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A "Painless" Death?

Michael Schiavo insists that dehydration is "the most natural way to die." It's more like torture.

11:00 PM, Nov 11, 2003 • By WESLEY J. SMITH
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MANY WHO SUPPORT Terri Schiavo's threatened dehydration assert that removing a feeding tube from a profoundly cognitively disabled person results in a painless and gentle ending. But is this really true? After all, it would be agonizing if you or I were locked in a room for two weeks and deprived of all food and water. So, why should we believe that cognitively disabled patients experience the deprivation differently simply because they receive nourishment through a feeding tube instead of by mouth?

An accurate discussion of this sensitive issue requires the making of proper and nuanced distinctions about the consequences of removing nourishment from incapacitated patients. This generally becomes an issue in one of the following two diametrically differing circumstances:

(1) Depriving food and water from profoundly cognitively disabled persons like Terri who are not otherwise dying, a process that causes death by dehydration over a period of 10-14 days. As I will illustrate below, this may cause great suffering.

(2) Not forcing food and water upon patients who have stopped eating and drinking as part of the natural dying process. This typically occurs, for example, at the end stages of cancer when patients often refuse nourishment because the disease has distorted their senses of hunger and thirst. In these situations, being deprived of unwanted food and water when the body is already shutting down does not cause a painful death.

Advocates who argue that it is appropriate to dehydrate cognitively disabled people often sow confusion about the suffering such patients may experience by inadvertently, or perhaps intentionally, blurring the difference between these two distinct situations. For example, when Michael Schiavo, Terri's husband, and his attorney, George Felos, appeared on the October 27, 2003 edition of "Larry King Live" the following exchange occurred:

KING: When a feeding tube is removed, as it was planned [for Terri], is that a terrible death?

SCHIAVO: No. It's painless and probably the most natural way to die.

FELOS: When someone's terminally ill, let's say a cancer patient, they lose interest in eating. And literally, they--by choice--they stop eating.

SCHIAVO: Cancer patients, they stop eating for two to three weeks. Do we force them to eat? No, we don't. That's their choice.

Later in the interview, Schiavo reiterated the assertion in a response to a telephoned question:

CALLER: Does it bother you that the death is so slow?

SCHIAVO: Removing somebody's feeding tube is very painless. It is a very easy way to die. Probably the second best way to die, the first being an aneurysm.

Yes, it is true that when people are actively dying from terminal disease, they often refuse food and water. The disease makes the food and water repulsive to them. In such circumstances, it is medically inappropriate to force food and water into a person who is actively rejecting it. Indeed, doing so could cause suffering.

But this isn't what is happening to Terri. She isn't dying of cancer. Her body isn't shutting down as part of the natural dying process. Indeed, she is not dying at all--unless her food and water is taken away.

WHAT HAPPENS to non-terminally ill people with cognitive disabilities whose feeding tubes are removed? Do they suffer from the process?

When I conducted research on this question in preparation for writing my book "Forced Exit," I asked St. Louis neurologist William Burke these very questions. Here is what he told me:

A conscious [cognitively disabled] person would feel it just as you or I would. They will go into seizures. Their skin cracks, their tongue cracks, their lips crack. They may have nosebleeds because of the drying of the mucus membranes, and heaving and vomiting might ensue because of the drying out of the stomach lining. They feel the pangs of hunger and thirst. Imagine going one day without a glass of water! Death by dehydration takes ten to fourteen days. It is an extremely agonizing death.

Dr. Burke opposes removing feeding tubes from cognitively disabled people and so some might dismiss his opinion as biased. But Minnesota neurologist Ronald Cranford's pro-dehydration testimony in the Robert Wendland case--Cranford also testified that Terri's feeding tube should be removed--supports much of what Dr. Burke asserted. While Cranford called seizures "rare," his detailed description of the dehydration process reveals its gruesome reality: