[Paleopsych] CHE: A Health-Law Expert Looks at the Terry Schiavo Case

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A Health-Law Expert Looks at the Terry Schiavo Case
The Chronicle of Higher Education, 5.4.8
http://chronicle.com/weekly/v51/i31/31a01402.htm

    By PETER MONAGHAN

    George J. Annas, professor of health law at Boston University's School
    of Public Health

    The right of competent patients or their designees to refuse unwanted
    medical treatment was settled by the U.S. Supreme Court in 1990, but
    Florida lawmakers nevertheless passed a bill ordering the continuation
    of Terri Schiavo's life support when her husband tried to remove it.
    Florida's Supreme Court found that unconstitutional, but last month
    the U.S. Congress passed legislation, signed by President Bush, that
    gave the parents of Ms. Schiavo, who had been in a "persistent
    vegetative state" for 15 years, the right to seek a new court review.
    Several federal judges subsequently ruled that Ms. Schiavo's parents
    did not have the right to reinsert her feeding tube.

    Mr. Annas's article, "'Culture of Life' Politics at the Bedside -- The
    Case of Terri Schiavo," will be published in the April 22 edition of
    The New England Journal of Medicine and is now available online.

    Q. Is the medical community troubled, frustrated, angered by what has
    happened?

    A. All of those things. It's unprecedented meddling in medical
    decision making by Congress. And the only hope is that Congress will
    learn from this never to do it again.

    Q. Will it?

    A. Only if the public react as they seem to be reacting. The
    overwhelming majority in the polls have said that they don't believe
    that Congress should be involved in this kind of decision. ...
    Congress misread the public. ... An overwhelming majority believe that
    the Supreme Court did the right thing to say that individuals should
    have the right to make these decisions themselves.

    Q. There's nothing to stop politicians from grandstanding, is there?

    A. That must have been the thinking going in. ... Either the feeding
    tubes will be put in, and then they can take credit for "saving Terri
    Schiavo's life"; or the feeding tubes won't be put in, and they can
    argue that the judges are out of touch with the new culture of life
    and should be replaced.

    Q. These issues may become very expensive, mightn't they?

    A. That's definitely true. The law right now is that patients have a
    right to refuse any medical treatment, but don't have a right to
    demand mistreatment. Put differently, patients would have a right to
    choose among reasonable medical alternatives. If there is an
    alternative that has no medical benefits for the patient, then
    certainly medical-insurance providers -- Medicare, Medicaid -- would
    be perfectly justified in saying, "We're not paying for that, we're
    only paying for reasonable medical treatments. ..." Is there some
    basic medical care that every American should be entitled to? Congress
    doesn't want to talk about that, but it's high time they did.