Monday, March 21, 2005

FRIST ON SCHIAVO. There's little doubt that some members of Congress are posturing on the Terri Schiavo issue. Still, I think it's important to listen to Senate majority leader Bill Frist, who is, as we know, a physician.

I am not a Frist fan. But these remarks come across as a genuine attempt by a politician-doctor to understand precisely what is going on with Schiavo. The transcript is obviously pretty rough, but it's worth making the effort to read it all the way through. In these excerpts, I'm cleaning the transcript up a bit for readability:

I called one of the neurologists who did evaluate her, and evaluated her more extensively than what at least was alleged other neurologists had. And he told me very directly that she is not in a persistent vegetative state. And I said, "Well, give me a spectrum" from this neurologist, who examined her. To be fair, he examined her about two years ago, and to the best of my knowledge, no neurologist has been able to examine her [since]. I'm not positive about that, but that's what I've been told.... But at that time, clearly she was not in a persistent vegetative state.


The attorney for Terri's parents have submitted 33 affidavits from doctors and other medical professionals, all of whom say that Terri should be re-evaluated.... Either 14 or 15 of these affidavits are from board-certified neurologists. Some of these doctors very specifically say they believe on the data that they had seen that Terri could benefit from therapy. There have been many comments that her legal guardian - that's Terri's husband - either has not been aggressive to rehabilitation to other reports that say that he has thwarted rehabilitation since 1992. I can only report what I have read because I haven't met him. Persistent vegetative state, which is what the court has ruled - I say that I question it. I question it based on a review of the video footage, which I spent an hour or so looking at last night in my office here in the Capitol. And that footage, to me, depicts something very different than persistent vegetative state.


In 1996, a British medical journal study conducted at England's Royal Hospital for Neurodisability concluded that there was a 43 percent error rate in the diagnosis of PVS [persistent vegetative state]. It takes a lot of time, as I mentioned earlier, to make this diagnosis with[out] a very high error rate. If you're going to be causing someone to die with purposeful action, withdrawal of a feeding tube, you're not going to want to make a mistake in terms of diagnosis.

Now, it's certainly possible that Frist's knowledge of medicine greatly exceeds his knowledge of the facts in this specific case. Just for starters: I thought Terri Schiavo had undergone tests far more extensive than Frist seems to believe, and it may well turn out that Frist is wrong. Still, a few observations are in order here:

1. Frist's comments are clearly those of a thoughtful, anguished person who understands a lot more about brain damage than the ideologues on either side of this case do. I find it interesting that he thinks the video clips are useful, since a commonly voiced criticism is that they only represent a few minutes excerpted from more than four hours of trying. I assume Frist knows that.

2. Even if Schiavo is not in a chronic vegetative state, she still has a right to die, whether Frist and his fellow Republicans like it or not. The courts have ruled that she expressed a desire to die if she ever found herself in such miserable circumstances.

3. Which brings me right back to where I started on Saturday. Indeed, if Schiavo really isn't in a persistent vegetative state, that should make this all the easier. Just ask her! Either Judge Greer or a designated representative, accompanied by Schiavo's family, should spend a few hours at her bedside to attempt to determine whether she is capable of responding to questions about her fate, as the family's lawyer, Barbara Weller, claimed the other day.

If she is, and she expresses a desire to live, then that obviously supersedes what she told her husband, Michael, many years ago. If she isn't, then we have to accept that this is a charade, as most of my fellow liberals have already concluded. At that point, she could be allowed to die with dignity, and the political grandstanding now under way could be brought to a rapid end.

GOOGLE 101 AND PUBLIC SAFETY. The Boston Globe today publishes a terrifying story about a website in which folks caught on the wrong side of the criminal-justice system can finger people who they believe may be police informants.

There is a moment of unintentional black humor. Reporter Kathleen Burge writes:

The Globe is not naming the website because it is impossible to verify whether all the people listed there are informants, and because publicizing access to their identities could jeopardize their safety.

Hmmm ... I didn't time myself, but I'm pretty sure it took me less than 30 seconds to find the site based on hints in Burge's story. I'm not going to identify the site, either. But I'm not going to pretend that anyone can't do what I just did.


Anonymous said...

I'm pretty horrified by the suggestion that I'm about to make, but poor Terri's dignity has long since been tossed aside in this case. So, about bringing cameras into her room and arranging for a live "interview" with her --- I think Larry King would be the best choice for this ghoulish little exercise. If she tells Larry that she wants to live, then obviously the court case becomes null and void and her wish to continue to live should be respected.

However, if it's clear that she's unresponsive, then we should trust the Florida courts on this. That would also get us away from the cherry-picked video that everyone has seen. I know her parents would say she's just having a bad day, but come on.

And Frist? He's running for President and has hitched his wagon to this star. He's free to make armchair diagnoses if he wants (and I'm sure he can do it in a way that makes him seem thoughtful and genuine) but we should also be free to see his words through the lens of a guy running for President who wants to win votes from the pro-life crowd.

Lis Riba said...

Amy Sullivan has a nice takedown of Frist's history of using his medical degree to make scientifically-dubious political pronouncements at

Anonymous said...

Frist *was* a practicing, licensed physician, it is true.

He *is* also a doctrinaire right-wing idealogue who's running for the GOP nomination in '08.

As such, he is beyond either shame or reasonable examination of an issue.

Anonymous said...

RE: Google 101 - This story was published 1/12/05 in Herald,one could almost say it was "lifted" from there.

Frist just another chump, who once said he gave up medicine for the money.

Anonymous said...

Dan, are you kidding? Frist is making a "genuine attempt by a politician-doctor to understand precisely what is going on with Schiavo"?

He's only become involved to score political points with the Religious Right crowd. He was silent when Lauren Rainey was getting her medicaid cut off. He said nothing in support of the Hassan orphans. He's never criticized George W. Bush's Texas Futile Care Law , which allows hospitals to remove life-support against the wishes of family members and was recently used to cut-off support for a conscious, 6-month old Sun Hudson.

Frist is a right-wing ideologue. He made-up his mind and supported federal government interference into the Schiavo case before ever learning a single fact about it --because the Religious Right crowd already had adopted it as a political wedge. Frist wouldn't change his political posture no matter how many doctors, judges, nurses and family members contradict him.

And come on, d'ya think the millionaire Religious Right groups can't pay for "experts" to back-up whatever view they want?

Nelson, Roslindale

Anonymous said...

Gee Dan,

Are you going all Howard Kurtz on us? Frist does nothing in good faith. I'd feel more positive about his samaritan trips to Africa (or wherever) if he were less anxious to publicize them. Frist is a political hack, first, last, and always.

Your gut was right--you should have left the Schiavo mess alone.

Anonymous said...

Dan --

You're a good guy who evidently wants to see altruistic motives in everyone from Bill Frist to Tom DeLay to Jeff Gannon. But I can assure you, as one who grew up in a Southern Baptist household in Tennessee, that Frist and his fellow right-wingers are venal beyond your wildest blue-state imaginings. You need to spend a few years in the Bible Belt to grasp just how pious, mean-spirited and hypocritical -- un-Christian, actually -- these demagogues are.

Please stop giving them the benefit of the doubt -- or you will lose the support of the very readers who make your blogging possible.

P.S. Run, don't walk, to Dahlia Lithwick's posting today on Slate. She makes mincemeat of Frist and others (like you) who have based your medical conclusions on a very short and over-exposed video clip.

Anonymous said...

Before you trust Frist's word as a cardiac surgeon, perhaps you should read this from Respectful of Otters. And she's opposed to euthenasia, by the way.

Anonymous said...

Re: "I'm pretty horrified by the suggestion that I'm about to make, but poor Terri's dignity has long since been tossed aside in this case. So, about bringing cameras into her room and arranging for a live "interview" with her --- I think Larry King would be the best choice for this ghoulish little exercise."

Awww... don't be horrified, Paul. I actually like your idea! But CNN and Larry King's people would never in a million years go along with it -- Not because of the "ghoulish" factor -- but because they're definitely fearing, of course - that GWB's "Live & Let Die" Right-Hand-Man regarding Health and Inhumane Services - Senate majority leader Dr. First N. Last might actually declare Liberal Leaning Larry brain dead!

Besides; if they put the poor woman on tonight; Larry would have to cancel his Earth-Shattering interview with Michael Jackson's Anal Wart Removal Doctor and Personal Valet who CNN has already committed four and ½ hours of air-time to!

Anonymous said...

Dan - You cut Mr Frist a lot of slack, yet seem to put the heat on Judge Greer. Implying that he hasn't done his job well because he shouldn't only trust all the testimony from doctors, parents, husband, and previous trial verdicts, but should go visit her in person. Yet for Mr Frist, you think it's enough for him to view an outdated video of Mrs Schiavo, and give him the benefit of the doubt when he solemnly says he knows as a doctor that the video shows just how alive and responsive she is. Contrary to what the actual examining doctors have said again and again. At the least, I think you'd have to insist on Frist going to visit her too, before you supported his clap tr...I mean point of view. Then again, I have a nagging suspicion that he'd be a bit creative in his interpretation of what he saw if he were to visit.

Anonymous said...

Something we all have to step back for a moment and admit here...

The power of the web to make so many people concentrate on and perceive themselves as being "experts" or authorities regarding any given topic [in the NY Minute that has past since this story became the must-comment-on topic] is simply astounding.

"You need not tell the truth, unless to those who have a right to know it all. But let all you tell be truth." [Horace Mann]

Anonymous said...

While it's unsurprising that talk radio blowhards think reading a few editorials and watching a couple video clips gives them sufficient medical expertise to dispute years of first-hand professional examinations and CAT scans of Mrs. Schiavo, it's shocking how many journalists do the same thing.

Dr. Wolfsohn's report is dated Dec 1, 2003 and is publicly available. How many journalists (cough, cough, Media Log, cough) bothered to read it before making judgements on Schiavo's vegetative state or on the sincerity of people like Sen. Frist?
How many journalists actually read the findings of fact in the various legal judgements?

The intellectual laziness and shoddines of MSM "professionals" on the Schiavo case raises the question of whether Dr. Wolfsohn ought to examine them as well.

Nelson, Roslindale

P.S. I also highly recommend Dahlia Lithwick's Slate column.

Anonymous said...

From the LATimes:

Frist's comments raised eyebrows in the medical community.

Although there are no official rules against the practice, ethicists said, it is generally considered unprofessional for a doctor to make or question a diagnosis on the basis of incomplete information.

Anonymous said...

As for any religious pronouncements about "right to life," Here's something Susie Madrak snipped from a Salon interview with a bioethicist who happens also to be a Catholic priest:

This is Holy Week, this is when the Catholic community is saying, "We understand that life is not an absolute good and death is not an absolute defeat." The whole story of Easter is about the triumph of eternal life over death. Catholics have never believed that biological life is an end in and of itself. We've been created as a gift from God and are ultimately destined to go back to God. And we've been destined in this life to be involved in relationships. And when the capacity for that life is exhausted, there is no obligation to make officious efforts to sustain it.

Anonymous said...

Let's not forget that "Doctor" Wolfson is not a practicing physician or even a physician for that matter. According to his curriculum vitae he has law degree and a doctorate in public health. Do you think "he" examined Terri?