many medical topics? How often, in the past two years, have you opened the newspaper and seen something to the effect of, “Mammograms are worthless…” “Mammograms save lives…” Mammograms don’t save lives…” Mammograms detect breast cancer better than a self-exam…” “A self exam is better than a mammogram…” and so on. Certainly gives you a lot of confidence in the modern medicine.
Right to die?
I cringe whenever I see things that “Terri has the right to die with dignity” or that she has a “right to die.” Is “dying with dignity” applicable when a person is not near death? It would be one thing if Terri had been in organ failure, or had a terminal disease, or was failing. Then I would say fine, withhold treatment and let her go. But she was healthy, well nourished and nowhere near death. So where does the “death with dignity” come in? Right to die? Uh, she wasn’t dying. And that is what I consider so wrong about this decision.
When it comes down to it, no one can speak for Terri. Her parents, husband doctors, lawyers, politicians–no one knows what she wants, or what she would have wanted. Her husband blabs about Terri’s wishes, but I hardly think that they sat down and discussed what she would want or not want, should she ever fall into a persistant vegetative state. I highly doubt that she said, “Michael, please don’t let them connect me to a feeding tube, and if they do, please have it pulled.”
As I posted earlier, in Europe, this case would be a no-brainer. Terri left no written directive, she did not insist on death. Therefore, feeding continues. And in our nation, you would think that since there was no firm directive from Terri, that all of us–courts, lawyers, family, etc–would err for life over death. At least, that is what civilized societies are supposed to do.
It is sad that this case has become so political, and has garnered so much attention. If we really had good laws that protected people like Terri, and that clarified this type of issue, then there would be no need for this.
A reader in the NY Times wrote a letter to the editor, and I find these two sentences especially poignant:
I relate to those who want Ms. Schiavo to live based on her family’s grief and belief that she might be helped by advances in medical science. Harder to comprehend is the passion of some who are actually eager for her death.
If anything, I hope that this case will at least polarize the need for better laws protecting those who cannot speak for themselves, and better define what exactly, is meant by artificial life support.. In my interpretation, food and fluid is basic care. And that’s all that Terri was receiving.