This article appears in the August 2005 edition of the Catholic Medical Quarterly
Ordered to Die
C. Sofoulakis, C&M Papaloucas
After having a cardiac arrest 15 years ago, Tern Schiavo was in a vegetative state. She died on the 31st of March 2005, after a court order to stop artificial nutrition and hydration, because, according to doctors' opinion, her condition was not reversible. It is well known that, when a medical doctor qualifies, he/she swears to God the Hippocratic Oath, to which they express their allegiance for the rest of their life; nobody can order the doctor to violate it. A doctor exists in order to save lives; turning into an executioner is against his/her moral principles.
According to to our opinion, in Terri Schiavo's case, a court ordered doctors to violate their oath by removing the tube in order to let Terri die. Should doctors obey such orders?
Her husband claims that Terri had told him before getting ill - when she was 26 years old or younger - that, if she were to get into such a bad condition, as she was in her last 15 years, she should be let die! But what other response would anybody expect to be made by someone so young and in excellent health to such an hypothetical question?
How many terminally ill patients, seriously suffering, pray to God to let them die and even sign authorisations for euthanasia, but, as soon as they feel a little better, change totally their mind and live in hope of better times?
Many young people, especially soldiers going to war, ask their relatives, even in writing, that, if they get seriously wounded, if they lose their limbs, eyes, genital organs, they be offered euthanasia, but, after they get seriously wounded, they cope with the new situation and try to live their live at all costs! Life is `sweet' !
Very characteristic is the reference to the law of Oregon by Susan Okie (3) according to which patients can request a prescription for lethal medications; but in order to obtain it "the patient must be capable of making an informed decision, be not clinically depressed and able to take it orally; family members, friends, doctors and other health care workers are forbidden to administer the drug". However from 326 patients who obtained prescriptions only 208 made use of them (3). As it is obvious, even in this very advanced law, there are limitations. Who can guarantee then that Terri's wishes, even if they had been expressed15 years ago, which is questionable, could be considered as irrevocable?
Medical science progresses rapidly; who knows what happens tomorrow? Who could imagine 40 years ago heart transplantation? About 40 years ago the Russian Vladimir Demicow of Sclifosovci's Institute in Moscow transplanted to the neck of a dog the head of a puppy (Fig. 1) which survived for 29 days! Who can foresee the future? And who can reject the possibility that Terri might recover, sometime, with the use of new drugs and techniques?
What ought also to have been taken under consideration were the principles of Terri's religion: she was a Catholic.
Her husband, Mr Schiavo, her legal guardian, was, for years, over-zealous to apply euthanasia to Terri, maintaining that he was acting for her benefit and that euthanasia was her own will (I don't want to be kept alive on a machine).
However, one wonders how it is possible for a man to be considered the legal guardian of his wife when he is living with another woman and has two children by her. Shouldn't the authorities have removed him from the legal stewardship since he had found a new family and his devotion to Terri's best interest became seriously questionable?
References .
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Demicow V. In: Medical history (In Greek). Papyros Press 1968; p. 594-596.
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Mason JK and McCall Smith. Law and Medical Ethics. 1994, 4th Edition; p.314
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Okie S. Physicians-assisted suicide-Oregon and beyond. N Engl J Med 105; 352: 1627-1630
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Quill TE. Terri Schiavo - A tragedy compounded. N. Engl J Med 2005; 352: 1630-1633.
C. Sofoulakis is a Public Prosecutor
C. Papaloucas MD PhD is Assistant Professor of Anatomy, Thrace University
M. Papaloucas Attorney at Law, PhD, is Associate Professor, Peloponnese
University
Correspondence to:
Dr Papaloucas Christos
14 Moschonission Str.
Athens 11252,
Greece
Tel: +30210 8643907
Fax: +30210 8643337
e-Mail: onyxii@yahoo.com