Huge email bag on this of course, still coming in. This was one of the, if

not the, most eloquent to date:

Mr. Derbyshire—I am a physician, a board certified Internist, who cares
for many patients in nursing homes. I am also a conservative, at least I
think I am. I am greatly disappointed by the tone of most of the posts in
The Corner regarding this case, and was relieved at least to read yours.
Let’s assume for a moment that Mr. Schiavo loves his wife dearly and that
sometime when she was well and competent they had a discussion in which she
told him she did not want to be kept alive by artificial means, or at least
not indefinitely, by artificial means. She say’s to him “promise me you
won’t do that to me”. He says “I promise”. This is a conversation many
loving couples have and one I have had with my wife. Unfortunately, Mrs.
Schiavo apparently never produced a document stating this clearly. This is
the norm not the exception, particularly in younger people. Now, you are
left with a man, if my assumption is correct, who spends a great deal of
time with that promise ringing in his head. The thing she asked him to do,
that she made him promise to do, and he can’t do it. That man would be
tormented.
Consider further that even when people do provide a living will it is almost
impossible to take into account all the variables. If a man has a stroke or
an intracranial hemorrhage and becomes incapacitated to the extent that
immediately thereafter he cannot fend for himself, i.e. get water, drink
water, get food, eat food. Is that it then, ballgame over, no tubes, no i.v.
Of course not, some people take many weeks or months of intensive therapy to
recover that capacity, and of course some men never do. The problem is it
can be very difficult to predict this. So now you may have a man who is
stuck forever on tubefeeding when all he might have reasonably wanted was to
be given a “fair” shot at recovery. See how quickly we get into deep water.
Almost nobody defines in their living wills how long they would like to be
given to recover. Who would best know whether this man was given the
chance, the fair shot he desired. His wife, likely, and probably no one
else. You live with someone you get a feel for what they would want and
what would be intolerable. Your colleagues in the Corner (many, not all)
have demonized Mr. Schiavo I believe in a most unfair fashion. It is very
likely that Mr. Schiavo is the only one that truly knows what his wife would
have wanted. To call him a killer is in my opinion beyond the pale. At the
very least he is allowing her to die, at best he is fighting like hell to
fulfill his promise.
Let me say something else, and I admit up front that I don’t know all the
details of this case: in my experience poeple who have had a financial
interest in the life or death of a loved one have almost always been
interested in keeping that person alive. They may be living in a home which
is in the patients name, they may have control of that person’s bank
accounts, his pension checks, his assets. If they have been given financial
power of attorney, this is almost certainly so. I have seen this situation
before, rarely thank God. A family member puts his completely demented
octagenarian mother through a series of painful operations even though she
is already completely non-communicative and dependent on tube feeds. You
might say “why didn’t the ethical physician object? The answer is he
probably did, and was told: “If you let my mother die I will own you.”
Again, in my experience, anecdotal though it may be, this is much more
common than the guy who just can’t wait for daddy to die so he can inherit
his money. After all, depending on the will, he may have to share it with
siblings, the Humane Society, the church, and of course, depending on the
size of the estate, the Federal government. Your colleagues have made some
awful assumptions about Mr Schiavos motives, and as you ask “is there any
proof?” It seems to me if he had just wanted to be rid of her, he could
have easily gotten a civil divorce and been on his way. It seems to me at
least that it is very possible, even likely, that he believes himself to be
her champion, fighting for her wishes, fighting the courts and now fighting
congress. There is a lot to be admired in this.
As a physician, from a practical standpoint, this whole affair is a
nightmare. It calls into question the primacy of the husband and wife
relationship and therefore terribly muddies the waters as to who has the
right to make these difficult heart rending decisions. I always tell my
patients, the best thing to do is consult with your family and try to reach
a consensus. But obviously, this is not always possible. If there is a
disagreement you pray for paperwork defining who has medical power of
attorney. If there isn’t, there has to be a pecking order. If the patient
is married, it starts with the spouse, after that it gets very troublesome
very quickly. Let me say for all physicians, we are not excited about
having to testify in court everytime there are family members who disagree
with the spouse, much less about having to wait for congress to pass a law
each time this question comes up so that a higher court may decide. This is
nonsense, as much as my conservative sensibilities loathe the overreaching
of our courts, this is exactly where it belongs, not in congress. Let a
local judge review the facts, the paperwork if any, the testimony and make a
decision and be done with it. Most physicians want only some clear
direction in these cases. It takes someone awfully well acquainted with Him
to state that one choice or the other is the moral one. I can’t do it and I
think I have tried my best to know Him.
Finally, it seems to me that much has been written on your site about the
primacy of marriage, how it must be protected, cherished, encouraged,
valued, that we must fight to keep it from being disregarded, belittled,
lumped into the evergrowing, soiled pile of disposable, unsacred
relationships. The position that many of your colleagues have taken and I
gather the editorial position of your publication can only hurt this. How
can we convince our children that this will be the most important
relationship they will ever have. They will ask why? What am I supposed to
tell them? “It’ll be great because you’ll get to have sex and not feel
guilty”. That’s a child’s view — and what the hell everyone is already
doing that anyway. No: At least in part, I will say, it’s because you will
get to stand together with that person through thick and thin with God at
your side. That you will tell that person things that you would never tell
another soul. That you will know them better than you know yourself. That
when the end comes, you will do right by her and she will do right by you.
That you will ease each others passing through this insufferable imperfect
world and meet perfectly in the next. It’s an awfully big leap to tell Mr.
Schiavo that he doesn’t know his wife best. It’s an impossible leap to to
tell that to the rest of us.
Sincerely,
[Name], M.D.