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Miscellaneous thoughts and ramblings
Monday, March 21, 2005
Princeton Bioethicist on Terri Schiavo
Robert P. George on Terri Schiavo on National Review:

Thought provoking interview touching on some of the moral, ethical and governance issues associated with Terri Schiavo's plight.


"It is pointless to ask whether Terri Schiavo had somehow formed a conditional intention to have herself starved to death if eventually she found herself in a brain-damaged condition. What's really going on here — and I don't think we can afford to kid ourselves about this — is that Terri's husband has decided that hers is a life not worth having. In his opinion, her continued existence is nothing but a burden — a burden to herself, to him, to society. He has presumed to decide that his wife is better off dead.

Even if we were to credit Michael Schiavo's account of his conversation with Terri before her injury — which I am not inclined to do — it is a mistake to assume that people can make decisions in advance about whether to have themselves starved to death if they eventually find themselves disabled. That's why living wills have proven to be so often unreliable. One does not know how one will actually feel, or how one will feel about one's life and the prospect of death, or whether one will retain a desire to live despite a mental or physical disability, when one is not actually in that condition and when one is envisaging it from the perspective of more or less robust health.

Consider the case of a beautiful young woman — an actress or fashion model perhaps — who is severely burned in a fire. Prior to actually finding herself in such a condition, she might have supposed — and even said, if the subject had come up in a conversation — that she would rather be dead than live with her face grotesquely disfigured. But no one would be surprised if in the actual event she did not try to kill herself by starvation or some other means, and did not want to die.
In any event, it is clear that the only reason for Michael Schiavo's decision is that he considers Terri's quality of life to be so poor that he wants her to be dead. He claims that she would want that too, which I don't grant, but even if he's right about that, we should treat her like anyone else who wants to commit suicide. We rescue, we care. We affirm the inherent value of the life of every human being. Our governing principle should be always to care, never to kill."


"The other thing that Congress is being accused of is interfering in a family decision. Now look: Terri Schiavo has been abandoned by her husband. Michael Schiavo took a vow to be faithful to Terri "in sickness and in health, forsaking all others, 'til death do us part." But he has not been faithful; he has not forsaken all others. He has set himself up in a marriage in all-but-name with someone else, a woman with whom he already has two children. He has disrespected Terri and, indeed, forsaken her. Now he is seeking to bring about her death by starvation. Notice something wrong with this picture? Terri's parents and siblings, by contrast, have never abandoned her. They are prepared to shoulder all the burdens, including the financial burdens, of caring for her. They want to provide the therapy that many medical people who have observed Terri, whether at the bedside or by videotape, believe can help her. No one expects a full recovery, but it may be possible for her to make genuine progress. That possibility will be foreclosed, however, if she is killed by deliberate starvation before it can begin."
That article contains a number of misconceptions, primarily that Ms. Schaivo can make progress towards consciousness. The chance of her improving are less than me of making the NBA, and I am short, over 40, and my jump shot left me long ago. If people dont like the US legal system that allows people to refuse food/water/treatment, then work to change the system. If people dont like the fact that surrogates can make decisions for those that cant, then change the system. The reality is even if Ms. Schaivo was awake and talking, she could refuse a feeding tube. And, no one has proven that the husband does not have her best ineterests at heart. However, interfering with the legal system because you dont like how it worked in one particular instance, (with only innuendo, rumors, and false facts to back you up) is not the way our legal system and checks and balances is supposed to work. Worse, the president and congress are pandering to the Christian right, and setting a dangerous precedent for interference. Dont get me wrong, I am opposed to starving the lady, but if that is what the system allows, and it has gone through the courts fairly and squarely, the pres. and congress have to respect the rule of law. By the way, you can see my longer take on it at my site if you wish.
I agree with almost everything in the post above. Except that I think it is fine to allow her to die. How did this person get to be a *bio*ethicist, anyway. He seems to have no understanding of modern medical ethics at all. People who are terminally ill or severely impaired can choose to go without any medical treatments, and therefore to die sooner. This is different from taking your own life with a gun. Terri Schiavo is in a "persistant vegetative state." She is not merely "disabled." If she can smile, talk and laugh in response to people, why didn't anyone just ask her if she wants to live? You know why? Because she is functionally brain-dead with only brain stem functions still working. She is not conscious, she will never be conscious and she should be allowed to die if this is what all of her surrogate decision makers decide (including court appointed ones having no relation to her husband). I don't know all the details of the case, but I do know that it has been heard, I believe, 26 times in various courts with the final decision being made that she would not have wanted to live like this.
Re: Terri is in a persistant vegetative state.

As I read bnc's words, I'm hearing 180 degree contradiction from a nurse who took care of Terri. Responsive, verbally communicative, if at reduced capacity. Nobody is saying that she is going to write a dissertation, but there is much dispute regarding the pvs diagnosis from those who have spent time with her, including medical professionals, family members and 2 of 5 examining neurologists in an appeal several years ago.

If you accept permanent vegetative state as the diagnosis, I can see how it would be easier to come to your conclusion. I am not ready to accept it, having heard more than a few people with firsthand knowledge say otherwise.

Her wishes are unknown. Her condition is very much in doubt.
See also this post, which touches on uncertainty issues with Terri's condition.
from this article.

Nor is there agreement that Terri is in a vegetative state right now. Her family disputes it, saying she sometimes responds to their loving gestures and words. Their perceptions are dismissed as wishful thinking. But a neurologist who was nominated for the Nobel Prize in 1999 (and who examined Terri Schiavo several years ago) told BP News (www.bpnews.net/bpnews.asp?ID=20400) that Terri is not in a vegetative state. She sometimes responds. Terri (he says) has been able to swallow pudding in the past, and can swallow her own saliva right now. With therapy, she might not even need the feeding tube. "They are truly withholding food from a person who is awake, alert, and can eat and swallow."
I, too have heard reports that she is verbally responsive and cracks jokes. Oh, please. If she is even sometimes communicative, one of the judges would have simply asked her if she wants to live or die. Why haven't they? Because she is in a vegetative state! This method of allowing a person to die is used every day in this country and I find it chilling and frightening that that right may be taken away from people soon and that the government will intervene in the doctor-patient relationship more than they already have. On this, I (shockingly) agree with the representative of the ACLU that I saw on T.V. today.
One final note. I think that what is bothering me the most about this case is that Terri Schiavo may or may not be in a vegetative state, and she will die soon, but she is one single person. However, every year over one million babies lives are snuffed out for NO REASON AT ALL. I think each abortion should get 1/100th of the scrutiny of this case to be sure that we are not violating the rights of perfectly normal fetuses who surely, if they could speak, would want to live. There, I said it.
Responsive and able to answer questions of life and death are different things. Nobody's claiming she's cracking jokes. Nobody's claiming she's functioning higher than a severely retarded person would.

But your "oh please" differs from numerous neurologists and caretakers who have actually spent time with and examined Terri.

Arguing that this is about Terri's right to be deprived of food, water and the company of her mother and father until she dies is missing the point. Arguing that, because this happens every day in the country (like abortion) it is right is also missing the point.

You seem convinced of her condition. Some doctors who have examined her agree with you. Others disagree strongly. Bottom line, we aren't sure. We don't know if there's anyone home or not. To presume that we do is dangerously arrogant.

It seems to me that the "rights" that are being honored here are the rights of the husband to be rid of the burden. You may believe that he's acting to fulfill her wishes (and it's possible he is), but it somehow took him 8 years, a new de facto wife and 2 kids to remember those wishes. That nobody else among her family members agrees with his newfound discovery of Terri's wishes should raise your suspicions a little bit, no?

Finally, it's tangential, but letting a woman die at the behest of her husband will in no way further the cause of saving unborn babies from the same fate. Rather, it will strengthen the positions of those who believe in abortion on demand. If a grown woman can be put to death because she can't speak for herself, it's an easy, if not entirely well thought out, leap to permit the same fate for a 7 month old fetus.

I'm not sure if you've read all of the posts I've put up on Terri. Should a woman on whom neurologists disagree about her condition, be permitted at least an MRI before being sentenced to death? Terri hasn't been allowed one. CT Scan's are nice, but they don't tell nearly what an MRI does. Why put her to death when her condition's in doubt?
And, how about a PET Scan? Something that could actually provide some hard evidence as to brain function? She's been denied this as well.

Surely, as a compassionate individual, you'd agree that a person should be given the RIGHT to have all reasonable diagnostic options exhausted before being sentenced to death. Is an MRI or a PET Scan unreasonable? If she were an athelete with a sore elbow, she'd get an MRI with 6 hours notice.

Are you really comfortable letting Terri starve to death in the absense of a diagnosis arrived at using all of the tools available to modern neurologists? Think about that for a second, and think of this case outside of the larger philisophical issue of whether this is an appropriate remedy for the country at large.

Does Terri Schiavo's situation match the minimum moral criteria to allow this death to progress? Over the 15 years of her convalescence, has her official diagnosis been arrived at by exhausting all of the minimally invasive options available? No. Can you be even reasonably sure that her husband's decision (in contradiction to the rest of her family) to sue to have her food and water removed after 8 years, a new de facto wife and 2 children, was a decision based on Terri's wishes? Or, is it at least as likely that the decision was motivated by selfish interests?

As a matter of principle, I'm not ready to abandon the concept of allowing nature to take its course for those who are with out hope, and/or for those who have expressed their wishes to allow it. But, to my eye, there is just no way that Terri Schiavo's case rises to the minimum standard we should be setting as a society.

It is entirely possible that Terri's diagnosis of pvs is wrong. It is entirely likely that her husband is acting not in her interests, but in his own. To believe otherwise is to accept that he ignored those same wishes for 8 long years.

In the absense of a person's known wishes, and of a thorough diagnosis, we shouldn't be condemning people to die.
For the sake of defragmenting the conversation about the Schiavo case, please make all further comments on this thread. Thank you.

Move along. Nothing to see here.
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