People are talking about end-of-life decisions, with all the attention to the case of a Florida woman who’s spent a decade and-a-half in a vegetative condition. Some critics of the effort to halt her tube-feeding have expressed opposition to the method, saying it’s cruel compared to turning off a respirator or other “extreme” life-sustaining method. University of Iowa School of Medicine professor Bob Weir (rhymes peer) holds the medical school’s Caplan Chair in Bio-Medical Ethics, and says they’re making a distinction that’s meaningless. He says it was “pretty well settled” 20 years ago that decisions apply to all life-sustaining technologies, from feeding tubes and respirators to chemotherapy and surgery, at least a different dozen different kinds of technology that would be withdrawn to permit a patient to die. Weir says one reason the Terry Schiavo (SHY’-voe) case has drawn attention is the difference between what he calls “statistical lives and identifiable lives.” The doctor says there are probably around 10-thousand people in this country in persistent vegetative states, kept alive only by feeding tubes, but “That’s hard to get worked up over, ten-thousand statistical lives…” He says in the case of Terry Schiavo the public’s seen lots of coverage, even video and photos of her. Still, Doctor Weir says there’s nothing about her case that wasn’t decided and accepted as general practice years, even decades ago in the treatment of patients. Weir says “one of the truly tragic things in this case has to do with the split between the husband and her parents. One could wish that that kind of dysfunctional arrangement didn’t exist — but it does. One could also wish that certain politicians didn’t choose to milk this case for all of its political worth, but that’s what’s goin’ on.” Another member of the medical teaching staff, Doctor Lauris Kaldjian (lorris, KAL’-jun), says it’s a signal to make sure you know who would have power of medical decision-making if you were the patient in the spotlight. He says since he’s married his wife would be his legal representative and they don’t have to discuss it any further. Someone without such a close relationship may have someone in mind they’d like to have appointed, and he says they ought to do it. If they don’t, he warns there may come a time when there’s confusion or uncertainty as to who should take responsibility when tough decisions have to be made. Kaldjian, who recently published an article in a medical journal on medical ethics and decision-making, says it’s wise to decide who you’d trust to make such critical decisions, tell them, and put it in writing.
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