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A Diagnosis with a Dose of Religion    •

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    Shameless Right-Wingers Exploiting Terri Schiavo
    By Joe Conason
    The New York Observer

    Wednesday 23 March 2005

Did God create Schiavo case to deliver Tom DeLay from political persecution?

    Never underestimate the Republican leaders in Washington. Whenever they appear to have exhausted the possibilities for cynical abuse of their authority, they can still inflict fresh outrages upon the nation.

    By intervening in the sad dispute over Terri Schiavo between her husband and parents, the President and his Congressional allies have again revealed how little respect they have for any conservative or constitutional principle that doesn't enhance their partisan power. In the name of defending human life, they have swept aside their own party's traditional commitment to federalist respect for state law and to the separation of powers between the legislature and the judiciary. In the name of equal protection under the law, they have departed from all traditional notions of legality.

    Under civilized rules of debate - particularly over a matter as emotionally disturbing as this one - it is wise as well as polite to assume that everyone is arguing from a position of sincerity. The Schiavo case shows why those rules have become increasingly difficult to observe with a straight face.

    While husband, parents and the brain-damaged woman herself are all deeply sympathetic figures, touching the deepest feelings of people on both sides of this vexing issue, that cannot be said for the politicians who claim to be advocating Ms. Schiavo's cause. Their claim to the presumption of integrity has been voided by their own behavior.

    In the Senate, Republicans circulated a "talking points" memo last week discussing Ms. Schiavo's fate in terms that emphasized political opportunism. "This is an important moral issue and the pro-life base will be excited that the Senate is debating this important issue," that memo explained. "This is a great political issue, because Senator [Ben] Nelson of Florida has already refused to become a cosponsor [of the Schiavo bill] and this is a tough issue for Democrats."

    In the House, Majority Leader Tom DeLay rightly denounced that Senate memo as "disgusting." But then a recording surfaced of remarks he'd delivered the other day to the Family Research Council, a powerful religious-right group that backs Republicans. There Mr. DeLay declared that the Almighty - working as always in the most mysterious ways - intended that Ms. Schiavo should relieve him of his mounting legal and ethical problems.

    "One thing that God has brought to us is Terri Schiavo, to help elevate the visibility of what is going on in America," Mr. DeLay explained, according to The New York Times. "This is exactly the issue that is going on in America, of attacks against the conservative movement, against me and against many others." (He also mentioned "a huge, nationwide, concerted effort to destroy everything we believe in" - a category that clearly includes free golf vacations provided by casino lobbyists.)

    And in the White House, George W. Bush rose from his bed the other night to sign the bill that provides a special privilege of federal legal appeal solely to Ms. Schiavo's parents. For dramatic effect, he had rushed back to the capital from Texas. Perhaps he didn't want to sign that awful legislation in his home state, thus recalling another law he signed as Governor in 1999.

    That Texas statute permits hospitals to withdraw critical care in certain cases, despite the most vehement objections of family members. It established a bureaucratic process that can doom such patients even if, unlike Ms. Schiavo, they are fully capable of speech, thought and feeling. And under that statute, Ms. Schiavo's husband Michael would have been designated as her "surrogate." With her doctors concurring, Mr. Schiavo would have been able to discontinue her life support - without enduring federal interference.

    When Mr. Bush signed that earlier bill, he was trying to save money for the Texas Hospitals Association, of course. Although he claims to honor a "culture of life" and would spare nothing in defense of innocent humanity, the harsher truth is that keeping people alive when their brains and organs can no longer function is extremely expensive. Presented with an easily exploited symbol like Ms. Schiavo, the President and his Congressional allies will pretend that money is no object. Yet they are hardly inclined to spend whatever might be needed to preserve every single human life for as long as possible.

    Instead, the Republicans consistently prefer to relieve the suffering of their wealthiest constituents. Consider the new budget crafted by Mr. DeLay and his minions, in which they proposed to cut as much as $20 billion from Medicaid, the health-insurance program for the nation's poorest citizens. The House budget could deprive more than a million children of basic medical care, while providing still more tax breaks for people whose luxuries include the most advanced medical attention on the planet.

    These pious politicians don't really care about defending human life. If they did, they would immediately enact and fund a national health-insurance program - to protect the 18,000 Americans who now die every year for lack of essential care.


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    A Diagnosis with a Dose of Religion
    By John Schwartz and Denise Grady
    The New York Times

    Thursday 24 March 2005

    William P. Cheshire Jr., the Florida doctor cited by Gov. Jeb Bush yesterday in his announcement that he would intervene again in the case of Terri Schiavo, is a neurologist and bioethicist whose life and work have been guided by his religious beliefs.

    Dr. Cheshire directs a laboratory at the Mayo Clinic branch in Jacksonville dealing with unconscious reflexes like digestion, and he is director of biotech ethics at the Center for Bioethics and Human Dignity, a nonprofit group founded by "more than a dozen leading Christian bioethicists," in the words of its Web site.

    In an article last year in Physician magazine, published by the evangelical group Focus on the Family, Dr. Cheshire, 44, said doctors are too quick to declare that a patient is in a persistent vegetative state.

    "I'm not sure the diagnosis is used consistently," he told Physician. "I am sometimes asked if a patient is in P.V.S., but it's only been a few days. By definition, you have to wait at least a month."

    Yesterday, in an affidavit supporting a petition by the Florida Department of Children and Families in the case, Dr. Cheshire said it was more likely that Ms. Schiavo was in a "minimally conscious state."

    "Although Terri did not demonstrate during our 90-minute visit compelling evidence of verbalization, conscious awareness or volitional behavior," he wrote, "yet the visitor has the distinct sense of the presence of a living human being who seems at some level to be aware of some things around her."

    Mr. Bush called Dr. Cheshire a "renowned neurologist," but he is not widely known in the neurology or bioethics fields. Asked about him, Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, replied, "Who?"

    Dr. Cheshire, who graduated from Princeton and earned a medical degree at West Virginia University, did not return calls to the Mayo Clinic seeking comment. The clinic said in a statement that his work on the Schiavo case was not related to his work at the clinic and that the state had invited his opinion. "He observed the patient at her bedside and conducted an extensive review of her medical history but did not conduct an examination," the statement said.

    Dr. Caplan said that was not good enough. "There is just no excuse for going in and making any pronouncement about the state that Terri Schiavo is in unless you're going to go in and do some form of technologically mediated scanning that would overturn what's on the record already," he said.

    Dr. Ronald Cranford, a neurologist and medical ethicist at the University of Minnesota Medical School who has examined Ms. Schiavo on behalf of the Florida courts and declared her to be irredeemably brain-damaged, said, "I have no idea who this Cheshire is," and added: "He has to be bogus, a pro-life fanatic. You'll not find any credible neurologist or neurosurgeon to get involved at this point and say she's not vegetative."

    He said there was no doubt that Ms. Schiavo was in a persistent vegetative state. "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."

    Dr. Cheshire entered the field of bioethics relatively late in his career. A profile of him on the Web site of Trinity International University, where he enrolled in the master's program in bioethics in 2000, states that he was "searching for how he should integrate his faith with his medical career." After getting the degree, he became an adjunct professor of bioethics there.

    A search of his publication record in the online medical library PubMed yielded articles in medical journals, with a focus on headache pain, in particular trigeminal neuralgia, a painful disorder originating in a cranial nerve called the trigeminal. None of the papers dealt with persistent vegetative states.

    His papers show a fondness for puns, as in the title of a letter to The New England Journal of Medicine about a patient whose fillings caused an electrical current that made her condition worse: "The shocking tooth about trigeminal neuralgia."

    He was also the author, with others from the Center for Bioethics and Human Dignity, of a paper opposing stem cell research.

    The center's Web site notes that he and his wife and four children are members of the Episcopal Church of the Redeemer in Jacksonville and that he has done medical missionary work in Honduras and Siberia.

    He has also written poetry, including "Exit Ramp," a poem about the movement to allow physician-assisted suicide that uses the metaphor of a highway off-ramp to warn of a different kind of slippery slope:

Such killing fast degenerates,
Despite concern for patients' best,
Into a plot that terminates
Without explicit prerequest.


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