03.22.05
Posted in politics, culture at 4:44 pm by
Seems like just about everyone in the whole wide blogosphere has taken their turn sharing an opinion on the Schiavo case. I figured, what the heck, I might just as well throw my two cents into the mix too, right?
The issue is pretty simple for me. The issue at hand has been colluded by a number of facts floating around, but quite simply it comes down to this. The Schaivo case, in my opinion, is not about the right to live or the right to die. That may not sound very kind, but I think it’s true.
If this case was about the ‘right to die or the right to live’ it wouldn’t have needed a family in turmoil. Let’s face it, had Terri Schaivo’s parents agreed with her husband, Terri Schiavo would’ve died years ago. Her feeding tube would’ve been removed, and no illegal act would’ve been committed.
What is on trial in this case, in my opinion, is not the right to live or the right to die, but rather what is on trial is the issue of the sanctity of marriage. What floors me about this case is that the one person who took a vow to love Terri Schiavo and know her inside and out is now being told that he knows less about the wishes of Terri Schiavo than her parents.
I just can’t get around the fact that when married a son and a daughter leave their parents. Michael Schiavo shared secrets with his wife, had deep talks with her, loved her, cared for her, stood by her side during a horrific life threatening accident, and–I would argue–has continued to stand by her side. If her parents agreed with him, Terri would be gone.
If we’re going to trust ANYONE to know Terri Schiavo’s wishes–it better be Michael Schiavo.
Now, I don’t want to turn Mr. Schiavo into some sort of angel; frankly, he’s probably not. But, when it comes down to it, claiming that Terri Schiavo’s parents knew Terri’s wishes better than her husband seems a little farfetched. And, really, isn’t that what this whole debacle is about, knowing Terri’s wishes?
Who knows them best? Who knows for sure. But if government is about to legislate that her family takes precedent over her husband…well…let’s just say that for a conservative party that holds the “sanctity of the institution of marriage” on such a damn high pedestal–this action is a little two-faced.
But then again, who does that REALLY surpise.
NOTE: Because it was lacking in clarity, the author of this post has taken artistic priviledge of editing his thoughts.
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Posted in politics, culture at 4:44 pm by
Seems like just about everyone in the whole wide blogosphere has taken their turn sharing an opinion on the Schiavo case. I figured, what the heck, I might just as well throw my two cents into the mix too, right?
The issue is pretty simple for me. The issue at hand has been colluded by a number of facts floating around, but quite simply it comes down to this. The Schaivo case, in my opinion, is not about the right to live or the right to die. That may not sound very kind, but I think it’s true.
If this case was about the ‘right to die or the right to live’ it wouldn’t have needed a family in turmoil. Let’s face it, had Terri Schaivo’s parents agreed with her husband, Terri Schiavo would’ve died years ago. Her feeding tube would’ve been removed, and no illegal act would’ve been committed.
What is on trial in this case, in my opinion, is not the right to live or the right to die, but rather what is on trial is the issue of the sanctity of marriage. What floors me about this case is that the one person who took a vow to love Terri Schiavo and know her inside and out is now being told that he knows less about the wishes of Terri Schiavo than her parents.
I just can’t get around the fact that when married a son and a daughter leave their parents. Michael Schiavo shared secrets with his wife, had deep talks with her, loved her, cared for her, stood by her side during a horrific life threatening accident, and–I would argue–has continued to stand by her side. If her parents agreed with him, Terri would be gone.
If we’re going to trust ANYONE to know Terri Schiavo’s wishes–it better be Michael Schiavo.
Now, I don’t want to turn Mr. Schiavo into some sort of angel; frankly, he’s probably not. But, when it comes down to it, claiming that Terri Schiavo’s parents knew Terri’s wishes better than her husband seems a little farfetched. And, really, isn’t that what this whole debacle is about, knowing Terri’s wishes?
Who knows them best? Who knows for sure. But if government is about to legislate that her family takes precedent over her husband…well…let’s just say that for a conservative party that holds the “sanctity of the institution of marriage” on such a damn high pedestal–this action is a little two-faced.
But then again, who does that REALLY surpise.
NOTE: Because it was lacking in clarity, the author of this post has taken artistic priviledge of editing his thoughts.
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Adam said,
March 22, 2005 at 6:19 pm
Now there’s a perspective I hadn’t considered. Very interesting…
Kevin said,
March 22, 2005 at 6:38 pm
Your points are well taken, Brandon. I don’t know a whole lot about the case (so correct me if I’m wrong), but from what I do know, most people on the other side of the debate would say that the husband has been living with another woman for a while, in which case they would say he forfeits any say in the matter.
ol cranky said,
March 22, 2005 at 7:53 pm
Kevin:
Michael Schiavo got into his current relationship years after Terri sustained her injury (and he started dating at her parents insistence); he was not carrying on some sort of affair that came into the open once his pesky wife was put away. He has, for all intents and purposes, been widowed without being able to have the final closure other widows/widowers generally get when they bury their spouse and finality sets in. She has been in this condition for 15 years, it took him quite a few years to finally give up hope of improvement after many lessons in futility. He is in limbo.
If your wife was seriously injured in a car accident, you were informed there was nothing medical staff could do but make her comfortable, and you decided it was time to withdraw life support do you think you should have to divorce your wife if her parents disgreed with you?
Kevin said,
March 22, 2005 at 8:18 pm
Ol Cranky:
Thanks for the background. I was playing devil’s advocate, incidentally, but in answer to your question, no.
Joan said,
March 22, 2005 at 8:48 pm
It’s true that if the parents and the husband had been in agreement, she would have been gone long ago. But I still would have disagreed with their actions (except that I wouldn’t have known about it because it wouldn’t be in the news).
The source of my disagreement is that I don’t consider assisted feeding to be artificial life support. Withholding food is different from turning off a ventilator and letting nature take its course. This is an assisted suicide, if her husband is correct about what her wishes would have been. I think we should have a pretty high standard of proof of the patient’s wishes in cases of assisted suicide (otherwise, it’s euthansia, which I am against).
The fact that her parents are fighting it has given people (including politicians) a platform to make their own opinions known. It is, however, very strange for it to have become a federal case.
Karen said,
March 22, 2005 at 9:56 pm
As a nurse, a couple things about this strike me as being very ironic. Terri had an eating disorder which triggered the whole event in the first place (extreme electrolyte imbalance which triggered the heart attack)and now she is starving to death. Assisted suicide? Was she suicidially depressed when her eating disorder was out of control? They did take her off the vent way back when & she survived, but I think it’s clear to everyone that she will never “recover”.
Brandon said,
March 23, 2005 at 8:09 am
I think you raise valid points, Joan. This case really does come down to having a high standard of proof of the patient’s wishes. I would also agree that it’s another issue entirely if you agree or not with the concept of letting Terri die.
There seems to be something extremely barbaric about letting her begin starving while we just wait to hear from a judge about her fate…why don’t we exhaust all efforts prior to pulling the feeding tube? AND…is death by starvation ethical?
However, I still think that all these points are ancillary to the main one; this is a matter of deciding who knows Terri’s wishes best. If she did not want to be kept alive, she should not be. And, I think if we choose anyone to know that better than Michael Schiavo–we’re setting a frightening precedent.
njc said,
March 23, 2005 at 10:40 am
I disagree that this is different from taking someone off a vent. Both are invasive manuevers; in fact, a feeding tube is a surgical procedure (albeit a minor one), while intubating and ventilating is not. In addition, I think Brandon brings up a good point in the medico-legal world–who should decide when a patient can’t speak for themselves? In many states, spouses and parents have the same weight in the matter; one cannot “trump” the other. This is a good reminder to all of us to designate a healthcare power of attorney and write a living will. One way to make sure our wishes are followed is to have them written down.
One last tangent–it was cases like this that convinced me that we need to legalize gay marriage or allow civil unions. Many times long time partners of patients have NO say in the matter of care, even if they have known the patient intimatly for years, while estranged parents or siblings can fully dictate end-of-life matters.
ol cranky said,
March 23, 2005 at 11:07 am
Joan:
To add to Karen’s comments, cessation of mechanical ventilation is much more difficult on the patient (especially if they’re aware), even when sedated - just ask anyone who’s have a few rough weaning trials. The outcome of death may occur sooner than withdrawal of nutritional support, but the difficulty of the dying process is much greater. In the Schiavo case, Terri is not conscious of what’s going on as the cognitive center of her brain is gone; Terri Schiavo’s body still exists but Terri Schiavo does not.
There are 2 ironies in this case, the one about how this all started out due to her bulemia leading to hyperkalemia induced cardiac problems and the fact all the “save Terri” folks are so worried about the horrifying death from starvation Terri will endure without showing much concern/becoming activists for all the people in the world who are aware of their starvation and are dying from malnutrition.
mainsheet42 said,
March 23, 2005 at 11:45 am
One thing that has been glossed here is the hypocritical inconsistency in the Repugnican campaign.
In 1999, Dubya signed a law in Texas that allows a team of physicians to overrule someone’s medical power of attorney under certain circumstances. You ask what the circumstances are? I’m glad you asked:
(1) The physicians must conclude that continuing treatment is futile;
(2) The patient must not have the resources to continue treatment.
So hey — if you’re poor or middle-class and your health insurance has run out, it doesn’t matter what you or your designated decision-maker may want, they can cease treatment. In one of life’s educational ironies, a severely handicapped six-month old was taken off life support at Texas Children’s Hospital under this law (and died) while Congress was passing their “Err on the side of life” act.
I shouldn’t be surprised: Repugnicans and militant right-to-lifers are interested only in fetal rights-to-life and in banning anything they think smacks of euthanasia.
Once upon a time, and even today in some parts of the world, it was common for parents to bury their children. With the advent of sanitation, an understanding of infectious disease processes and microbial biochemistry it is no longer common. In fact, it is so uncommon that we feel it is unnatural and wrong. Terri Schiavo’s parents are deep in denial. Unfortunately, they haven’t realized something that every medical professional recognizes: there are things worse than death.
I don’t think that I’d withhold nutrition and hydration. But I’d damned sure pray for pneumonia and not treat it when it happened.
Audrey
the dude said,
March 23, 2005 at 1:49 pm
i would like to add a comment to the terri case. i must admit i am a bit surprised by the vast generalizations posted by audrey; however, one thing i would agree with is that there are things worse than death. one of those things would be intentionally starving someone who is helpless.
first of all life is defined essentially. it is not valued by what someone can or cannot do. second of all, there are speculations that her husband has been acused of beating her early in their marriage, injecting her with high levels of insulin (in an attempts to kill her) and more. furthermore, i would argue that it is the abusive husband that may be culpable in accelerating an eating disorder… a disorder that led her through a series of events that brought her to the present. what is his responsibility?
without a living will, we cannot know what her wishes are or were. and in this particular case (although i respect the what brandon posited about the marrital bond) i am not likely to consider the husband the most qualified person to determine her fate. one could argue that he has a record of not seeking her best interest.
also evidence suggests that her body is capable of sustaining life. anyone who is deprived of food will die. she has the functionality necessary to breathe, digest food, and sustain her own life. if we were to deny even the most hardenned criminals food we would be seen as barbaric… maybe even as a “repugnican”!
the real unnerving president that is being established is a statute of limitations being placed on what brain functions are necessary to perform in order for one to be considered “worthy of food”.
finally, the “she is beyond a cure and doesn’t know what is happening to her arguement” has several limitations. if it is true that she doesn’t know that the tube is out, then she wouldn’t know that the tube is in. that coupled with a willing family to care for her seems to be the compassionate course. perhaps it is not up to us to determine why someone would want or not want this. it may just be the case that after a life time of caring for someone in these circumstances that we come to a deep understanding and appreciation for life and suffering.
ol cranky said,
March 23, 2005 at 7:03 pm
the speculations about abuse by her husband are very recent history. I find it hard to believe that the Schindler’s were so unaware of this abuse and were extremely supportive of him until the malpractice lawsuit. This is yet another red herring from the “prolife” movement to join the accusations of his inappropriate relationship and children with another woman.
This is not a matter of being worthy of food. As you mention, she is unaware of whether the PEG tube is in or out; she is also psychologically/cognitively unaware of her starvation. Any human being can refuse to eat, you cannot force that person to eat or force nutrition via invasive methods (unless you are their guardian who is allowed make that decision on a patient’s behalf). People die of starvation (against their will) every day, where is the outrage against that?
This is actually a matter of her right to self determination and right to refuse medical treatment. When a patient is no longer competent to make those decisions, a legally authorized representative (LAR) makes the decisions by proxy - in this case, the LAR is her husband Michael. To force any treatment (invasive or not) on someone in light of the court accepted wish to refuse treatment is nothing short of battery and is actually quite unethical.
NEJM Legal Issues in Medicine
mainsheet42 said,
March 23, 2005 at 7:06 pm
Dude,
I’ve reread my post and I don’t find any vast generalizations except maybe in my comment about Repugnicans and militant right-to-lifers. But I’ll stand by that generalization.
That said, you apparently glossed almost my whole comment. I said at the end of the comment that I don’t think I’d withhold nutrition and hydration. But I don’t know what I’d do because I haven’t been confronted with this sort of tragedy. Other medical tragedies, yes, I’ve been there and done that and got the tee-shirts to prove it.
The point of my post was this: how does President Bush reconcile two things. First, he signed a law in Texas that permits a committe of physicians to override the expressed wishes of a patient’s guardian provided that they believe continued treatment is futile, and the patient/guardian do not have the resources to pay for treatment themselves. In other words if you’re poor and in need of life support, your life continues at the whim of a committee of doctors.
President Bush needs to reconcile with that with his well-publicized statement that governments and legislatures should err on the side of life. That statement is incompatible with his action in signing that 1999 law. The only possible reconciliation is to be Alice’s Red Queen and believe that believing three impossible things before breakfast is good intellectual exercise. It’s not.
Terri Schiavo’s guardians (including the court) have some serious moral issues to weigh. Among them:
1. How does she benefit by receiving care that keeps her alive in her condition, whatever that condition may be.
2. What burden is she subject to by receiving this care?
3. Does this use of scarce resources serve justice in some broader sense?
4. Posit for a moment that the doctors are correct and she is in a persistent vegetative state. Does she benefit by kept alive in that condition?
Insisting that she be kept alive simply because we can keep her alive embraces vitalism — it posits simple physical existence as the ultimate value. Every other possible value is subordinated to being kept alive regardless of the means required or the quality of the life. For most religious people, vitalism is not an acceptable doctrine, and it’s certainly not acceptable Christian doctrine. Incidentally, your insistence that life is ‘defined essentially’ appears to me to be a vitalist definition.
I’ve glossed the question about whether nutrition and hydration amount to extraordinary care. Some people will agree that they do, others will disagree. I tend to fall in the ‘not extraordinary care’ camp, myself. Consequently, I’d continue to provide her nutrition and hydration. But there’s no reason to doubt the neurologists and other disinterested parties who have examined her carefully and concluded that Terri Schiavo checked out fourteen years ago.
I’ll remember to thank God tonight that I’m not charged with making this tragic decision. And while I’m at it, I’ll remember not to judge anyone (like Michael Schiavo) who has been charged by our society with this time of hard testing.
Audrey
Wendy said,
March 24, 2005 at 2:43 pm
Brandon, here’s a great article talking about how much Michael loved his wife and had her best interests at heart. Check it out: http://www.crosswalk.com/news/weblogs/beam/?adate=3/19/2005#1319138
Brandon said,
March 24, 2005 at 3:38 pm
Wendy,
So glad you dug up such an unbiased article for me to trust. Seriously, though, I think for you to post that article in response to my post belies your misunderstanding of the thrust of my message.
I don’t really care how lousy of a husband Michael Schiavo was or wasn’t. Truth is, we can all speculate, but none of us know. The fact remains, I believe he should have the voice that matters when it comes to speaking for the wishes of his wife, Terri.
Wendy said,
March 24, 2005 at 4:17 pm
Even biased news sources (and they’re all biased) are required to report the facts.
I was on jury duty some months back, and the job of the jury was to decide who should administer the will of a late doctor: his wife or his mistress? The question was, who was more emotionally capable and willing to do the right thing? Turns out we decided in favor of the wife.
In most cases, I’m all for the sanctity of marriage and two people being one and having the legal right to make these sorts of decisions. However, one must judge each case by its own merits. In this case, the judge is ignoring a wide body of evidence that Michael may not be the best person to make decisions for Terri. Should the Schindler’s be allowed to make this decision then?
I personally think that the judge needs to appoint a neutral party, but that won’t happen. She’ll probably starve to death, which is a much less humane death than convicted serials killers on death row receive.
Somehow I really doubt you’ve done your homework on this case. There is a lot more to it than the things you’ve discussed here.
Wendy said,
March 24, 2005 at 4:20 pm
http://slate.msn.com/id/2115208/
P.S. Slate also has an “unbiased” article. Perhaps you’ll like this one better, coming from a liberal ‘zine?
Brandon said,
March 24, 2005 at 4:45 pm
Doubt all you like, Wendy. Doubt all you like.
Derby said,
March 25, 2005 at 12:51 am
Even biased news sources (and they’re all biased) are required to report the facts.
I must have missed the passage of that law.
mainsheet42 said,
March 28, 2005 at 11:49 pm
Wendy,
The court did appoint a disinterested party to evaluate TS — that person is called her guardian ad litem(GAL), literally her guardian at law.
Apparently the GAL reported to the judge that he agreed with the neurologist’s evaluations. He also agreed that MS had TS’s best interests at heart.
As far as I’m concerned, the whole thing is a private family tragedy and ought rightly be handled in private. As a modest aside, this case also illustrates an ancient principle. Be careful what you wish for, you may get it. The Schindler’s wished for support from the Right-to-Life community, and they got it. When they wanted everyone to go home yesterday, a significant number told them to forget it. Apparently even the Schindler’s don’t know what’s in TS’s best interests…
Audrey