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Doctor Contrasts Terri Schiavo's and Pope John Paul II's Deaths

Dr. George Isajiw’s talk on end-of-life issues at the Delaware Pro-Life Coalition Convention April 2 couldn’t have been more timely.

Just two days earlier,amidst great national furor, Terry Schiavo had died of court-ordered starvation and dehydration.

Pope John Paul II was near death, and even as Dr. Isajiw was speaking, passed away.

The media coverage [on Schiavo and the Pope] has led to a parade of so-called experts in bioethics, many with conflicting and confusing claims,” said the doctor.

But these “bioethics experts” are more or less self-proclaimed, he said; there is no official discipline in bioethics in which one can be certified.

Dr. Isajiw has practiced general internal medicine since 1977. Through his ongoing experience with patients who are dying and in the end stages of life, and his knowledge of medical ethics gained from long-time, active involvement in the Catholic Medical Association, he has formed some definitive opinions on ethical end-of-life treatment of patients.

Much can be learned from the contrasting cases of Terri Schiavo and the Holy Father, he said. A vital distinction between the two is that John Paul was dying; Terri wasn’t.

Terri’s case was not about ‘end-of-life’ issues, as many were trying to frame it. It was about how you treat disabled people.

If someone isn’t dying, you can kill them, but you can’t ‘allow them to die,’” Isajiw explained: “in order to allow someone to die, they have to be dying of something in the first place. She wasn’t.”

Dr. Isajiw helped organize the International Congress on the Persistent Vegetative State held in Rome in March 2004.

It was at this congress that Pope John Paul II stated that food and hydration should be given to patients in the persistent vegetative state.

When the Holy Father made this statement, people said, ‘Oh, it’s not true! Even the Catholic Health Association in the U.S. has for many years been condoning the withdrawal of food and water.’ They said, ‘We have to study this; it’s a new teaching.’

But this is not a new teaching of the Catholic Church,” Isajiw insisted. “A feeding tube is not extraordinary treatment.”

The feeding tube, which has been in use for a hundred years, is nothing more than a conduit inserted in the stomach, he explained; beyond that, everything happens ordinarily, unlike intravenous feeding.

I have seen openings for rings in belly buttons much bigger than openings for feeding tubes!” he said.

The term, “persistent vegetative state,” (PVS) was coined in 1972 in an article in the British medical journal, Lancet, entitled, “Persistent Vegetative State after Brain Damage: A Syndrome in Search of a Name.”

In PVS, the article’s two authors stated, the brain-damaged person is awake, but not aware of what is going on around him.

The authors were not sure whether people could communicate with these patients.

It was a cautious diagnosis, but the medical community ran with it,” said Isajiw. “So it became a hard-core diagnosis that could be your death sentence.”

At the 2004 conference in Rome, he said, “There was agreement that PVS is misdiagnosed 30 percent of the time.

So you’re talking about giving people a death sentence and you’re not even sure it’s the correct diagnosis.”

He noted that some of the neuro-rehabilitators from Europe at the conference showed videos of the progress that patients in supposed PVS had made: “It was absolutely amazing!”

The Church teaches that you have a duty to accept ordinary treatment; otherwise, you are committing suicide, the doctor said. But extraordinary treatment is optional.

The Vatican declaration on euthanasia says that the judgment as to whether a treatment is ordinary or extraordinary should be left up to the doctor who is most expert in that area.

If it is extraordinary treatment, it’s up to the patient whether he has it,” said Isajiw.

In contrast to Terri, who was not dying, the Holy Father was dying; his kidneys had failed, and he couldn’t control his lungs. Knowing that death was near and certain, he declined extraordinary treatment.

We are never allowed to choose death,” said the doctor.

But we are justified in refusing extraordinary treatment when the treatment itself is going to cause pain and suffering; it’s going to have a very limited benefit; it may prolong life, but not very long; and it’s the suffering that the treatment will cause that we are rejecting.

It’s not a decision to die: it’s a decision not to accept additional burdens from the treatment.”

The rationale for euthanasia is, “I’d rather be dead than suffering,” said Isajiw.

The Church rejects all euthanasia on the basis that death is not necessarily the end to all suffering – has anybody heard of Hell or Purgatory? – and that eternal life is not inevitably achieved by death.”

In a society that denies this, we will inevitably have euthanasia, just as we have abortion, he said.

It will take a great religious awakening to reverse it.”