Wednesday, March 23, 2005

Terri Schiavo: Second Opinions on Second Opinions

Last night in a post-playoff basketball stupor, I caught a discussion of the Terri Schiavo case on CNN's Lou Dobbs Tonight. Dobbs had on two medical ethicists as well as Jay Wolfson, Terri's guardian ad litem, an independent party appointed by the court to advocate for the best interests of an abused or neglected person — most often a child.

Wolfson was impressive for his obvious compassion for all parties in the case and for his refusal to make any personal judgments. He stated that he spent prolonged periods in Terri's room, trying to assess the reality of her condition throughout the 30 days of his investigation on behalf of the Terri and the state.

Because he was so careful in what he said, I'm reluctant to paraphrase, so I will quote from a 38-page report Wolfson made in December 2003 to Florida Governor Jeb Bush and the 6th District Court.

"There are instances where she appears to respond specifically to her mother. But these are not repetitive or consistent. There were instances during the GAL’s visits, when responses seemed possible, but they were not consistent in any way.

"This having been said, Theresa has a distinct presence about her. Being with Theresa, holding her hand, looking into her eyes and watching how she is lovingly treated by Michael, her parents and family and the clinical staff at hospice is an emotional experience. It would be easy to detach from her if she were comatose, asleep with her eyes closed and made no noises. This is the confusing thing for the lay person about persistent vegetative states.

"Theresa’s neurological tests and CT scans indicate objective measures of the persistent vegetative state. These data indicate that Theresa’s cerebral cortex is principally liquid, having shrunken due to the severe anoxic trauma experienced thirteen years ago. The initial oxygen deprivation caused damage that could not be repaired, and the brain tissue in that area continued to devolve. It is noteworthy to recall that from the time of her collapse, and for more than three years, Theresa did receive active physical, occupational, speech and even recreational therapy."

On PoliBlog, there's an excellent digest of Wolfson's report by Dr. Steven Taylor. Read it before you're tempted to put any credence in the diagnosis of Dr. Bill "4-minute Videotape Exam" Frist, or the latest new evidence of misdiagnosis from Gov. Jeb "Found Me a Good Christian Doctor to Give a Second Opinion, Though He Hasn't Actually Examined the Patient" Bush. (For a diagnosis of Dr. Frist, using the good senator's own hands-off technique, see Night Light.)

Dr. William Cheshire is the doctor who asserts Terri Schiavo is "most likely in a state of minimal consciousness." Since so many reputable physicians and court officers like Wolfson have weighed in on the case, I was curious about the medical credentials of the Mayo Clinic (Jacksonville) neurosurgeon, who has lately come forward with this new information that suggests she may regain consciousness, according the Florida authorities.

A link to recent medical publications from his official Mayo page yielded only one draft paper — by another author. It was in response to a Cheshire paper entitled, "Human Embryo Research and the Language of Moral Uncertainty," which appeared in The American Journal of Bioethics and is only available free online in abstract.

The article appears to examine where there is bias in reporting about embryo research. "Concerned readers should take notice when any category of humanity becomes subject to prejudicial and disparaging language and the value of vulnerable human life is trivialized alongside sensational assertions of anticipated medical cures."

This statement apparently refers to anticipated benefits of stem cell research, although "sensational assertions of anticipated medical cures" could just as easily describe the latest transparent attempt to revise Terri Schiavo's prognosis.

More digging revealed Cheshire as a speaker at "Stem Cell Research & Human Cloning: Where Do We Draw the Line?" — a symposium sponsored by New England School of Law, a bottom quartile law school in Boston. And he published "Returning to the Judaic Roots of the Christian Faith" in Restore, the publication of the Restoration Foundation.

It turns out Dr. Cheshire is also Director of Biotechnology Ethics for the Center for Bioethics and Human Dignity which appears to have strong links to Focus on the Family, Dr. James Dobson's special mission, Moody Broadcasting and the Moody Bible Institute. The Center for Bioethics and Human Dignity gives a more in-depth biography than the Mayo Clinic, the only employer cited in the news accounts.

By the way, the Center's Speakers Bureau niftily provides a key to evaluate potential speakers as to religious affiliation, whether they believe the principles of the Bible offer counsel to all or most ethical decisions, and whether they would be considered pro-life. Dr. Cheshire isn't listed there, so we can only guess.

(By the way, Cheshire's Christianity isn't the point here. It's the lack of any other evidence of scholarly or clinical research in the field where he is being held up as an authority by citing his affiliation with a brand-name medical clinic.)

Just who was Terri's mother addressing when she pleaded, that legislators not play politics with her daughter's life? Surely not Tom DeLay, who remarked of Micheal Schiavo: "I don't have a lot of respect for a man who has treated a woman in this way," he said. "What kind of man is he?"

According to Jay Wolfson, Terri's Guardian ad Litem, this is the kind of man Michael is:

"Proceedings concluded that there was no basis for the removal of Michael as Guardian. Further, it was determined that he had been very aggressive and attentive in his care of Theresa. His demanding concern for her well being and meticulous care by the nursing home earned him the characterization by the administrator as 'a nursing home administrator’s nightmare.' It is notable that through more than thirteen years after Theresa’s collapse, she has never had a bedsore."

[For four years] "he had insistently held to the premise that Theresa could recover and the evidence is incontrovertible that he gave his heart and soul to her treatment and care. This was in the face of consistent medical reports indicating that there was little or no likelihood for her improvement."

Do these politicians really believe now they can just say anything at all and not be called to account? Terri Schiavo's great legacy could be tilting the hypocritical wing of the Party in Power toward self-destruction.


Blogger Charlie Quimby said...

I see David V. of Left2Right has dredged up some other great Dr. Cheshire treasures, including a 34-stanza poem on euthanasia!

10:13 PM  
Blogger Charlie Quimby said...

And yet another example of Dr. Frist's embrace of the Hypocritic Oath — from Eschaton.

7:33 PM  

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