Rebecca Rae Anderson

Rebecca Anderson is a genetic counselor and medical ethicist at the University of Nebraska Medical Center and is also a lawyer.Anderson suspects that most signers of the petition either didn't read it or didn't think about how far it would go.Anderson added, "What I don't know is if we can educate the state enough to turn it down."

Rebecca Anderson is a lawyer, genetics counselor and ethicist who counsels patient families and teaches ethics to medical students at the University of Nebraska Medical Center.She said several factors may be at work.

Among them, she said, are modern attitudes about death and dying and a belief by some that people should be kept alive at all costs.

"It used to be that half to a third of all children would die before adulthood," she said."And when people were sick and dying, you cared for them at home.That's not the case as much anymore.And there's a reduced understanding that death is a natural and inevitable process."

Another issue, Anderson said, is that some people consider a feeding tube basic -- not extraordinary -- care.
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Both Schulz and Anderson said there's some public confusion about what "persistent vegetative state" means and whether Schiavo -- shown blinking and moving her eyes in videos, not comatose as one might expect -- could ever improve.
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"When somebody's eyes open and the eyes are moving, people expect that person is processing information and has some awareness," Anderson said.
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Anderson and Schulz said that, in their experience, the vast majority of such disputes are settled in a single family meeting with a social worker, ethical consultant or medical staff member.
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Anderson said the ethical choice in such cases is whatever the patient would want or, if that's unclear, what is in the patient's best interest.

"Sometimes it's a comfort for the family to hear that it's their duty to do what the person wanted," she said.

Anderson said the doctors' oath to "first do no harm" applies to end-of-life care as well.Treatments that stand little hope of helping a person can be considered unnecessary and even torturous, she said.

But who gets to decide if the patient hasn't put his or her desires in writing or designated a decision-maker?

Anderson said Nebraska judges have discretion in determining the power of attorney if you haven't picked one, but typically the decision maker would be your spouse, your adult children, your parents, your siblings or other relatives -- in that order.
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Anderson added one additional lesson to be learned from the Schiavo case: Never let family quarrels get out of hand, and call in a mediator if you can't agree.

"When you see a dispute arising, gather family members together and try to resolve it," Anderson said.

• Rebecca Rae Anderson is associate professor of health promotion, social and behavioral health sciences at the University of Nebraska Medical Center in Omaha. She is a board-certified genetic counselor, a member of the Social, Ethical, Legal Issues Committee of the American College of Medical Genetics and the author of Religious Traditions and Prenatal Genetic Counseling. Contact 402-559-1997, randerso@unmc.edu.