Thursday, June 16, 2005

Somehow I doubt there will be an apology

As Lindsay pointed out yesterday, the autopsy report on Schiavo verifies the diagnosis of PSV, the inability of any legitimately expected clinical improvement (if a miracle were to be granted by G-d, He would not require the assistance of invasive feeding or other medical intervention), the lack of corroborating evidence for the accusation that Michael Schiavo beat her to cause her hypoxic brain injury and/or attacked her physically in some way while she was in the hospital to kill her when he tired of her, and that, as a neurologist, Bill Frist is a CT surgeon. It also points out something your average MS1 knows, actual examination of a patient is of great assistance to making a diagnosis.

Despite all this, there are still foks saying that since she showed no signs o f bulemia on autopsy, she must not have had bulemia (maybe Didion can focus her attention on Congress and heatl ed calsses using correct clinical terminology and accurate facts, this would be much more productive). Considering the amount of time she'd been in treatment prior to her death, it's unlikely she would necessarily have shown signs especially if her precipitating cardiac event occured during an acute electrolyte imbalance. None of this seems to matter, provided the "pro-life" crowd can still accuse Michael Schiavo of being an abusive husband (including another health care specialist with a radio show who diagnosed him as a classic wife abuser based on interviews with the Schindler family who were pressing a case - apparently direct examination and/or interaction with a subject under evaluation is completely unnecessary in certain forms of political psychiatry/psychology as well).

In short, this was a case in which a man, who may have been a schmuck of a husband (or not) finally stopped deluding himself that his wife would improve and thought it best (if you buy the claim she, as a Catholic, would never have agreed to be a DNR or refused any treatment) that she be allowed to die a natural death instead of prolonging her "life" through invasive means that could not improve her clinical status or outcome versus her biological family who had what can only be described as a pathological unwillingness to accept the extremely painful loss of their child/sister because they refused to accept her actual condition & felt that she should be kept alive solely for their comfort. Luckily for Terri she is, ostensibly, at peace (though I will not be surprised to hear they've had a seance and that she's refuting the autopsy reports from beyond the grave) and, hopefully, remained blissfully unaware of the public circus her "life" had become.

Regardless of whether you feel that withdraw of life support was what Terri would have wanted (or not) or is something that is morally acceptable (or not); the Schindler family and their supporters leveled some slanderous accusations at Michael Schiavo that have, forensically, been refuted. Had they not done so, and gone to such extreme in pressing their charges, maybe he would have been more magnanimous towards them after her death. Regardless, they owe him a public apology and retraction of their charges.

Bill Frist owes the country an apology for overstepping their bounds, setting off rhetorical incendiary devices in what was already a highly flammable environment and for the hubris of claiming that because he is a licensed physician, he knows more about any given medical situation than those with intimate knowledge of a patient's clinical status.

I don't expect anyone standing up and being a responsible adult about this because, in the end, it really boiled down to politics - not medicine, love or humanity.

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