Senator Bill Frist, a Tennessee Republican who was a leading heart surgeon before he turned to politics, added a new twist to the bitterly fought case when he offered a controversial medical opinion based on his reviews of family videotapes of Schiavo lying comatose in bed.

Frist took to the Senate floor to dispute findings by Florida doctors that their 41-year-old patient was in a “persistent vegetative state”.

After seven years of legal wrangling over whether Schiavo should be kept alive artificially, the Florida judge in charge of the case ruled last week that her feeding tubes could be removed.

Yesterday she began her first full day without food or water and is expected to die within two weeks unless another court overturns Judge George Greer’s ruling. The case has provoked a frantic effort by conservative politicians to keep Schiavo alive. Tom DeLay, the Republican leader in Congress, called the removal of the feeding tubes “barbarism” and “an act of medical terrorism”.

Frist, the Republican leader in the Senate and a potential presidential candidate in 2008, dropped a bombshell in both medical and political circles by offering a lengthy diagnosis based on video footage that he said he had spent “an hour or so looking at” in his office.

He quoted several medical texts and concluded: “She certainly seems to respond to visual stimuli.” His remarks were widely seen as an attempt to court conservative right-to-life activists who claim that removing Schiavo’s feeding tubes is tantamount to state-approved murder. Schiavo’s parents are convinced that she responds to their voices and that medical advances might one day improve her condition.

Yet Frist’s comments and continuing efforts by Congress to overturn Greer’s ruling appalled supporters of Schiavo’s husband Michael, who believes his wife has no cognitive powers. He has been arguing for years that she should be allowed to die and recently turned down a $1m offer from a right-to-life supporter who wanted him to walk away from the case.

Democratic officials accused Frist of playing politics with a family tragedy. “It’s quackery,” said Jim Jordan, a Democratic strategist. “It would be hilarious if it wasn’t so grotesque.”

“I suspect that Senator Frist has his eye more on the Iowa caucus (the launch pad for the presidential campaign) than the Hippocratic oath,” added Marshall Whitmann of the Democratic Leadership Council.

Medical ethicists also questioned the propriety of a heart surgeon commenting on a neurological case without even examining the patient.

There was further uproar over an attempt by Congress to sidestep Greer’s ruling. A congressional committee issued a subpoena for Schiavo to give evidence, although she has not been able to speak since she suffered a near-fatal heart attack 15 years ago.

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