Don't get sick in Texas
The attending physician stated that the patient was definitely NOT brain dead, simply brain damaged from a stroke. The patient is NOT experiencing organ failure, meaning her lungs, heart, kidneys, liver,...everything is working. The patient has a trach collar, but she breathes on her own, and she processes food and hydration appropriately. She is free from infection. During the meeting, I pointed out that the withdrawal of food and water would effectively starve the patient to death, and the doctors dismissed me as if I did not understand medical science. I am not sure what exactly is scientific about starvation, but the patient's mother agreed and was bewildered at the discussion of withdrawal of treatment including food and water. Oh yes, did I mention that the patient has NO insurance? The medical folks involved in these cases adamantly avow that financial considerations never enter into the futility decisions; however, I have yet to hear from the family of any patients with good, adequate health insurance....
One wonders how many of these cases never reach the RightToLife folks, let alone the press...
As a doc who worked for years with the retarded, and had co authored an article on Euthanasia before it went into the headlines, the translation for all this is:
We are now going from "brain death" (turn off respirator, person dies)
to "they are in a coma and might as well be dead" to "the are persistant vegetative state and that is (almost) the same as a coma, so they might as well be dead"
to "they are not brain dead, and their family and doctors say they are awake, but they sometimes look to an outside neurologist as if they might be in persistant vegetative state, so they might as well be dead" (Terry Schiavo)
to "they are mentally handicapped, so they might as well be dead" (One of my Native American patients who a Neurologist tried to talk her family into pulling a feeding tube)
to "they are alert, they are not dying, but they have some brain damage, so they may as well be dead and anyway, they don't have insurance, and look at all the money they are costing us"...
"Medical futility" means that treating you will not make you normal...so treating you is futile.
And the definition of medical treatment here is a feeding tube, but don't be confused, since Dr. Ronald Cranford told the court in one case that even spoon feeding is a "intrusive medical treatment".
Now, none of this is the same as keeping a dying person comfortable.
And one wonders why "bioethics" specialists seem more alarmed at this than rejoicing...maybe because if word gets out, fewer people will trust the diagnosis of PVS, which as I noted in an earlier post, is wrong 45% of the time.
Sorry for the rant...
anyone who want more references, I can supply them...
One wonders how many of these cases never reach the RightToLife folks, let alone the press...
As a doc who worked for years with the retarded, and had co authored an article on Euthanasia before it went into the headlines, the translation for all this is:
We are now going from "brain death" (turn off respirator, person dies)
to "they are in a coma and might as well be dead" to "the are persistant vegetative state and that is (almost) the same as a coma, so they might as well be dead"
to "they are not brain dead, and their family and doctors say they are awake, but they sometimes look to an outside neurologist as if they might be in persistant vegetative state, so they might as well be dead" (Terry Schiavo)
to "they are mentally handicapped, so they might as well be dead" (One of my Native American patients who a Neurologist tried to talk her family into pulling a feeding tube)
to "they are alert, they are not dying, but they have some brain damage, so they may as well be dead and anyway, they don't have insurance, and look at all the money they are costing us"...
"Medical futility" means that treating you will not make you normal...so treating you is futile.
And the definition of medical treatment here is a feeding tube, but don't be confused, since Dr. Ronald Cranford told the court in one case that even spoon feeding is a "intrusive medical treatment".
Now, none of this is the same as keeping a dying person comfortable.
And one wonders why "bioethics" specialists seem more alarmed at this than rejoicing...maybe because if word gets out, fewer people will trust the diagnosis of PVS, which as I noted in an earlier post, is wrong 45% of the time.
Sorry for the rant...
anyone who want more references, I can supply them...
posted by Nancy Reyes at
7:36 AM
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