Michael Arnold Glueck and Robert J. Cihak
Wednesday, Oct. 29, 2003

So says Jane M. Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS), who issued this statement in response to the emergency action of the Florida legislature to reinstate feeding and hydration of Terri Schindler-Schiavo:

"Terri Schindler-Schiavo has won a temporary stay from execution by a method too cruel to be used for convicted criminals. And yet her husband's attorney is trying to spin it into a 'death with dignity issue' with his comments on Tuesday last week."

Her husband says it's cruel to begin rehydration. The opposite is true - dehydration is a cruel, painful death. It is unconscionable that the state ordered removal of her feeding tube in the first place – it's nothing less than state-sponsored euthanasia.

Terri is not dependent on advanced medical interventions. Nothing is mechanically pumping her blood, or forcing oxygen into her lungs. She is simply being fed through a gastrostomy tube. This is not an extreme or extraordinary means of life support. Would we allow a retarded child to be starved to death?

Some physicians believe that Terri could be rehabilitated to some extent, at least so that she could swallow oral feedings and eliminate the need for the tube. She should be allowed to try, but so far her husband has blocked every attempt to see whether she can swallow. Doctors have offered pro bono treatment, if money is the barrier for her husband.

Although severely disabled, some believe that Terri does have the capacity to communicate a desire to live. Her husband has obstructed efforts at rehabilitation or independent assessments of his wife's true state. This does not mean we should be without compassion and concern for her husband, who has also suffered immensely.

Notes Dr. Orient, "Where are the 'compassionate end-of-life' groups such as the Robert Wood Johnson 'Last Acts' initiative, and why aren't they weighing in on this?"

The ethical question for her nurses and physicians – prior to the Jeb Bush "reprieve" – was whether they would cooperate in carrying out a death warrant. And the ethical question for all of us is whether we will allow the state courts to obstruct the efforts of people who want to provide the minimum of medical care to a patient who should receive it.

If we go down that path, who's to say what treatment the state will prevent you from getting?

And ultimately, looking to the future, would it not be far better for the courts, legislatures, governors and lawyers to stay out of medical care and leave the difficult decisions to those trained in the health-care professions and to their patients?

Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a past president of the Association of American Physicians and Surgeons.

Contact Drs. Glueck and Cihak by e-mail.

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