About two weeks ago there were reports that former president Chen Shui-bian (陳水扁), currently serving a prison sentence, was feeling some discomfort in his chest and suffering from shortness of breath. He was diagnosed with coronary heart disease (CHD) and heart failure by the prison doctor, and was later said to be experiencing severe headaches. Chen’s family and lawyers subsequently applied for a temporary prison release to arrange further medical examinations.
However, the warden of Taipei Prison said Chen’s illness was “not as serious as expected,” implying that a “medical parole” was unnecessary.
As a professor of medicine, my understanding is that oxygen shortage and the accompanying feeling of tightness in the chest experienced by CHD patients may be caused by a narrowing of the coronary arteries. If left untreated, the condition can cause occlusion of the main or branching coronary arteries, resulting in damage or localized death of heart muscle tissue, which is basically a heart attack.
In more serious cases, in which severe heart muscle tissue damage is caused by blockage of a main artery, the patient can die suddenly. Less serious cases will lead to heart failure, as appears to have happened to Chen. If he is short of breath while walking or even standing, as described in the newspaper reports, he may well have CHD or heart failure and will be in need of detailed examinations and advanced treatment.
Shortness of breath is not only a continuous symptom; it can also be intermittent depending, in some cases, on specific posture of a patient. It is also important to note that a patient does not necessarily feel the typical chest tightness when a small coronary artery or a small part of heart muscle tissue suffers.
A few years ago, a photographer of former vice president Lien Chan (連戰) passed away after doctors failed to diagnose symptoms of a heart attack when he felt discomfort in his chest.
Chen is a candidate for CHD or mild heart attack, considering his age and background. He should be granted the chance to undergo a detailed medical examination outside of prison. This is, at the very least, one basic human right Chen is entitled to as a Republic of China citizen, let alone a former president. After the exam results come back, a diagnosis would be made — by means of evidence-based medicine — to determine whether Chen has the diseases in question. If he does, he should be treated; if he doesn’t, or when he finishes the treatment, he should, of course, report back to the prison.
As a former member of the Human Rights Advisory to the president, I currently serve as convener of the Department of Health’s Working Group on Human Rights Protection for Hansen’s Disease (Leprosy) Patients. Chen and his family broke the law, leveraging his influence as president, but he has already received his prison sentence as punishment for his wrongdoings.
Now he should be judged on a fair basis. He should be permitted release for medical treatment if the prison doctor’s professional opinion suggests it is necessary. The apparently imprudent and unprofessional judgment made by the warden, on the other hand, seems to be inappropriate.
The right to health, as one of the basic human rights, will be enhanced if Chen’s case is properly handled. I also believe this would strengthen Taiwan’s democratic achievements.
Chen Yao-chang is a professor of medicine and forensic medicine at National Taiwan University Hospital.
TRANSLATED BY LIU YI-HSIN
Source: Taipei Times - Editorials 2011/01/12
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