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Exultate Justi
Wednesday, February 16, 2005
 
A Painless Death? - Revisited


Around two years ago, when the Terri Schiavo case first broke upon the national stage, I wrote a couple of posts - More Terri Schiavo, and The Weekly Standard On Schiavo's Dehydration. In those two pieces, I excerpted parts of a Weekly Standard piece (written by Wesley Smith) on the agony of death by dehydration, and titled A "Painless" Death?

This article recounts, in harrowing detail, the experiences of a woman named Kate Adamson, who had - at the advice of her doctors, who believed that she would never emerge from a stroke-induced Persistent Vegetative State (PVS) - had her feeding tubes removed, in preparation for a surgery to remove a bowel obstruction. She was without food or water for eight days. Rather than being unaware of her surroundings, or the things happening to her (as her doctors beleived her to be), she was trapped in a nightmare world, where - though fully aware and sensate - she was unable to respond. From the Smith piece:

In preparation for this article, I contacted Adamson for more details about the torture she experienced while being dehydrated. She told me about having been operated upon (to remove the bowel obstruction) with inadequate anesthesia when doctors believed she was unconscious:


The agony of going without food was a constant pain that lasted not several hours like my operation did, but several days. You have to endure the physical pain and on top of that you have to endure the emotional pain. Your whole body cries out, "Feed me. I am alive and a person, don't let me die, for God's Sake! Somebody feed me."
Unbelievably, she described being deprived of food and water as "far worse" than experiencing the pain of abdominal surgery. Despite having been on an on an IV saline solution, Adamson still had horrible thirst:


"I craved anything to drink. Anything. I obsessively visualized drinking from a huge bottle of orange Gatorade. And I hate orange Gatorade. I did receive lemon flavored mouth swabs to alleviate dryness but they did nothing to slack my desperate thirst."

Apologists for dehydrating patients like Terri might respond that Terri is not conscious and locked-in as Adamson was but in a persistent vegetative state and thus would feel nothing. Yet, the PVS diagnosis is often mistaken--as indeed it was in Adamson's case. And while the courts have all ruled that Terri is unconscious based on medical testimony, this is strongly disputed by other medical experts and Terri's family who insist that she is interactive with them. Moreover, it is undisputed that whatever her actual level of awareness, Terri does react to painful stimuli. Intriguingly, her doctor testified he prescribes pain medication for her every month during the course of her menstrual period.


BEYOND THE TERRI SCHIAVO CASE, it is undisputed that conscious cognitively disabled patients are dehydrated in nursing homes and hospitals throughout the country almost as a matter of routine. Dr. Cranford, for example, openly admitted in his Wendland testimony that he removes feeding tubes from conscious patients. Thus, many other people may also have experienced the agony described by Adamson and worse, given that dehydrating to death goes on for about a week longer than she experienced.


AT THIS POINT, defenders of removing feeding tubes from people with profound cognitive disabilities might claim that whatever painful sensations dehydration may cause, these patients receive palliating drugs to ensure that their deaths are peaceful. But note: Adamson either did not receive such medications, or if she did, they didn't work. Moreover, because these disabled people usually can't communicate, it is impossible to know precisely what they experience. Thus, when asked in a deposition what he would do to prevent Robert Wendland from suffering during his dehydration, Dr. Cranford responded that he would give morphine but that the dose would be "arbitrary" because "you don't know how much he's suffering, you don't know how much aware he is . . . You're guessing at the dose." At trial, Cranford suggested he might have to put Wendland into a coma, a bitter irony considering that he had struggled over many months to regain consciousness.

The time has come to face the gut wrenching possibility that conscious cognitively disabled people whose feeding tubes are removed--as opposed to patients who are actively dying and choose to stop eating--may die agonizing deaths. This, of course, has tremendous relevance in the Terri Schiavo case and many others like it. Indeed, the last thing anyone wants is for people to die slowly and agonizingly of thirst, desperately craving a refreshing drink of orange Gatorade they know will never come.
Once again, we find ourselves having to speak up, and to fight for the life of a woman whose mother and father simply wish to care for her throughout the rest of her life. They are opposed by a husband who has since moved in, and fathered a child with a lover. Michael Schiavo refuses to simply divorce Terri, and move on with his life. In point of fact, he wants her dead. Conveniently enough, he is the only person with whom Terri ever shared her "desire" to be taken off of life support in a situation like the one in which she now finds herself. There is no corroborating evidence to support Michael Schiavo's assertions to the contrary.

Once again, we find ourselves with a clear line of demarcation running across our society - a line between those who would determine for voiceless others whether or not their lives meet an arbitrary standard of quality, and are therefore "worth living", and those who point out that maybe, just maybe, when the issue involved is the taking of an innocent human life - the stoppage of a heartbeat, and the premature elimination of a person who is loved by someone else - it might be wise to err on the side of caution.

The term "evolution", in its purest sense, has nothing to do with origins. It simply describes change. Certainly, in that we, as a culture have changed, one could accurately say that we have "evolved". There is no more clear indication of this fact than the passion that is now expended in declaring the mercy inherent in robbing the life from a person who has not sought to have that gift taken from them, and is rendered incapable of defending themselves.

What is now called mercy, was once simply known as murder.

When this crude Darwinism is the rule of the day, why should one be surprised when "survival of the fittest" makes no provision for the helpless?

God gives life to man. Man kills God. Man turns on himself, and wonders why he's left alone.


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