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A lack of brain activity in Congress

By PHILIP GAILEY
Published March 20, 2005

Terri Schiavo has been in a "persistent vegetative state" for 15 years, kept alive by a feeding tube her husband has waged a long legal battle to remove. Medical experts say the thinking side of her brain shows no activity. A lack of brain activity in the U.S. Congress last week only partially explains why lawmakers behaved so disgracefully in Terri Schiavo's name. Most lacking were political courage, honesty about the facts and respect for the courts.

It was a cynical political spectacle that should disturb all Americans, regardless of which side of the Schiavo case they are on, who believe that politicians should not meddle in a family's end-of-life decisions. Sadly, Democrats, including Sen. Bill Nelson of Florida, went along with the Republican uprising against state courts and expert medical opinion. Some lawmakers voted for the legislation even though they said they believed it was unconstitutional.

To no one's surprise, the U.S. House approved the most dangerous legislation. It would apply to thousands of incapacitated people on life support, giving federal courts the power to weigh in on the withdrawal of life support from patients who left no written instructions. The Senate limited federal court review to Terri Schiavo's case.

When the House and the Senate couldn't agree, Republicans, led by Florida Republican Sen. Mel Martinez, decided to turn a tragic situation into absurd theater. The Senate Health Committee "invited" Terri Schiavo and her husband Michael to come to Washington to testify. In the House, Republican leaders were in no mood to send out invitations. They issued subpoenas commanding Terri Schiavo, her husband and hospice officials to appear at a congressional hearing later this month. It is not clear exactly what they expect to hear from Terri Schiavo, who cannot speak.

Next to the demagoguery, the most appalling aspect of the floor debate in both chambers was the ignorance of - and indifference to - the medical facts in the Schiavo case. The worst offender was Senate Republican Leader Bill Frist, a Harvard-trained physician who, of all people, should know better. Frist ignored the testimony of independent medical experts who have examined Schiavo and said he could tell from watching a video that she is not in a persistent vegetative state. He also said she had not undergone a CAT scan. Wrong again. Brain scans show that parts of her brain have atrophied and been replaced by spinal fluid. (Remind me not to call Dr. Frist in the event of a medical emergency.)

It was obvious that Frist and his colleagues had not bothered to read a lengthy letter that George J. Felos, the lawyer representing Michael Schiavo, sent to every senator explaining the medical facts in this case. It included this description of persistent vegetative state written by the Multi-Society Task Force on PVS and published, after peer review, in the New England Journal of Medicine:

"The vegetative state is a clinical condition of complete unawareness of the self and the environment, accompanied by sleep-wake cycles with either complete or partial preservation of hypothalamic and brain-stem autonomic functions. Patients in a vegetative state are usually not immobile. They may move the trunk or limbs in meaningless ways. They may occasionally smile, and a few may even shed tears; some utter grunts or, on rare occasions, moan or scream."

Florida courts have ruled repeatedly that Michael Schiavo has the legal right to carry out what they concluded was the expressed will of his wife. Terri Schiavo's parents have fought him all the way. When they lost in state courts, they asked federal courts to intervene. None has. Last year the U.S. Supreme Court refused to take their appeal. No one's right to due process has been violated.

The real issue is not the removal of the feeding tube. If the parents had agreed with their son-in-law that it was what Terri would have wanted, it would have been done years ago and there would have been no protests, no court battles, no calls for political intervention in Tallahassee and in Washington. Pro-life activists would not have screamed "murder." What this fight is really about is whether Michael Schiavo, acting as his wife's legal guardian, has the right to carry out her wishes over the parents' objections. The courts have ruled that he does.

Terri Schiavo's feeding tube was removed Friday afternoon. But that only intensified the political scramble in Tallahassee and Washington to override the courts.

Philip Gailey's e-mail address is gailey@sptimes.com

[Last modified March 20, 2005, 01:08:30]