Re: cruzan v schiavo what a difference a decade makes

So now it comes out. You think that it is not "constitutional" to allow a
husband to withdraw a feeding tube without explicit instructions to do so.
That in itself is a reasonable position. To have a discussion about that
would be constructive.

How much evidence, and what type is required to withdraw life sustaining
treatment? Like I said that is a good question, one that can be discussed.
I will say that essentially, it comes down to an overall risk benefit
analysis, and each State has laws that allow withdrawal in different
circumstances. For example, in Maryland, if there is no advanced directive,
and the care givers are relying on spouse, or other family member that was
not specifically authorized to make decisions, that persons decision making
capacity is limited to not being allowed to authorize withdrawing life
sustaining treatment unless the patient is terminaly ill, or in a PVS. The
assumption being that if the condition is as bad as those conditions, it
would not be unreasonable to think that a person would agree to withholding
life sustaining treatment, if they were able to make their wishes known. So
the amount and type of evidence that is required might be less than if the
persons condition is less severe. And the laws in each state, that appoint
decision makers when none had been previously appointed, have stood up to
constitutional scrutiny over the past 15 years that these cases have been
written.

But the laws do not make the ethical issues go away. And, from the part of
view of the medical professional, patients cannot be treated against their
wishes. They need to agree to treatment. If a surrogate is unsure about
what a patient would want, then I am sure that in most cases they would err
on the side of treatment, in a case of life sustaining treatment. But if a
surrogate was sure about what a patient would want, and if all other family
members agreed, then it would be permissible to with hold life sustaining
treatment, even if the underlying condition is completely reversable. An
example being a comatose Jehova's Witness, that will die without a blood
transfusion. And there are all variations between those extremes.

As far as your advanced directive, the problem is that you cannot forsee all
potential scenarios. And the best advanced directive is appointing someone
to be your decision maker, and discussing your wishes/values with that
person as often as it comes up.

But when there is nothing written down, and no one specifically appointed,
we (physicians) need something to go on to give us some idea of what the
patient would want. (Having a good long term relationship with your primary
physician, which happens less and less, might be a good idea.) But just
becuase someone has not written their wishes down, or specifically appointed
someone as their decision maker, does not necessarily mean that the patient
should be denied the right to having their wishes carried out.
----- Original Message -----
From: "Glenn Morton" <glennmorton@entouch.net>
To: "'D. F. Siemens, Jr.'" <dfsiemensjr@juno.com>; <rogero@saintjoe.edu>
Cc: <asa@calvin.edu>
Sent: Monday, March 28, 2005 9:58 PM
Subject: RE: cruzan v schiavo what a difference a decade makes

>> Unless there is a whopping big insurance policy, which I have
>> nowhere seen mentioned, his stand is penalizing him. There
>> was recently an offer of $1,000,000 cash to turn her care
>> over to the Schindlers.
>>
>> Have you noted that every arguer for feeding Terri tacitly
>> assumes that she is alert enough to feel what they would feel
>> if starving and dehydrated (or think they would feel)? Not
>> one considers the nature of the PVS.
>
> That is simply false, David. I have specifically given my wife
> permission to pull a feeding tube out of me. So it is not fear of pain
> on my part. My argument is about constitutional protections. Her
> preferences are not in writing. The government has the duty to protect
> life in the absence of that, IMO. The liberals used to have a saying
> that a society would be judged by how they treated their most helpless
> people. Today we abort babies by the millions and courts hold that
> feeding tubes can be removed on the testimony basically of a husband.
> If we or a court now holds that you are not mentally competent enough to
> live, you get to die.
>
> I know that there is a saying in the debate circles that if one has to
> raise Hitler, you have lost. Well, I have already lost in the Schiavo
> case so I am going to throw in the towel with a Hitler reference. It is
> instructive that Germany in the eary 30s took a eugenics turn and
> decided that killing imbeciles was a good thing to do. Scince a PVS is
> clearly an imbecile, our society is doing something similar to what the
> Germans thought OK in the early 30s. Hipp Hipp hooray for us. I, for
> one, am saddened at the prospect
>
>
> They all "know" that
>> neurologists and judges are wrong. Indeed, I just heard
>> someone asking why one of the Bushes doesn't break the law to
>> rescue her. Also, I have seen none note that Terri was given
>> aggressive therapy for five years without positive result? If
>> immediate therapy was useless, why would therapy after
>> fifteen years have a positive effect? Dave
>
> I am also saddened that those who hold life as a precious gift are
> mocked by you.
>>
>
Received on Mon Mar 28 22:47:18 2005