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Irrelevance of the "Artificial" vs "Natural" Distinction

Arch Intern Med. 2005;165:2574-2576.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

The recent case of Terri Schiavo has reignited a public dispute about certain aspects of the care of patients who are severely cognitively impaired, including those in a persistent vegetative state. Schiavo’s parents repeatedly pointed out that her ability to swallow was never tested and believed that it was possible for her to be safely hand-fed. They also unsuccessfully petitioned the courts to be permitted to attempt hand-feeding if and when her gastrostomy tube was removed.¹ In the United States there is an ethical and legal consensus that a competent adult or surrogate may refuse any unwanted medical intervention. Since hand-feeding is not a medical intervention, this request by Schiavo’s parents may have appeared legitimate. In this article, we argue that a convincing response to their request cannot be made within the framework of the current consensus. Instead, we propose that under certain circumstances surrogates may choose that all forms . . . [Full Text of this Article]

AUTHOR INFORMATION

Robert D. Truog, MD; Thomas I. Cochrane, MD, MBA

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