kolmapäev, märts 30, 2005

What Liberal Neurology?

Much has been made by some--well, really just by one of my friends and a few conservative radio hosts--of the bias of various doctors involved in the Schiavo case.

The reasoning goes that someone like Cheshire will be more likely to diagnose Terri as non-PVS because of his religious beliefs and vocal opposition to physician-assisted suicide. And if you accept that premise, Ron Cranford might be saying she is PVS because he wants to do some euthanizing.

I don't buy it.

I think it's significant that Cheshire sat in Terri's hospice room and observed her for quite a while but chose not to examine her. Why? Maybe because he knew he wouldn't like what he'd find? I've read his affidavit. He states that he saw no consistent signs of responsiveness but he really felt like he was in the presence of a living person. That really doesn't sound like science.

More importantly, though, I find it much more plausible that a doctor with beliefs like Cheshire's would lean toward a pro-life diagnosis because he wants Terri to live than that a doctor, any doctor, would want to find someone in a vegetative state knowing it would mean their death. I just don't see the upside to that. I don't believe a doctor would be so mean-spirited. I don't think there's an ideology that would seek out the death of patients. It seems to go against the concept of being a doctor at all. It's one thing to support mercy killing. It's another to actively desire diagnoses that could let you kill the patient. I've spent quite a while looking into Cranford's background. His support for euthinasia is indeed well-documented and I think it goes a bit further than most are comfortable with. That belief, though, has nothing to do with his ability to diagnose PVS. He is, in fact, one of the nation's leading PVS experts. He's been studying this for nearly 3 decades. He got game.

Much is made by people who really hate him of Cranford's diagnosis of police officer David Mack as PVS in 1979. 20 months later, Mack woke up. Setting aside that this was 25 years ago and both Cranford and medical technology have improved quite a bit, it's not clear that this was actually a misdiagnosis. It appears to be considered something of a medical mystery how he was able to recover. That recovery, however, did leave him in a state of disability where he and his wife would both come to say that they wished they had just pulled the plug and let him go in 1980. It's a bizarre case, and Cranford may have made a mistake, but that was very long ago and it hardly disqualifies him from offering his expert opinion here or in the many, many PVS cases he's been part of since. PVS is a difficult diagnosis. Some studies suggest it is misdiagnosed very often. This is why so many doctors were asked to look at Terri. And all of the credible neurologists (not including "Nobel Prize nominated" liar William Hammesfahr) said it was PVS. That's got to count for something.

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