Schiavo and the Times

Tom Maguire points us to an article in the New York Times yesterday. The piece, by John Schwartz, contends that "Experts Say Ending Feeding Can Lead to a Gentle Death."

The experts Schwartz speaks to in his article include Dr. Linda Emanuel, a doctor at Northwestern University who specializes in "end-of-life care" and tells us that "From the data that is available, [be dehydrated to death] is not a horrific thing at all." One data point omitted by Dr. Emanuel, Schwartz, and the rest of the staff at the Times is Kate Adamson.

I refer readers, again, to the invaluable work of Wesley J. Smith, who detailed the case of Kate Adamson, a woman who, was diagnosed to be in a persistent vegetative state (like Terri Schiavo) and had her feeding tube removed (like Terri Schiavo). It turns out that she wasn't in a PVS and, luckily, she lived to tell us exactly what being dehydrated to death feels like.

Appearing on The O'Reilly Factor, Adamson was asked if having her feeding tube removed was painful. She replied: "Oh, absolutely. Absolutely. To say that--especially when Michael [Schiavo] on national TV mentioned last week that it's a pretty painless thing to have the feeding tube removed--it is the exact opposite. It was sheer torture."

Here is Smith's account of Adamson's story:

In preparation for this article, I contacted Adamson for more details about the torture she experienced while being dehydrated. She told me about having been operated upon (to remove the bowel obstruction) with inadequate anesthesia when doctors believed she was unconscious:

"The agony of going without food was a constant pain that lasted not several hours like my operation did, but several days. You have to endure the physical pain and on top of that you have to endure the emotional pain. Your whole body cries out, 'Feed me. I am alive and a person, don't let me die, for God's Sake! Somebody feed me.'"

Unbelievably, she described being deprived of food and water as "far worse" than experiencing the pain of abdominal surgery. Despite having been on an on an IV saline solution, Adamson still had horrible thirst:

"I craved anything to drink. Anything. I obsessively visualized drinking from a huge bottle of orange Gatorade. And I hate orange Gatorade. I did receive lemon flavored mouth swabs to alleviate dryness but they did nothing to slack my desperate thirst."

Apologists for dehydrating patients like Terri might respond that Terri is not conscious and locked-in as Adamson was but in a persistent vegetative state and thus would feel nothing. Yet, the PVS diagnosis is often mistaken--as indeed it was in Adamson's case. And while the courts have all ruled that Terri is unconscious based on medical testimony, this is strongly disputed by other medical experts and Terri's family who insist that she is interactive with them. Moreover, it is undisputed that whatever her actual level of awareness, Terri does react to painful stimuli. Intriguingly, her doctor testified he prescribes pain medication for her every month during the course of her menstrual period.

In other words, the Times did a story on what being dehydrated to death feels like, but ignored one of the only people alive with first-hand knowledge of the matter.

A Note on Dr. Linda Emanuel: Let's look at Dr. Emanuel. In the past she has done studies for the Commonwealth Fund and the Nathan Cummings Foundation, groups which work with George Soros's Project on Death in America.

She edited the 1998 book, Regulating How We Die: The Ethical, Medical, and Legal Issues Surrounding Physician-Assisted Suicide. Her own views on physician-assisted suicide are quite moderate. She thinks, for instance, that Dr. Kevorkian was too extreme. In August 1996, she said of Kevorkian, ""This exemplifies the dangers of misuse that motivate our resistance to physician-assisted suicide. His threshold has always been so far below what we consider to be appropriate for professional practice . . ."

Later in life, she took a more mainstream pose, declaring that "'We do not have a right to die, but we do have a right to be free of unwanted intervention."

And what does she think about intervention? She gave this account of how she became interested in "end-of-life care":

Dr. Linda Emanuel was shocked into participation by a chilling experience in an intensive care unit.

Emanuel, vice president for ethics standards at the American Medical Association, recalls joining emergency room doctors and nurses who sprang to the rescue and celebrated when an unconscious dying woman was revived.

"Later, I went to intensive care only to discover the woman was there in a vegetative state," said Emanuel. "We thought it was cut and dry, where success equaled resuscitation. It wasn't. We didn't know if she wanted to be resuscitated. No one talked to the family. No one even thought of it. And that was the standard of care."

So where does Emanuel stand on Terri Schiavo? In October 2003, she issued a statement saying she believed that replacing Schiavo's feeding tube was a mistake.

Update, 9:54 a.m.: I concluded my original post by saying, "Glad the Times was able to find an unbiased expert."

Galley Reader arrScott writes, "By the standards implicit in your statement, only an expert in a field who held no opinions about her field would qualify as 'unbiased.' But such a person would, by definition, not be an expert. If she is biased, then so is every human, and therefore the word, by describing all people at all times, is meaningless."

That's a good point. In retrospect, my complaint against the Times is: (1) They present a woefully incomplete report; and (2) They present Dr. Emanuel as an expert without giving us any indication of her disposition on the issues which lie upstream from Terri Schiavo, and which place her opinion in context. Anyway, my thanks to arrScott and apologies to Emanuel and the Times.