Matters of Life and Death

Life as a political football

I suppose I have no choice but to blog about the case of Terri Schiavo. It has managed to squeeze even a high-body count school shooting nearly out of the headlines (although I suspect there's some interesting link between these two phenomena in early 21st century American culture ...).

Even just looking at what NPR has posted today is pretty overwhelming. (I must say, however, this commentary makes me love Daniel Schorr more than I did already.)

Certainly this is a very sad situation: Terri Schiavo has been in what doctors have identified as a persistent vegetative state for 15 years. Her husband says that Terri told him (after family funerals of relatives who had been kept alive through extraordinary medical measures) that she never wanted to be kept alive in that condition. Her parents hold out hope that the doctors are wrong and she'll come out of it. Given my dad's medical travails, I'm not unsympathetic to her parents' position ... but 15 years is an awfully long time. And ultimately, I think their position ignores the possibility that some things may be worse for us than death.

Let's say Terri held a firm conviction that being kept alive indefinitely in a permanent vegetative state was a bad thing -- no help to the person being kept alive, a source of anguish for that person's loved ones, a waste of resources on a futile end. In this case, her parents' actions (and the intervention of the U.S. House of Representatives) actually go against Terri's values. Arguably, such actions then hurt her more than they help her.

(How could it hurt her to keep her alive? If a permanent vegetative state means that she's not conscious of any pain, neither being kept alive nor being allowed to die could literally hurt her. On the other hand, if, as a person, she was serious about her values and took them as being at least partly definitive of the person she was, then anything that acted against these values would be acting against her.)

It's possible, of course, that Terri might (given the chance) have changed her mind and said, "Give me the best medical treatment money can buy and don't give up no matter how grim it seems." Even in this instance, it seems there would be a point after which it would be appropriate to listen to the medical judgment that there's nothing more to do. Otherwise, modern medicine may find itself saddled with the obligation to keep all of us alive indefinitely, and, for that matter, to come up with the technology to make us immortal.

Whenever I contemplate whether immortality would be good for me, I start by assuming I'd be conscious. I know of very few people who would opt for immortality in a permanent vegetative state.

Indeed, the issue at hand is not shutting off a respirator but withdrawing a feeding tube. It's been pointed out that death by withdrawal of nutrition and hydration can take a while. (Is it painful? Maybe to the family, but not to Terri if she's not conscious of pain. Of course, a lethal dose of morphine might ease the exit, but that's not part of the life-is-more-important-than-anything-else agenda.) Some have argued that society has a fundamental responsibility to provide Terri with nutrition and hydration (since she is unable to provide them for herself). Yet wouldn't this obligate society to provide nutrition and hydration for everyone unable to secure them himself or herself, whether for physical or economic reasons? It's not like people don't starve in these parts.

If Terri Schiavo were to come out of the persistent vegetative state, I wonder what kind of life she would have -- dealing with parents who made disagreement with her husband so nasty and who showed so little regard for their adult daughter's stated position, living in a society where people cared about her as an object of political discourse but probably care very little about her actual well-being (and certainly don't act consistently to treat all the living with such "high regard". It might be enough to make her want to go back down.