“Much Ado About Nothing?” Ben Carson on Starving Terri Schiavo.

Terri Schiavo [1]Presidential candidate, Dr. Ben Carson, was recently quoted in the Washington Post  regarding the starvation death undergone by the severely brain injured (and NOT brain dead) Teri Schiavo,

“We face those kinds of issues all the time and while I don’t believe in euthanasia, you have to recognize that people that are in that condition do have a series of medical problems that occur that will take them out,” he said. “Your job [as a doctor] is to keep them comfortable throughout that process and not to treat everything that comes up.”

When the reporter asked whether Carson thought it was necessary for Congress to intervene, he said: “I don’t think it needed to get to that level. I think it was much ado about nothing.”

While this has occasioned all manner of denunciations in pro-life quarters, Carson’s comments as a pediatric neurosurgeon are particularly potent, and merit a measured analysis and response.

Recalling that time, many news outlets carried the news that Schiavo was brain dead. If that was what was in Carson’s mind when he made his statement to WaPo, then his comments would appear to make clinical sense, though lacking in any warmth or sensitivity toward the family she left behind. Further, Catholic bioethics would agree that in the case of an active dying process, one would try to keep the individual comfortable, while not treating everything that comes up.

But Terri Schiavo existed in a steady state for years. She wasn’t dying, nor was she dead.

There are many of us in science and medicine who contend that what is called, “brain death,” is so broad in its criteria that the majority so labeled are not actually dead yet. It has become a convenient set of criteria to help facilitate the organ transplant industry.

The fact that many of these “cadavers” are administered anesthetics during the harvesting should be a rather obvious indication that something is terribly, terribly wrong with our diagnostic criteria for death, especially brain death.

It has always been the contention of Terri Schiavo’s family that they had physicians who challenged the diagnosis of brain death, and that these voices were largely ignored by the media and the courts.

What next becomes troubling about Carson’s comments is the notion that a “brain dead” person could have existed in an intact, dynamic physiological state for years. Dead people don’t track visual stimuli, something that Schiavo did and had captured on video. Doctors for her husband called it a “reflex,” though there is not balloon-tracking reflex that I have ever seen in medicine. In fact, one of the criteria for brain death is the absence of deep reflexes.

So how a “dead” brain would be capable of processing visual stimuli and formulating commands to the motor neurons to move the head and eyes along with the side-to-side motion of the balloons, Carson did not say or care to opine.

Dead brains don’t see, don’t process what they can’t see, and don’t issue commands to follow what they can’t see.

They’re dead.

A world-renowned pediatric neurosurgeon certainly knows these things. He should also know that a brain alive enough to have brainwave activity, track visual stimuli, and maintain dynamic, integrated systems functioning is a brain that can’t be, “kept comfortable,” while it is being starved and dehydrated to death.

Carson knows this. He also knows that severely brain damaged people are not the same as people who are dead.

Perhaps the question for Carson in the next debate would be whether he thinks severely brain damaged people such as Terri Schiavo aren’t worth the expenditure of medical and financial resources. If so, then perhaps Dr. Carson might define for us the functionality and worthiness criteria he would have a national healthcare system use in determining when enough is enough.

When is it much ado about nothing, and when does the finality of a single human life degenerate into much ado about nothing?

This scientist would dearly love to know.

Dr. Gerard Nadal is Science and Health Education Policy Advisor for the Bioethics Defense Fund. He holds a Bachelor of Arts degree in Psychology with a minor in Philosophy from Saint John's University, New York City. After his post-baccalaureate sciences at Columbia University, New York City,  Dr. Nadal returned to Saint John's University where he received his Master of Science in Cellular and Molecular Biology, Master of Philosophy in Biology, and Ph.D. in Molecular Microbiology. Also a member of University Faculty For Life and the Catholic Writers Guild, Dr. Nadal is a columnist for Headline BistroDr. Nadal also serves on several advisory boards, including the Coalition on Abortion/Breast Cancer, Good Counsel Homes, and the Children First Foundation. A Fourth Degree Knight of Columbus and unapologetic Roman Catholic loyal to the Magisterium, Dr. Nadal and his wife home school their three children. He blogs at Coming Home.

  • Howard

    This is very disturbing. I’m afraid Ben Carson is probably the best candidate with a realistic chance of winning, but sometimes the best available is still not good enough.

    There are better things he could have said that perhaps capture his meaning, but (1) he didn’t actually say them and (2) we can only speculate about what he “really meant” apart from the words he used. That said, the focus on palliative care might be appropriate in many cases, but, depriving someone of food and water scarcely qualifies as “keep[ing] them comfortable throughout that process and not … treat[ing] everything that comes up.” As for the involvement of Congress, it would have been defensible if he had said that hard cases make bad laws, and that rapid changes in medicine mean it can be counterproductive to legislate the details of medical treatments rather than general principles.