My response

The following was my email response to the email reproduced in the post below. The original email's snippets are blockquoted.

This was done in voice recognition

So... very... cool... (Despite the inherent wrongness in the physician having cooler tech toys than the engineer).

One of the greatest vagaries that I know of is medical ethics. Here you have medical experts, who present factual information, and this factual information gets contorted by the legal system and by the emotions of the general public, and then the know-it-all government gets involved and mucks things up even further.

See, there's gonna' be a divergence here. The stuff I was writing was mainly concerned with what the courts owed the case. I did not comment on the various legislative acts, nor did I take exception to official medical findings.

Ninety-nine times out of a hundred (or more, for all I know), stuff of this type never gets waved under the nose of any magistrate or arbiter. That's perfectly okay. It means that there was no disagreement about what should happen, or that any disagreement which existed was resolved. But this particular case got into the justice system, and I find the case remarkable for what happened therein.

T. Shiavo has been in a persistent vegetative state for 15 years.

I agree with [the writer's] appraisal of Schiavo's medical condition. I have not disputed this.

All we have is the verbal request, as stated by her husband and friends, that she did not want to have any extraordinary measures (tubes, etc.) and that she essentially declared herself as a do not resuscitate.

Well, that is what the courts have. The courts have the hearsay of the husband, and those that the husband chose to bring forward. Anybody with hearsay that contradicts this was not invited. My major criticism of the Florida courts is procedural.

This case was disputed. It went to court. There were no documents indicating T Schiavo's preferences. At that point, is it too much to ask to have an uninterested party appointed by the court to do factfinding, and verify that M Schiavo's (very sketchy) evidence is the only evidence extant? I don't see that as onerous or a high threshold, especially considering all the fighting and hair-pulling that has since unfolded.

Ethically/legally, the husband is the guardian. It makes no difference what her parents ask to be done or anyone else other than her husband.

Legally, what the Florida courts professed to matter were the wishes of Terri Schiavo herself. And if that is what mattered, the courts were remiss in only availing themselves of one side's evidence.

In case there's some misunderstanding here, I am not all broken up that T Schiavo has died. What spurred me to write was what I viewed to be remarkable procedural shortcomings in a life-and-death matter before the courts. If procedural short-shrift is allowed to become precedent, we pave the way for undesirable outcomes in the future.

If she had a mere stroke, but still had some cognitive function to provide quality of life this would be a more difficult case. One would expect a true guardian to do everything possible to provide quality care and treatments to maximize her quality of life and one would think there were ulterior motives if the guardian did not fulfill the obligation on behalf of the patient.

And when the "more difficult case" comes to court, I would have vastly preferred that in the Schiavo case they had set the precedent of permitting independent fact-finding.

Removing the feeding tube is not killing someone (medical ethics 101), and until society understands the medical profession with both its extraordinary capabilities of extending natural life and shortcomings of failing to provide immortality we will continue to have discussions like these.

I was talking about a court case. You are talking about medical ethics. Correct me if I'm wrong, but the reason that removing a feeding tube is not killing (from the medical ethics standpoint) is that there is an a priori assumption at work that you have discharged your duty of care and you have no further obligations. We would say the same thing about a patient on a ventilator, would we not? When the necessary obligations of care have been satisfied and the responsible parties have agreed to termination of life support, you turn off the ventilator. This is not an ethical violation, because your duty of care was terminated.

At the same time, I think we all understand that turning off the ventilator can be murder if, for example, some nurse unilaterally decides to pull the plug in the dead of night. Duty of care was still in place and was intentionally violated. Big difference.

So in referring to a court case in which it was to be decided whether a duty of care did in fact still exist, I do not think it hyperbole to say that if the court gets it wrong that they would be "killing" unjustly. And please recognize that this language does have different implications in court as compared to medicine. After all, if state court X were to decree that food should be denied death-row inmate Y, the court would never get away with claiming that they weren't killing Y.

Thus I believe I was using language appropriate to the venue.

Schiavo died 15 years ago.

Personally, I agree. From what I can tell, the characteristics that made T Schiavo a person perished when her brain perished.

But legally she did not die. And yes, the laws can be changed for the better or for the worse, and will probably say something different about this sort of thing in 25 years. That's a different discussion.

If she is truly alive then she needs to feed herself, communicate needs, experience happiness, sorrow, grief, anger, interact and show awareness to the world.

All of the above, to be alive? That's a little stricter than I'd like, but again, a different discussion.

Society is very quick to say that doctors are killing their loved ones.

Society is jerky -- which is why I prefer law, which is merely an ass.

Imagine the cases similar to this nationwide and the amount of funds spent in futility.

Whole 'nother topic!

No hard feelings.

Not at all. I'm just sorry it wasn't convenient for you to post your reply. Thanks for emailing.