Toward Tradition says…

65 thoughts on “Toward Tradition says…”

1. Though I believe that we need to error on the side of avoiding pro-active measures in bringing about someone’s death (as in Terri’s case), if we are pro-life we must also reject the death penalty.

   I was watching some news clips yesterday of the sentencing of Scott Peterson: while his crimes were barbaric and incomprehensible (assuming he actually did them), we must guard against satisfying our desire for revenge, understandable though it is. The death penalty is a form of despair over the potential for spiritual renewal in a person, and it cannot bring any true form of justice (execution will not bring back the deceased victims).

2. From the Basic Social Concept of the Russian Orthodox Church. Full document available at the Moscow Patriarch’s server: http://www.mospat.ru/chapters/e_conception/

   Section is Crime and Punishment –

   “The death penalty as a special punishment was recognised in the Old Testament. There are no indications to the need to abolish it in the New Testament or in the Tradition or in the historical legacy of the Orthodox Church either. At the same time, the Church has often assumed the duty of interceding before the secular authority for those condemned to death, asking it show mercy for them and commute their punishment. Moreover, under Christian moral influence, the negative attitude to the death penalty has been cultivated in people’s consciousness. Thus, in the period from the mid-18th century to the 1905 Revolution in Russia, it was applied on very rare occasions. For the Orthodox church consciousness, the life of a person does not end with his bodily death, therefore the Church continues her care for those condemned to capital punishment.

   The abolition of death penalty would give more opportunities for pastoral work with those who have stumbled and for the latter to repent. It is also evident that punishment by death cannot be reformatory; it also makes misjudgement irreparable and provokes ambiguous feelings among people. Today many states have either abolished the death penalty by law or stopped practicing it. Keeping in mind that mercy toward a fallen man is always more preferable than revenge, the Church welcomes these steps by state authorities. At the same time, she believes that the decision to abolish or not to apply death penalty should be made by society freely, considering the rate of crime and the state of law-enforcement and judiciary, and even more so, the need to protect the life of its well-intentioned members.”

   I would say that in the minds of the Russian synod, the stand against the death penalty is far from absolute.

3. Ok, looks like it’s time for the weekly analysis of Schiavo disinformation:

   1) “Judge George Greer, who issued her death warrant…” FALSE. No “death warrant” was issued. This is utter propaganda designed to inflame the ignorant.

   2) “…recognize that starving an invalid is murder…” This is not starving an invalid. This is withdrawing medical care from someone who expressed a desire not to be kept in that situation.

   3) “Judge Greer Thursday last week re-interpreted the law, calling food and water ‘medical treatment’…” Totally false. Nurtition and hydration administered through a feeding tube is a medical procedure that can only be done through a physician’s order. If you don’t think so, try getting it without one.

   4) “…thus allowing Michael Schiavo to withdraw Mrs. Schindler-Schiavo’s feeding tube.” More propaganda. I have never seen any indication that Terri Schiavo’s legal name is “Schindler-Schiavo.” Unless someone can produce some documentation that that is her real name one must assume that this is yet another falsehood designed to mislead the ignorant.

   5) “This also ignores the rights of Terri’s primary caretakers and loyal defenders, her mother and father.” Utterly and completely false. Michael Schiavo is her guardian, and his status as guardian has been continually upheld by the courts. Her parents are not her loyal defenders, but those who oppose her stated wishes.

   6) “Those that support the impending murder . . .” More hyperbole for the ignorant.

   7) “…might consider that Kate Adamson, a California woman who suffered a sudden double-brainstem stroke…” Again, and again, and again, apparently one must explain the difference between someone who has an intact but damaged brain, and one whose brain tissue is gone and has been replaced by fluid.

   8) “Mrs. Adamson recently spoke out on behalf of Terri Schindler-Schiavo at a rally protesting the pre-meditated murder plot by her husband and the courts.” More inflammatory propaganda for the ignorant.

   9) “Toward Tradition applauds US Senator Mel Martinez and Representative Dave Weldon (FL), who have introduced a bill to Congress entitled the ‘Incapacitated Persons’ Legal Protection Act,’ guaranteeing constitutional rights to those who cannot speak for themselves.” They already have rights. They have the right to refuse medical treatment that they don’t want or to accept treatment that they do want. A better name would be the “Ignore the Previously Stated Wishes of Incapacitated Persons” Act.

4. Why does Michael want her dead? Even the most jaded hard heart would take a million dollars and release her to her parents care. What does Terri know that Michael wants to keep quiet?

5. R Starr writes: “Why does Michael want her dead? Even the most jaded hard heart would take a million dollars and release her to her parents care. What does Terri know that Michael wants to keep quiet?”

   Patients have the right to refuse any medical care. The issue in the Schiavo case is to determine what her wishes would have been were she able to speak. When Michael Schiavo and the Schindlers could not agree on those wishes, Michael petitioned the court to make that determination. During a hearing the court heard testimony from Michael Schiavo, the Schindlers, and several others. Based on all the testimony, the court held that by “clear and convincing” evidence Terri Schiavo would not have wanted to be maintained in her current condition.

6. Jim, why do you persist in describing anyone who doesn’t come down on your side in this debate as “ignorant?”

   There are doctors who reject the PVS finding that Judge Greer has accepted. They are not on your side. Are they ignorant?

   There are lawyers who point out that animals and death row inmates get better treatment under the law than Terri Schiavo has received. They are not on your side. Are they ignorant?

   You know, Jim, reading your persistent defenses of this case used to make me angry. I was beside myself that you could so easily dismiss the fact that we are talking about a person made in the image of God whom the courts, through little more than hearsay, have ordered be denied food and water (or what you call “medical treatment”). A big part of my anger comes from the fact that my sister suffered head trauma and some of her brain tissue was displaced by excessive fluid. She was in a coma for months, receiving food and water via a feeding tube. Thank God the doctors weren’t enthralled, at that time, to the bioethicists that reign today. My sister was not starved to death, and today she is healthy and living with my folks. She is not the functioning adult she was when the accident happened but she is not a “useless lump of flesh” that should just be disposed of either.

   I don’t get angry any longer. I have little doubt that you will pull sentences out of this comment and tell me things like “Terri Schiavo’s brain tissue hasn’t been displaced. It is gone. More appeals to the ignorant.” Or you will point out that the doctors and lawyers don’t have standing since the judge didn’t accept their opinions. OK, fine, call me ignorant; call us all ignorant. I am saddened by the hole in your soul that blinds you to the person in that Florida hospice. I think, while we pray for Terri’s life, we should also remember to pray for you and everyone else who stands with Michael Schiavo and Judge Greer, for I believe that when you stand before the Lord He will ask you, “Where were you when I was lying in bed, unable to speak and unable to move, in that Florida hospice?”

7. Of course whether that evidence is actually “clear and convincing” is one of the issues still unresolved given the only “evidence” is Michael’s testimony. No documentation whatsoever exists.

   Note 3: There is a difference between what constitutes medical “treatment” and what constitutes medical “care.” Euthanasia advocates argue that food and water constitute “treatment.” You do as well above. But this question is far from resolved, as you well know.

   If food and water are “treatment” (withholding them is no different than withholding medicine), then air should be “treatment” as well. Why not just suffocate Terri instead of letting her starve? What’s the difference?

   Is it that she is breathing on her own but cannot feed herself? What about paralytics? What about new-borns?

   Why is it that liberals are so eager to embrace the culture of death?

8. Father, your question about newborns is highly appropriate. Many babies are born with brain defects, some of which include diminished brain tissue.

   Is it just – is it moral – that a newborn, with a brain defect that leaves it with significantly reduced brain tissue, be left alone in a room to die by starvation and dehydration?

9. Daniel writes: “Jim, why do you persist in describing anyone who doesn’t come down on your side in this debate as ‘ignorant?'”

   It’s not just that someone doesn’t come down on my side of the case. If someone is truly possessed of all the facts and comes to a different conclusion, great. But what I’ve seen here is a continual repetition of falsehoods and profound misunderstandings.

   Look, when someone who doesn’t understand the concept of patient autonomy, and how that functions in modern medical ethics, and tries to argue the Schiavo case, it’s like arguing WW2 with someone who wasn’t aware of the existence of nazi Germany. It’s like arguing politics with someone who doesn’t realize what the Republican party is. Whatever side one might come down on, there is a certain body of basic knowledge that is required to understand this case. There are certain critical distinctions that are necessary to make.

   At some point I conclude either that a) many people just don’t know the facts, or b) many people are unwilling to educate themselves on the facts, or c) many people know the facts but ignore them.

   Daniel: “There are doctors who reject the PVS finding that Judge Greer has accepted. They are not on your side. Are they ignorant?”

   I think they are wrong. In my reading, the overwhelming medical concensus, confirmed by the hard science and the history of the case, is that she is in a PVS. I suppose for many conditions you can find physicians who have alternative opinions.

   Daniel: “A big part of my anger comes from the fact that my sister suffered head trauma and some of her brain tissue was displaced by excessive fluid. She was in a coma for months, receiving food and water via a feeding tube. Thank God the doctors weren’t enthralled, at that time, to the bioethicists that reign today.”

   Your story illustrates the importance of time in assessing such conditions. If Terri Schiavo were three months or six months or even a year in a non-communicative state, I would say the thing to do is wait and see what happens and hope for improvement. But when you’re fourteen years down the road, all the therapies have failed, and the brain itself has atrophied, there isn’t going to be any improvement. So yes, don’t rush to a decision in such a case, but surely fourteen years is enough.

   Daniel: I have little doubt that you will pull sentences out of this comment and tell me things like ‘Terri Schiavo’s brain tissue hasn’t been displaced. It is gone. More appeals to the ignorant.'”

   There are many sad facts about this case, and one of those facts is that her cerebral cortex is gone. There will be no recovery, just as there is no awareness. There is nothing that you or I can do about that, but we can recognize it as a fact.

   Daniel: “I am saddened by the hole in your soul that blinds you to the person in that Florida hospice.”

   The person in that Florida hospice stated long ago that she did not want to be maintained in such a condition. What I want done for her is what she would have wanted for herself. To force her to continue in that condition is to dishonor her wishes. The issue here is not what you or I would want, but what SHE would want. The last and best thing we can do for her at this point is to honor her wishes.

10. If Judge Greer and his fellow travellers have their way it is. When the abortion laws were thrown out with Roe v. Wade, some prescient commentators warned us the infirm would be next. Then the elderly. Then anyone else. Look at what is happening.

    Here is a disabled woman who needs defenders, and there are some. But did you notice who blocked all efforts to keep her alive in Congress yesterday? The self-proclaimed guardians of the poor and oppressed. The ones always first to champion the causes of the dispossessed. They will be going after your grandmother next, then you mother, and maybe you if you have the misfortune of suffering some malady they don’t approve of.

    The eagerness to see this woman dead is revolting. Pray that by some miraculous intervention of God this will be reversed. Our nation is at a crossroad. Many, many, people are confused. Speak the truth and speak it clearly.

    Tonight we celebrate our first Atkathist, the Lenten commemoration to the Mother of God who gave birth to the Savior. Once I dedicated the worship to a young father dying of cancer. Within two weeks his cancer reversed and eventually disappeared. Tonight I dedicate it to Terri Schiavo so that she might live.

    May God have mercy on our souls.

11. Daniel writes: “Jim, why do you persist in describing anyone who doesn’t come down on your side in this debate as ‘ignorant?'”

    It’s not just that someone doesn’t come down on my side of the case. If someone is truly possessed of all the facts and comes to a different conclusion, great. But what I’ve seen here is a continual repetition of falsehoods and profound misunderstandings.

    Look, when someone who doesn’t understand the concept of patient autonomy, and how that functions in modern medical ethics, and tries to argue the Schiavo case, it’s like arguing WW2 with someone who wasn’t aware of the existence of nazi Germany. It’s like arguing politics with someone who doesn’t realize what the Republican party is. Whatever side one might come down on, there is a certain body of basic knowledge that is required to understand this case. There are certain critical distinctions that are necessary to make.

    At some point I conclude either that a) many people just don’t know the facts, or b) many people are unwilling to educate themselves on the facts, or c) many people know the facts but ignore them.

    Daniel: “There are doctors who reject the PVS finding that Judge Greer has accepted. They are not on your side. Are they ignorant?”

    I think they are wrong. In my reading, the overwhelming medical concensus, confirmed by the hard science and the history of the case, is that she is in a PVS. I suppose for many conditions you can find physicians who have alternative opinions.

    Daniel: “A big part of my anger comes from the fact that my sister suffered head trauma and some of her brain tissue was displaced by excessive fluid. She was in a coma for months, receiving food and water via a feeding tube. Thank God the doctors weren’t enthralled, at that time, to the bioethicists that reign today.”

    Your story illustrates the importance of time in assessing such conditions. If Terri Schiavo were three months or six months or even a year in a non-communicative state, I would say the thing to do is wait and see what happens and hope for improvement. But when you’re fourteen years down the road, all the therapies have failed, and the brain itself has atrophied, there isn’t going to be any improvement. So yes, don’t rush to a decision in such a case, but surely fourteen years is enough.

    Daniel: I have little doubt that you will pull sentences out of this comment and tell me things like ‘Terri Schiavo’s brain tissue hasn’t been displaced. It is gone. More appeals to the ignorant.'”

    There are many sad facts about this case, and one of those facts is that her cerebral cortex is gone. There will be no recovery, just as there is no awareness. There is nothing that you or I can do about that, but we can recognize it as a fact.

    Daniel: “I am saddened by the hole in your soul that blinds you to the person in that Florida hospice.”

    The person in that Florida hospice stated long ago that she did not want to be maintained in such a condition. What I want done for her is what she would have wanted for herself. To force her to continue in that condition is to dishonor her wishes. The issue here is not what you or I would want, but what SHE would want. The last and best thing we can do for her at this point is to honor her wishes.

    [Sorry if this posts twice, but I sent it earlier and it didn’t go through.]

12. Jim, et. al. Recently there was a young lady just north of me in Hutchinson, Ks that had been in a “non-communicative state” for over 15 years and then just started talking again. Her parents and others who cared deeply for her had given her consistent and frequent stimulation during all of that time, offering prayers and keeping hope. I have not the slightest idea of the different medical situations involved, but the length of time is roughly the same.

    Most of what passes for offical medical ethics these days is a pile of doo-doo and I place as much confidence in it.

13. Fr. Hans writes: “If Judge Greer and his fellow travellers have their way it is.”

    There have been many comments about Judge Greer, Attorney Felos, Michael Schiavo, liberals embracing the culture of death, and even about me and my “ilk.” Such a focus on ad hominem remarks distracts people from the central facts of the case. These facts as I see them are as follows:

    1. Terri Schiavo is in a PVS. This is confirmed by her behaviors and movements. It is confirmed by the documented extensive loss of brain tissue. It is confirmed by the very long time that she has existed in this condition. It is confirmed by the concensus of medical opinion. It is confirmed by the opinions of guardians ad litem Richard Pearse (1998) and Dr. Jay Wolfson (2003). Dr. Wolfson’s report also notes that even the Schindler family acknowledged that she is in a PVS (pg. 14).

    While other people have come back from comatose or other states (the woman in Kansas to which Michael refers was in a “semi-responsive” state for 20 years) what these people have in common is that they all had brains that were substantially intact. Unlike these people, Terri Schiavo’s brain has an extensive loss of brain tissue. So in assessing Terri Schiavo’s chances for recovery we have to compare like cases.

    2. Terri Schiavo expressed a wish not to be maintained in such a state as that in which she now exists. This is confirmed by a court decision in which the judge held that there was “clear and convincing” evidence of her desire.

    Fr. Hans responds that “Of course whether that evidence is actually ‘clear and convincing’ is one of the issues still unresolved given the only ‘evidence’ is Michael’s testimony. No documentation whatsoever exists.”

    With all due respect, that simply is not true. There was a hearing in which a number of people testified, NOT just Michael Schiavo. The judge considered all the testimony, and based his decision on the testimony of all witnesses. Here is an excerpt from the actual court order:

    “The court heard testimony as to various issues; most of which having little or nothing to do with the decision the court is called upon to make. The court also heard from witnesses who ran the gambit of credibility, from those clearly biased who slanted their testimony to those such as Father Murphy whom the court finds to have been completely candid. The court also has concerns about the reliability of testimony which differed from prior deposition testimony. Vague and almost self serving reasons were given for the changes including reflection, reviewed in another fashion, knowledge that this was a real issue, found a calendar, and so forth, to the extent that at trial recollections were sometimes significantly different and in one case were now ‘vivid.’ The court has had the opportunity to hear the witneses, observe their demeanor, hear inflections, note pregnant pauses, and in all manners assess credibility above and beyond the spoken or typed word. Interestingly enough, there is little discrepancy in the testimony the court must rely upon in order to arrive at its decision in this issue.”

    The court order goes on to discuss the particulars of the testimony of the FIVE witnesses who testified. So the judge’s decision was not based on Michael Schiavo’s testimony alone. While there is no documentation in the form of an advanced directive signed by Terri Schiavo, there is in fact documentation of the decision, namely the court order, trial transcripts, and related depositions.

    What all this is fundamentally about is determining what Terri Schiavo would have wanted. But this is not how her parents see it. Guardian ad litem Wolfson noted in his report that the Schindlers said that even if they knew that Terri did not want to be maintained in a PVS they would disregard those wishes: “Within the testimony, as part of the hypotheticals presented, Schindler family members stated that even if Theresa had told them of her intention to have artificial nutrition withdrawn, they would not do it” (pg. 14). Well, that’s just wrong. Medical ethics is about doing what the patient wants, not what the patient’s parents want.

    – – – – – – – – – – –

    These are the facts of the case as I see them. Now if someone wants to dispute those facts, that’s fine. But so far most of what I’ve seen are comments that do not reference these facts. If someone wants to argue that Terri Schiavo is not in a PVS, then have at it. But it’s not enough to just state that or to reject the medical concensus in favor of a particular doctor. If you want to claim that Terri Schiavo would have wanted to be maintained in a permanent, non-responsive, non-sensate state for the rest of her life, then do so. But you can’t just state that; you have to make the case. You have to deal with all the witnesses in that case. You have to attack the judge’s reasoning, not attack the judge.

14. Jim, you have a lot of faith in the judgment of one judge. Many other people don’t, including the Florida legislature, the US House of Representatives, members of the US Senate, medical professionals, and others. The issue here is not only the facts in evidence, but also those not in evidence. Restricting your decision solely to those considered by Judge Greer does not allow for any assurance the decision is credible, particularly when the lawyer and doctor seeking Terri Schiavo’s death have a track record of euthanasia activism. Justice requires a reevaluation of all facts, not only those on which Judge Greer based his decision.

15. Fr. Hans writes: “Jim, you have a lot of faith in the judgment of one judge.”

    Ok, let me throw out some very basic questions that call for very specific answers:

    1) Do you agree that the primary consideration in this case is what Terri Schiavo would want for herself? For example, if a signed and notarized advanced directive from Terri Schiavo were discovered, should we act in accordance with that document? And even if she stated explicitly that she didn’t want to be maintained in a PVS? If her wishes are not the primary consideration, then what is?

    2) Where precisely is the flaw in Judge Greer’s decision that Terri Schiavo would not want to be maintained in her current state? Since no one seems to be able to point out a flaw in the decision, why shouldn’t I have confidence in his decision? If there’s a specific flaw, let’s hear it.

    3) What exactly is the mistake that the majority of physicians seem to make in Terri Schiavo’s PVS diagnosis?

    Fr. Hans: “Many other people don’t, including the Florida legislature, the US House of Representatives, members of the US Senate, medical professionals, and others.”

    So far I have not heard any of them identify one single error that Judge Greer has made. I have not heard any of them show how a diagnosis of PVS is incorrect.

    Imagine a situation in which a person has been convicted of a crime. There is massive outrage over the conviction. People denounce the judge, criticize the jury, and vilify the prosecutor. But for some strange reason no one can really say *why* the person shoudn’t have been convicted, except just that he shouldn’t have been convicted. Virtually all the evidence points toward guilt. There don’t seem to be any procedural errors. Nonetheless people are outraged, and they just know he shouldn’t have been convicted.

    This is how the Schiavo situation seems to me. There is tremendous outrage. But the people who are outraged rarely reference the details of the case. They speak in broad, hyperbolic, irrelevant generalities in which the sky is always falling and the liberals are always coming to kill your grandmother. They are unable to identify *specific* errors in legal or medical judgement in this case. They continually direct ad hominem comments toward certain individuals even as they avoid the specifics of the case. They cling relentlessly to the Schindler version of events even as they avoid the material in the official legal record that contradicts the Schindler version. They repeat urban legends surrounding the case but are silent concerning the facts. The official legal decisions, the court records, the depositions, the transcripts, mean nothing. The opinions, case review, and analysis of the guardians ad litem mean nothing. They never reference the relevant ethical considerations of how medical decisions are actually made. They know that the decision is wrong because, well, because they just know it is wrong, and anyone who disagrees with that gut assessment is wrong.

    Taking into account the actual facts of the case, please give me *specific* reasons why Judge Greer’s opinion on Terri Schiavo’s wishes is wrong. Please give me *specific* examples of how physicians have erred in making the PVS diagnosis.

16. Here are some articles that address your questions.

    Johansen

    Weekly Standard

    Affidavits of 17 doctors asking for better medical evaluation than Judge Greer allowed:

    Terri’s Fight

    Legal issues not probed:

    Rutherford

17. It has been reported in several places that Michael Schiavo has not allowed an MRI or PET Scan of Terri. Wouldn’t this be rather important if someone wants to make a determination on the condition of the brain tissue? X-Rays cannot be used to determine the condition of soft tissue.

    Jim writes, Terri “expressed a wish not to be maintained in such a state as that in which she now exists.” Actually this is only hearsay. You can’t convict someone of jaywalking based hearsay evidence. But here we are supposed to accept hearsay to uphold the starvation of an otherwise perfectly healthy woman. Why do you hang so much on hearsay in this case?

18. To follow up on my Note 17: Michael Schiavo never once mentioned that the alleged comment Terri made, about not wanting to be kept alive in her current condition, until after the lawsuit which provided a great deal of money that was supposed to be used for Terri’s treatment and therapy. This is a fact that Jim conveniently leaves out everytime he raises the argument that “this is what Terri wants.” If there were 5 other witnesses to Terri’s statement, where were they for 9 years while the lawsuits were going on?

    Jim writes, “all the therapies have failed, and the brain itself has atrophied.”
    There hasn’t been therapy for Terri since Michael started beating the drums for Terri’s death. So that claim is wrong. There has been no MRI or PET Scans so no one knows the exact state of the brain tissue.

    From the National Review article, which Jim seems to not want to read:
    “Terri’s diagnosis was arrived at without the benefit of testing that most neurologists would consider standard for diagnosing PVS. One such test is MRI (Magnetic Resonance Imaging). MRI is widely used today, even for ailments as simple as knee injuries – but Terri has never had one. Michael has repeatedly refused to consent to one. The neurologists I have spoken to have reacted with shock upon learning this fact. One such neurologist is Dr. Peter Morin. He is a researcher specializing in degenerative brain diseases, and has both an M.D. and a Ph.D. in biochemistry from Boston University.”

    “In the course of my conversation with Dr. Morin, he made reference to the standard use of MRI and PET (Positron Emission Tomography) scans to diagnose the extent of brain injuries. He seemed to assume that these had been done for Terri. I stopped him and told him that these tests have never been done for her; that Michael had refused them.”

    “There was a moment of dead silence.”

    ” “That’s criminal,” he said, and then asked, in a tone of utter incredulity: “How can he continue as guardian? People are deliberating over this woman’s life and death and there’s been no MRI or PET?” He drew a reasonable conclusion: “These people [Michael Schiavo, George Felos, and Judge Greer] don’t want the information.” ” [emphasis added]

    ” “Dr. Morin explained that he would feel obligated to obtain the information in these tests before making a diagnosis with life and death consequences. I told him that CT (Computer-Aided Tomography) scans had been done, and were partly the basis for the finding of PVS. The doctor retorted, “Spare no expense, eh?” I asked him to explain the comment; he said that a CT scan is a much less expensive test than an MRI, but it “only gives you a tenth of the information an MRI does.” He added, “A CT scan is useful only in pretty severe cases, such as trauma, and also during the few days after an anoxic (lack of oxygen) brain injury. It?s useful in an emergency-room setting. But if the question is ischemic injury [brain damage caused by lack of blood/oxygen to part of the brain] you want an MRI and PET. For subsequent evaluation of brain injury, the CT is pretty useless unless there has been a massive stroke.” ”

    I work with medical imaging technology. A CT is really nothing more than a powerful X-Ray. With regards to the precise condition of soft tissue, after a long period of time, Dr. Morin is correct; it is almost useless. Why would the people clamoring for Terri’s death not want an MRI or PET scan unless they feel they already have the information they want.

    Jim complains that people aren’t reading the court transcripts on this case, and therefore are ignorant of the facts. Judge Greer, Felos & Michael Schiavo do not want these tests done. Who exactly are the ones who want to be ignorant in this case?

19. Correct Daniel. The facts in evidence are hand selected by Felos and Schiavo. Judge Greer went along with it. Well, no more it appears.

20. Daniel writes: “It has been reported in several places that Michael Schiavo has not allowed an MRI or PET Scan of Terri. Wouldn?t this be rather important if someone wants to make a determination on the condition of the brain tissue? X-Rays cannot be used to determine the condition of soft tissue.”

    The problem that I have is the phrase “it has been reported . . .” What I have noticed continually in almost everything having to do with this case is a great amount of rumor and misinformation floating around. Now it seems to me that if MRI or PET scans were necessary in order to determine the amount of brain tissue loss, that would have been done by now — that this would have been an issue addressed by the Schindlers. As far as I’m aware, this was never mentioned in any of the court proceedings.

    Daniel: “To follow up on my Note 17: Michael Schiavo never once mentioned that the alleged comment Terri made, about not wanting to be kept alive in her current condition, until after the lawsuit which provided a great deal of money that was supposed to be used for Terri?s treatment and therapy. This is a fact that Jim conveniently leaves out everytime he raises the argument that ?this is what Terri wants.? If there were 5 other witnesses to Terri?s statement, where were they for 9 years while the lawsuits were going on?”

    I don’t think there’s any big conspiracy here. My impression of what happened is that over the years it became clear to Michael Schiavo that there wasn’t going to be any improvement. In fact, guardian ad litem Jay Wolfson briefly discussed the process during which Michael Schiavo came to understand that improvement was not a possibility, and discuses why the issue was not raised up front.

    In general, this is the kind of case in which it’s easy to snipe from the sidelines — in which rumor has free play. Part of the reason for that is that Michael Schiavo has not had much of a public presence, largely reserving his arguments for court, in which he has continually prevailed over a period of years.

    And this is one reason why I tend not to give credence to the many rumors and innuendos in this case. A court is the venue in which facts are tried and testimony under oath is presented. Web sites and blogs are not. So I think people are within their rights to raise certain issues about the case, but I look to the courts as providing the definitive judgement.

21. Well, Jim, an MRI or PET scan, as noted in the article which you are apparently refusing to read, is required to make a determination on status of brain tissue, but it has not been done. In fact, it was raised by the Schindlers but Judge Greer on the urging of Felos & Michael Schiavo blocked it. You do not deny the fact that the tests didn’t take place, but dismiss it as “So what? If the court felt it needed it Judge Greer would have asked for it.” Unbelievable.

    Like I said above, who, exactly, is it that wants to remain ignorant in this case?

22. Daniel writes: ‘Well, Jim, an MRI or PET scan, as noted in the article which you are apparently refusing to read, is required to make a determination on status of brain tissue, but it has not been done.”

    A CAT scan can’t image brain function, but it can show basic structures:

    “CT scanning provides more detailed information on head injuries, stroke, brain tumors, and other brain diseases than do regular radiographs (plain x-ray films). It also can show bone, soft tissues and blood vessels in the same images.”
    http://www.radiologyinfo.org/content/ct_of_the_head.htm

    “CT scans can also be used to assess the size of the ventricles (the location where spinal fluid is produced) within the brain. If spinal fluid flow is blocked, the ventricles may become enlarged, a condition called hydrocephalus. In another condition, the ventricles may enlarge due to gradual loss of surrounding brain tissue, a condition called hydrocephalus ex vacuo. Because there is a fixed amount of space within the skull, if brain tissue is lost, then the ventricles enlarge to fill this space. This condition, unlike pressure hydrocephalus, does not require a shunting procedure to remove spinal fluid.”
    http://www.birf.info/artman/publish/Ed-Brainimg_doc.shtml

    As far as I know a CAT scan would be sufficient to image a very large loss of brain tissue. I just don’t think this is quite the scandal that it’s cracked up to be.

    This follows the typical pattern: announcement of some new great scandal, that proves to be either overblown or not true.

23. “As far as you know” Jim? And you’re willing to starve a woman to death based on “as far as you know”? And when board certified neurologists call it “criminal” that an MRI or PET hasn’t been done, that doesn’t bother you in the least? You run off to some website, find a few descriptions of what a CT can do and come back here with, “as far as I know a [CT] scan would be sufficient.” Like I said before, now who’s being ignorant?

    Why, why, why are you so adamant that this image of God be starved to death? Why!? Because a Judge said so?!? Is that your standard for right and wrong?!? Is that where your morality lies?!? In Legal Documents?

    I’ve listened to the recording that can be found here, something that Michael Schiavo and George Felos would not have us listen to (are you brave enough to listen to this Jim?). The voice in that recording is exactly what my sister sounded like. That’s what she sounded like before, that is, she started receiving speech therapy. But Michael Schiavo doesn’t want Terri to receive any speech therapy, does he? In fact, Terri hasn’t received any therapy whatsoever since Michael has been hounding the courts for her death in the early 90s. Now why would that be? Because Dr. Canford, who has never failed to give a PVS diagnosis when it was wanted, after whacking Terri in the head, to which she responded by moaning and turning away, decided she was PVS?

24. “Thou shalt not kill, but shouldst not strive, officiously to keep alive” This has always been one of the tenets of good Medicine (before the legal profession got its foot in the door) and, as a palliative care physician, a clinical problem with which I am not unfamiliar. To atificially keep alive someone who is permanently comatose and/or has no quality of life, against their wishes (or those of their proxy) is in most western countries regarded as common assault and is a criminal offence.

25. It is truly fascinating to look at the Classic Hippocratic Oath and the Modern Version.

    Putting aside the elements in the Classic Oath that speak to teaching medicine to “brothers in male lineage” look at those parts that speak to how a physician should practice medicine:
    “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”
    “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.”

    And the Modern Version? Well, of course, the part about ensuring that the practice of medicine is passed to those in “male lineage” is gone. That’s a positive advancement I’d say. And the rest?

    Well … also gone is the simple statement “I will keep [the sick] from harm and injustice.” It now reads “I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.” Yes, always ensure that there’s a way out if you want your patient to die. “I’m awfully sorry, Mrs. Jones, but your husband didn’t die because I refused to treat him. His expiration was due to natural causes while I simply avoided therapeutic nihilism.”

    Gone also is any reference to not giving women abortive remedies. In fact gone are all references to not giving “deadly drug to anybody who asked for it.” The Modern version recognizes the difficult situation physicians may be in: “If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty.”

    While the Modern version no longer acknowledges that a physicians, “in purity and holiness” will practice their art, it does caution them that they “must not play at God.” Well, isn’t that nice.

    In The Culture of Death, Wesley J. Smith quotes Leon Kass, “To regard life as sacred … means that it should not be violated, opposed or destroyed and that positively it should be protected, defended and preserved.” (p.19) It strikes me that the Modern Hippocratic Oath doesn’t quite agree with Dr. Kass’s statement.

    As Dr. Ward has shown us, the Hippocratic Oath has transformed from the popularly understood, “First do no harm”, to “Thou shalt not kill, but shouldst not strive, officiously to keep alive.” Forgive me if I disagree with the good Doctor, but his version most certainly has not been “one of the tenets of good Medicine.” It is one of the tenets of the culture of death. And do not blame the change on lawyers, Doctor. It is your own profession bowing down before utilitarian philosphers, like Joseph Fletcher and Peter Singer, and bioethicists that has enshrined this evil idea that it is a doctor’s job to kill his patients.

26. Daniel writes: “‘As far as you know’ Jim? And you’re willing to starve a woman to death based on ‘as far as you know’?”

    Well, I don’t claim to have perfect knowledge. I say “as far as I know,” because I’m not physician. So I have to rely on what I read. And no one is starving her. A medical intervention is being withdrawn in response to a legal determination that she does not want to be kept alive in her current condition. If you want to impose that interpretation on it that’s your business, but I reject that language.

    Daniel: “And when board certified neurologists call it ‘criminal’ that an MRI or PET hasn’t been done, that doesn’t bother you in the least?”

    Anybody can say anything. The guy could be a fraud or a fruitcake for all I know. He could be dishonest. I have no way of knowing. As I mentioned before there’s been a tremendous amount of misinformation surrounding this case. What if one board certified neurologist says that it’s criminal and 5,000 others say it isn’t? I’m not rejecting his opinion merely because he’s on the opposite side of the issue. I just don’t take a single opinion as definitive.

    For example, here’s an analysis of some recent “expert” opinion that’s been floating around the net:

    “Moreover, most of the “experts” are quite upfront about having viewed only heavily-edited videos, whereas the trial judge and the doctors who saw the uncut footage saw no evidence of consciousness. Several of the affidavit filers state explicitly that their opinions are based on video clips from Terri’s parents’ website!

    “Not a single one of the so-called experts has even examined Terri. Generally speaking it is considered unethical for a physician to diagnose a patient without examining her. Only a handful of the “experts” even claimed to have reviewed her medical records. Most filed from outside the state of Florida.

    “Two of the experts identified by the Schiavo Foundation website as “Dr.” hold no doctoral degree of any kind (speech and language pathologists Hyikn and and Lakas), and a third claims to have a doctorate in “neuroscience” but admits under oath that his PhD is in clinical psychology (Dr. Hooper).

    “Dr. Ralph Ankenman is a psychiatrist who wants to treat Terri with Namenda (memantine) a drug indicated only for Alzheimer’s disease. . . .Dr. Beatrice Engstrand believes Terri is conscious based on ‘a television show that [she] watched’ and her experience caring for the Central Park Jogger in 1989. . . . Dr. Richard Neubaeur wants to treat Terri with hyperbaric therapy, herbs, and acupuncture. It should also be noted that Dr. Neubaeur is also the owner of the largest neurological hyperbaric clinic in Florida and that his affidavit reads like an infomercial. . . . Dr. Carolyn Heron’s affidavit contains at least two elementary errors about the neuropathology of PVS. She argues that the fact that Terri’s swallowing reflex is partially preserved indicates that she is not in a PVS. In fact, the reflexive component of swallowing is often preserved to various degrees in patients with PVS (cf. Cole G, Cowie VA. Clin Neuropathol. 1987;6:104-9.) . . . . Dr. Lawrence Huntoon’s assessment is based on video clips from ‘Terri Schiavo’s web site’ . . . Perhaps the most bizarre contribution comes from Dr. Richard Weidman, the head physician at the US Department of Engraving and Printing. He has not examined Terri Schiavo, instead he bases his opinions on his experiences with his mother, who had Alzheimer’s disease . . . ”
    From http://majikthise.typepad.com/majikthise_/2005/03/red_herrings_17.html

    So pardon me if I’m a little wary of the latest and greatest expert opinion.

    Daniel: “Like I said before, now who’s being ignorant?”

    There is an important difference between not falling head over heels over a single opinion vs. not having a grasp of the basic facts and documents related to the case.

    Daniel: “Why, why, why are you so adamant that this image of God be starved to death? Why!? Because a Judge said so?!? Is that your standard for right and wrong?!? Is that where your morality lies?!? In Legal Documents?”

    Where to start . . . . Have you read any of Judge Greer’s orders? I have. From what I read he’s very attentive to the details. He carefully considers evidence. He has been presented with cases by competent attorneys. He’s heard witnesses on both sides. He has heard from independent physicians and from those chosen by the parties. If you don’t like him, keep in mind that his decisions have been upheld on appeal. If you don’t like the appeals court his interpretation of the facts is also consistent with the interpretation of the facts and case review done by Dr. Jay Wolfson, guardian ad litem appointed by the State of Florida.

    The issue is not “just because a judge said so,” but because of the evidence and testimony presented, the process, the judge’s consideration, and the confirmation at the appeals level, etc.

    What if it’s true that a) Terri Schiavo would not want to be maintained in her current state, and b) she is in fact in a PVS, has no awareness, no consciousness, and will never recover? Would any of that matter to you? In other words, is there any possible evidence or testimony that would convince you that the feeding tube should be removed?

    Daniel: “I’ve listened to the recording that can be found here, something that Michael Schiavo and George Felos would not have us listen to (are you brave enough to listen to this Jim?).”

    Whether it sounded like your sister is irrelevant because you sister’s condition was not the same.
    I listened to it. It shows that you can present a recorded excerpt and make it look like she’s responding. Everything I’ve read indicates that she makes such vocalizations even when people aren’t in the room or aren’t trying to elicit a response. What about all the times when she makes vocalizations like that in response to nothing? What about when she’s silent even as people beg her to respond — the exact experience of the most recent guardian ad litem?

    Daniel: Terri hasn’t received any therapy whatsoever since Michael has been hounding the courts for her death in the early 90s. Now why would that be?”

    Because Michael Schiavo came to understand that his wife’s condition is permanent and irreversible, and that any further therapy was futile.

27. Here’s a description of the time that Jay Wolfson, most recent guardian ad litem, spent with Terri Schiavo:
    ———————————–
    When awake, Schiavo’s eyes rolled about the room. She made random noises that sounded like groaning or the start of a laugh or cry.

    But court documents said Schiavo’s cerebral cortex, where reason and emotions are housed, had degenerated to fluid. So Wolfson set about trying to determine whether Schiavo’s noises and jerks were merely reflexive or if they indicated something more.

    He played Elton John CDs for her, and Bach and Mozart and music from the late 1980s, when she was in her 20s, prior to her collapse. He held her hands, squeezing them, and stroked her hair and face.

    He put his face close to hers and tried to make eye contact, pleading desperately, trying to will her into giving him any kind of sign.

    “I would beg her, `Please, Terri, help me,'” he said. “You want to believe there’s some connection. You hope she’s going to sit up and bed and say, `Hey, I’m really here, but don’t tell anybody.’ Or, `I’m really here, tell everybody!'”

    But Schiavo never made eye contact. When Wolfson visited her when her parents were there, she never made eye contact with them either, he said. And for all of Wolfson’s pleadings and coaxing, he never got what he most wanted: a sign.
    http://www.realcities.com/mld/krwashington/11175622.htm

28. “… no one is starving her. A medical intervention is being withdrawn …”

    Man with gun: “Officer, I didn’t shoot her in head. I just happened to be standing there when a metalic projectile issued forth from an instrument in my hand, and this projectile just happened to be passing by at such high velociy that when it struck her cranium, that just happened to be in the projectiles path, it just happened to impact with a tremendous amount of deconstructive force. But I didn’t shoot her.”
    Officer: “Oh, well since you put it that way, you can go home.”

    Removing this “medical intervention” is tantamount to smothering someone who has the audacity to keep breathing when you take them off artificial ventilation.

29. I will grant you this, Jim, you are with the cultural elite on this issue. I’m not at all convinced that the federal judge now looking at this case will do the right thing, which is hold in high regard the sanctity of life, and rule in favor of the parents. In fact, I believe he will rule with Judge Greer, not because the facts of the case support it, but because the law and medicine have been taken over by an elite that believes it, alone, can determine when life is worthy of life.

    Michael Schiavo was right about one thing (in the many interviews he’s done instead of being where he belongs at his dying wife’s side), this kind of thing happens all the time. People do not want to be burdened with a handicapped relative, and when given an out by a doctor or hospice attendant to end the suffering they feel by seeing their handicapped relative, not necessarily the suffering of the handicapped person, they take it. They are not happy about it, but in a few days, they convince themselves that they did the right thing, that their handicapped relative is in a better place.

    I’ll confess, I have thought that my family would have been much better off if my sister had died. It is a very hard thing to care for a brain damaged adult. I wince inside when I see my 41 year old sister with the mental functioning of a small child. It is a very painful for me. But because it causes me pain doesn’t mean that I have the right to end her life, that her’s is a life not worth living.

    Micheal Schiavo used his wife’s tragedy to win a lawsuit, then, for some reason, he decided to discard his cross because it was too much of a burden. He simply didn’t want to carry it any further. Fine, then he should just go away. Don’t come in at the end and tell everyone that Terri didn’t want to live this way, when there’s nothing else that supports this. Just walk away, and let Terri’s parents pick up the burden. None of the facts, as you see them Jim, explain to me why Michael Schiavo doesn’t just go away and live out his life with his new common law wife and their two children and let Terri’s parents care for her. Nothing explains this to me. I am either led to conclude that he is doing this for the money, or he is doing this so he doesn’t feel guilty for not taking care of Terri. Believe me, I know that the latter is a very strong motivator.

30. Daniel writes: “I will grant you this, Jim, you are with the cultural elite on this issue.”

    With all respect, it’s not the cultural elite. Look at the poll results. Typically in the range of 2 to 1 or 3 to 1 for removing the feeding tube. The results are greatly in favor of removing the feeding tube even among Catholics. Evangelicals are more evenly split but a majority favor removal of the tube. Even self-described conservatives favor removing the tube. And this is even in light of the tremendous propaganda campaign going on, with most of the propaganda coming from the religious right. There are thousands of web sites and blogs repeating the Schindler version of events. On the other side I’ve only found maybe four or five worthwhile web sites that offer a contrary version.

    I think what has happened here is that the religious right has greatly overreached. The standard operating procedure for the religious right is to get people whipped up into a state of continual outrage and umbrage. This is what has happened in the Schiavo case. You find continual references to culture of death, euthanasia, holocaust, killing the infirm, murder, and so on. The problem is that most people understand that this is not what is happening.

    The bottom line is that the tactic of keeping people in continual outrage isn’t working. That’s because much of the material on which the outrage is based simply isn’t true. I listed to the entire three-hour debate in the House on Sunday and heard the same falsehoods repeated that I’ve seen here — Michael Schiavo will inherit millions of dollars, etc.

    In other words people have simply not been well-served by the so-called information presented to them.

    Daniel: “Micheal Schiavo used his wife�s tragedy to win a lawsuit, then, for some reason, he decided to discard his cross because it was too much of a burden.”

    What happened is that he realized over the years that his wife was not conscious, could not be rehabilitated, and would never recover. It’s no mystery.

31. If Michael Schaivo succeeds in murdering his wife, will we witness more of an acceptance of euthanasia as a means of dealing with disabled family members? To me, the true measure of our society is how we treat our weakest members.

32. Regarding the ABC poll the “right to die” enthusiasts are using to trumpet support for the death of Terri Schiavo: This is a classic push poll. Its questions were designed to elicit a particular response in support of suicide, assisted suicide and euthanasia.

    Take a look at some of the key questions:
    1. “How closely have you been following the case of Terri Schiavo…” This question shows that 44% of the respondent were not following the case closely at all. You talk about the level of disinformation out there about the case, I would agree with you on that. There is a tremendous amount of disinformation out there. Some disinformation is that Terri is dying or that Terri cannot swallow or that no expense has been spared to test Terri’s so-called PVS diagnosis. None of this is true, but people believe these things about this case. To me that means that 44% of the responses in this poll are invalid.

    2. “Schiavo suffered brain damage and has been on life support for 15 years.
    Doctors say she has no consciousness and her condition is irreversible.” The only part of this statement that is accurately reflects the truth is that Terri suffered brain damage. She has not been on life support for 15 years any more than you and I have been on life support because we eat every day. Some doctors have said her condition is irreverisible and some have said she can improve if she was given therapy, which she hasn’t received since 1992. Despite the fact that it asks about removing the feeding tube it has already set up the condition that Terri is beyond hope. Clearly the polsters are trying to lead those being polled to answer, “Yes, Terri should be allowed to die.” That alone is an odd place to lead those being polled since Terri was not dying until her food and water was witheld.

    3. “If you were in this condition, would you want to be kept alive, or not?” What exactly is the relevance of this? Does that mean that because John & Jane Doe wouldn’t want to live this way then we can put someone who is in this condition to death? Is this how we are going to decide who has a right to life? I wouldn’t want to live out my life in a wheelchair. Does that mean we should start locking paraplegics in hospice facilities and depriving them of food and water, or what you call “medical interventions”?

    But, for the sake of argument, let’s accept these poll findings as completely valid. Again this doesn’t surprise me because most people don’t give much thought to life and death, most people don’t want to have to care for an handicapped relative, and most people think it is a morally good choice to allow people who are handicapped or have some debilitating disease to kill themselves. They have bought into this because most people have accepted without question what the cultural elites have sold them. That is why two films about assisted suicide – Million Dollar Baby and The Sea Inside – can win accolades in Hollywood and those no one bats an eye. In fact, it is the people who are critical of these films that are attacked.

    Furthermore, media outlets keep referring to the Terri Schiavo case as a “right to die” case. This is a lie, but it is spun this way in because the media elites support assisted suicide. It never was a “right to die” case because Terri, during the court deliberations, was never dying. That is a fact. This is a passive euthanasia case. This is a case of killing a woman because her husband tells us that she wouldn’t want to live that way. I would bet you if the media reported the story in as I’ve factually described it, the ABC poll would be different. No one should think of this case as turning off grannies respirator so she can quietly expire. People should think about Kevorkian putting plastic bags over peoples heads in order to suffocate the imfirm.

    Some more information that should be kept in mind when evaluating this poll.
    1. Even after hearing about what a tragic case this is how many people are still are refusing to face these issues? According to this poll 51% have not “had any discussions with friends or family members about what [they] would want done if you were in this condition.” So a majority of those polled still refuse to face end of life issues. They don’t want to talk about these issues as it relates to them personally, but I should care that they have an opinion about how these issues effect Terri Schiavo?

    2. How many of those polled have ever had to make a life or death decision for a friend or relative? 66% have never had to personally deal with removing life support from a friend or family member. And of those who have personally experienced this only 18% were actually involved in the decision making. It should be noted that this question again confuses the issues in the Schiavo case – Terri is not on life support, she is merely being fed and given fluids by another.

33. Firstly, Physicians do not swear the hippocratic oath, which in any case is a pagan one. Secondly, “primum non nocere” (first do no harm) overides all – the point I make is that to administer anything, food or medication, or to undertake surgery against a patient’s will is to assault that patient and deprives him or her of automony and dignity. To force feed a patient who is unable to feed him or herself to artificially prolong life when such has been refused lays the doctor open to prosecution, civil action and is also a sin against God.

    This is not euthanasia. It is allowing nature to run its course. There is nothing in any medical oath that requires a doctor to prolong someone’s suffering artificially or unnecessarily.

34. “It is one of the tenets of the culture of death. And do not blame the change on lawyers, Doctor. It is your own profession bowing down before utilitarian philosphers, like Joseph Fletcher and Peter Singer, and bioethicists that has enshrined this evil idea that it is a doctor’s job to kill his patients” – Daniel.

    Just watch whom you allege is bowing down to unitarianism, friend. I happen to be an Orthodox Christian and active member of ROCOR. I neither believe in euthanasia nor abortion, although you seem quite pleased that the anti-abortion clause in the Pagan Hippocratic oath has been removed. The problem with modern society and North American society specifically, is that people think that this life is forever, to the point where brain dead are artificially kept “alive” in intensive care units for long periods of time. If that’s how you want to spend your last days, months or years go for it – but put it in a “living will”, there’s a good chap, or your poor doctor might end up being charged with criminal assault.

35. Note 33. Christopher Reeves couldn’t feed himself. Should we have let him starve too?

36. Fr. Hans writes: “Christopher Reeves couldn’t feed himself. Should we have let him starve too?”

    You’re comparing someone who didn’t want to live in a PVS with someone who wanted to live in spite of paralysis.

    But let’s go with your example. Suppose Christopher Reeve decided early on that he didn’t want to live that way and ordered, in full knowledge of the consequences, that the ventillator be turned off. What are you going to do? Force him to be ventillated when he doesn’t want it?

    What do we do when a diabetic doesn’t control his blood sugar? Arrest him and inject him with insulin? Or when someone with emphysema continues to smoke? Or when someone with cancer decides not to receive chemotherapy?

    There’s a very fundamental issue here — the right of an adult, competent patient to decide which medical interventions or advice he will or will not accept. If a person can’t make that most personal of decisions, why should we allow people to make any decisions?

    Once again I ask the question that I’ve asked three times before, so far without answer: If Terry Schiavo truly expressed a desire not to live in her current condition, should we continue to keep her alive contrary to her wishes?

37. There is no documentation this woman wanted to die. All we have is hearsay. When you argue for “patient autonomy” you really mean “judicial autonomy” given that the decision to kill this woman was made without due process. The standards are lowered because she is handicapped. All we need from now on in order to kill a handicapped person is the comment of a spouse.

    You ask: “Once again I ask the question that I?ve asked three times before, so far without answer: If Terry Schiavo truly expressed a desire not to live in her current condition, should we continue to keep her alive contrary to her wishes?”

    I have already answered that living wills need to be honored, but let’s at least establish the minimal standard that a signed paper needs to be on file somewhere.

    Ted Bundy got more consideration than she did. It’s a crime to starve a dog in Florida. Yet euthanasia advocates hail this as victory. In fact its judicial tyranny of the worst sort. The culture of death marches forward.

38. “living wills need to be honored”
    Absent a living will, the right to make medical decisions goes to the spouse (whether we like their decision or not). It’s one of the “benefits” of marriage. Do we need to revisit whether this law is prudent?

39. Fr. Hans writes: “I have already answered that living wills need to be honored, but let’s at least establish the minimal standard that a signed paper needs to be on file somewhere.”

    Ok, thanks for the clarification. I wasn’t trying to be difficult. But some people are not in favor of terminating any life-sustaining measures under any conditions. As I mentioned previously, the Schindlers are on record saying that even if they knew Terri didn’t want to be kept alive they would ignore those wishes anyway.

    I’ll be the first to admit that there’s a lot about this case that I wish were different — that she weren’t sick in the first place, that the terrible brain damage had not occurred, that she had left clear written instructions on what she wanted done, that money had not brought the complication of possible conflicts of interest (for BOTH the Schindlers and Michael Schiavo, as the guardian’s report makes clear), that the families had not ended up in dispute, that Terri Schiavo had not become a political symbol and cause celebre, and that a long-term campaign of misinformation had not clouded so many issues.

    But the fact that there are many unfortunate complicating factors does not relieve us of trying to ascertain Terri Schiavo’s wishes. As Dr. Ward rightly pointed out a physician cannot force life-sustaining measures on a patient without a determination that this is what the patient would have wanted. You can’t just say “well, there’s no written document so we’ll err on the side of life and perpetually maintain her in this incurable, insensate condition wihtout making any attempt to know if she wanted to live like that.” It doesn’t work that way, nor should it.

    And so you have to make a decision about what the patient would have wanted based on the information that is available. You make the best decision that you can while acknowledging that it may not be the perfect decision. The vast majority of the time this decision is made by the family in consultation with the patient’s physician, clergy, and other advisors, and you never hear about it. This time it was made in the courts and then second-guessed and re-tried in the court of public opinion.

    And so there is a “minimal standard,” but it’s not a standard of documentation. The minimal standard is that you always try to ascertain the patient’s wishes, in spite of the complicating factors, and however difficult that may be. It’s a process that works reasonably well. It doesn’t mean that there won’t be difficult cases and tough calls and sometimes questionable decisions. But overall I believe we’re far better with that process than without it.

40. Read Krauthammer’s article.

41. Note 38. In practice it works differently than you might think. End of life decisions can be gut wrenching, but the imminent death of a person is usually a certainty, not time or date necessarily but certainly with the week or so. When this time approaches, the discussions about what kind of medical intervention begin.

    Keep in mind also that living wills indicate intention. They cannot forcast events. Every death is different, and people die for a host of different medical reasons. Sometimes the heart stops. Sometimes the kidneys fail. Some deaths require significant amounts of pain medication, others very little.

    The decision is ultimately a family decision, and considerable work may occur to arrive at a concensus — a necessary process for the peace of the family after their loved one passes away. In cases like the Terri Schiavo situation where a family is split, the dynamics get very difficult and a concensus may not be possible to achieve.

    In the Schiavo case, the disregard for the family apart from Michael along with no documentation of Terri’s intent is one issue that clouds this affair. Also, Terri was not dying. The unclarity regarding her diagnosis makes the entire decision to pull the tubes ambiguous (a point made by the dissenting judge in the Atlanta appeal). Remember, Terri’s death is forced. She is being killed. She had not entered the stage of life where death was imminent.

42. Dr. Ward, this is a passive euthanasia case not a “right to die” case because Terri Schiavo is not dying (at least she wasn’t until food and water were withheld). Terri Schiavo did not give Michael Schiavo power of attorney to make end of life decisions. Terri Schiavo did not write a living will stating that she would like food and water withheld if she is in the condition she is in today. Michael Schiavo is arguing for killing Terri, because he thinks she wouldn’t want to live this way.

    In this case we have one side arguing that Terri wants to die so the “husband” can move on with his life, and the other side says Terri wants to live and who want to assume all responsibility for her. In short, one side favors death and the other life. True, Judge Greer (may his name be blotted out) ruled in favor of Michael. I want someone to explain to me where has the moral core of the court has gone that it falls down in favor of death instead of life?

43. From Krauthammer: “There is no good outcome to this case. Except perhaps if Florida and the other states were to amend their laws and resolve conflicts among loved ones differently — by granting authority not necessarily to the spouse but to whatever first-degree relative (even if in the minority) chooses life and is committed to support it.”

    This seems a little inconsistent with the views stated previously regarding the inviolability of civil marriage, no? Would this law only be applicable if a spouse is seen to be in violation of the marriage contract? Krauthammer doesn’t say, although I’m willing to bet it’d be irrelevant.

    This is why I’ve stated repeatedly my concerns regarding the way civil marriage is viewed: no matter whom I was married to, I’d still want my parents to have a say in the way my medical decisions were handled were I incapacitated.

44. Regarding my comments about the Hippocratic Oath, I either did not express myself clearly, or, Doctor, you must read more closely. I was in fact mocking the modern version which removed the anti-abortion parts. I am absolutely NOT “quite pleased” that this portion has been removed. That the classic version was pagan, well, I wouldn’t exactly say that your version was an improvement.

    Stating that you’re an active member of the Russian Orthodox Church Outside Russia carries no weight with me. All you’re doing is make a fallacious argument from authority, while avoiding the point I made that, in general, medicine has tossed out the “sanctity of life” ethic and now bows down before “quality of life” thinking that started with utilitarian philosophers like Fletcher and reached its epitome with people like Peter Singer. I would think the last thing an active member of ROCOR would want is to be perceived as defending people like Peter Singer.

    I pray, Doctor, that, as an Orthodox Christian, you still hold to the “sanctity of life” ethic, not the “quality of life” ethic; and that you would not be standing with Michael Schiavo in this case (but that doesn?t seem to be the case, does it?). Sanctity of life does not mean that people who are “brain dead” are forced with machinery to stay alive (it should be noted that Terri is not “brain dead”). Sanctity of life does allow for a person’s natural passing. Starvation and dehydration, however, are not natural ways to die.

45. Unfortunate Complicating Factors Are Not Rare but a Constant

    Whenever a member of a family is ill, it creates a burden on the remaining family members. Given that burden and given human nature there is always the incentive to look for ways to terminate the life of a sick family member, if for no other reason than to be free of the burden of hospital visits and doctor consultations. Husbands and wives might want to be free to marry someone else. Some family members might be better off if a sick family member with dangerous knowledge of wrongdoing isn’t around any more. If the sick family member also owns or controls property the incentive is even higher. Unfortunately, the practice of law gives you a complete education in the depravity of human nature.

    During my twenty plus years as an attorney I have been involved with more than 30 different estates. Some of the estates were large most were mid-size, middle class families. I have seen people become snarling dogs over inanimate objects with limited monetary value. I can just imagine the rancor that would arise in the case of a genuine controversy with a large amount at stake. The entire “right-to-die” movement ignores this aspect of human nature.

    Lastly, even given the highest level of formality to guard against forgery and deceit, what about people who change their minds? What if I signed a living will in good faith in January and by February I changed my mind? What if I hadn’t gotten to my safety deposit box to change the living will? This is dangerous nonsense may heaven help us.

46. The OCA weighed in on this issues. Sadly, the comments show a complete lack of understanding of the key moral issues and an amazing diregard for the truth of the situation. Such moral relativistic stance is unbelievable!

    ____________________________________________________________
    Thoughts on the Terri Schiavo Case
    http://www.oca.org/QA.asp?ID=235&SID=3

    QUESTION:

    In general, how should an Orthodox Christian view the current situation with Terry Schiavo? I guess one of the issues is that of extraordinary means. Does the Church have a position on extraordinary means? I presume it does but then what are extraordinary means? Does the Church consider a feeding tube extraordinary means?

    Another related question would be: How does the Orthodox Church view the matter of a person’s wishes in the event they ended up in a vegetative state? In other words, does anyone have the moral right to deny themselves food, water, etc. If they enter a vegetative state or would that be considered suicide. I was reading in the paper today that doctors speak of a sort of spectrum here. On one end would be coma, then the vegetative state and finally brain death. Maybe you could comment on whether the Church would make a distinction between these states and what would be allowed or not allowed in each instance. For example, I would guess that the Church would consider a person in a coma should be treated as any other living person and that a brain-dead person would be considered as having already died. But, where would a person in a vegetative state fall, in the Church’s view? And does it depend at all on the factors listed above e.g. so-called quality of life, prognosis of recovery, length of time in the state or whatever?

    ——————————————————————————–

    ANSWER:

    YOU WRITE: In general, how should an Orthodox Christian view the current situation with Terry Schiavo?

    RESPONSE: The principle affirmed by the Orthodox Church is that, while extraordinary/unnatural means should not be taken to prolong a life, especially in the case of brain death, it is also the case that extraordinary/unnatural means should not be taken to prematurely end it. The problem in the Schiavo case is that there is no real consensus, whether it be among her husband and parents and other family members or within the medical establishment, as to whether she is in fact brain dead. While I am certainly no specialist in this, from what I have seen she seems to be responsive on some level and is obviously not in a coma. As such, it would only be my opinion that to hasten her death would be morally and ethically wrong. I have seen people, including my own father, who were brain dead, and from my uneducated perspective his and their situations were quite different from that of Mrs. Schiavo.

    YOU WRITE: I guess one of the issues is that of extraordinary means. Does the Church have a position on extraordinary means?

    RESPONSE: Yes, as stated above. In the case of my father, whose heart had been stopped for over two hours — far longer than necessary for brain death — and who had been hooked up to a respirator with no chance of ever being able to breath or function on his own, the procedure was clearly extraordinary, and after two futile days, he was removed from support after it was clear that in no way would he be able to breath or function without assistance. Mrs. Schiavo, however, does not appear to be in this same vegetative state.

    YOU WRITE: I presume it does but then what are extraordinary means?

    RESPONSE: The example of my father would constitute extraordinary means. The respirator did not assist him in breathing; rather, it breathed for him. As the doctor himself opined at that time, one could hook up a child’s inflatable swimming pool up to the respirator, and it would force it to “breathe.” Pumping air into someone or something, and forcing the air out, in reality does not constitute “breathing.” The doctor noted that if he were to be removed from the respirator, there would be no way that he could breathe on his own, since there was absolutely no brain activity.

    The flip side of “extraordinary means” comes in bringing a life to a premature ending, as in the case of administering medications designed to literally kill a suffering person, a la Dr. Kevorkian.

    And one must always be concerned with such buzz terms and concepts as “quality of life,” “death with dignity,” and so on. “Quality of life” is a highly subjective term, while “death with dignity,” depending on its precise meaning, stands in conflict with the Orthodox Christian belief that death is always a tragedy, that death, not being part of God’s creation, is always “unnatural,” inasmuch as we were not initially created to die. [Here we’re reminded by Saint Paul that death came into the world as a consequence of sin, not by the express will of the Creator.]

    YOU WRITE: Does the Church consider a feeding tube extraordinary means?

    RESPONSE: The answer is relative, depending on the condition of the individual. In my father’s case, it — the respirator — was clearly an extraordinary/unnatural means, inasmuch as it was clear that he would never breathe or function in any way, due to brain death. In the case of Mrs. Schiavo, for whom no real consensus has been forthcoming yet who clearly is in a different “place” than one who is totally unresponsive on any level, the feeding tube would not be seen as extraordinary / unnatural means. What makes it even more complicated in the case of Mrs. Schiavo is that there are some who have opined that with appropriate therapy, she might return to her former state. While this clearly seems to be a “long shot,” it is equally clear that she may be responsive on some level, and as such, it is impossible for anyone to know what is really and completely going on “in her head,” so to speak.

    YOU WRITE: Another related question would be: How does the Orthodox Church view the matter of a person’s wishes in the event they ended up in a vegetative state? In other words, does anyone have the moral right to deny themselves food, water, etc. If they enter a vegetative state or would that be considered suicide.

    RESPONSE: Based on the principle noted above, it would seem that one who requests that no extraordinary/unnatural means of prolong life, especially if brain death occurs, would not be inappropriate and would not constitute suicide, strictly speaking. This is different than requesting a lethal injection of a death delivering substance should one be diagnosed with a terminal illness. For example, the cancer patient who, rather than facing his or her illness requests to be euthanized would not be acting morally or ethically, inasmuch as what he or she is requesting is essentially assisted suicide — which is, indeed, suicide.

    YOU WRITE: I was reading in the paper today that doctors speak of a sort of spectrum here. On one end would be coma, then the vegetative state and finally brain death. Maybe you could comment on whether the Church would make a distinction between these states and what would be allowed or not allowed in each instance.

    RESPONSE: Obviously, these matters, much less such distinctions, are not found in the traditional writings of the Holy Fathers; this is “new territory,” so to speak. It is clear that coma is not synonymous with brain death, and there have been numerous cases — one just a few weeks ago — of individuals who have been in comas for years suddenly emerging from them, to the shock of family and physicians alike. Brain death is something completely different, from my uneducated perspective. Taking extraordinary means to prolong the life of a brain dead individual, on the notion that they might “snap out of it,” as in the case of so many coma victims, is more than a “long shot.” I must clarify that this is my opinion, and I must also note that it is a somewhat uneducated one, at best.

    YOU WRITE: For example, I would guess that the Church would consider a person in a coma should be treated as any other living person and that a brain-dead person would be considered as having already died.

    RESPONSE: This would be reasonable, given the Church’s definition of death as the parting of the soul from the body.

    YOU WRITE: But, where would a person in a vegetative state fall, in the Church’s view?

    RESPONSE: Again, the term “vegetative state” is somewhat subjective. One can say that Mrs. Schiavo is in such a state because she is completely dependent on others; at the same time, one could say that my father was in such a state as, being brain dead, he was completely dependent on others. For that matter, one could say that a newborn infant is also totally dependent on others — “vegetative” in a different sense of the word. This would seem to indicate that there can be different “shades” of the vegetative state — but I do not want to delve into the area of pure speculation, other than to observe that there is a lot of “gray area” here.

    YOU WRITE: And does it depend at all on the factors listed above e.g. so-called quality of life, prognosis of recovery, length of time in the state or whatever?

    RESPONSE: Each case would have to be evaluated on its own merits from the pastoral as well as medical perspectives.

    Hope this helps.

    In Christ,

    Father John Matusiak
    OCA Communications Director

47. This insistence on equating liberalism with the ” culture of death ” is offensive nonsense. How about capital punishment? Isn’t that death? And who supports capital punishment? That would be the political right. Who has supported the war in Iraq? Why that would be the political right once again. So if you want to accurately identify members of the ” culture of death ” then you need to include many conservatives as well as liberals. The use of handy, snap phrases to describe groups of complex human beings is foolish and ultimately misleading. I am as liberal as they come but I am Pro Life, anti capital punishment and against war for any reason other than a response to a direct attack on American soil. You know what else? There are many other left leaning folks who share my views.

48. Note 47: Dead civilians on the wrong side of a war in which we’re engaged are not dead civilians, they’re “collateral damage”. Capital punishment isn’t murder, it’s Old Testament retribution against people who are 80% likely to be guilty but 100% guilty-looking. In the case of Terri Schiavo, you can make medical decisions for your spouse if you’re married, but you can’t make medical decisions for your spouse if you’re married.

    I think Lewis Carroll devised this logic …

49. Daniel: If you possess a dictionary, look up the word decerebrate.

    Sanctitiy of life does not preclude taking into account a person’s quality of life, life expectancy or imply that withdrawal of life-supporting treatment is evil. Another word you might look up is compassion. Don’t class me with Peter Singer; I deal with dying people all the time and sanctity of life is of prime importance. That does not mean keeping people alive contrary to nature just for the sake of it. I assume from your posts that you are a young person. Read more than one book and don’t be so arrogantly dogmatic. Also, mind your manners when addressing your elders.

50. I know that killing someone is wrong, but deeply all of you ask yourself if you would be able to watch your child live through that. I couldn’t. I personally would have done anything to not have my child suffer. I wouldn’t want to live like that too. This is a lesson for all. Have your living wills done. My heart goes out to the parents and also husband and childrenl. May God be with them through this horrifying ordel.

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