Helen Valois
March 29, 2006
A recent history of starvation/dehydration
By Helen Valois

When one reads stories about Terri Schindler-Schiavo, one often encounters a timeline which places her on a continuum with Karen Ann Quinlan and Nancy Cruzan. It is difficult, however, to understand why these cases are thought to be related. Quinlan's parents removed a respirator, not a feeding tube, from their daughter. "When asked if he also wanted her intravenous feeding ended, her father said, 'Oh, no, this is her nourishment!'" according to Nat Henthoff [1]. In Nancy Cruzan's case, it was her own parents who, unlike the Schindlers, fought to kill their daughter. Instructively, Joe Cruzan, Nancy's father, also killed himself shortly thereafter. So as we ponder the meaning of Terri's execution-by-court-order this week, why not situate it in the context of precedents that are more pertinent?

Take the case of Paul Brophy, for instance. A firefighter who suffered a ruptured blood vessel at the base of the brain, Brophy was being fed by tube and was diagnosed, amidst medical controversy on this point, as being in a "persistent vegetative state." His wife Patricia went to court to have the tube removed, on the grounds that: "My husband is not the man I married . . . In essence his life is over. . . . There is no quality of life." [2] Sound familiar?

If reporters wanted to bring up cases that would truly shed light on the Schindler-Schiavo situation, they might direct our attention to scenes like this one, that occurred during the Brophy trial [3]:

There was another thing the judge wanted to know. If he ruled that all nutrition and hydration should be stopped, what would happen to Paul Brophy? He would die within five days to three weeks. But how would he die?

In his findings of fact, the trial judge, David Kopelman, listed the effects 'Brophy's body would be likely to experience' if he were to be deprived of all nutrition and hydration.

This is what the judge found out:

  1. His mouth would dry out and become caked or coated with thick material.

  2. His lips would become parched and cracked or fissured.

  3. His tongue would become swollen and might crack.

  4. His eyes would sink back into their orbits.

  5. His cheeks would become hollow.

  6. The mucosa (lining) of his nose might crack and cause his nose to bleed.

  7. His skin would hang loose on his body and become dry and scaly.

  8. His urine would become highly concentrated, causing burning of the bladder.

  9. The lining of his stomach would dry out, causing dry heaves and vomiting.

  10. He would develop hyperthermia, a very high body temperature.

  11. His brain cells would begin drying out, causing convulsions.

  12. His respiratory tract would dry out, giving rise to very thick secretions, which could plug his lungs and cause death.

  13. Eventually his major organs would fail, including his lungs, heart, and brain.

This information disturbed the judge. So did testimony by Dr. Richard Field, the chief of staff at New England Sinai Hospital, where Paul Brophy was a patient. Dr. Field was asked if he had ever seen a person dehydrate and starve to death.

Yes, he had. When?

During World War II, Dr. Field explained, he had been attached to an infantry division, and it was his division that liberated Dachau.

The courtroom became very quiet.

'I saw,' Dr. Field said, 'literally thousands of people who had been subject to both dehydration and starvation both dead and dying . . . Bringing about death through dehydration and starvation is a barbaric and savage way to induce death, and as such is cruel and abusive and unconscionable.'

Dr. Field made it clear that if the court ordered him to remove Paul Brophy's feeding tube, he would, in conscience, refuse. And so would the other doctors and the nurses at New England Sinai Hospital.

This information convinced Kopelman, who ruled that Paul Brophy's feeding tube must stay in place. Patricia Brophy, however, appealed to the Massachusetts Supreme Judicial Court, which reversed the trial judge. Mr. Brophy's spouse was given judicial permission to move him to a more cooperative facility, where he died of starvation/deydration not long afterwards.

But, wait a minute. Weren't we all lectured at length, when Congress gave Widdemore's court authority to review Terri's case de novo, that trial judges are in the best position to do fact-finding, that they must not be second-guessed by outside parties (like other courts, the Governor, the Congress, the President, the Vatican, etc.) who cannot possibly be asked to understand the situation as well as they do? Evidently second-guessing is no problem, when it leads in the direction of death.

So, Terri is far from being the first denizen of the modern age to be starved/dehydrated to death. It happened in Missouri to Nancy Cruzan, and in Massachusetts to Paul Brophy. (For a detailed chronicle of other American cases, too extensive to go into here, see the website of the International Task Force Against Euthanasia and Assisted Suicide, www.internationaltaskforce.org). And it happened in Dachau and at other death camps, in massive numbers. Remember the martyrdom of Father Maximilian Kolbe at Auschwitz, when he traded his life for that of another man chosen to die in the hunger bunker? We are told that some of his nine condemned confreres took to drinking from their own buckets of urine, as the days of their deathwatch wore on. Even they, unlike Terri, were permitted to take something per os.

"The methods used in these camps were varied," Dr. Wertham explains. "They included, among others, shooting, hanging, poisoning, torturing, beating to death, 'extermination by labor' (i.e. working to death), starvation, carbolic acid injections into the heart, burning alive, wounding and leaving to die in mass graves with others already dead, vivisection, stomping, drowning, electrocution, locking as a group in a bunker and throwing grenades into it, freezing wither in icy water or from standing naked in snow, clubbing or kicking to death, and keeping people packed in upright position in a cell with only standing room until they died." [4] And of all these approaches, according to author and concentration camp survivor Dr. Elie A Cohen, starvation/dehydration was the most sadistic, the most feared. [5]

Still, it was not the SS man with his shiny boots and steely expression who originated this procedure in its modern context. It was the "expert" the doctor, the psychiatrist, the philosopher, the association of irrefutable, professional elitists who both launched and responded to a "spirit of the age" in which starvation/dehydration became the kingpin. Consider this scene reported by Dr. Wertham, which took place well before any concentration camp had opened its hellish gates [6]:

As early as autumn 1939, a student of psychology, later a public-school teacher, Ludwig Lehner, was permitted with other visitors to go through the state hospital Eglfing-Haar. He went there as part of his studies in psychology. In the children's ward were some twenty-five half-starved children ranging in age from one to five years. The director of the institution, Dr. Pfannmueller, explained the routine. We don't do it, he said, with poisons or injections. 'Our method is much simpler and more humane.' With these words, the fat and smiling doctor lifted an emaciated, whimpering child from his little bed, holding him up like a dead rabbit. . . . The methods employed were deliberate withdrawal of food, poisoning, or in many cases a combination of both. The poisoning was done by injections or overdoses of drugs. Patients screaming from hunger were not unusual. If it got too bad, they were given injections which quieted them, made them apathetic, or killed them. This was called euthanasia too. 'Euthanasia' by starvation.

"Such methods," Dr. Wertham goes on to comment, "had the advantage of more discretion; patients who were destroyed in this way could be more easily counted as 'natural deaths.'" Keep this in mind the next time you hear that Terri wafted out of this world in peaceful bliss. When someone minimizes Terri's demise by pointing out that such happenings are not out of the ordinary, remind them about the sort of society which considers starvation/dehydration commonplace.

And when someone tells you not to worry any more about what happened to Terri, that what's done is done and we can all turn our attention to more recent news events, realize that they are echoing the sentiments of one Father John Paris, a medical ethicist from Holy Cross College who served as a witness for Patricia Brophy. "Some people," he is said to have commented sardonically in reference to the imminent slaying of her incapacitated husband, "are getting very, very excited about starving someone to death." [7] And I say the more excited the better.


[1]  Henthoff, Nat. "The Small Beginnings of Death," in The Human Life Review, Spring 1988, pp. 53-88; p. 59.

[2]  Patricia Brophy's testimony before the Trial Court, Probate and Family Court Department, Massachusetts, 1986; in Henthoff, p. 78.

[3]  Henthoff, pp. 78-80.

[4]  Wertham, Fredric, M.D. A Sign for Cain: An Explanation of Human Violence. (Macmillan, 1966; excerpts reprinted as The German Euthanasia Program, Hayes, 1976), p. 10.

[5]  This can be considered a central point raised in his work, Human Behavior in the Concentration Camp (New York: Grosset and Dunlap, 1953; translated from the Dutch by M. H. Braaksma).

[6]  Wertham. pp. 52, 55-6.

[7]  In Henthoff, p. 81.

© Helen Valois

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Helen Valois

Helen M. Valois is a homemaker and mom currently residing in the northwoods of Wisconsin. She is a member of the MI (Militia Immaculatae) movement founded by St. Maximilian Kolbe. In 1996, she received a Master's Degree in Theology from Franciscan University of Steubenville. Helen's articles and book reviews have appeared in a number of publications since that time.


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