An epilogue on Terri Schiavo.

Just an excellent, well thought out article by a physician.

The opinions expressed above are very widespread in the medical community today. Variations of these views are espoused by many of the physicians with whom I have discussed this topic. For this reason, they cannot be lightly brushed aside. Please understand that the issue is not autonomy (which is an independent and important issue), but the definition of life. Is the cerebral cortex what makes us human and is it true that “if the cortex is dead, then the human individual is dead”?

Of course not. My physician critic clearly has stepped beyond the bounds of medicine into the realm of philosophy, and that is the problem. As any physician knows, there is neither a state in America nor any sane physician in the world who would declare that someone who is in a persistent vegetative state is dead. If PVS really equals death then why bother pulling the feeding tube? Just bury the patient with the feeding tube still in place! The doctor’s comments are clearly hyperbole, and represent a very insidious type of bias that leads people to equate PVS with death.

Terri Schiavo did not die of PVS; she died of starvation and dehydration.

Why do people do it? Because it allows them to feel comfortable that they are not murdering someone if the person that they “kill” is already dead. Terry Schiavo was not dead until two weeks after her feeding tube was removed. She did not die of PVS; she died of starvation and dehydration.

As hard as it may be for physicians to accept, the definition of death is not a medical one; it is a philosophical and societal one. While physicians certainly may participate in the debate, the value of their opinions should be weighed based on merit, not medical training. There are no medical criteria that can answer the fundamental question of what is life and what is death. Once society decides how it wants to determine death, then the physician is called upon to use his or her expert knowledge to confirm that the criteria have been met. While physicians may use their expertise to offer information to society’s decision-makers so that the definition of death is grounded in accurate information, they have no more proficiency in the areas of ethics or philosophy than anyone else.

Hat tip, Open Book Blog.

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