Check this from the Minnespolis Star-Tribune...
Victor M. Sandler: Few patients long to die attached to tubes
Victor M. Sandler
March 25, 2005
Yes, as a practicing geriatrician and signer of hundreds of death certificates in my 30 years of medical practice, I'm absolutely certain that it's true: You are going to die.
But maybe there is hope, not from medical science, but from our politicians. I've seen the news reports; it's fantastic, the Bush administration is establishing a "Culture of Life."
Maybe this means that the next time we invade a country we will cut the loss of innocent civilian life to less than the 100,000 or so who died in the Iraq war. Maybe it means the Bushies have changed their minds and want to restrict automatic weapons sales in the country. Or perhaps even decided to restrict foreign arms sales (we are the biggest sellers in the world). Or maybe they've decided to provide health insurance for all children.
But we all know better than that.
The "Culture of Life" the Bush administration speaks of repeatedly in recent days has to do with saving the life of Terri Schiavo. They know that keeping this severely brain-damaged woman alive by mandating ongoing tube feeding is certainly a pro-"Culture of Life" stance.
As a geriatrician who has cared for thousands of living and dying patients, I'm puzzled. Because overwhelmingly when I have discussions with my patients, they do not want tube-feeding used to prolong their lives if disability makes it impossible for them to take food and liquid by mouth. They (both Republican and Democratic patients, I'm sure) seem to understand that dying will be the last chapter of their life. Most people want to die at home and not attached to tubes.
What "Dr. Bush" doesn't understand is that dying is part of life. As a person of faith, I believe in the ongoing survival of the spirit after death. As a physician and a person of faith, I cherish life and in each life is hidden the image of our creator (that means God, to you atheists out there.)
But God made life finite. My supposition is that this gives life a value and richness it might not otherwise have.
I also believe that God is loving and compassionate and allows the passage from life to death to be peaceful. As a physician who has cared for hundreds of dying patients, including my mother, my faith in God has been enriched by my personal and professional experience of watching life as we know it end.
Unfortunately most people -- including most physicians -- have little or no experience with caring for people who are very disabled and dying or terminally ill and dying badly.
I and similar physicians and nurses who routinely care for dying patients will tell you that the process in no way resembles the "starve to death" battle cry heard from politicians. People who are dying develop an "anorexia of dying." They lose their desire for food and fluids and can be comforted easily by the hospice team and a properly guided family.
You have probably inferred from my words that I believe Karl Rove's talking point "Culture of Life" somewhat disingenuous. But in fact, as a physician and a person of faith, I find it hypocritical.
So, Mr. Bush, next time your team comes up with a talking point, don't lie to me. It is wrong to lie; it says so in the Ten Commandments. The vast majority of reasonable people don't want their lives continued by tube feedings if they are severely disabled. So please don't refer to your position as a "Culture of Life." Call it a culture of sound-bite manipulation, political deceit, or an extension of suffering; then you would be honest.
Victor M. Sandler, a physician specializing in internal medicine and geriatrics, is cochair of the Fairview University Bioethics Committee.
