Magazine article Clinical Psychiatry News

Ethicist Decries Florida Feeding Tube Decision

Magazine article Clinical Psychiatry News

Ethicist Decries Florida Feeding Tube Decision

Article excerpt

CHICAGO -- When the Florida legislature authorized Gov. Jeb Bush to replace hospice patient Terri Schiavo's feeding tube in October 2003, overriding the state's judicial system, it opened a Pandora's box that could come to haunt physicians, family members, and lawmakers alike, ethicist Arthur Caplan, Ph.D., said during the annual clinical congress of the American College of Surgeons.

"It will create absolute chaos in the management of the dying and the management of the severely brain injured in the state of Florida," said Dr. Caplan, who is director of the Center for Bioethics at the University of Pennsylvania, Philadelphia.

It is troubling enough, Dr. Caplan said, that the governor and legislature overrode 6 years' worth of court decisions by 19 judges in ordering the reinsertion of a feeding tube to prolong Ms. Schiavo's life while an independent guardian could be named.

But the Florida legislature's recent action also calls into question the long-held principle that a spouse is in a unique position to make decisions on behalf of a patient who has no living will, Dr. Caplan added.

"We don't want your mother vetoing your decisions. We don't want a sister flying in from California saying, 'Feed him,'" Dr. Caplan said.

The Florida case could spawn confusion about a far-ranging array of medical decisions, Dr. Caplan added, ranging from "do not resuscitate" orders to ventilator placement, and from organ donations to autopsies.

Ms. Schiavo, 39, has been judged by four independent, court-appointed physicians to be in a persistent vegetative state, incapable of recovery, since suffering deprivation of oxygen following a heart attack 13 years ago.

Her husband has insisted that Ms. Schiavo would not want to be kept alive in such a state.

Her parents disagree, however, and question their son-in-law's motives in seeking to allow her to die. …

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