Death Watch

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62 Responses

  1. Joe Schick says:

    “In 1973, all fifty state legislatures had laws against abortion.”

    That is not accurate – a number of states had by then passed laws allowing abortion on demand up to 24 weeks. In the late ’60’s and early 70’s, prior to Roe, abortion was being legalized in many of the states.

  2. Gil Student says:

    “the right to kill unwanted babies?”

    Toby, certainly you know that many abortions, perhaps most, are not halakhically considered to be murder. If not, see this post on my blog: http://hirhurim.blogspot.com/2005/03/abortion-ii.html

  3. lawyer says:

    Joe already beat me to the punch-but legalized abortion was spreading through the country like wildfire before Roe v.
    Wade. I’m not sure of the timing but certainly New York State had legalized it before 1973. Note that part of the reasoning of Roe v, Wade is impinging on doctors rights. Probably because Blackmun was general counsel of the Mayo Clinic before becoming a judge. Politically-it was only a matter of time before it would have become legalized in the whole country. I’m not saying I like the abortion culture-but the right to do what one chooses is ingrained in US culture. Thats why we can relatively easily be frum Jews in the US.

  4. Seth Gordon says:

    According to the polls (see http://pollingreport.com/news.htm), over 75% of Americans would not want to be kept alive if they were in Terry Schiavo’s condition, about 60% would have made the same decision for their spouse if the spouse was in that condition, and at least 70% believe Congress and the President should not have intervened in the Schiavo case. I don’t think all these people consider themselves liberals or feminists. (If they did, then John Kerry would have won by a landslide in November.)

    This is not an issue of religion versus atheism; it’s an issue of competing views of whether or not Terry Schiavo’s “soul has irrecoverably fled” (http://delong.typepad.com/sdj/2005/03/we_mourn.html), and of what the proper role of the state is in this situation.

    I should also note that if it’s immoral to remove the feeding tube of someone in a persistent vegetative state, then it doesn’t matter whether Mr. Schiavo is trying to “get rid of an unwanted wife” or whether he is demonstrating his loyalty to her through his efforts to fulfill her desires.

  5. Seth Gordon says:

    To follow up Joe Schick’s comment: one of the most permissive abortion laws before Roe v. Wade was a California law signed by that well-known liberal, Governor Ronald Wilson Reagan.

  6. a says:

    “This one is so outrageous, I find myself hyperventilating just thinking about it. Let’s call a spade a spade. The “right to die” is Newspeak for the “right to kill.”

    No one really knows what Terri wants, or would have wanted. We have only the word of the husband who wants her dead. The judge who sentenced her to death believes her husband because, he has said, “I would not want to live that way.” News flash: no one would want to live that way! Does that mean that death is the only reasonable option!? ”

    Okay, so you are against all proxies then? Parents acting for children? Children acting later for parents (as guardians or power of attorney)?

    The only issue is whether he has nefarious purposes. The courts found he was being truthful. Thus, she had expressed a desire to die in such circumstances.

    The allegations about him being abusive is a very, very belated attempt to distinguish him from the norm in such circumstances.

  7. Seth Gordon says:

    http://abstractappeal.com/schiavo/infopage.html has a timeline of the Schiavo case with links to all the relevant legal documents. In the first February 2000 decision authorizing the removal of the feeding tube, the judge noted that…

    (a) Ms. Schiavo had expressed a desire not to be “hooked up to a machine” to people other than her husband, and the judge found those other witnesses’ testimony to be credible

    (b) Mr. Schiavo and the Schindlers appeared to have their falling out after Mr. Schiavo refused to split his loss-of-consortium malpractice award with them, and if he divorced his wife, then the Schindlers would become her heirs, so everybody involved in this case is tainted by financial interest.

  8. JW says:

    Part of the problem is that people are totally ignoring the history of this case. I can’t understand why everyone makes claims like “her husband wants her dead”. Her cardiac arrest (which precipitated her current condition) happened in 1990 — for many years after this, until about 1998 I think, her husband brought her to specialist after specialist to see what could be done to improve her condition or at least give her a partial recovery. Everything they tried failed. He made a huge effort on her behalf toward her recovery and nothing they tried worked. She had told him earlier that she would not want to be kept alive artificially — hooked up to machines. It’s his report of her desires against her family’s beliefs. Her family is on record as having said that even if Terri had made a written request (ie. in a living will) to not be kept alive artificially, they would have ignored it.

  9. Menachem Yehuda says:

    “The only issue is whether he has nefarious purposes. The courts found he was being truthful. Thus, she had expressed a desire to die in such circumstances.”
    Wrong! in fact the only issue is whether she is considered alive, and on that issue I don’t think that there is any disagreement.
    The argument that the Liberals make is that her life is not of high enough quality to preserve, and if she wants to die we should not interfere. But the Torah takes a very different perspective. Chazal tell us that three things are beyond our control; birth, life, and death. She is alive, and even if her husband’s motives are pure and she truly did say such a thing, we still should not starve her.
    I find it quite ironic that the same people who are deciding which lives are worth something are accusing others of “playing G-d”.
    Finally let me say that I agree with “a”, the only relevant legal issue is whether the husband has alterior motives, but I think that Toby’s point is that this is a sad state of affairs.

  10. a says:

    Menachem Yehuda,

    1. We do not live in a halachic state. Neither Michael nor Terri Schiavo are halachically Jewish, nor do they consider themselves bound by the halacha.

    2. I agree that a troubling aspect of this case is that Terri Schiavo’s tubes are being pulled when she is neither suffering nor in danger of immediate death. I do not quite understand why that is legal and would personally be for that being impermissible in whatever state I lived in.

    3. Judaism sometimes prefers death where secular law prefers life, i.e. three cardinal sins and martyrdom, fighting in milchemet mitzvah. Yet there, one takes his life into his own hands to (but we would say of course we are doing G-d’s Will).

    4. G-d bless Terri Schiavo and her family.

  11. Shira Leibowitz Schmidt says:

    There have been several comments on this blog on the blurring of the difference between providing food and water (in normal fashion or intravenously) and being “kept alive artificially – hooked up to machines” (to quote one commentator). I thought that halakha forbids discontinuing food & water, but that it does not insist on “hooking up to machines” and other heroic measures. Providing food and water is not what is meant by “hooking up to machines.” I would like to hear more about this critical difference.
    There seems to be a slippery slope here. Some agree that utilizing machines or taking heroic measures (e.g. experimental medicines and surgery) are optional, but then people tend to slide from this position into saying food & water are optional. It seems to me that intentionally stopping nourishment borders on murder. Could someone with expertise in this area comment? (For the sake of simplicity, let’s say this drama were taking place in Israel and all concerned – judge, patient, husband – were Jews.) Even if a patient bound by halakha had clearly indicated she didn’t want food & water, is such a declaration halachically valid and can others discontinue such nourishment?
    Shira Schmidt – Shushan Purim

  12. Zev says:

    “I’m not saying I like the abortion culture-but the right to do what one chooses is ingrained in US culture. Thats why we can relatively easily be frum Jews in the US.”

    It was relatively easy to be frum in the US before abortion culture set in too. Believe it or not, we can be frum even if unwanted babies are not killed.

  13. Sholom Simon says:

    Why are some so insistent on using phrases such as “the right to kill unwanted babies?”

    1. Halacha does not consider a fetus a baby; and
    2. (As R Student, above, pointed out) In many cases abortion is not considered murder

    Should we conclude that such emotion-laden-incorrect language is an attempt to infuse the discussion with emotion, to obfuscate inconvenient facts?

    One my study partners’ daughter, sadly, had a big problem with her pregnancy, just last year. They are halachic Jews, and went to a halachic authority, who recommended an abortion. (Zev, are you paying attention?). Isn’t it great that we live in a country where such a decision can be made by a couple and their rabbi, rather than Congress?

  14. Sholom Simon says:

    Toby — there are too many things factually incorrect to even know where to start. A few have been pointed out by other commentators. Here’s another one:

    “Orwellian: “brain dead.” Terri is not brain dead. Her EKG does not show a flat line.”

    What does an “EKG” which measures her heart, have to do with her brain? That’s a non-sequitor. In fact her “EEG”, which does measure her brain activity, is, indeed, flat.

    BTW, let me pose another question:

    We know that there is a halachic problem with removing a tube, as it is an active hastening of death. Is there a halachic problem, however, with letting the food on the other end of the tube run out?

  15. Zev says:

    Sholom Simon objects to my referring to unwanted babies as such, since halachah doesn’t consider them babies. I don’t see the relevance of what they are considered halachically; I call them “babies” because that is what they are. When your expectant wife tells you about the kicking, she doesn’t say that the fetus kicked; she talks about the baby. And when the child is quiescent, she says that the baby is sleeping. And when, God forbid, a woman suffers a miscarriage, she knows that what she lost was a baby. So if playing word games makes Sholom feel better about the things he supports, he’s welcome to do so, but I won’t oblige.
    Besides, abortion *is* sometimes considered retzichah, and *is* sometimes considered shefichas damim, and many, many of the abortions performed in the States, perhaps even the majority, fall into one of those two categories, so let’s not pretend that according to halachah, everything is just peachy keen.
    As for SS’s rhetorical question: “Isn’t it great that we live in a country where such a decision can be made by a couple and their rabbi, rather than Congress?”
    Yes, it’s great that we live in a country with religious freedom. It’s not great that the sanctity of life is being devalued in our country through the practice of such abominations as abortion on demand, partial-birth abortion and euthanasia.

  16. Sholom Simon says:

    Zev — you don’t know what I support. But I can tell you this: I support accuracy in facts. As to your comment: “I don’t see the relevance of what they are considered halachically” — I am very surprised. If a fetus, chas v’shalom, would cause the death of an expectant mother, halacha demands an abortion. And yes, I suppose some religious Christians might say that we are killing unwanted babies, but Judaism would not.

  17. Sholom, are you saying it if an abortion is halachically mandated because it would cause the death of an expected mother that it is “considered halachically” to be a “fetus” not a “baby”? Are there different Hebrew terms for those that are defined based on whether an abortion is permitted? I could be wrong, but I don’t think so.

    When the continuation of a pregancy could result in the death of the mother (how can she be a “mother” without a “baby”?), the baby/fetus is termed a “rodef” (pursuer), and thus acquires the same status as a someone who is pursing an innocent person with intent to commit murder. Obviously, the baby/fetus does not have intent as such, but that does not mean it’s “considered halachically” to be a non-baby. Lee Harvey Oswald was not a “fetus” when he killed President Kennedy just because he was a rodef.

  18. Zev says:

    Sholom, why do you pretend that all abortions are performed to save the mother when in fact the vast majority are not. In all those other cases, the babies, yes babies, are unwanted, and are killed on that account. As for what you support, it is all too clear from your comments.

  19. Michael says:

    Sholom, while Toby may be guilty of a typo, your error is far more grave than merely confusing an EEG and EKG. Terri’s EEG is not flat. Were it flat they would not be giving her morphine.

    “The records show that the second dose was given after nurses noticed ‘light moaning and facial grimacing and tensing of arms,’ he said.” “He” is George Felos, Michael’s attorney, who has been trying to put Terri to death. He says that she feels pain. Maybe no more than an animal does, but she feels pain.

    If you starve an animal to death, you will be put in jail. Why is Terri worse than an animal?

  20. dilbert says:

    Ms. Katz’s venom towards liberals makes me think that my comments will fall on ears that in her case will be deaf, but hopefully others reading this still have a glimmer of an open mind. I am proud to be called a liberal. Liberals stand for equality in education, not letting rich private schools get richer. Liberals stand for more money for the poor and homeless, avoiding tax cuts for the wealthy, equal rights under law for minorities, no descrimination against women, blacks, Jews, and other groups. Liberals are against coorporate welfare, for the rights of the working person. Liberals work towards equal opportunity, against country clubs that descriminate. Seems that all of these are consonant with Torah values. In pursuit of these goals, liberals also have included rights for things that are not Torah values, homosexuality, abortion on demand, and others. However, one can be a liberal and still be opposed to the non-Torah parts of the agenda. Overall, liberal values fit much better with the Torah than the Conservative agenda and what GWB and cronies have done.

    Feminism has brought many benefits to todays society, specifically that women are treated with respect, and have opportunities for advancement in society that were denied them previously. Ms. Katz, I dont know if you have a daughter, but if you do, she will have a lot more opportuinty to advance in society(if she wishes) and professionally all because of feminism. And if chas v’shalom she is carrying a baby that has Tay Sacks disease, she can have it aborted if she wishes(if she follows the Tzitz Eliezer shita and not Rav Moshe Feinstein). If there was a law making abortion illegal, she would not have that choice.

    Finally, there is a long tradition of autonomy in american medical and legal ethics, which far predates the abortion issue. There is absolutely no connection between the abortion issue and this case. In this case, American law recognizes the autonomy of the person to make a decision not to accept food/water. It is quite simple. Your histrionics and exaggerations do not do you justice, nor add credence to your arguements.

  21. Sholom Simon says:

    I plea for a bit of accuracy here. Including a plea that when I am attacked, my words are reported accurately. I also plea that people do not be so presumptuous as to attribute positions to people when they don’t know.

    1. Zev, I in no way did, or imply, that “that all abortions are performed to save the mother.” The point I was makaing only needed that _some_ are.

    2. Michael, you claim that the EEG is not flat. Dr. Ronald Cranford, the neurologist and medical ethicist at the University of Minnesota Medical School who examined Ms. Schiavo on behalf of the Florida courts, said there was no doubt that Ms. Schiavo was in a persistent vegetative state and that “Her CAT scan shows massive shrinkage of the brain,” he said. “Her EEG is flat – flat. There’s no electrical activity coming from her brain.”

    Now, I’m not a neurologist, nor did I see her EEG. I can only rely on what I read. But at least I have a reliable source here that asserts her EEG is flat. Do you have a source that says otherwise?

    3. Zev, you write: “As for what you support, it is all too clear from your comments.” What I “support” isn’t even clear to me — how in the world do _you_ think it’s clear?

    4. FWIW, I am a halachic Jew, and I have no doubt that if I were in Terri’s husband’s place, I would follow the p’sak of a rabbi. OTOH, I am also aware that neither the Florida legislature, nor Terri, nor her husband, nor the judge, are Jews. I am unclear where to draw the line between following halacha and imposing it on others. FOr me, it’s a hard, confusing case — perhaps I am just dense — that is made all the harder by all the factual inaccuracies and ad hominem attacks.

    My purpose in this thread has been, mostly, to attempt to correct blatant inaccuracies where I see them. Unfortunately, some see that as an advocate for a position. Nothing could be further from the truth.

  22. Zev says:

    Sholom,

    In one of your comments on this thread, you wrote that living halachically depends upon free access to abortion; this implies support for abortion.

    You protested my use of the term “killing of unwanted babies,” saying that I was using emotion-laden language to obfuscate inconvenient facts. To which inconvenient facts were you referring? You can only have meant the inconvenient “fact” that abortion on demand does not equal the killing of unwanted babies. To me, that implies support for abortion.

    As for whether you said that all abortions are performed to save the mother, you did imply that, in your reply to my description of abortion as the killing of unwanted babies, and our subsequent exchange, but detailing it takes too much effort for me right now.

  23. shanna says:

    In one of your comments on this thread, you wrote that living halachically depends upon free access to abortion; this implies support for abortion.

    It most certainly does not. Living halachically also depends upon free access to many things that an individual may not support (such as a vegetarian who does not want to see shechita outlawed).

  24. Cara says:

    I find it incredibly interesting that so much of this country is so busy turning this into a religious-political debate, insulting one another and hurling epithets right and left, and yet so few people seem to notice one extremely important fact:

    The United States Congress has no jurisdiction here. The President of the United States has no jurisdiction here.

    This debate should not be about whether Mr. Schiavo is right or wrong. It shouldn’t be about abortion. It should be about the rights of private citizens and the interference of the government.

    Who do you want to make your medical decisions if you are not able to do so yourself: the people who raised you? Very logical. The person you married? Also logical (allowing for circumstances, of course). Your children or siblings? Again, logical.

    Politicians? I don’t think so.

  25. Zev says:

    Re. whether Schiavo’s EEG is flat, see this article by Nat Hentoff, which in general is a powerful indictment of what amounts to judicial malpractice in this case:

    http://www.villagevoice.com/news/0513,hentoff,62489,6.html

  26. Zev says:

    Shanna wrote: “It most certainly does not.”

    Yes, it does. If living halachically is an imperative, and it is contingent upon access to abortion, then one who wishes to live halachically must perforce support abortion.

    Of course, the whole thing is a red herring, because the one is actually not contingent upon the other, but that point has already been made.

    Cara finds it interesting that a matter of personal rights is being debated as though it has something to do with morality. I find it amazing that a person can observe this case *without* comprehending what it says about contemporary morality, or the lack of it.

  27. Michael says:

    Sholom,

    Either Dr. Cranford or Michael Schiavo’s own attorney (who was merely repeating what the doctors said on-site) is wrong. Considering the consequences of being wrong in this case, this alone should be enough to have the feeding tube re-inserted.

    The Labor Law Talk Encyclopedia was the first site in a google search to give a good definition of brain death:

    A brain dead individual has no electrical activity and no clinical evidence of brain function on neurologic examination (no response to pain, no cranial nerve reflexes (pupillary response (fixed pupils), oculocephalic reflex, corneal reflexes), and no spontaneous respirations).

    In other words, the fact that Terri Schiavo feels pain — according to the statement of Michael’s attorney, George Felos — is clear and conclusive evidence that her EEG is not flat.

    Do we get it yet? She’s being murdered.

  28. Cara says:

    Zev, discuss the moral issues all you want. I’m not saying that there aren’t real ethical dilemmas involved.

    What I am saying is that there are constitutional limits to what the Unites States government can and cannot so, and that those limits have been violated. This is not meant to brush aside the moral debate, but to draw attention to a different aspect of this case that holds equally horrifying repercussions for society.

  29. Zev says:

    Article III of the Constitution grants Congress the power to establish and ordain courts. That can certainly be read as allowing Congress to order the federal judiciary to revisit a particular case, which is all Congress did in this case. I don’t see any horrifying repercussions arising from that. The real horror is the cruel state-ordered murder of this poor woman.

  30. Jack says:

    The government has no place within this discussion. The essay above was nothing more than an error filled rant and while I can appreciate the passion and discomfort it doesn’t mean that anything in it is accurate or appropriate.

    The comment about allowing proxies is to be applauded. We all have times in our lives in which others speak for us, in which they have to be allowed to speak for us. And we should offer some respect to those who do that.

    I have two children and cannot imagine the agony that Schiavo’s parents are in, but that doesn’t mean that their pain hasn’t affected their ability to see what is happening here.

    If there were real and compelling reasons to believe that she might improve, that she might reach a place in which cognitive function and communication were going to be restored it would be one thing.

    But based upon medical testimony this is not the case.

    At some point you have to take a step back and gain some perspective here.

  31. DovBear says:

    Zev, the state orders the murder of people all the time, and on flimsier evidence than what was presented in the Schavio case.

    I don’t agree that Terry Schavio is being murdered, for the reasons others have already given, but a good GOP-Jew like yourself surely recognizes the right of judges to order executions.

    Why is this case different? A court heard the testimony of multiples witnesses and mutliple doctors, and delivered an opinion that is firmly grounded in the evidence. This opinion was reviewed by two state appeal courts, and three federal courts later confirmed the decision as well.

    So what’s not to like?

    If you object to this, I hope you’ll object as forcefully to every instance of state sponsored, judicialy mandated homocide.

    But, of course you won’t.

  32. DovBear says:

    Do we get it yet? She�s being murdered.

    Michael, do you object to the death penalty? If not, you have no standing to object to this case. If this is murder, every state ordered execution is murder. If you do not recognize the rigth of the courts to hear evidence and make a life/death decision in this case, you shouldn’t recognize it any case.

  33. & says:

    Not only was abortion permitted in many states prior to Roe v. Wade, but the states that did ban it were doing so under a relatively new philosophy. Beats me how it could have been the case, but the historical evidence seems pretty clear that the set of abortion bans Roe struck down were enacted out of a fear that all these highly-reproducing immigrants were going to outbreed white, Protestant Americans, resulting in “race suicide”. Sort of like if Modern Orthodoxy started banning all forms of birth control, specifically to keep up with the Ultra-Orthodox.

    Historically, there’s been a lot of difference of opinion over when something is an abortion, and what that means. Under English common law, termination of a pregnancy wasn’t considered abortion until the mother could feel the fetus. Traditional Judaism, Islam and Christianity all believed at some point that abortion in the first trimester did not involve a human life.

    I’m not much of a fan of abortion, and have independent reservations about Roe v. Wade. But the historical background in the opinion is very well-researched; maybe we now know enough about biology to realize that abortion is more of a problem than we thought. But the lines between abortion, murder, and some random medical procedure were less than obvious to plenty of devout, pious people for centuries.

  34. Zev says:

    “If you object to this, I hope you’ll object as forcefully to every instance of state sponsored, judicialy mandated homocide.”

    Are you nuts? What does the death penalty have to do with the killing of an innocent person?

  35. Michael says:

    Dov,

    How many appeals did she get? How many opportunities were there to re-examine the evidence, given the husband’s refusal to provide care? Apparently not only is her EEG not flat, but it wasn’t even measured recently.

    The doctor said her EEG was flat. But a flat EEG means she doesn’t feel pain, and they gave her morphine because she’s feeling pain. Were this a death penalty case, you’d have a stay of execution right there.

  36. Michael says:

    You know, I just went to the web site suggested by Seth Gordon and started reading Judge Greer’s original decision.

    On page 6, the judge writes: “The unrebutted medical testimony before this court is that such death would be painless.”

    Yet on March 27, the parent’s attorney David Gibbs also said Terri Schiavo is receiving morphine for pain. George Felos, who is Michael‘s attorney, agreed and said that he was told by hospice workers that Schiavo has received two five-milligram doses of morphine, one on March 19 and another on March 26.

    Morphine is a pain medication. The only other reason to give morphine is to hasten death, and that takes much higher doses. So what happened to the “unrebutted medical testimony”?

    We’re not playing conspiracy theories here. The husband’s attorney agrees that she received medication for pain. Dov, Sholom, et al — how does that jibe with the declaration of the Court that “death would be painless?”

    Why is she receiving medication for pain that she supposedly cannot feel?

  37. Edvallace says:

    “Zev, the state orders the murder of people all the time, and on flimsier evidence than what was presented in the Schavio case.
    I don’t agree that Terry Schavio is being murdered, for the reasons others have already given, but a good GOP-Jew like yourself surely recognizes the right of judges to order executions.”

    First of all, the fact that flimsier evidence is used to sentence people to death should have bearing on Terry Schiavo’s case. Is it really okay to murder someone because “it’s done all the time with less evidence”?

    Furthermore, you cannot compare capital punishment carried out in the name of justice, and the defendant is given numerous opportunities to defend him/herself etc. etc. etc. to a case of pulling a feeding tubo out of a live woman because her husband recalls a conversation from ten years ago with no written directives etc. No comparison.

  38. a says:

    Florida law appears to consider a feeding tube part of medical procedures that a patient may reject. The courts have found that Terri Schiavo, via her husband, has rejected such medical procedures.

    I have not heard a compelling argument that would make me think the court was wrong for finding Michael Schiavo’s testimony about her desire not to live in such circumstances as truthful.

    This is a question both of personal choice and the right to die. Specifically, in what circumstances does society feel its appropriate to allow the person the right to choose to self-terminate. We know that with death approaching, especially where pain (and also where enfeeblement may occur), death is often allowed. What I did not know, until this case, was that a suicide in the case of a person who is neither in pain nor in danger of imminent death is lawful. Frankly I don’t understand that nor do I like it. But lawful it is.

    If we want to change the law fine. But as murder is an unlawful killing and this is a lawful killing, it is not murder under US law. You may morally find it no different then a murder but the state of Florida, and by implication the majority of its citizens, disagrees.

    If you feel this is equivalent to murder the goal should then be to change the law and limit personal choice. But not interfere w. the death of Terri Schiavo whose case has run the gamut of the US court system.

  39. Sholom Simon says:

    Michael wrote: “In other words, the fact that Terri Schiavo feels pain – according to the statement of Michael’s attorney, George Felos – is clear and conclusive evidence that her EEG is not flat.”

    Are you a doctor? Can you point me to an authoritative source which concludes such?

    At least I’m willing to admit I don’t know. I only know what I read, and I read (and quoted to you) that the court appointed doctor said that her EEG is flat. I haven’t seen anything reputable which disputes that. Does it mean she can or can’t feel pain? I have no idea. Even if it can, what does that imply vis-a-vis her consciousness (most of her cerebral cortex is just _gone_), I have no idea.

  40. Zev says:

    Edvallace, did you see Nat Hentoff’s article that I linked to above?

  41. Michael says:

    Sholom,

    No, I’m not an M.D., but it’s well-known. Did you check the Labor Law Talk Encyclopedia? This is an undisputed one-to-one relationship: brain death, i.e. flat EEG, means no pain response. “A brain dead individual has no electrical activity and no clinical evidence of brain function on neurologic examination (no response to pain, no cranial nerve reflexes (pupillary response (fixed pupils), oculocephalic reflex, corneal reflexes), and no spontaneous respirations).” Also see this lawyer’s site which refers to the criteria for brain death, including “total unawareness of external and internal stimuli; no response to pain.”

    Note that this Dr. Cranford is a “death activist” who addressed the Hemlock Society in 1992, and in 1997 wrote an opinion piece in the Minneapolis Star Tribune titled: “When a feeding tube borders on barbaric.”

    He is projecting his own opinion of what should be, onto the patient. If she were brain dead she would not be receiving morphine. Again, this isn’t “conspiracy” mumbo-jumbo. Since he believes she “ought” to be dead, he may be telling you what you want to hear. The administration of morphine absolutely puts the lie to the claim that she is completely brain-dead.

  42. Zev says:

    Sholom wrote: “I haven’t seen anything reputable which disputes that.”

    Then you haven’t bothered to check out the article I pointed to a number of comments back.

  43. DovBear says:

    Ok, let’s see if I can answer all my detractors at once. First, Michael and the pain medicine: As the Times reported on Monday, doctors have not prescribed morphine; rather the morphine (the equivlent of less than one tablet of Percocet)is being delivered by “overly cautious nurses.” She feels no pain, and that is the sworn testimony of several doctors. Until you have the chance to examine her, perhaps you should not speculate so freely?

    Zev, et al: The issue isn’t whether or not Terry is a convicted criminal (of course she isn’t) the issue is whether or not judges have the right to make life and death decisions. People who are pro-death penalty say they do. If pro-death penalty people are today objecting to Judge Greer’s decision on the grounds that he overstepped his authority they are being inconsistant. In this country, unfortunately, Judges are empowered to make those sort of decisions; sadly, it happens all the time, often on flimsier evidence than Judge Greer heard.

    When a person is sentanced to death on bad evidence (and, again, it happens all the time) where are the “let’s err on the side of life people?” Most (including President Bush, and Congressman DeLay) are conspicuously silent. Why?

  44. DovBear says:

    Edvalaace said, “Furthermore, you cannot compare capital punishment carried out in the name of justice, and the defendant is given numerous opportunities to defend him/herself etc. etc. etc. to a case of pulling a feeding tubo out of a live woman because her husband recalls a conversation from ten years ago with no written directives etc. No comparison.”

    First, the judge heard sworn testimony from five people, not just her husband. Second, the case has been in litigation for 8 years in 6 different venues. That’s not “numerous opportunities? Third, what you call “capital punishment carried out in the name of vengance” is often based on bad evidence, and driven by feelings of vengance, not justice. If you’re willing to err on the side of life for Terry Schavio (which is commendable) why not err on the side of life for people who MIGHT be innocent, who MIGHT have been convicted on bad evidence? Why do you presume that evry convicted criminal is in fact guilty? Why not err on ther side of THEIR lives, too?

  45. Michael says:

    Dov, an excellent suggestion. So why doesn’t the husband allow a quick and painless EEG & MRI to prove you are right? Why is he only willing to have a post-mortem autopsy, when it will no longer be possible to prove whether there was any signal at all?

    Don’t tell me he doesn’t have the money to afford the MRI.

    Overly cautious nurses? Don’t be silly. I’ve had relatives in hospice care, and no medicine can be administered without a doctor’s prescription, especially an addictive drug like morphine. Access to morphine is controlled. So what are these nurses, who are at her side, “overly cautious” about? Don’t tell me they’ve never seen a brain-dead patient before.

    I don’t think Greer overstepped his authority. I think he’s wrong. He didn’t afford Terri the opportunity to seek alternate counsel.

    Honestly, if she is feeling no pain — what is the benefit in having her die now? Let Michael move on, marry his girlfriend, and let the parents take over visitation. The parents want to have their daughter. Is that so evil?

  46. Sholom Simon says:

    You’re barking up the wrong tree — I didn’t say she was brain dead, and I have never said so. In fact, I’ll be the first to say that she isn’t brain dead.

    I said that testimony was that her EEG was flat. Those are two different things. If brain dead, then EEG is flat — but not the other way around.

    A flat EEG, at least how I understand it, indicates no activity in the cortical areas of higher function. This correlates with CAT scans taken of Terri which show the vast majority of her cortex to be, quite simply, missing. (Her CAT scans are all over the web).

    In fact, some of Terri’s supporters say the same thing. They accept that the EEG is flat, and they argue that this doesn’t prove that she’s brain dead. They are correct.

    What we, apparently, are able to see are some of the functions that originate in the brain stem: breathing, blinking, yawning, digestion and some reaction to light and noise, sleeping and waking. This is brain stem activity, reflexes, but not from the cortex.

  47. DovBear says:

    Letting Terry live with her family isn’t evil, it simply goes against her wishes, as understood by Michael and the judges. Is following her wishes “so evil?”

    As for the morphine, here’s the quote: (http://www.nytimes.com/2005/03/29/national/29schiavo.html)

    “The issue of whether Ms. Schiavo was receiving morphine and why has been a persistent source of concern among the protesters outside her hospice. Some of the placards and statements from supporters have referred to her being on a morphine drip, which many saw as evidence that she was dying in pain.

    Mr. Felos said Monday that Ms. Schiavo had never been on a morphine drip. She has received two five-milligram suppository doses of morphine in the last 11 days, most recently two days ago, he said. Each dose was minimal, he said, and would have worn off in about four hours. [snip]

    Another doctor with long experience treating patients at the end of life, Douglas Nelson of Hickory, N.C., said that providing morphine to a patient in a persistent vegetative state was unnecessary because the patient would be unaware of pain or discomfort.

    But, Dr. Nelson said, “It’s not uncommon for the nurse to suggest, ‘Let’s just give her a suppository to be on the safe side.'”

    See? Sorry, but you lose.

  48. Sholom Simon: The CT scan(s) may be “all over the web” but the records include only a single CT scan, which is posted here on the blog of a radiologist. This radiologist quotes the Florida appeals court ruling that says “Over the span of this last decade, Theresa’s brain has deteriorated because of the lack of oxygen it suffered at the time of the heart attack. … At this point, much of her cerebral cortex is simply gone and has been replaced by cerebral spinal fluid.” The radiologist then says (emphasis in the original),

    First, I contest the theory that Terri’s brain actively continues to degenerate as implied by the above statement. How could they gauge serial brain degeneration without serial follow-up? And by what mechanism would her brain CONTINUE to atrophy? Second, Terri’s cerebral cortex has not been replaced by fluid. That is inaccurate. The cortex is thinned and the sulci are enlarged. There is a difference.

    First of all, the University of Miami’s appellation for this scan is inaccurate. “Cortical regions” are not and can not be filled with spinal fluid. The sulci (spaces between cortical ribbons) are enlarged secondary to cortical atrophy and these sulci are filled with cerbrospinal fluid.

    The most alarming thing about this image, however, is that there certainly is cortex left. Granted, it is severely thinned, especially for Terri’s age, but I would be nonplussed if you told me that this was a 75 year old female who was somewhat senile but fully functional, and I defy a radiologist anywhere to contest that.

    I HAVE SEEN MANY WALKING, TALKING, FAIRLY COHERENT PEOPLE WITH WORSE CEREBRAL/CORTICAL ATROPHY. THEREFORE, THIS IS IN NO WAY PRIMA FACIE EVIDENCE THAT TERRI SCHIAVO’S MENTAL ABILITIES OR/OR CAPABILITIES ARE COMPLETELY ERADICATED. I CANNOT BELIEVE SUCH TESTIMONY HAS BEEN GIVEN ON THE BASIS OF THIS worrisome, no alarming thing that I heard a bioethicist and several important figures on the major media describe Terri’s brain as MUCH WORSE. One “expert” said that she had a “bag of water” in her head. Several experts described her as a “brain stem preparation”

    These statements are wholly inaccurate. This is an atrophied brain, yes, but there is cortex remaining, and where there’s cortex (?life) there’s hope.

    If you starve this woman to death it would be, in my professional and experienced medical opinion, the equivalent of starving to death a 75-85 year old person. I would take that to the witness stand.

    In addition, the EEG is not “flat.” At least not according to Dr. William Hammesfahr, who examined her in 2002 for the Florida appeals court. His report is here and it makes very interesting reading. (I am not a physician and I had no problem understanding it.) About the EEG, he says,

    EEG: I have reviewed the EEG recently obtained. The EEG has large amounts of artifact. The technician’s attempted to remove artifact by filtering. Unfortunately, filtering also affects and reduces evident brain electronic activity. This EEG is not adequate and should be repeated. It should be repeated at the patient’s bedside, with the patient in a non-agitated state.

    He also recommends several other tests, which I believe were not done. He also says (emphasis added):

    ENT: The patient can clearly swallow, and is able to swallow approximately 2 liters of water per day (the daily amount of saliva generated). Water is one of the most difficult things for people to swallow. It is unlikely that she currently needs the feeding tube. She should be evaluated by an Ear Nose and Throat specialist, and have a new swallowing exam.

    Did you hear that? “It is unlikely that she currently needs the feeding tube.” Yet, after ordering the removal of the feeding tube, Judge Greer also ordered no feeding by mouth, either.

    He did not simply order the removal of a “feeding tube.” He ordered removal of food and water, delivered by whatever means.

    They now have three police officers posted in her room to make sure she isn’t given a sip of water, an ice chip, or whatever it is they give for Catholic communion.

    Is this what halacha allows, even if the feeding tube is considered “medical”?

  49. Michael says:

    “Sorry, but you lose?” Poor DovBear, it looks like you’re running out of intelligent arguments so you need to be snide.

    Initially, I believed she was obviously in a persistant vegetative state, and didn’t care — the Torah says you don’t kill someone even if they are in “PVS.” But I’m a little more open-minded than you, and I don’t ignore huge elephants wearing the word MORPHINE on their backs when they wander up to my preconceptions.

    “To be on the safe side,” they give her morphine? That’s hardly “sorry, but you lose.” The fact that they gave her morphine proves doubt in their minds, however small, as to whether she really feels no pain. And regardless of what the Times delivered, I’m sure Dr. Nelson is well-aware that he has to sign off on doses of morphine.

    If the nurses really want to be on the safe side, they’ll keep giving her food and water until they know she needs no morphine. And we’ve not arrived at that point.

    Obviously, they don’t know that she doesn’t feel pain.

  50. DovBear says:

    I don’t know why you can be so sure she feels no pain. Are you a doctor? have you examined her? have you heard the testimony of people who have? No?

    Well the case has been reviewed multiple times, and each time, the opinion of Judge Greer was upheld, so either their is a massive conspiracy to kill this woman, involving multiple courts, doctors and witnesses, orthe doctors and witnesses were convincing. Which seems more likely to you?

    As for the morphine, be snide about the times all you want. They still produced an expert who said on the record that nurses deliver small morphine doses on their own , which is exactly the argument you keep sumarilly rejecting. Speaking of ignoring elephants…

  51. Michael says:

    From the snide to the silly. The Times produced one doctor who said nurses do it on their own.

    Did he say that nurses do it on their own when they are absolutely certain that she is brain dead and feel no pain? Did he actually say that doctors don’t sign off, and nurses just wander off with controlled substances and claim they gave them to patients?

    No, he didn’t say that. He didn’t say that because if they were absolutely certain that she was brain dead, they would have no reason to give her morphine.

    The Times is trying to explain away the evidence. But the evidence is still standing there, making a stench.

    Make up all the excuses you want. The fact is that nurses aren’t stupid. They don’t give dead people medicine. And they don’t give brain-dead people pain medication for pain they can’t feel.

  52. edvallace says:

    Dovbear,
    “If you’re willing to err on the side of life for Terry Schavio (which is commendable) why not err on the side of life for people who MIGHT be innocent, who MIGHT have been convicted on bad evidence? Why do you presume that evry convicted criminal is in fact guilty? Why not err on ther side of THEIR lives, too?”

    Actually, I would be willing to consider that suggestion. Although you accused Zev of being a GOP-jew who undoubtedly supports capital punishment [something you can’t know] I personally do not. I agree that the judicial system is highly flawed and I’d be willing to dispense of capital punishment today.
    Your comparison stil holds no water. Why should Terry be allowed to die because of flimsy evidence in CP cases?

  53. DovBear says:

    EdV huh? Who said Terry should be allowed to die b/ of CP cases? I said that people who support capital punishment shouldn’t be whining about Judge Greer or how he conducted the trial, unless they also object when other judges happily send people to death on worse evidence. It wasn’t an argument about TS. It was an argument against the hypocricy of pro-death-peanlty people.

    Michoel: You can’t run away from the fact that an expert doctor said “ďż˝Itďż˝s not uncommon for the nurse to suggest, ďż˝Letďż˝s just give her a suppository to be on the safe side.��

    And you can’t run away from the fact that three judges heard compelling evidence that she feels no pain and has no chance for survivial.

    You’re trying to, but you can’t. People who know more than either of us about the facts of this case have spoken, and they disagree with you.

  54. Sholom Simon says:

    “In addition, the EEG is not “flat.” At least not according to Dr. William Hammesfahr”. Dr. William Hammesfahr was the only one of eight doctors who felt that way, and this is not in his field. The other seven all testified the other way. That is why the court rejected his testimony.

    “So why doesn’t the husband allow a quick and painless EEG & MRI to prove you are right?”. She’s already had EEG’s, and she’s had two CAT scans.

  55. dilbert says:

    pain is the FEELING that a conscious person has when presented with a noxious stimulus. You have to be conscious to feel pain. Otherwise, the stimulus is just a stimulus. And you can have a REFLEX response to a stimulus, that does not indicate consciousness or feeling pain. It is COMMON for nursing staff to give pain medications to those who are not conscious, “just to be on the safe side.” Does this imply doubt about her being conscious? on the side of the nurses- maybe. On the side of the doctors? probably not.

    The CT scan posted by the radiologist shows a tremendous amount of loss of brain substance, and the spinal fluid spaces have enlarged to fill the space left by the shrunken brain. The person posting the picture is clearly not a neuroradiologist(someone specially trained to read head CT ‘s and neurologically related studies). This is not a scan of a normal person, not even a 93 year old normal person. It is a scan of a person who has suffered a PROFOUND loss of brain substance. It is consistant with(but not diagnostic of) persistant vegetative state. I have posted some information about brain injury on my site, for those interested.

  56. dilbert says:

    by the way, I would guess that Terry Schiavo’s EEG is not flat, but it doesn’t matter. If it is flat, it shows that there is not enough electrical activity in her brain for the monitors to pick up. It indicates so little electrical function that it is essentially not viable. Given how she looks on the few pictures I have seen, my guess is her EEG is very abnormal, but not flat. btw, A flat EEG is consistant with BRAIN DEATH, and at the very least, would indicate that she could not possibly be conscious at the time the EEG was done. Her brain scans probably would not change much after the first year or two after the injury. Getting more scans wont add any information. It’s not like the brain can show improvment on scans over time. It doesn’t

  57. DovBear says:

    Thanks Dr. Dilbert for explaining things to these non doctors, especially the bit about it being common for nurses to give pain meds to non-concious people.

  58. Michael says:

    OK, so Dr. Dilbert says that the EEG isn’t flat, after all, and DovBear declares victory. Fantasy meets reality?

    Dr. Dilbert, what’s your area of specialization? I asked a physician today and he contradicted this Dr. Nelson, if he meant to say that a Doctor would not need to sign off on the administration of morphine. Morphine is an addictive, controlled substance. It is illegal to administer it without prescription. In these settings it is common to sign a prescription on an as-needed basis, but they have to sign off.

    Furthermore, you said that the state of the person is determined by observation, and then said the nurses might have doubted. I will agree with you that a doctor knows far better what he’s looking for than a nurse, but he still had to sign off on the prescription, and the administration still means the nurses had doubt.

    Dov, address that. Don’t say doctor this or doctor that. Tell us that you believe that the nurses cared for this woman 24/7 and had the strange misconception that she feels pain, but they were totally wrong, because that’s what you are saying. You just refuse to put it in so many words.

  59. dilbert says:

    Michael- I am not going to identify my specific speciality, but I can honestly tell you I have dealt with this type of situation more than 99% of the doctors that you will meet. Of course an order from a doctor is need for morphine. And I certainly did say that the nurses may have some doubts about whether Ms. Shciavo is conscious. And, that the doctors probably did not have doubt. I am not here to insult nurses, who have one of the most thankless, and in some cases poorly paying jobs. However, they are usually not trained neurological observers, especially in a hospice. There is a possibility/liklihood that they may interpret some reflexes as being purposeful behavior, and some random movements as thinking responses to stimulus. I am not saying they are always wrong, but the vast majority(actually a lot of doctors who are not specialists make the same mistakes) are not trained to make these sorts of distinctions. Therefore, if a nurse raises a question about consciousness(and it has already been settled to some degree by a specialist) the path of least resistance is to order pain medication, rather than argue with the nurse about whether the patient is conscious or not, seeing as a small amount of pain medication likely will not have significant side effects. Also, my guess is that the neurologists came and consulted, and left, and the day to day managament is left to an internal medicine specialist, or hospice doctor, who also could make a mistake in diagnosing consciousness. Therefore, a patient getting morphine is not ipso facto conscious, there are a lot of factors that go into it.

    You could put someone in front of all the commentors here, and ask if the person was conscioius, and get all sorts of opinions. Only someone who takes the time and effort to examine(sometimes multiple times are neccessary) and has a good idea of what is reflex and what is conscious movement, can give a good answer. People can get “feelings” about who is conscious or not, but that is just a gut feeling, and not very scientific, and not very provable.

  60. DovBear says:

    Dilbert, don’t confuse the poor republicans with complexity… if it’s not black or white, off or on, true or false, their brows get all furrowed.

  61. Avi Burstein says:

    So why doesn’t the husband allow a quick and painless EEG & MRI to prove you are right?

    There’s a good reason she hasn’t been given an MRI. In the early years of her condition, an experimental treatment was done on her that implanted electrodes in her brain in order to stimulate neuronal growth. Those implants are still in her skull. An MRI uses powerful magnets to create it’s image and would cause the implanted electrodes to act as a blender inside her skull. Not a good idea.

  62. Bob Miller says:

    With all due respect to those who tried to discover, or think they did discover, or maybe even invented Terri Schiavo’s wishes or physical condition—we need to think about the basic issue in a halachic context; G-d’s will and knowledge expressed through Torah override the subjective will and knowledge of any created being. I’d hate to see the secular-utilitarian approach to life continue to sneak up on believing Jews. Many of us have already absorbed far too many attitudes from our environment, to the point that we are unaware that we have done so.

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