Dehydration death called 'cruel, agonizing'

Is pain a factor for Terri Schiavo?

While some news stories have suggested her starvation is painless, the head of the Christian Medical Association is debunking what he calls "the myth" that it does not involve pain.

"Contrary to those that try to paint a picture of a gentle process, death by dehydration is a cruel, inhumane and often agonizing death," said Dr. David Stevens, who says most so-called experts have never seen someone die under such circumstances.

"Unfortunately, having worked for 13 years in Africa, where the most common cause of death in children is dehydration from gastroenteritis, I have seen hundreds if not thousands of patients with dehydration and some of them so far gone, that despite resuscitation attempts, they died."

Stevens, who represents a group of 17,000 physicians, explained what happens with starvation:

As dehydration begins, there is extreme thirst, dry mouth and thick saliva. The patient becomes dizzy, faint and unable to stand or sit; has severe cramping in the arms and legs as the sodium and potassium concentrations in the body goes up as fluids go down. In misery, the patient tries to cry but there are no tears. The patient experiences severe abdominal cramps, nausea and dry-heaving as the stomach and intestines dry out.

By now the skin and lips are cracking and the tongue is swollen. The nose may bleed as the mucous membranes dry out and break down. The skin loses elasticity, thins and wrinkles. The hands and feet become cold as the remaining fluids in the circulatory system are shunted to the vital organs in an attempt to stay alive. The person stops urinating and has severe headaches as their brain shrinks from lack of fluids. The patient becomes anxious but then gets progressively more lethargic.

Some patients have hallucinations and seizures as their body chemistry becomes even more imbalanced. This proceeds to coma before death occurs. The final event as the blood pressure becomes almost undetectable is a major heart arrhythmia that stops the heart from pumping.

But Stevens' statement is contradicted by other doctors.

"The cessation of eating and drinking is the dominant way that mammals die," Dr. Ira Byock, director of palliative medicine at Dartmouth Hitchcock Medical Center in New Hampshire told the Los Angeles Times. "It is a very gentle way that nature has provided for animals to leave this life."

Dr. Robert Sullivan at Duke University Medical Center told the Times that after 24 hours without any food, "the body goes into a different mode and you're not hungry anymore," he said. "Total starvation is not painful or uncomfortable at all. When we were hunting rabbits millions of years ago, we had to have a back-up mode because we didn't always get a rabbit. You can't go hunting if you're hungry."

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