Terri Schiavo rant

[Edited. I didn't realize when I first posted it that MS Word had put a whole batch of odd stuff in it. My apologies. I'm not sure it's 100% clean, but it's cleaner than it was. --Liam]

I plan to write a more humorous essay on my opinions in the "right to die / do not resuscitate / no extraordinary measures” debate, but this one’s been eating at me since the decision was made last week to remove the feeding tube, so I have to rant for a bit.

My problem is that once again, I fall somewhere in the middle of the story, and it’s hard to know how to feel about this SPECIFIC case, because we don’t have all of the details. I haven’t followed the case as closely as I should have, so some of the "facts" as I understand them may not be, and if you know something to be different, please post a comment or e-mail me and correct me.

That said… There are a lot of issues here. There’s money involved. There are the wishes of the woman in question. There’s morality.

The thing that makes it difficult for me is that we don’t KNOW the wishes of Terri Schiavo. She did not leave a living will behind, nor a health care directive. Even had she, I’m not sure how clearly applicable it would be to this case. But the point of the case is that we have only her husband’s word and her parents’ as to what she "would have wanted".

I do not believe in the sacredness of life, when life is technical only. If Ms. Schiavo was in a non-responsive coma, with so little brain function she could not even keep her own heart beating or lungs breathing, then I do not believe any favors are done for anyone by keeping her alive, because she clearly would not be, except in the barest of medical technicalities. That case does not apply here. We’ve all seen the video (shown in endless exploitation on the news shows) of her sitting up, visibly conscious, even smiling. She’s not, by any stretch of the imagination, dead. Which means even had she left a health care directive, I’m not sure it would be clear that this is a case of “permanent vegetative state”.

The argument has been made by co-workers of mine that withholding a food/water tube is only different "by degrees" from mechanically keeping a heart beating and lungs pumping, but I see a clear distinction. If your brain is damaged so badly that not only are you not conscious and non-responsive, you can’t even sustain minimal life signs in your own body, you are pretty clearly beyond any reasonably hope for recovery. However, the brain does some amazing things, retraining itself to do things in working parts of itself which used to be handled by damaged parts. It seems to me that if Terri Schiavo is capable of being conscious and mildly responsive (such as smiling), and her brain is capable of maintaining basic life functioning, starving her to death (or more correctly, dehydrating her) is murder, not particularly different than smothering her with a pillow.

Which is not to say that, given her state, that might not be what she would have wanted, but let’s call it by it’s real name. Some of the same people who don’t have a problem with removing her feeding tube would be incensed if we were to suggest that she be given a fatal dose of morphine to end her suffering. I do not object to right-to-die, I do not even have a moral objection to suicide (although I do think as a society we should do our best to help people who are suicidal to solve their problems so they do not need to resort to it). But euthanasia always bothered me, because it carries with it a certain implication of making that decision FOR the patient, different from murder only in that in a murder case, the decision is made for a wholly functional human being. But would we feel justified in denying basic biological needs to the functionally retarded? Because that’s what (my impression of) Terri Schiavo is: functionally retarded.

On top of everything else, my understanding is that there’s a large medical malpractice settlement riding on this case. Again, I don’t have all of the facts, but the story as I’ve heard it is that her doctor was successfully sued because he didn’t recognize the vitamin deficiency that led to the event that led to her condition… even though she never divulged to him that she had an eating disorder. If these really are the facts, then it’s a travesty that this doctor was expected to recognize the results of a disorder he was not informed was extant. This is tantamount to going to the doctor because you stepped on a nail, never mentioning to the doctor even so much as “My foot hurts”, and then suing the doctor because your foot gets gangrenous and must be ultimately amputated. But again, I may not have all of the facts.

The point is, though, this settlement is in a fund to pay for the care of Ms. Schiavo, and is being eroded by paying FOR it. When she dies, whatever is left goes to whoever her primary guardian and legal care giver is at the time. To me, this is a heck of an incentive for her husband to want her allowed to die. Convince yourself that there’s no chance for any kind of recovery (admittedly, after 15 years, probably a pretty good bet), and so you’re not doing anything to Terry, she’s already dead. Then I can see wanting to at least get your hands on the money, both while she’s still your legal responsibility AND before it’s been eaten up paying for medical bills.

So in Solomonic solution, let’s remove it from the equation. Have a court declare that that money stays in a fund to pay for her continued care, goes to HER (for her loss) if she comes around enough to legally be responsible enough to take custody of it, and goes to charity (perhaps brain function research?) if she dies without being able to take custody of it and form a will providing for other disposition of it. Then let’s see if her husband is so certain that “Terri wouldn’t have wanted to live this way.” Let’s see if her parents aren’t hoping her husband will divorce her so he can marry his (now) girlfriend, thus leaving that money to THEM.

I’m not saying that money IS the motivating factor on either side, I’m just saying that it very well COULD be, and it’d be nice to know. (Of course, even if we remove the money, at this point there’s face to be saved, so it is doubtful that either side would change their story publicly, but perhaps they’d stop spending as much effort to argue their side of it, if money really is their prime motivation).

But it all comes back to three things: Do you support euthanasia? Is Terri Schiavo so far gone as to be functionally dead and beyond reasonable chance of even partial recovery? And if so, what would she have wanted?

For me, the answers are No (not without a patient directive or clear knowledge of the patient’s wishes), No (there’s too much basic functioning, even basic consciousness, to believe that all hope is lost) and I have no idea. Given these three answers, I can’t support what amounts to murder, be it by introduction of fatal doses of medication, smothering with a pillow, or merely forced starvation and dehydration.

--Liam.

(And let me say again, I really do want to hear if you believe the facts are other than I understand them, or if you have a different take on the matter.)

Copyright © March 22, 2005 by Liam Johnson. http://www.liamjohnson.net