Thursday, March 31, 2005

Terri Schiavo: The Day The Music Died

Bye, Bye Miss America, Bye
Drove my Chevy to the levy, but the levy was dry
Them good ol' boys were drinking whiskey and rye
Singing, this will be the day that I die

Theresa Marie Schindler-Schiavo died this morning.

When I heard the news, I didn't realize how much it would depress me.

Yes, I realize that I have become attached to this case, maybe on a personal level. I'll tell you why: it has made me re-evaluate some things that I thought I believed. It challenged me to re-think my stance on a few issues.

No, I have not changed my opinion that patients do have the right to refuse, verbally or in writing, any medical treatments, up to and including the removal of a feeding tube. It has not changed my opinion that the closest family member or an appointed agent through a Durable Medical Power of Attorney is an appropriate person to make those decisions for the patient if they become incapacitated.

So, why did I get exercised over the Terri Schiavo case?

I have a short list of issues with the case, however, I will only address one: the legal definition of life.

If you listen to some folks talking, this case was about "state's rights". Supposedly, this case is about who has the right to decide who the legal guardian is of an incapacitated person; who has the right to hear cases regarding this matter; who has the right to determine if an individuals health directives, verbal or written, are followed.

Nice try. That has become such a huge red herring. This is one area that congress made a mistake: trying to pass a law that gave the federal courts the power to review cases on patient rights when it concerned life or death matters. The courts refused to review the case.

Why do I say it was a mistake for congress to pass this law? It wasn't just a mistake, it was a cop out. The Supreme Court was correct, procedurally, in refusing to hear the case because they recognized a hand off of a loaded bomb. But, ultimately, refusing to hear the case was a cop out by the Supreme Court as well.

Why do I call it a cop out?

Neither the Congress of the United States nor the Supreme Court wanted to make any law nor set any precedent that might in anyway define the meaning of "life".

In the end, that is what this case was about. It wasn't about some dry and arcane discussion about "states rights" nor any laws about "patient's rights" or "living wills" nor even the law regarding establishment of guardianship over incapacitated people.

This case was about life and who gets to establish what "life" means.

Is "life" the essence of "being"? In order to be considered alive, some people believe that a thing, a person, must have a recognizable cognition of their surroundings, an ability to interact intellectually, not just physically, with their surroundings, to have a personality or character as would be defined by something they refer to as the "higher brain", and, in essence, be something that we can recognize as a "conscious" human being.

Is "life" the essence of "living"? In this definition, living would be defined as breathing, heart beating, eating (whether tube, intravenous or hand fed), body functioning in all ways except the brain no longer imposes or only imposes a minimal essence of "being": conscious, recognizable interaction with people and their environment.

Why did Jeb Bush refuse to issue a directive that the police take Terri Schiavo into state protective custody?

Because, if he had, the state would have been defining the meaning of "life".

It was a cop out.

Herein lies the rub: I know that, in the past, I have noted the issues with trying to define the meaning of life. By defining the meaning of life, other laws would be put to a new test. Other aspects of life, such as the patients right to refuse treatment, might be put to a new test. The question of embryo based research into genetically driven medical treatments would be put to a new test. The most inflammatory issue, abortion, would be put to a new test.

The test of "life" as defined by law.

I recognize this problem. I have recognized this problem for a long time, particularly as I have been a "pro-choice" supporter and insistent that government should make no laws regarding medical procedures that impact a woman's control of her reproductive system, though I have been concerned about the number of abortions performed and what it meant about society. I have recognized this problem when discussing embryotic research, which I have supported, though I have been concerned about the development of embryos as a "marketable" item, thus putting a price on life. Let's not forget organ donation. In order to harvest organs, a patient must be considered "brain dead", but their heart and lungs must still function. Usually, this is through artificial and mechanical means as "brain death" also entails the portion of the brain that controls these functions.

In the past, I supported the governments attempts to NOT define life for the simple reason that "life" seemed to have more than just one meaning and had so many implications regarding existing society and medical practices.

For several months and, more specifically, thirteen days, I watched a woman that I would have considered to be "alive" be denied food and water, dehydrating and starving her to death.

All for the want of a legal definition of "life".

You see, if Terri Schiavo was considered to have "life", without a terminal illness that was already recognizable ending her life, they could not have deprived her life without first meeting the guidelines of the fifth amendment to the Constitution:

No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offence to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.

Being unable to feed yourself is not a terminal illness unless you are in the wilderness, far away from civilization where feeding, as in the case of Terri Schiavo, could not be provided mechanically.

Some people would argue that this in itself defines the essence of Terris condition: a mechanical device performing a function for her because the organ that controls it no longer does. If we looked at it from that perspective, then we'd have to start questioning things like dialysis, pace makers, colostomies, artificial hearts, etc, etc, etc.

Which returns us directly back to the main issue: what is the definition of "life"?

And, after that question, what is the value of "life"?

From my perspective, life has suddenly become incredibly cheap and expendable.

Worse yet, what I must come to recognize as well as my compatriots from either side of this debate is that, while we argued about the meaning of life and we have allowed our elected representatives not to define "life" through a defined and recognizable law in order to avoid possible conflict with other existing laws, a small court in the state of Florida has already made that law by setting precedent in this case; determining that Terri Schiavo was in a medical condition that was "less than life" and, so having determined that to be true, her spouse could have her life ended through the removal of a "medical treatment."

In all honesty, this is probably not the first court case that set this precedent. This was only the case that received national televized presence. It was the case that finally caught our attention and started anew our debate about "life".

If there was anything good to be said about Terri's death, it was that she made this conversation possible. In the past, discussions about abortion and the meaning of life became stagnated around the question of women's rights and Roe v. Wade. People could easily argue that a fetus not out of the womb could not be considered "alive" or having "life" and others could argue the opposite, but, because it was a baby and babies are inherently considered the responsbility and, let's face it, property of the birthing parent, we the people have been reluctant to try and establish a time frame or other landmark that would signify the beginning of "life" and when the child must be protected under the laws including the basic rights outlined in the Declaration of Independence, the first "rights", of "life, liberty and the pursuit of happiness".

"Life" the first "right" recognized by our founding fathers. Who knew 229 years later the question of what "life" is would be so important?

Terri, though, she was not a baby. She was not somebody's property. She was a living, breathing, heart beating, bodily healthy human being that had life until it was taken from her. She had value as a human being. She lived fifteen years after the incident that disabled her, whatever that living condition was, and, after fifteen years someone decided that her life was not worth living.

Not just someone. A court in the county of Pinellas Florida along with her "legal" spouse.

That is who has decided the meaning of life. That is who has set the precedent that will be cited in court cases through out the state of Florida and referenced in every court through out the land.

You are not alive unless you can also "be". Your life is not about your existence as flesh and blood. You must be recognized by the courts as having a personality, a character, an ability to recognizably interact with your surroundings and people. Without that, you are not alive. You are nothing.

Because we are cowards. I was a coward. Because I, we, have held these other issues as in danger or requiring redefinition should we define the meaning of life. Because Congress has decided that someone other than the highest law of the land should define life, be that a doctor, a judge or your average person walking down the street. Because, I, we, have not demanded that a definition of "life" be prescribed in our constitution, as another orator of recent fame noted, the chickens have come home to roost. That chicken landed squarely on the shoulders of Theresa Marie Schindler Schiavo and it cost her her life.

I watched it live on my television for thirteen days. Thirteen days that have changed me and my perceptions. I watched as the definition of "life" was defined by a county court in Pinnellas County Florida.

For all those who support the anti-abortion "right to life" movement , who demand that the capital punishment, as defined by the death penalty, be withdrawn as "cruel and unusal punishment" and, yet, would not support this woman's right to live as an invasion of privacy or a "family matter" regarding "medical decisions", I would say that you missed the whole point: everything that you worked for has been defined by this moment.

There is no "right to life" because "life" has been defined as something more than existing. "Life" means that you must "be".

The state and the federal government, along with the judiciary, can decide who dies and who lives, whose life is worthy and whose life is not.

Article I

Section 1.

All legislative Powers herein granted shall be vested in a Congress of the United States, which shall consist of a Senate and House of Representatives.

Section 8.
To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.

The absence of a law was the law in this case. The absence of such a law has cost Theresa Marie Schindler Schiavo her life.

So, here we stand, what is the definition of life, when does that life have "value" and are you comfortable that the decision was left in the hands of a county court, the "expert" opinions of physicians and a couple of lawyers?

Should the definition of life be left up to the opinions of each citizen of this country to define as they see fit?

What ramifications does that have?

I can think of one and that is now, as it has been for some time, it is the individual's idea of the value of human life and that value is too often cheap and expendable.


Brian H said...

I read it all, but all the time I was wondering, "what about the right not to be forced to live in a medically irreversible or permanently severely degraded condition?" (As an aside, I don't believe ANY "right" is absolute; they are claims which are warranted or not, and are almost always counterbalanced by others. They are defined by US, as necessary to a good quality of co-existence and interaction.)

If, as the courts held, TS did tell her husband she didn't want her life extended artificially for long periods of time, that is a claim on her right not to be put through that experience. Whether she was "alive" or not when she was removed from life support would then be irrelevant. The counterclaimers put "life at all costs, whether you want it or not" ahead of that.

Ed - Dallas said...


You bring up questions that are easily answered by Kat's last sentence:

"I can think of one and that is now, as it has been for some time, it is the individual's idea of the value of human life and that value is too often cheap and expendable."

Individuals decided, based on statements professed by other individuals, that a person wouldn't want to live within parameters set by other individuals.

Kat said...

Ed pointed to exactly to the sentence that I was most trying to explain.

I've listened to everyone, I looked at other details, that which was available, I asked myself many questions about self determination and "end of life" decisions.

I have posted before things that concerned me about whether Terri would have, could have made any such statement or even have understood when she did what that meant.

You see, even now, even when I was typing this commentary, my own mind having just watched this spectacle play out before me, still cannot conceive of being in that condition. You can't when you don't experience directly.

Of course, experiencing it directly would mean that I would be unable to convey my final thoughts on the matter. I have to say that most people think "pulling the plug" means they are talking about being connected to a respirator and a number of other devices, breathing, collecting urine, hydrating, etc. That is "life support" not the simple feeding of the body even if it is done "mechanically". People cannot concieve of all of the in between states they could arrive at.

So, what I am left with is trying to figure out where we have come as a society and how it has affected how we look at life, how we treat each other, the value that we place on it.

It is without a doubt that the value of life is less than the value that was placed on it when my grandparents were young or even my own parents.

Somewhere, at some time, something appeared on our cultural conscience that told us that simply living was not enough. We had to not only be "conscious of being" but we must also represent some qualitative productivity, some qualification above just "living" to be valued.

Having entered our cultural conscience, individuals now are taught to qualify and quantify their life and justify it's value, their existance, to themselves and to others.

We talk about this qualification and quantification as an individuals right to self determination. Instead I believe it has cheapened life.

Further, the right to self determination, to make decisions about "how we want to live and how we want to die" is our controlling self that thinks that we should be able to control this one last thing and direct it to our will if at all possible. Particularly, if we have suffered an uncontrollable illness or debilitating disease or even an accident that makes us "less" than what we were before.

In qualifying and quantification, determining we are less, we no longer value our own lives as we once did which makes it so much easier to decide it has little if any worth and it should be ended by any means at that point.

As time has come and gone and time goes on, I believe we will, by dent of this inundation of self and societal qualification and quantification, begin to value it even less.

I believe that this case points to that conclusion along with "assisted suicide" laws in Oregon, the "hemlock society", criminal cases that give passes to parents that kill their children.

What is the value of life? How do we measure it? Is it how much we can do? Am I to believe that worth is based on our ability to act or to be or to simply be alive?

What is the base of this measurement? What is the minimum?

I ask this not just about "society" or "culture", but as individuals, having had this blight enter our common discourse, where are we to draw the line in our own consciousness about our own worth? Why do we feel the need to suggest to others, however subliminally or overtly, that they must qualify and quantify?

That is what we have created in this society.

Frankly, what bothers me much also is that, in raising this question, it is ME that is considered the extremist or crazy or something. I'm talking about living and everyone else is talking about "dying" and I'm the extremist crazy person.

Having come this far in our discourse, we are teetering on the edge and we have been for a very long time. That edge is so fine and delicate it is near piercing our soles, if not our souls.

Honestly, part of me asks then, if we will do this, why DON'T we just offer to give patients a lethal injection? Surely that is more humane than this "pulling of the plug"? And, I'm not just talking about Terri Schiavo because, narrowing it down that far is what is giving people the out from having to think about the greater implications. They like to talk about her lack of "consciousness" as making this kind of death acceptable. She couldn't feel it after all, right? We know that for sure? I don't feel comfortable with those assertions as nice as they are at assauging our guilt.

As a matter of fact, too many people are trying to keep it this narrow for that very purpose. They see the edge, are looking over it and pretend that closing their eyes and not looking down will make it go away.

What is stopping us from going the full "euthanasia" route in this country? What is stopping us from literally putting qualification and quantification on life?

Nothing. We've already done it I just didn't realize it until today. I didn't realize that supporting "reproductive rights" of women through abortion qualified and quantified life until I woke up this morning and found that we had applied those same qualifications and quantifications to a 41 year old woman who has the capabilities of a newborn baby.

And surely, even had she written it down, had it notarized and filed with her attorney, part of me still asks what it is that drove her to make that quantification and qualification?

It is our society, our culture. We have put a minimal value on life and we have conveyed that to our citizens. We have told them in overt and subliminal ways, whether in openly discussing and allowing state "assisted suicide" laws to exist, to even contemplate that is a devaluation of life whatever condition it is and for however short it may be. We just have not had the guts to put it into written law because we want to pretend we are not the "others", people like the eugenics experts of Nazi Germany or Saddam against the Kurds, or the Tutsi and the Hutu or the Darfur massacres.

Yes, I am inflating it a bit to make a point.

What I want to know, what I want to hear is an answer from someone that will allow me to believe once again that this is not a possibility, that I can forget about it, that I can go back to pretending that we would not put such a low value on life much less act on it, either as individuals or the state.

Without hysteria I can tell you that this morning I felt like I did at about 10:53 AM on September 11. My perception of the world around me has changed irrevocably. I've been forced to re-evaluate many of my ideas, ideas I've tried to hold together even though some contradicted others. I've tried hard to justify them to myself.

For some reason, this morning, I couldn't do it anymore.

Anonymous said...

Hey Kat

You hit the nail on the head as far as I'm concerned.

I have become very concerned with the dehumanization of life. Terri is a "vegetable", she wasn't being "starved' or "denied food and water" but "allowed to die." An Associated Press article compared her to "Kismet" a robot. It's easier to kill people when you can redefine them into "nonpersons".

As Rich Lowry wrote in National Review: "Next time it will be easier. It always is. The tolerance of early-term abortion made it possible to tolerate partial-birth abortion, and to give advanced thinkers a hearing when they advocate outright infanticide"


As an aside here, I've heard friends, when mad at the terrorists, start to call them things like "subhuman". I call them on it and say no, we can justify killing them but let's not dehumanize them.

Then there's the ghoulishness of at least some of the "right to die" bioethicists. Michael Schaivo's lawyer, one George Felos, is positively out to lunch.


Anonymous said...


If anything good is to come from Terri's death it is that we are now awakened to the drift in our country towards Netherlands-style euthanasia. Her death may have ended a life, but it has started a whole new moral debate.