Judgenfuhrer Greer: "We black-robed Mullahs are fully aware that death by starvation instead of gas chamber
WAS the penalty for people trying to escape Auschwitz.
Pound sand and your so-called Constitution because they enjoy it."
Posted on 03/27/2005 6:21:04 AM PST by billorites
As an oncologist I frequently deal with the terminal care of patients and with end of life situations, and these are invariably complicated by the potential availability of medical interventions that can prolong life indefinitely. Such cases need to be individualized. They are never easy, are invariably wrenching and take their emotional toll on everyone –patients, relatives, loved ones and myself. But in such difficult situations with enough thought and concern and empathetic communication between the patient, their relatives and the hospital or hospice staff, a course of action that is decent, humane and compassionate usually can be reached for each individual patient.
Although I have not examined Teri Schiavo and do not have access to her medical records, there are a number of pertinent medical facts that are clear from the videos I have seen of her and from the results of diagnostic studies that have made their way into the news media. A number of years ago she apparently had a CT scan which showed severe atrophy of the brain cortex. Under such circumstances, performing a follow up MRI and/or PET scan would not be medically indicated because these more sensitive brain scans would not give her physicians any additional information (that is, MRI and PET scans would undoubtedly also show the same severe cortical brain atrophy).
Consistent with this CT scan her EEG (which measures the electrical activity generated from her brain) has been reported to be “flatline.” This does not mean she is “brain dead” (a provocative and medically useless term). She is clearly not “brain dead” because the “lower” regions of her brain that control her breathing and heart beat are definitely functioning. Rather the EEG (like the CT scan) is a good measure of “upper” brain function which includes rational thought, the use and interpretation of language, processing of visual and auditory input (sight and sound) and voluntary movement.
All of these “upper” brain functions appear gone in this poor woman. Indeed Teri Schiavo is paralyzed not from spinal cord damage but from damage to these upper portions of the brain that control these voluntary movements. In addition to being totally paralyzed she likely does not have any voluntary control over her bladder or bowel function, she likely cannot swallow, and she likely has difficulty coughing up or clearing her normal mouth and/or upper airway secretions.
It is difficult for any physician to determine whether this poor woman is feeling any pain. The regions of the brain which are largely responsible for processing pain stimuli are approximately midway between the upper and lower brain regions and no type of brain scan or EEG can be helpful in determining her level of pain. Some physicians who have examined her have suggested that Teri Schiavo is in an “intermittently conscious” rather than a “persistently vegetative” state and that she shows signs of being intermittently in pain. Unfortunately, if there is any pain, then she likely has great difficulty in communicating to others that she is in pain/distress, which for all we know might be severe and excruciating.
In determining the degree of medical intervention, it is best, in my mind, that the physician ignore political and religious dogma, set aside the political ramifications of this case, forget any ulterior financial motives and the adultery of Teri Schiavo’s husband, and honestly try to determine what is the most decent, humane and compassionate approach to take with this fellow human being, Terri Schiavo.
Should medical intervention (i.e. a feeding tube surgically placed through her skin into her stomach) be continued to indefinitely prolong the life of this woman, who is totally helpless and paralyzed and likely nearly blind, who cannot swallow and enjoy any food, who cannot communicate with the loved ones around her and likely cannot even understand what they have to say to her, who is incapable of rational thought, who may be in intermittent and perhaps severe pain and yet cannot get relief from this pain because she cannot communicate her distress to others, and who has been in this state for the past 15 years with no hope for recovery? What would I want for myself in this situation? What would I want for my children in this situation? What is the most decent and humane and compassionate approach to take?
In the case of Teri Schiavo in my mind the above issues are the only relevant questions - questions that unfortunately I fail to see being addressed by the politicians, the religious sector, and the media pundits and columnists who have offered their varied opinions.
Dr. Steve Collins is Medical Oncologist and Professor of Medicine at the Fred Hutchinson Cancer Research Center in Seattle
Another physician who believes that what is happening in Florida is the correct move. Let the villification begin.
I have lost total respect for judges, and about 90% for "Physicians". In the various talk shows, I have heard a total of SIX people call, state that they are doctors, then state that starving this woman is correct.
On the other hand, her parents see their daughter, whom they love & want the best for. They still see a bit of Terri inside of there & feel that with encouragement and love, that Terri could have a much better quality of life. She is obviously not getting it in a hospice. Her family is willing to take on the care of her so her husband can get on with his life.
If she can feel pain intermittently, can she also not feel pleasure intermittently? She is still a human being and she is still loved. This is a senseless death.
OK. I have seen the record of the doctor who supervised the CAT scan. He has presided over the deaths of numerous patients. It's his profession--declaring that patients deserve to be killed.
Considering the corrupt and unsavory character of all the participants, and the fact that George Felos presides over the nursing home, how do we know that that CAT scan was even Terri's?
Is that paranoid? Sure. But I don't trust the opinion of a doctor who has never seen the patient and is going by an old record of dubious provenance.
Has he seen the Xrays showing all the broken bones? Has he seen the patient herself?
I've had plenty of CAT scans myself, and they don't necessarily show much detail. Much depends on the chemicals injected into the system when the scan is taken. Why do Terri's caretakers refuse to let her be properly examined?
As an oncologist, a lot of this guy's patients die, but he is talking beyond his expertise here and he is going on the basis of dubious secondhand evidence.
Why is it constantly brought up?
And yet it's never occured to you that perhaps removing the tube truly is the more compassionate thing to do? The amount of denial around here has been amazing in the last 10 days.
Get the opinion of some radiation oncologists and surgeons who asctually do.
I have lost even more respect for irrational, religous zealots.
What you said.
As a physician, I concur with you completely.
Rationalization, justification, changing the subject from starving and dehydrating a living human being to death...just a few thoughts.
If talking beyond your expertise is a crime, then 99.9% of all the Schiavo related posts should be removed from Free Republic, including all of yours and all of mine. This "Expertise" requirement is being selectively applied to only those who are falling on the side of Michael Schiavo. You wouldn't be challenging this guy's expertise if he was a 2nd year med student, provided he concluded that the tube should be reinserted, and you know it.
I think this man asks good questions. He is as even-handed as anyone else I've heard on the subject. I believe that Terri Schiavo is being tortured to death through dehydration. I think that those who feel we cannot afford the simple act of judeo/christian charity all people claim to possess and make the necesary arrangements to feed her, then those people should step up to the plate and advocate lethal injection for her. Let's put the cards on the table. If Terri should die, let's accord her the same consideration we gave Timothy McVeigh. If the death advocates can't stomach (pardon the pun) the overt act of killing her, they should butt out of the question and let her parents decide Terri's fate.
Huh? I don't see any relevance to anything else!!!
Judgenfuhrer Greer: "We black-robed Mullahs are fully aware that death by starvation instead of gas chamber
WAS the penalty for people trying to escape Auschwitz.
Pound sand and your so-called Constitution because they enjoy it."
Ah, give them time, give them time. Little steps, one little step at a time.
"I have lost even more respect for irrational, religous zealots."
Me too.
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