Sunday, March 27, 2005

Dr. Cheshire

The Mayo Clinic is unhappy. Dr. William Cheshire is a doctor at the Mayo Clinic's, and he weighed in on Terri Schiavo lately. The Mayo Clinic issued this Comment on Dr. William Cheshire's involvement with Department of Children and Families:
Dr. William Cheshire was asked by the Florida Department of Children and Families to share his expertise related to potentially vulnerable adults. As part of this commitment, he was asked to render his professional opinion for the state of Florida in the case of Terri Schiavo. He observed the patient at her bedside and conducted a review of her medical history but did not conduct an examination.

Mayo Clinic recognizes that the standard of care for the evaluation of a comatose patient includes a detailed review of the patient’s history and previous evaluations as well as the performance of a comprehensive neurological examination. In some instances, electrophysiological and imaging studies may be used to establish a diagnosis.

The views expressed by Dr. Cheshire in the case of Terri Schiavo do not represent the opinion of Mayo Clinic or its Departments of Neurology. The Mayo Clinic Departments of Neurology do not have opinions regarding the diagnosis of Terri Schiavo because they have not performed an evaluation as described above.
He is a volunteer for the Florida Adult Protective Services. He was asked, in words taken from his affidavit, "to provide an independent and objective medical review of allegations of possible abuse, neglect, or exploitation of Theresa Marie Schiavo." He goes on to note specifically that "no one from the Department of Children and Family Services has inquired about my personal views about treatment decisions in cases of persistent vegetative state (PVS)." He then spends 7 pages describing how he thinks PVS should be treated, and does not specifically address the issue of "abuse, neglect, or exploitation."

I've argued, and will continue to argue, that Ms. Schiavo is being exploited, but not by her husband. There is a machine at work, composed of various people and organizations, like Randall Terry, Larry Pratt, Tom Delay, TRMPAC, Focus on Families, the Christian Medical and Dental Association, and Operation Rescue, which are using Terri Schiavo as a lever.

In a profile by the Trinity International University, where he got a masters in bioethics, Cheshire is revealed as a religious ideologue. His view of the dangers facing us: “even more than terrorism, bioethics presents us with the crucial decisions of our day that the church dare not ignore.” The article says that

He argues that we—as believers—“have been entrusted with a particular understanding of human nature that is vitally joined to the realities of our transcendent origin.” Some of the human realities that Bill describes include our “tragic fallenness, miraculous redemption, divinely appointed purpose, and future promise.” Do we dare lose sight of these vital connections to our Creator, making up our own moral laws instead of following the teachings of our God? Not just that, but “to lose sight of the transcendent value of early human life would be to risk abandoning the inestimable value of human life.”
This certainly raises the question of his motivations in visiting Ms. Schiavo. If his concern was with abuse or neglect, you'd think that he'd make some conclusion on the matter. If his concern was scientific, he wouldn't make this laughable claim:
To enter the room of Terri Schiavo is nothing like entering the room of a patient who is comatose or brain-dead or in some neurological sense no longer there. Although Terri did not demonstrate during our 90 minute visit compelling evidence of verbalization, conscious awareness, or volitional behavior, yet the visitor has the distinct sense of a living human being who seems at some level to be aware of some things around her.
I'm no doctor, but I am a scientist. I know that consciousness is tricky to define. But if each standard test of consciousness is absent, it is unscientific to claim that it's still there. His gestalt of the situation isn't the issue, because his personal biases are transparent. We have standardized methods for a reason, and the Mayo Clinic is quick to note that he did not apply those standard methods and that his opinion should not be considered an official statement of his institution, which is to say that the Mayo Clinic doesn't think his opinion is a medical opinion. In that sense, his opinion is worth little more than mine, and substantially less than the medical opinions of the doctors who've conducted legitimate examinations.

Here's what the Guardian ad Litem says of one bout of exams.

The scientific quality, value and relevance of the testimony varied. The two neurologists testifying for Michael Schiavo provided strong, academically based, and scientifically supported evidence that was reasonably deemed clear and convincing by the court. Of the two physicians testifying for the Schindlers, only one was a neurologist, the other was a radiologist/hyperbaric physician. The testimony of the Schindler’s physicians was substantially anecdotal, and was reasonably deemed to be not clear and convincing.

The fifth physician, chosen by the court because the two parties could not agree, presented scientifically grounded, academically based evidence that was reasonably deemed to be clear and convincing by the court.
The three doctors who provided evidence which was "scientifically grounded" and "academically based" concluded that she was in PVS. That's the same conclusion that doctors have reached before and after those exams. As Dr. Ronald Cranford, told The New York Times:

You'll not find any credible neurologist or neurosurgeon to get involved at this point and say she's not vegetative.

And so he's using Terri for leverage on a fight over stem cells and bioengineering. He was sent in to evaluate whether Ms Schiavo was being exploited, and used it as an opportunity to exploit her.