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March 21, 2005

Terry Schiavo

A reader has asked me what I think of the Terry Schiavo case. Well, naturally, I think that I think it's wonderful that we live in a country where the heads of the House, Senate and the Executive branch feel perfectly at ease using the immense power of the national government to micromanage the medical decisions of a single individual, because of course it's not like there's anything else it needs to be doing at the time. I additionally adore living in a country where a politician who doesn't know me or my spouse can decide he knows better what's in my medical interest than my spouse, and can say he doesn't care what my spouse thinks if I don't, in fact, leave detailed and notarized instructions for every specific medical incident that might occur. And obviously I am puffed up with pride whenever my national government decides the constitutionally enumerated rights of the states should be shunted aside when a state's courts come up with a decision that the leaders of the national government disagree and can make political hay with.

Yes, there's nothing that makes me feel more like my individual liberties, my system of federal government, and the sanctity of my marriage are all safe and sound than the capricious, imperial meddling of my national government and its leaders.

Also, of course, nothing embodies classical conservative political principles than all of the above, so it's heartening to see our nation's leaders -- conservatives all! -- so ably flying that flag. God bless 'em. I will pray for them, and for us all.

Update: Rivka over at Respectful of Otters has some interesting perspectives on the medical and ethical issues re: Mrs. Schiavo, with additional commentary from Obsidian Wings.

Update Update: I heart Dahlia Lithwick, who puts the whole thing in perfect jurisprudential perspective at Slate.

Posted by john at March 21, 2005 08:13 AM

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Comments

Kizz | March 21, 2005 09:28 AM

For a short but completely different view on this you can go, surprisingly, to www.katieallisongranju.com

My gut reaction is to disagree with KAG but unless one knows the husband in question there's no way of knowing who is most qualified to make this decision.

As the adult child of a nutjob I have been taught eye signals to look for in order to divine my mother's wishes should she end up unable to speak, sign or write so I feel like the wishes of the next of kin should be heeded, not the wishes of a bunch of asshats who don't know the woman.

John Scalzi | March 21, 2005 09:34 AM

A link to KAG's specific entry here. Otherwise you'll have to scroll down.

mythago | March 21, 2005 09:35 AM

if I don't, in fact, leave detailed and notarized instructions for every specific medical incident that might occur

Something it is wise for all of us to do, regardless of how cool our spouses are. Laws in your state vary, but many have checkbox forms.

John Scalzi | March 21, 2005 09:40 AM

Indeed, very wise. On the other hand, we shouldn't have to live in fear of Tom Delay swooping in to make cheap points with his political base on the back of our potential vegetative state, either.

diddidit | March 21, 2005 10:21 AM

Good reads on the whole case here:

http://abstractappeal.com/schiavo/infopage.html

It's the least biased source I've encountered.

did

Q | March 21, 2005 11:04 AM

The omnipresent Quotation Marks of the Smug rear their ugly head by the second paragraph of KAGs response...

I've been noticing this trend lately, particularly among the raging conservatives... If you disagree with something, lets just marginalize it as much as possible by placing it in quotations thus trying to force others to believe that somehow the term is inherently false, rather than simply counter to the writer's opinions... KAG uses it to marginalize Terry's "husband" ... how is this word quotation worthy? He IS her husband, legally. Just because YOU think he has ulterior motives does not change this fact. (I'm personally sick of the attacks on him as well... "Why doesn't he just divorce her and let the parents care for her?" Oh, obviously because he is heartless and wants her dead so he can profti somehow... obviously it COULDN't be because he honestly beleives he is following her wishes and refuses to let others bully him into going against them...)

But... back to the Quotation Marks of Doom... notice how they are most often applied to phrases such as "homosexual rights" or "gay marriage" such terms that the rabid conservatives want to pretend are simply made up... I'm sick of it, so I'll start fighting bac kin all my writing...

All in all I wish these sanctimonious "conservatives" who obviously believe that are the keepers and definers of all "moral issues" would just stay the hell out of our personal lives. After all, since my "wife" and I were not married in a religious ceremony, I'm sure somehow my "marriage" is not good enough for them as well...

It would be very nice if our "President" would actually see that, if we are smart enough to be trusted with our own money, maybe, just maybe, we are smart enough to be trusted with our own lives as well.

Bowler | March 21, 2005 11:11 AM

"Also, of course, nothing embodies classical conservative political principles than all of the above..."

I always thought "classical conservative political principles" in regards to government interferance in personal lives was actually the opposite of the above.

I'm not happy with what's going on, mind you, but I do tend to agree with Lilek's take on the whole thing, insofar as to say that since there is no "winning side" to this issue, maybe erring on the side of life isn't so bad?

Courtney | March 21, 2005 11:57 AM

Every time NPR or any other station starts talking about this and replaying excerpts of the congressional debate, I have to change the channel or turn off the radio because I am so very, very angry that a political party that prides itself on reducing "big government" and its intrusion into our lives repeatedly and consistently takes local control away from citizens on those issues that it feels it has the moral high ground, like this matter. Irate might be a better word. Excuse me while I try to lower my blood pressure...

John Scalzi | March 21, 2005 12:00 PM

Bowler says:

"I always thought 'classical conservative political principles' in regards to government interferance in personal lives was actually the opposite of the above."

Indeed they are. However, as I was being sarcastic above that particular paragraph, I felt I should be consistent across the whole entry.

"Maybe erring on the side of life isn't so bad?"

At the cost of providing the national government a precedent for interceding in the personal lives of its citizens when they are doing something they have the legal right to do -- i.e., make decisions for incapacitated loved ones? Thank you, no.

This isn't a benign political situation, Bowler. It's a situation where the national government is attempting to carve off a right you previously held. The suggestion that this will only happen this one time is ludicrous; if the government can decide it has the right to intervene -- despite the long process which has time and again shown that Mr. Schavio has the right to make medical decisions for his wife -- what will keep some point-making politician from making a move in other similar cases, or (as is very likely to be the end goal here for some involved) involving, say, a fetus? After all, a fetus didn't leave written instructions suggesting it was okay with being aborted.

Maybe you are content to have a politican decide he knows better than your own spouse what you want as regards your medical decisions; I am rather less comfortable with that. Perhaps erring on the side of controlling capricious government intervention isn't so bad, either.

Kevin Q | March 21, 2005 12:15 PM

Bowler,
I can completely understand that feeling. Nobody wants to make the decision that ends somebody's life. But my understanding of the situation is that based on the medical accident that put her in this position, large parts of her cerebral cortex have been replaced by spinal fluid, and that the only brain activity is in her brain stem. It's that activity that keeps her alive, and makes it look as though she's minimally cognizant of her surroundings.

There's a very interesting discussion of her medical condition at the bottom of this article, as well as a discussion of why this is such a hard decision for her family.

It seems to me that Terry Schiavo died 15 years ago, when her brain was deprived of oxygen, and she's just waiting for her body to catch up. But even if that's not true, I agree with John's post that this sets a dangerous precedent for our government.

K

Lisa | March 21, 2005 12:33 PM

I certainly understand and agree with John in his concerns of the meddling government into family issues. The problem is, this is not a right-to-die case, this is a disability civil rights case that liberals should take another look at.

The problem here is that Terry Schiavo's condition has always been a grey area and she faces a lot of discrimination because she is profoundly disabled. This case is important to all of us because the line that separates "prolonging death" and "sustaining Life" has been moved.

We live in a culture where "Million Dollar Baby" wins best picture and the lead character is applauded for her decision to end her life due to her disability. Every newly disabled person contimplates suicide, then, if they get the proper rehab, care, and support, they get over it. The National Spinal Cord Association called Million Dollar Baby a snuff film and, since it was made just months after Clint Eastwood lost his ADA case, a "personal vendetta" against the disabled.

Unfortunately, it is somehow acceptable for the severely disabled to want to commit suicide. It is even admired as being unselfish. There have been several cases where vent dependent quads have asked for the machines to be turned off not because of the condition in and off itself, but because of the lack of support and proper care for their medical needs. When in home support is denied for more expensive, less qualified nursing home care, what results is false imprisonment. This is often the cause of suicide, not the disability itself. If a person comes across anyone else whose unfortunate circumstances have left them suicidal, we try to help and support them back to desiring life. If a disabled person decides to commit suicide, we help them pull the trigger.

I am not against assisted suicide or withholding treatment in cases where treatment would only drag out death. In fact, when my mother had a terminal brain tumor I supported her decision to come out to Oregon (where I live) and look into the assisted suicide drug. (She died naturally before she chose to use this option, but I supported that decision as well.) In Terry Schiavo's case, she is not in the process of dying, she is a profoundly disabled living individual. A feeding tube is not life support, it is an accommodation to eating. Thousands of people use this very same accommodation and lead full lives. My partner, a C7 quadriplegic, uses a suprapubic catheter for urine output. If you removed it, he would eventually die. But you wouldn't consider him on life support.

The dangerous and grey area for Terry is this notion of persistive vegetative state. She is obviously not totally brain dead and is said to communicate nonsymbolically. Of course she said before-hand that she wouldn't want to live that way. Who says, "Yes, I want to have a debilitating injury. Hell, I want to have my house burned down, be rapped and pillaged, go bankrupt and move to a war-torn third world country." But when it happens, most people survive and move on. When you have a severe disability, you are supposed to want to not be a burden and not ever move on. You are just supposed to want to die.

My education and background is in teaching children with severe and profound disabilities. I have taught many children whose disabilities are very similar to Terry Schiavo's. They are loved and are part of a community if given the proper support. I could not look at these children and judge their quality of life.

If the line that separates prolonging death from ending lives of those who may cost more and contribute less to society we are on a dangerous slippery slope. Severely disabled people are already warehoused in prisons called nursing homes and institutions and encouraged to end their life. We as a society really have to decide where this line should be. This is why, although I cringe at the legislative and executive intervention here, I think it is very important for this case to be fully examined and for this disability issue to be addressed. This is not at all about the "culture of life" or christianity or whatever. It is about the civil rights of the disabled.

For more on this viewpoint, go to www.notdeadyet,org

Kait Mackenzie | March 21, 2005 12:55 PM

Holy Spoilers Batman...Would it have been too much to ask that you warn you were posting a spoiler to Million Dollar Baby? Some of us haven't seen it yet and it's a relatively recent movie so it's not like it's been out for 10 years...

Bowler | March 21, 2005 01:07 PM

"At the cost of providing the national government a precedent for interceding in the personal lives of its citizens when they are doing something they have the legal right to do -- i.e., make decisions for incapacitated loved ones? Thank you, no."

Hey, I'm not disagreeing with you that this is the best situation, and I'm no lawyer, but I'm pretty sure I've never had the right to terminate my spouse, incapacitated or not. Make decisions on saving her life? Yes. Pulling life support? Well, I've never been in that situation, thankfully.

Am I happy that the government is intervening? Nope. Am I happy with the idea that spouses can remove feeding tubes? Nope. Granted, this is an extreme case, and passing emergency laws for one person (as in this case) can never result in anything good in the long term. I'm not happy with any result from this, to tell the truth.

It all boils down to a living will. If she had one, we wouldn't even be discussing this. In fact, I think I need to call a lawyer and have some written up.

Lisa | March 21, 2005 01:15 PM

Sorry, Kait

I've seen it all over the news and blogs, I thought it was pretty much known. My bad.

John Scalzi | March 21, 2005 01:19 PM

"Hey, I'm not disagreeing with you that this is the best situation, and I'm no lawyer, but I'm pretty sure I've never had the right to terminate my spouse, incapacitated or not."

Actually, as the spouse the courts will turn to you in the absence of other determining factors to make medical decisions for your spouse, including decisions in extreme cases on whether to withdraw life support. To quote from another blog to which I linked in the main article:

In cases in which a patient is not competent to consent to or refuse treatment, there is a well-established way to proceed. First, you ask whether the patient has prepared a living will or an advanced directive, or has given a durable power of attorney to some other person, authorizing him or her to make decisions if the patient becomes incompetent. In this case, as often happens, there were no such documents. Second, you look around for other evidence about what the person would have wanted. That was done in this case, and the courts found "clear and convincing" evidence that Terri Schiavo would not have wanted to be kept alive in her current state. If there is no such evidence, a guardian gets to decide, based on the patient's best interests.
As I noted earlier, in this case Michael Schiavo is his wife's guardian, and might have decided what she would have wanted. However, he chose instead to ask the court to consider the evidence about what she would have wanted, and to make its own evaluation. It found that she would not have wanted to be kept alive. That is: this is not a case in which anyone is proceeding in the absence of evidence about what she would have wanted, nor is it a case in which Michael Schiavo is acting only on his sense of what his wife would have wanted, without allowing a hearing for anyone else's view.

"It all boils down to a living will. If she had one, we wouldn't even be discussing this."

Possibly not, but she didn't and here we are. Her lack of a living will, while regrettable, doesn't excuse the Congress and President interposing themselves here.

Bryan | March 21, 2005 01:23 PM

As an attorney, I am wondering how I can get on this bandwagon. I sure would like to take a case or two that I have lost and see if I could win the second time around.

Justin Anderson | March 21, 2005 01:23 PM

John: In your last comment, unfortunately you're falling into error when you say

The suggestion that this will only happen this one time is ludicrous; if the government can decide it has the right to intervene -- despite the long process which has time and again shown that Mr. Schavio [sic] has the right to make medical decisions for his wife[...]

Mr. Schiavo is in fact no longer the person with the "right to make medical decisions for his wife". Ever since he initiated the court proceedings to determine what Mrs. Schiavo would want, she has been a ward of the court. The court has determined, through two seperate trials and appeals, that Mrs. Schiavo would want to have the feeding tube removed. While one can certainly disagree with the court's determination, it is an undeniable fact that Mr. Schiavo no longer has any real power over her fate at this point.

It seems to me that some people who are opposed to the feeding tube removal would like the public to believe that Mr. Schiavo is the prime mover at this case, because it's easier to sling mud at him than it is to sling mud at the court system.

Q: You might be interested to know that the usage of quotation marks you refer to has a charming and brutally honest name: "scare quotes".

Lisa: While I understand your concern for the slippery slope, it does not change the fact that slippery slope arguments are logical fallacies. Also, it seems to me that calling Mrs. Schiavo's condition a "profound disability" is stretching the term "disability" well past the breaking point. My understanding is that she not only does not have any higher brain functions, at this point most of the brain matter responsible for those functions has been replaced by cerebral spinal fluid. As one of the court decisions notes, it would take a true miracle where God actually recreates the tissue that is simply not there anymore for there to be any substantial improvement in her condition.

Justin Anderson | March 21, 2005 01:26 PM

Addendum: Apparently under Florida law, feeding tubes are explicitly included in the definition of what qualifies as "life support", so the argument that feeding tubes are not, in fact, life support is a non-starter. Whether you think it should be or not is of course a different matter, but the law on this point is apparently clear.

John Scalzi | March 21, 2005 01:42 PM

"While one can certainly disagree with the court's determination, it is an undeniable fact that Mr. Schiavo no longer has any real power over her fate at this point."

Thanks for the clarification, Justin.

Lisa | March 21, 2005 01:45 PM

Touche, Justin, on the logical fallicy point. What needs to be decided here in as much as whether she is disabled or brain-dead is this: How much brain functioning must one have to be given medical care? More than O%, maybe, but then what? 2%? 25%? 50%?

I don't think anyone expects her condition to improve much, just that as a disabled women she deserves to live. This is a precedent setting case. i.e. the slippery slope reference. The next case may involve a woman on a feeding tube who has severe cognitive disfunction but can blink yes or no to indicate simple preferences. (The parents have stated that she does react to different television programs and different care givers with consistancy in indicating preference.) What if the husband was the one who caused the injury? What if the person did have a living will stating no feeding tube, and stating that they didn't want to live as a severely cognitively disabled person...then, they became disabled to the point of needing a guardian for medical decision making, but still indicated a preference for life. Can the person become cognitively disabled and change their mind? Who decides whether she/he is cognizant enough to change her mind? Who decides how much brain functioning one needs to express such a preference?

We, as individuals, family members and even the courts and expert medical opinion, do not understand enough about the brain and state of disability to make such decisions. There are too many grey areas and Terry Schiavo's to just deny years of history of discrimination, imprisonment, and abuse and killing of the disabled to deny their civil rights based on what we think they might want. Again there is a deep distinction between prolonging death and sustaining life. A person who lives without a terminal condition and whose body functions to sustain life (even if some accommodations are used for some life functions) is disabled, no matter what their level of brain activity is. (She gets SSDI benefits, the government has already declared her disabled.)

John H | March 21, 2005 02:29 PM

I agree with you, Courtney. Every time I see one of those windbag Republicans speaking about this it makes me want to throw a brick through my TV set.

This seems to be another case of the Rationalists vs. the Irrationalists (as John calls them). The rational among us can accept her doctors' opinions (the ones who actually examined her, not the ones who watched the cherry-picked video her mother put together). The irrational dismiss medical knowledge for their belief that because she blinked her eyes again she must be getting better.

As Kevin said, she died fifteen years ago. Time to let her go already...

Kevin Q | March 21, 2005 02:31 PM

Lisa said:
I don't think anyone expects her condition to improve much...

From what I understand, no doctor expects her condition to improve at all. As Justin pointed out, most of her cerebral cortex, the part of her brain that allows thought, has been replaced by her body with cerebral spinal fluid. Even if nerve cells could be regenerated (and they generally can't) there nowhere for them to regenerate to, since her cerebral cavity is filled with fluid. Any signs of higher brain functioning are simply reflex actions from her brain stem. She is not disabled. She has a non-reversable, incurable, living coma. Her body is simply now a machine for turning oxygen and food into waste material. She is no longer in her body. Her body needs peace.

K

Bruce | March 21, 2005 02:38 PM

Bryan sez "As an attorney, I am wondering how I can get on this bandwagon. I sure would like to take a case or two that I have lost and see if I could win the second time around."

Well, all you need to do is find a case that (a) has implications for the redefinition of "life", thus appealing to the antifreedom crowd who would overturn Roe v. Wade; (b) has implications with regard to federalism and permits a hypocritical set of "conservatives" to strengthen the central government at the cost of states' and individuals' rights, contrary to their professed principles; and (c) directly countradicts the principles of a law signed by the executive leader of this group of hypocrites when he held a lesser office, but makes big political hay in a country not well-informed by the news services that mostly suck up to said would-be feudal overlord.

Sounds pretty simple and straightforward to me.

Justin Anderson | March 21, 2005 02:43 PM

Lisa: I brought up the possibility for improvement, because it is one of the arguments that Mrs. Schiavo's parents are using in court: i.e., her decision would likely be different if there was (as they assert) a genuine chance at improvement. Whether they believe there is really a chance, I don't know, but they have advanced the argument in court.

The parents have stated that she does react to different television programs and different care givers with consistancy in indicating preference.

My understanding is that the court has found that the reactions that the parents refer to are basically random. I can certainly understand a parent not wanting to give up hope on their child, but I can also imagine that hope leading them to attach more significance to her actions than are really warranted.

You ask a bunch of really good questions and I'll give you my take on them (disclaimer: I'm just some guy on the 'net):

What if the husband was the one who caused the injury?

Well, in that case, I certainly hope there's enough evidence to convict the bastard. Certainly he should play no part in determining the fate of his wife.

What if the person did have a living will stating no feeding tube, and stating that they didn't want to live as a severely cognitively disabled person...then, they became disabled to the point of needing a guardian for medical decision making, but still indicated a preference for life. Can the person become cognitively disabled and change their mind?

Wow, that is a really good question. Personally I'm torn about this one, but I think I'd come down on the side of providing life support there. Our experiences change us all day by day, but there are certain experiences, both joyous and tragic, that in some sense re-create us as persons. I would say that in such a case, the new person has the greater right to determine their own fate than the old person that they were.

Who decides whether she/he is cognizant enough to change her mind?

Well, of necessity it would probably be the courts, assisted by expert medical opinion.

Who decides how much brain functioning one needs to express such a preference?

Here's where I'd expect medical experts to weigh in. I would not expect some arbitrary percentage to be used, though. I'd think that the question would need to be addressed on a case-by-case basis, with doctors determining first if the patient is capable of understanding the questions put to them, and second if they are capable of providing an answer. If the answer to both of those questions is yes, then I'd say that the patient need to be the final arbiter of any decisions. If the answer to either is no, then I'd go with the existing legal machinery: advance directives, guardians, et cetera.

We, as individuals, family members and even the courts and expert medical opinion, do not understand enough about the brain and state of disability to make such decisions.

Well, I can't accept that. Our understanding of everything is imperfect, but we must make decisions nonetheless. Perhaps in the future, we (as a society) will come to believe that the decisions made in the past were made in error, but it still falls to us to make those decisions.

Also, replacing the feeding tube is just as much a "decision" as leaving it out, so it seems you're not arguing that we can't make the decision, but rather that we must decide to provide life support in every case where we can't determine with absolute certainty what the wishes of the patient are.

There are too many grey areas and Terry Schiavo's to just deny years of history of discrimination, imprisonment, and abuse and killing of the disabled to deny their civil rights based on what we think they might want.

Clearly, you know far more than I do on this topic, but I submit that the current system Florida has, where it attempts to determine what the patient would want -- which could well come to an incorrect conclusion in individual cases -- is a better solution than mandating that all such cases should be treated one way or the other, which will have the effect of guaranteeing that many cases will result in an outcome that the patient would not have wanted.

Again there is a deep distinction between prolonging death and sustaining life. A person who lives without a terminal condition and whose body functions to sustain life (even if some accommodations are used for some life functions) is disabled, no matter what their level of brain activity is. (She gets SSDI benefits, the government has already declared her disabled.)

I'm certainly not saying that she's not disabled, I just think that it's a rather gross understatement, to the point that her condition is qualitatively different (even though it subsumes the definition of disabled). If I say that iced tea is 99% water, what I'm saying is factually true, but it also manages to completely miss the point of what iced tea actually is.

John H | March 21, 2005 03:00 PM

Lisa, who gets to make the decision as to whether she will recover? The doctors who examined her and declared her to be brain-dead, or her parents who want to believe she responds in some meaningful way?

This case has been dragged out for fifteen years, and every court that has heard the case has sided with her husband and the doctors that actually examined her - i.e., she is in a persistent vegetative state with no chance for recovery and she would not wish to be kept alive in that condition. Nobody has made a compelling argument before those courts that she can recover and should remain on life support, and so each court has in turn upheld the right for her to die.

To claim that this is about the rights of the disabled doesn't hold up. She's not disabled - she's brain-dead. No amount of wishful thinking is going to change that.

Brian Greenberg | March 21, 2005 03:00 PM

John - thanks for posting on this. As is usually the case, the discussion in your comments section is more informative than a dozen news articles on the topic. What what it's worth, here are my thoughts:

First and foremost, this is a lousy situation. Regardless of whether Mrs. Schiavo keeps her feeding tube or dies due to its removal, and regardless of who (or what) makes the decision on what to do, nobody is going to come away from this a winner. So, those who think they're making political hay out of this are sorely mistaken - all their doing is arousing the approval of those who already agree with them. To the rest of us, they're just being despicable.

Second, this is none of my damn business. As terrible as this is for the Schiavos, I have absolutely no idea why this is anything more than a local human interest story, let alone a multi-day national media circus. These folks have some very difficult decisions to make, and some very complex legal issues to wade through. Get them off the TV and let them live (and die) in peace.

Third, regarding living wills, I guess I'll be the only person to speak out against them here: living wills scare the crap out of me. I am not a doctor nor a lawyer. I have no idea how to properly translate my wishes into a legal document that would stand up in court.

For example, what if Mrs. Schiavo inspired me to write "don't put me on a feeding tube" in my living will. But then tomorrow, I have an accident from which I can fully recover, as long as I have a feeding tube for a few weeks while I heal? Would that document become my death sentence? Do I need to be more specific about the how/when/why of my feeding tube in the document? How do I know I've been specific enough?

Also, who's to say I know now how I'd feel at the time? Maybe I'd be so depressed that I'd just want to end it all. Maybe I would become resolute about beating my illness & seeing my kids grow up, even if it meant doing so from a hospital bed. If others can make that determination now, good for them, but I have no earthly idea...

Finally, I have this (potentially irrational) fear that the presence of these alternative courses of action will cause delays at critical treatment points. When the EMS arrives at the scene of my car accident, I want them to save my life first and ask questions later. I don't want them searching around for a "Do Not Ressucitate" order for fear of being sued if they save me when I didn't want saving. Legal liability issues being what they are, this doesn't strike me as outside the realm of possibility.

Brian Greenberg | March 21, 2005 03:07 PM

Oh, one other thing, in my humble opinion, of course:

Everybody who has, at the same time, been critical of the courts and/or the government for interfering in this case, but then goes on to express their own view on whether she should live or die is being just about the biggest hypocrite I can imagine.

Yeah, they should stay out of it. So should you.

That is all...

John H | March 21, 2005 03:16 PM

Brian, if you want to know how to fill out a living will, the ABA provides some good information on it.

John H | March 21, 2005 03:26 PM

Everybody who has, at the same time, been critical of the courts and/or the government for interfering in this case, but then goes on to express their own view on whether she should live or die is being just about the biggest hypocrite I can imagine.

I don't feel guilty about expressing my opinion on the matter - I feel like I can look at the facts and come to a reasonable conclusion. And most importanatly, my opinion doesn't matter one way or the other in this case.

When we ask that the politicians stay out of it we're not asking them to not form their own opinion. We're asking that they not abuse their authority by trying to subvert the court's decision (which has been upheld numerous times).

Kevin Q | March 21, 2005 03:28 PM

Brian, like any document, a living will, well written, will clearly express your desires. Most living wills are clearly designed to be effective only if doctors believe that you cannot communicate, and are never going to get better. For example, a living will form put out by the state of New York starts with this sentence:

I, [name], being of sound mind, make this statement as a directive to be followed if I become permanently unable to participate in decisions regarding my medical care. These instructions reflect my firm and settled commitment to decline medical treatment under the circumstances indicated below. Emphasis in the original.

This is different than a Do Not Resuscitate order, which is a decision you make while conscious, immediately prior to a major operation, that you do not want to be kept alive. A living will is a statement of your health care desires, regardless of what they are. If you want to be kept alive, no matter what, you may put that into a living will also. A living will is an opportunity to make your desires clear when you are unable to communicate. Talk about it with your loved ones, and then talk about it with your attorney.

K

Dave Pittman | March 21, 2005 03:30 PM

First, I hope against hope that she didn't** make the comments about not wanting to be maintained artificially because if she did and some part of her poor spirit now or later has any idea what a disgusting third-party circus this has become, then that part of her would be in absolute agony...if that makes any sense.

Last, I like how Scalzi's post for this thread would have easily won the "write like Scalzi" contest...maybe just one OMW mention to make it perfect. The sarcasm, the lovingly liberal tilt, the use of italics!! *kisses fingers* Perfetto!!

John Scalzi | March 21, 2005 03:36 PM

Well, Dave, and I say this with no false modesty, I write like me better than anyone else does.

Lisa | March 21, 2005 03:49 PM

She is not, by definition, brain dead. That is the whole problem here. She does have some brain functioning, if she didn't, she would be on more significant life support.

The problem here, and what makes it a disability civil rights case, is the closeted bigotry of the health care system and the courts towards people with disabilities. We are trusting two authorities with a history of systematically abusing the rights of the disabled.

When this happened with those darker skinned folks that were "owned" by whites and were determined to be only 3/5ths human, the courts cried "states rights" and we had a civil war over the federal intervention.

The health care system has increasingly encouraged disabled folks to die rather than to provide more costly care. Interestingly, a few decades ago, the health care system encouraged extraordinary measures to be taken in order to receive more reimbursement by insurance companies. This is why congress passed a bill to allow people to refuse medical care. Now in an era of managed care, severely disabled people are not given the support they need and told that they should "die with dignity."

Does Terry Schiavo want to live? Can she even conceptualize life and that decision? Does she feel pain? Does she feel pleasure? Does her life have value for her? I don't know. You don't know. Medical doctors don't know and the courts don't know. The disabled community is not comfortable trusting the health care field and the courts to determine these things based on their horrific record of discrimination against the disabled in the past.

Regarding improvement: My understanding is, and I'll admit to not having read the entire court case, is that the parents have always been disapointed that no amount of rehab was ever offered her. Not that they think she will recover fully, but that their may be or have been a chance that she could swallow on her own with some rehab. In which case, this whole issue would be moot, unless it becomes acceptable to just throw a disabled person out into a field and leave them to die.

I've had people who look at my severely disabled students and say, oh, I just can't stand to look at her. I hate to see her suffer like that." The truth is, this is the same reaction as people who are bothered by gay public affection or even blacks in the same restaurant. Just because you are uncomfortable with it doesn't mean it bothers them and they don't have a right to exist. It might not bother them how they look or act. I think that people see video of Terry Schiavo and are disturbed by it and then turn that into misplaced concern for her suffering. Yet they are not concerned that we don't know how much she will suffer while starving to death.

Brian Greenberg | March 21, 2005 03:59 PM

John & Kevin,

Thanks for your concern. I wasn't really fishing for advice on how to proceed with a living will, but I appreciate you providing the information.

As to your other points:

Kevin: the word "permanently" in New York State's standard form serves only to reinforce my fears: doesn't this just shift the legal battle from whether the patient wishes to remain alive to whether the patient's condition is premanent? I realize that in many cases (possibly even Mrs. Schiavo's) this kind of thing is medically provable, but in many, many cases, it is not.

John - yes, of course, everyone is entitled to their opinion (even Congress). But in cases like this, our opinions are vastly uninformed, since we don't know Mrs. Schiavo, her husband, her parents, her condition, her history, etc. If we keep that in mind, then we naturally refrain from declaring those invovled in the case to be right/wrong or good/evil (as has been the case).

RooK | March 21, 2005 04:04 PM

Lisa, I find your argument about the definition of "brain dead" a little disturbing. From the reports of the various reputable links we've seen on this thread, she has no brain. It's not just dead, it's gone. What's left is a brain stem that runs the autonomic functions allowing the brainless sack of meat to turn food into excrement, and it sometimes produces random spasms.

Your argument seems a little bit inverted. You argue compelling from the perspective of concerns about people that have lost some function, but don't seem to realize that this is a case of a function that lost a person. Not meaning to sound too ghoulish, but if a person were beheaded and by some miracle of medical science both the head and the headless body could be kept alive and functional, but not rejoined, which part would be the person?

Kait Mackenzie | March 21, 2005 04:21 PM

Lisa: No worries. Guess I've just been lucky enough to tiptoe around the actual spoiler...I picked up that there was a less than happy ending, but didn't know what the actual ending was...Ah well, I usually don't like watching boxing movies anyway--something about seeing people repeatedly pound each other in the head! =)

Lisa | March 21, 2005 04:25 PM

Rook,

My definition of brain dead is the whole crux of this case. That is what is in dispute. The parents feel she is not totally brain-dead, she is disabled and her life has value. They also beleive her guardianship has been abused by the husband and the state courts.

Medical professionals are also in dispute. Most truly brain dead (by all accounts) individuals are on primary life support (trach) and become organ donors. Schiavo's brain functioning is a grey area. Many children born with microcephaly or just a brain stem or slightly higher minimal brain function are students in our schools with families and homes and friends who love and care for them. Lacking that pivotal event such as an injury to decide whether or not to widthhold care, they just recieved care and lived a life.
This case is about where that line is drawn and who decides who draws it. The courts and husband decided the line is drawn at what they call "a persistive vegitative state," which is not a concrete, magic diagnosis but a judgement call. The parents, some in the medical community, and disability activists are saying no, Terry is not beyond that line, and furthermore, we want to decide were the line is.

People in the disability community do not want that magic line to move about at the convenience of those who may have other motivations against people with disabilities. We have for centuries lived with that line being moved to the point of murder for vast members of the community. If this was a case that was truly as concrete as chopping someone's head off, the woman would probably have been an organ donor 15 years ago.

RooK | March 21, 2005 04:57 PM

Lisa,

What medical professionals are in dispute? From what I've been able to read, the only medical support that Terry's parents have been able to scare up are people that didn't even examine Terry personally.

How can anyone possibly define any sort of all-balancing perfectly-definitive line in this kind of scenario? It seems to me that the best we can do is have some mechanism for allowing those responsible and qualified to make the hard decisions for themselves on a case-by-case basis. Which, incidentally, is what the US has - except that this case has revealed an attempt to circumvent it for what appears to be a disgusting attempt at political point-scoring.

With respect to the conspiracy to mistreat people with disabilities, I don't doubt that this is how it seems. Due to my deep-seated cynicism and misanthropy, I actually doubt that anyone is ever guaranteed to be treated fairly. However, I will concede that I think it would be best if everyone could be treated equally.

Lisa | March 21, 2005 05:23 PM

"How can anyone possibly define any sort of all-balancing perfectly-definitive line in this kind of scenario?"

Exactly. So why err on the side of death if her parents enjoy her and it will set precendent to help thousands of disabled individuals who struggle with the problems of guardianship rights and healthcare and other discrimination.

The same people who say she doesn't feel pain also don't want to see her "suffer" by staying alive and don't consider that she will suffer by starvation. The truth is, we don't know. If there is truly no one in there, no essence of Terry Schiavo or even in religous terms, her soul has already left her body, which none of us will never know, then to err on the side of keeping her alive to promote the rights of those under guardianship and bring these cases to the forefront already gives her life tremendous value.

Rook, even the medical journalist on CNN who reported to have looked at the medical records reported that her case is a grey area. No one has disputed that a good portion of her brain is dead, just what that means in terms of whether she is a person with rights to medical treatment or whether she is not. There have been medical experts aimed to testify on behalf of the parents that were not heard because the court case has never gotten past the guardianship issue and has ruled in favor of her being in a persistant vegetative state. Again, this is what is in dispute.

In a perfect world, everyone would have a wonderful wife like Krissy or a wonderful husband like John who would be an unselfish guardian who would truly with great intent and purpose do what was best for their loved one. Michael Schiavo may indeed have good intentions. But there is widespread elder, disabled, and guardianship abuse and so it is important that we as a society look at the basic rights that all people have, no matter what their medical condition and not single out a group of people as acceptable to be denied the right to life, no matter how little we can understand about the quality of that life.

This has been interesting discussion, thanks all who replied to me. I now have to feed my babies and then go to work. I encourage you to look into these and other disability issues, because they will affect up to 80% of us in our lifetime.

Here is kind of a cool place to start:
www.ragged-edge-mag.com

Kevin Q | March 21, 2005 05:37 PM

Brian, not really. If somebody wants to terminate your life support, first they have to prove by the great weight of the evidence, in a court of law, that you are in a permanent, vegetative state. Only after that is proven will they act on your living will. And then your living will has to grant permission for what they want to do. If you want to be kept alive as long as humanly possible, then you need to have a living will expressing that opinion.

It's much like a traditional will. After a factual determination is made by the court (that you are dead), then your will is read and acted on. It is not acted on before that legally provable point, and your last will and testament is not disregarded after your death, unless the will attempts to violate the law.

You can die without a will (many people do it every day), but then you get no say in what happens to your property after you die. The court will try to determine the best thing to do, but it is often done with complete disregard for what you would have chosen to do. In fact, the court can even undo some things you thought you had done. If you promise one of your children your car after you die, but never deliver that car, that promise in unenforceable in a court of law. The only way to have your wishes followed is to leave it in a will.

Same with a living will. Yes, a court will need to determine, based on all available evidence, whether your condition is irreversable and permanent. But if the court makes that determination, they still must do what you tell them to do in a living will. You can order the courts to keep you alive as long as possible. You can order the courts to kill you quickly, and not let you starve to death. You can do anything you want, as long as it doesn't violate the law. (So, no having your brain put into a supermodel's body.)

Having a living will isn't about letting the court kill you. It's about having a say in what happens to you when you can no longer communicate for yourself.

Nina K | March 21, 2005 06:09 PM

I find it very ironic that she got into this condition, at least in part, through bulemia. The bulemics I knew were people with strong control issues, and the one thing that they were happiest about was their ability to control what went into (and out of) their bodies. Now, she is kept alive through lack of being able to control nutrition going into her body.

It's profoundly anti-choice to say she does not have that right.

But obviously that has nothing to do with why Randall Terry is down there, shoving himself in front of every TV camera he can find.

RooK | March 21, 2005 06:16 PM

Lisa, I'd like to thank you for putting forth a sensible argument, so that we're not left with just the appalling arguments of a video spliced together from hours of footage of random twitches and unsupported claims from people in denial.

It would seem that it might boil down to a question of responsibility. If the Schindlers really were the ones responsible for Terry's body's life, then we wouldn't be having this conversation.

Rex Schrader | March 21, 2005 07:59 PM

It was cited earlier in this thread but it bears repeating - This link: http://abstractappeal.com/schiavo/infopage.html

has some awesome and comprehensive coverage of the issues and questions. It appeared to me to be as unbiased a source as was avalbile.



I didn't know much about this case starting today, but I've since read through a number of the actual legal documents regarding the case, as well as the information on the Abstract Appeal site.



A couple of things are pretty clear to me -

1) Terri does not have sufficient brain mass remaining to act in a cogent manner. This will never change. She exhibits random motion, etc that is associated with the undirected impulse of her autonomic nervous system.

2) Unable to make known her own wishes, 8 years after she entered a persistant vegitative state, her husband filed a motion to determine her wishes. The court determined, based on the testimony of 2 doctors, that she had no hope of recovery. Beyond that, based on the testimony of her husband and his siblings, the court determined that she had previously positivly asserted that she would not wish to be maintained on life support. The court also found that her parents testimony to be inconsistant with their previous depositions on the subject. On this legal basis, the court determined that she had no hope of recovery and had expressed a desire to no be maintained on life support.

3) This sort of legal proceding is not uncommon at all. It is an established procedure for these sorts of tough cases. The decision of the orginal court has been upheld through a huge number of appeals.

4) The husband, regardless of his motives (which in my opinion are the purest), has been made into a villian by the parents who are unable to accept the fact that their daughter is effectivly dead.



It's a sad, sad case, to be sure, but not nearly as sad as the (likely unconstitutional) circus that is going on in Washington. I've been a long term supporter of Bush's policies in Iraq, but this recent bill is an embaressment of the highest order. Thank goodness for the Judicial system is all I can say.

Andrew Wade | March 21, 2005 09:34 PM

Lisa K:

The same people who say she doesn't feel pain also don't want to see her "suffer" by staying alive and don't consider that she will suffer by starvation.

I doubt that, being something of a counterexample. I rather doubt that there is a "she" there to feel pain, by the same token I don't think she's going to suffer by staying alive. (I also don't think starvation is going to cause suffering in this particular case).


However, I am not in favor of withdrawing feeding tubes as a means of killing someone/letting someone die. If we are to choose death for others, it makes sense to me to choose a death that is free of suffering. (And if we are to allow people to choose the time of their death, surely it behooves us to offer pain-free methods). Even if that means killing rather than "letting die". In the case of Terry Schiavo, I don't think she's going to suffer regardless, but it makes sense to me to reduce that possibility if we decide that she is to die.

Nina K:

Now, she is kept alive through lack of being able to control nutrition going into her body.


It's profoundly anti-choice to say she does not have that right.


Sure, I agree, but that is not exactly the right in question. Terry Schiavo is not in a position to choose, is not a position to communicate any such choices, and there is nothing anyone can do to change that. Perhaps I am wrong on that, but I really doubt it.


And when it comes to suicide, I do think some infringement in liberty is warrented. AFAIK, suicidal people do often change their minds eventually. I don't have a particularly good argument against allowing people to commit suicide, my reluctance is more of a gut feeling. But suicide's not exactly what's going on here.

Mikhail Capone | March 21, 2005 10:18 PM

More interesting stuff here:

http://www.underthesamesun.org/content/2005/03/index.html#000422

mythago | March 21, 2005 11:39 PM

We, as individuals, family members and even the courts and expert medical opinion, do not understand enough about the brain and state of disability to make such decisions.

Well, it's like this: somebody has to make that decision, eventually, because Terri Schiavo can't. Deciding to remove life support and deciding to continue it are both, well, decisions. If it's a "gray area," then how can you argue for one and against the other? You can't.

John, as long as Tom DeLay is out of jail we all should worry just on general principles.

That said, I'm going to issue a blanket nag for everyone to get their what-if paperwork in order. No, it is not OK to assume that your sister will take care of your son if something happened to you. No, it is not sensible to assume that in an emotionally hellish situation, your spouse will be able to make a calm, clear-headed decision that is exactly what you would have wanted. You DON'T need a lawyer for 99% of this paperwork, guys, and you can find most of the info you need at Nolo Press, whose books your local library probably has.

rayyy | March 22, 2005 05:10 AM

Tragic case. I was tempted to post my *opinion* but it's really no business of mine.
(Thanks, Brian, for reminding me of that.)

Harry | March 22, 2005 08:45 AM

Here's something that is my business:

The care that the administration wants to see continued is being paid for by a large court settlement (exactly the kind they want to limit/reduce) and by Medicaid, which the administration wants to cut.

Hypocrites.

Courtney | March 22, 2005 09:06 AM

Kait--I knew the ending of the movie and still found it gripping when I went to see it.

I think a movie like "Million Dollar Baby" just demonstrates that a decision like this is one that is deeply personal and individual. While we can read the briefs and news reports and listen to press conferences, we can never really get a good handle on the personal motivations and/or wishes of anyone involved.

Part of the reason that people have such extreme and heart-felt opinions on this matter is that we project our personal desires with regard to our own lives and the lives of those we love onto the Schiavos. I have an opinion, but mostly it is an opinion as to what I want to happen to me and/or my family and has little to do with the actual facts involved in this case.

Brian Greenberg | March 22, 2005 09:13 AM

KevinQ:

If somebody wants to terminate your life support, first they have to prove by the great weight of the evidence, in a court of law, that you are in a permanent, vegetative state. Only after that is proven will they act on your living will.

True, but here's a case where a significant portion of a woman's brain has been replaced by cerebral spinal fluid, and her parents are still arguing in court that she has reactions to certain people & television shows. It's likely, therefore, that a living will would have done nothing but change the court case from "what should happen to her" to "is she permanently damaged". I'd also argue (less convincingly, I think) that the mere presence of the legal document predisposes people to legal battles, where most of these matters (this one excepted) are probably settled within the families.

Also KevinQ:


You can die without a will (many people do it every day), but then you get no say in what happens to your property after you die.

Actually, that's not true. If I die without a will, my estate becomes the property of my wife. If we *both* die without wills, then our estates become the property of the state (this, btw, is one of the arguments for gay marriage, but that's an entirely separate can of worms). It seems the same law applies here: because she didn't have a living will, her husband becomes her decision making proxy. She didn't become a ward of the state until her husband decided to ask for that.

mythago:


That said, I'm going to issue a blanket nag for everyone to get their what-if paperwork in order. . . . You DON'T need a lawyer for 99% of this paperwork, guys, and you can find most of the info you need at Nolo Press, whose books your local library probably has.

Wow, I'm not sure I agree with this. Given our previous discussion, if I were to even consider drafting one of these documents, I'd consult a lawyer *AND* a doctor. It seems the consequences of being unclear about your wishes in a document like this can be disasterous, and given the propensity of our legal system to pick documents apart down to each indivdiual word, I'd want to be damn sure I got them all right...

rayyy:


Tragic case. I was tempted to post my *opinion* but it's really no business of mine.
(Thanks, Brian, for reminding me of that.)

You're welcome. Thanks for your restraint! ;-)

darren | March 22, 2005 09:39 AM

"Everybody who has, at the same time, been critical of the courts and/or the government for interfering in this case, but then goes on to express their own view on whether she should live or die is being just about the biggest hypocrite I can imagine."

I disagree. This thing has opened the door for many much needed discussions. From so many people realizing they are woefully unprepared to deal with the unthinkable in their own lives, to watching the hypocrits in Washington apparently doing complete 180s on their own stated beliefs of smaller government, state's rights, and personal responsibility. Either way, I disagree because expressing views is a good thing. It promotes discussion and leads to resolutions. The problem with the government, is that the republicans aren't just expressing views. They are forcing their views down everyone's throat through legislation that they believe they are getting straight from Christ. But from the government standpoint I believe this is not about Terri Shiavo at all. Its about "Hey look over here! Look over here!" that this particular administration is very good. Why do you think Delay is being so boistrous about this? Look at the timing. When I hear Terri Shiavo's mother make statements like "She is my whole life," key word being "my" makes me realize that it isn't about Terri with her own mother either. Shiavo herself is an afterthought in the discussion getting in the way of everyone elses selfish indulgences.

"So why err on the side of death if her parents enjoy her"

You too are making the mistake of thinking of her in terms of some kind of dolly to indulge the parent's denial. I have never met anyone, and I mean anyone (unless of course you're saying this) who has claimed to want to continue existing in a permanant vegistative state. Are you saying you would be happy to continue with Terri Shiavo's existence?
I'm sure this poor woman wonders where the hell all of you "right to lifers" and "compassionate conservatives" were when this was going on. http://www.usatoday.com/news/nation/2005-03-15-baby-ill_x.htm

darren | March 22, 2005 09:48 AM

I just did a double take on the article I just posted. I thought the story was a year or two old. It is barely a week ago that this baby died. Texas legislation that Governor George W. Bush signed into law allowing the hospital to make the choice to take critical patients off of life support was at play in this case. Now he flies off to D.C. in the middle of the night on a moments notice to sign the Terri Shiavo bill into law? Hello America? Anyone awake out there? Helloooooooooooo.

John H | March 22, 2005 12:20 PM

The Republicans always claim they want smaller, less intrusive government, but that isn't exactly true. They want smaller, less intrusive government for businesses. They see no problem, at all, telling you or me how to live our lives, and shoving their values down our throats.

And if anyone is in doubt that this "law" (using those good, old scare quotes) isn't solely for political gain should consider the timing. The judge ruled several weeks ago that he would allow the feeding tube to be removed on the 18th. Why then did Congress wait until that day to introduce legislation, forcing a special session over the weekend, and making Bush fly back in the middle of the night to sign it?

I guess it wouldn't have been so dramatic if they had worked it up in advance. What kind of cowboy would he be if George didn't get to ride in and save the day?

Brian Greenberg | March 22, 2005 06:42 PM

Darren: expressing opinions is good, unless it's government officials expressing their opinions, especially if these opinions are faith-based?

We should remember that our government officials are in Washington to represent us. Lots of times, that means expressing their opinions and taking action on them. No one was complaining about them expressing their opinions when they opposed the Iraqi war, for instance.

To be clear: I, too, criticize(d) the administration for getting involved here, but that's because I think this is none of their business and because they can't possibly have enough information to create an informed opinion.

Just. Like. Us.

carly | March 22, 2005 11:17 PM

Can the mere appearance of living qualify as 'life'? Why do right to lifers completely disregard the term 'vegetative state'? I keep reading about what these people camping outside Terri's hospital talk about God's gift of life, and so on. Terri is alive today because of medicine, not because of the will of God. If the right to lifers are so hung up on God's will anyway, they should perhaps refuse all kinds of advanced medical intervention- for these, after all, have been devised by us sinners.

darren | March 22, 2005 11:43 PM

"Darren: expressing opinions is good, unless it's government officials expressing their opinions, especially if these opinions are faith-based?"

Again, they can "express" their opinions as much as they want. What they can't do is impose them on us against our wills. Well, apparently they can, but they shouldn't. We are closer together on this than not Brian. At this point, it is down to the semantics of the difference between expressing opinion, and bringing down the full weight of the federal government via late night law making sessions.

"No one was complaining about them expressing their opinions when they opposed the Iraqi war, for instance."

Like hell! Not only were certain people complaining about those opposing the Iraqi war expressing their opinions, in many cases they were calling them traitors and threatening their lives!

"they can't possibly have enough information to create an informed opinion.

Just. Like. Us."

Well, I think most rational people's opinions are based on what they know at any given time. The irrational among us continue to believe contrary to new information either out of basic stupidity, or a complete aversion to admitting when we are wrong. Most people I've spoken to on this issue are of the ilk that base their opinions on available data and are open to changing their opinion as new or contrary data becomes available. The crux of what most people I know are discussing isn't whether or not we should force Michael Schiavo or the Shindlers to bend to our will, but that we should get our own affairs in order so there is no question should a similar unfortunate event occur to us. And, of course, that the federal government is absolutely as wrong about how it is handling this situation as it has been about just about every situation since the Lincoln administration.


Brian | March 22, 2005 11:46 PM

Totally aside from the arguments about the propriety of Congress's actions, health care power of attorney, etc., I think the means of death being employed here could stand a great deal of scrutiny.

"A 'Painless' Death?"

If it's decided that Terri's life should be terminated, starvation and dehydration seem to me to be clearly inappropriate, given that she was not refusing food and drink before the feeding tubes were removed. Since there is debate as to what level of perception she has, it would seem to be the most humane option to assume that dehydration/starvation would be (and thus are right now) torturous for her and therefore shouldn't be used. If she is still going to be put to death another method of euthanization obviously must be chosen, but at least it might be something with less risk of suffering in the event that she can experience pain.

Regarding the main issue (noting Brian G.'s accurate observation about uninformed opinions and blatantly ignoring it), I feel that neither Michael Schiavo or Judge Greer are acting in Terri's best interests, and thus the decisions for her care should default to her parents. However, based on (my admittedly limited understanding of) the letter and official procedure of the law (and disregarding the highly questionable venture of Congress into the matter), Michael Schiavo has the power to make the health care decisions for Terri. I feel that his choices for Terri have been cruel and morally reprehensible, but cannot effectively argue that they have been illegal.

darren | March 23, 2005 12:14 AM

"given that she was not refusing food and drink before the feeding tubes were removed."

I don't understand this statement. She can't refuse or accept food and drink at all. Hence the need for the feeding tube. As far as what you find morally reprehensible about Michael Schiavo's choices, I can't speak to because you didn't cite any instances. Many think he is after the money. The bulk of the money awarded ($750K) was put into a trust to cover her medical expenses. There is currently about $50 K left. The balance (about $350K) which was under her husband's control, has been completely exhausted in legal fees. There is no money left. Additionally, Mr. Schiavo has been offered money by right-to-life groups ($1,000,000 by one) to relinquish his guardianship and allow her parents to care for her; he has refused. I really don't think he's after money. I think he made a promise to his wife and sincerely wants to honor her wishes. I hope my wife has the strength to do the same for me. I wouldn't want to live that way if I didn't know what was going on around me, and I sure as shit wouldn't want to live that way if I did know what was going on around me. I certainly wouldn't want that decision to fall into my mother's hands. I am rational enough of a person to realize that my mother would be completely irrational about what was best for me. All she would be able to think is that I was her whole life, and she would know in her heart of hearts that I would want to be kept alive artificially so she could wipe the drool from my parched mouth, brush the scavies from my infected scalp out of my unkempt hair, and have CNAs empty my catheter and clean the pus out from around its insertion point, and change my diapers and wipe my butt for me. I would like to say that fortunately it is in my will that life support be pulled under certain circumstances like that, but this new government intervention worries me that they will try to keep me alive in spite of myself.

RooK | March 23, 2005 12:31 AM

Brian, I suggest you read the links that John has at the beginning of this thread. It offers excellent clarifications on all your assumptions and deductions that cogently disagree with you.

To sum it up:
Michael Schiavo asked the courts to decide what to do with Terry a long time ago; she has been a ward of the court for years. She suffered brain damage because of a heart attack that was actually induced by her bulemia. If you understand bulemia and the body-image issues associated, then you can understand how the courts have so consistently determined that Terry really didn't want to be maintained in this manner. Hence, this is actually about her right to refuse medical treatment that she didn't want.

This whole circus is a combination of her parents being unable to cope with her death, the media churning out hype, and the 'Publican party trying to score some cheap political points with the Pro Life groups who are otherwise going to be disappointed at how much Dubya won't do about abortion.

jinnderella | March 23, 2005 12:17 PM

Here are two articles published in the New England Journal of Medicine online yesterday. One on the medical perspective, one on the legal perspective.

Perspective
Terri Schiavo — A Tragedy Compounded
T.E. Quill
http://content.nejm.org/cgi/reprint/NEJMp058062v1.pdf

Legal Issues in Medicine
"Culture of Life" Politics at the Bedside — The Case of Terri Schiavo
G.J. Annas
http://content.nejm.org/cgi/reprint/NEJMlim050643v3.pdf

Tripp | March 24, 2005 10:59 AM

A couple very late points.

Terri's parents have stated they would fight this even if she had a living will telling them not to.

Would Bush fight it as well? I don't know, but I hope the answer is "No!"

By coincidence my wife and I have just completed our wills, powre of attorney, and living wills.

The thing about the living will is that, as clear as you can try to be when you write it there may always be something that happens that you haven't considered.

In that case I have given my wife, who knows me the best, the awesome responsibility to speak as best she can for me and express, as best she can, my wishes as I've made them known to her.

This is a huge trust and responsibility to place in someone else's hands. This kind of thing adds to the sanctity of marriage.

To have the Leviticans tear down Terri's marriage and villianize her husband to try to get their way is despicable.

EMDoc | March 24, 2005 11:56 AM

While I did not touch on the legal aspects of this issue in my blog, I agree that the state and federal government officers aree taking themselves way to seriously on this issue. I did not mention the fact also, that this is really a family feud. The medical aspects of it have been lost.

mythago | March 25, 2005 09:59 AM

and given the propensity of our legal system to pick documents apart down to each indivdiual word, I'd want to be damn sure I got them all right...

This is why most states have FORMS. You don't have to pick out the funny wording. You check off boxes and get the signatures, notarization, or whatever is required in your state, which will be made clear on the form. You could run it by a lawyer if it made you feel more comfortable.

"I'd have to pay an attorney" is a delaying tactic, but it's not a good reason to get going on this.

Lisa | March 25, 2005 03:04 PM

I heart Harriet McBride Johnson.

Her article from Slate.

http://slate.msn.com/id/2115208/

It is interesting that, in all the controversy of what Schiavo did want 15 years ago in a different life in her early twenties compared to what she may be able to wanting now, no one has bothered to ask or listen to those who are in similar circumstances and who understand disability rights issues without prejudice.

Predictable.

Andrew Wade | March 26, 2005 03:13 AM

Lisa wrote:

... she may be able to wanting now, ...

Er?


I do take your point that the Terri Schiavo of 15 years ago isn't a good guide to what Terri Schiavo wants now. But the question of what she wants may be moot; she may not be in a condition to have preferences.


... no one has bothered to ask or listen to those who are in similar circumstances ...

Are those in similar circumstances going to hear and understand the questions? I suppose we could learn whether those with severe cognitive impairments are generally unhappy or suffering (I doubt it), but I don't think Terri Schaivo is suffering. (So there's not much reason to end her life).

Anonymous | March 26, 2005 02:48 PM

Terry Schiavo and Republican Hypocrisy
Scott Ricketts is a member of Democracy for Cincinnati in Ohio.

I just want to understand this.

While govenor of Teaxs, the president signed into law a bill allowing hospitals to pull the plug on life support if the patient's family did not have the means to pay for continuing treatment. This week, that law was upheld and six-month-old Sun Hamilton died despite his family's wishes simply because they had no money.

Yet when Terry Schiavo's husband wants to allow her to pass away, suddenly our representatives all in favor of not only the federal government's power to overrule a state court's decision, but they demand that she be kept alive because all life is sacred?

This couldn't have anything to do with the fact that Sun Hamilton was poor and black, and Terry Schiavo is white and lives in the swing state of Florida, could it?

darren | March 28, 2005 01:38 AM

You seem to understand quite well anonymous. Now if the folks protesting outside Terri Schiavo's hospice would pay attention to something other than what Faux Spews wants them to pay attention to, they might understand also.

Sarah Coleman | May 4, 2005 09:07 PM

Now that Terri is dead,this issue is not over. How long will it be before it is decided that allowing someone to starve to death is cruel and inhumane. So, why don't we put them down like a dog?
I am very much against assisted suicides. I believe my father was murdered by our local hospitol because they felt at 87, he had had his run. They gave him penicillan when they knew he was allergic to it. We reminded them he was allergic to it and they told us that it was 'worth the risk'. Yeah, because they were tired of him. At the time (20 years ago), it would have been impossible to sue them.
One of the legacies that Terri has left behind is that the Right to Life groups are really energized over this. She may not have saved herself, but she may be the reason we get legislation passed to protect other handicapped people.
Also, this case has been a wake up call for those of us concerned about the out of control judicial system. Too many judges are legislating from the bench. This case proved that there are no checks in place for an out of control judiciary.
Terri may have lost her battle but she may have won our war.

Sarah Beth | December 6, 2005 11:51 AM

I am doing an argumentative paper on the Terry Schiavo case. I am still angry over this whole issue, it makes me sad to even think that a human life was taken for no reason at all. I have never felt this much hate towards one person (husband) before. Well I really dont have much else to say about it, I am just glad that there are some people out there that agree with me b/c it seems that I am the only one here that stands up for the right thing.

kyera garrett | January 23, 2006 10:16 PM

i think that terry was a beatiful woman but after the accident she wasn't even herself i look and i think would i want to be at that state and i say no and im sure after all those years being hooked up to the machine even if she did come back what wouldd she do she wouldnt be able to recap memories and what not so0o0o therefore it was best what had happened i meanit hurts to lose a love one but what is best is best!!!!

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