When Is A Doctor Not A Doctor?

By DemFromCT

Is Bill Frist being a surgeon when he reviews a videotape and makes a complex diagnosis without examining the patient? Is Howard Dean being an internist when he suggests Frist is inappropriately diagnosing the patient that way? My internist would certainly agree with Dr. Dean on that one. Frankly, surgeons have no business acting like neurologists (special exception for neurosurgeons, which Frist ain't) and no doctor should be diagnosing anyone without seeing the patient (again, rare exceptions. My pediatrician can diagnose croup over the phone). But all of the above, including Congress' doctors, dentists and nurses, are not acting as medical personnel when they act as partisan politicians.

Enter Jeb Bush. Wisely realizing that he can't rely on Dr. Frist, he arranges for a neurologist with a healthy seasoning of religion to get into the act.

William P. Cheshire Jr., the Florida doctor cited by Gov. Jeb Bush yesterday in his announcement that he would intervene again in the case of Terri Schiavo, is a neurologist and bioethicist whose life and work have been guided by his religious beliefs.

Dr. Cheshire directs a laboratory at the Mayo Clinic branch in Jacksonville dealing with unconscious reflexes like digestion, and he is director of biotech ethics at the Center for Bioethics and Human Dignity, a nonprofit group founded by "more than a dozen leading Christian bioethicists," in the words of its Web site.

In an article last year in Physician magazine, published by the evangelical group Focus on the Family, Dr. Cheshire, 44, said doctors are too quick to declare that a patient is in a persistent vegetative state.

So now we have a real expert involved. Someone the public can have confidence in.

Mr. Bush called Dr. Cheshire a "renowned neurologist," but he is not widely known in the neurology or bioethics fields. Asked about him, Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, replied, "Who?" ...

Dr. Ronald Cranford, a neurologist and medical ethicist at the University of Minnesota Medical School who has examined Ms. Schiavo on behalf of the Florida courts and declared her to be irredeemably brain-damaged, said, "I have no idea who this Cheshire is," and added: "He has to be bogus, a pro-life fanatic. You'll not find any credible neurologist or neurosurgeon to get involved at this point and say she's not vegetative."

He said there was no doubt that Ms. Schiavo was in a persistent vegetative state. "Her CAT scan shows massive shrinkage of the brain," he said. "Her EEG is flat - flat. There's no electrical activity coming from her brain."

Dr. Cheshire entered the field of bioethics relatively late in his career. A profile of him on the Web site of Trinity International University, where he enrolled in the master's program in bioethics in 2000, states that he was "searching for how he should integrate his faith with his medical career." After getting the degree, he became an adjunct professor of bioethics there.

A search of his publication record in the online medical library PubMed yielded articles in medical journals, with a focus on headache pain, in particular trigeminal neuralgia, a painful disorder originating in a cranial nerve called the trigeminal. None of the papers dealt with persistent vegetative states.

His papers show a fondness for puns, as in the title of a letter to The New England Journal of Medicine about a patient whose fillings caused an electrical current that made her condition worse: "The shocking tooth about trigeminal neuralgia."

He was also the author, with others from the Center for Bioethics and Human Dignity, of a paper opposing stem cell research.

So what if reality and image are blurred once again. So what if medicine and science take a hit in the name of politics. Who cares about that, anyway? We've got reporters to bamboozle and cable networks to confuse. Thank God cable doesn't fact check, or the public might really get confused.

[UPDATE] David Schuster (writing on Hardblogger) has some choice words for Frist as well:

As part of our coverage in the Terri Schiavo case, I've been consulting and talking with several doctors. And while they disagree on who should decide Schiavo's fate, what tests should have been done, and the different steps the Florida courts might have taken, these physicians are united in their disgust over one key player in the Schiavo case— Senate majority leader Bill Frist.  As one doctor said, "Frist has embarrassed and brought shame upon the medical profession."

For the MSM, this is pretty scathing stuff.

 

Comments

[emptypockets]

Bioethics, a infant field with the potential to do great good over the next century, seems to be becoming nothing more than a comfortable chair for nonscientists to sit in while they tell scientists what to do.

[Meteor Blades]

Bioethics? How about some plain, old-fashioned ethics? Like not exaggerating or concocting your credentials? I don't know who is worse, the rulers who try to fool the megamedia, the fools reporting for the megamedia, or the tools running the megamedia.

[Hprof]

Thanks for this, DemFromCT--his credentials sounded fishy, but this nails it.

As for Meteor Blades' question, about who is worse--my answer, in descending order:

Rulers
Tools
Fools

Simply on the principle that those with the most power are to be held most responsible for its abuse....

[Nellcote]

How does one file a complaint with Frist's liscensing board?