Update (3/18/05): If you’ve landed here through an Internet search, please see the latest post on Terri Schiavo.
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Unless a judge intervenes, Michael Schiavo will be allowed to remove his wife’s feeding tube, which will begin the starvation process. I haven’t followed the case over the years, so I have no idea if starvation is the normal method of killing brain-damaged patients. As I wrote in a previous post, I know why the doctors won’t simply shoot her up with a lethal dose of something. That would be an unmistakable murder. Think about “partial birth abortion,” and you’ll see the connection. Where is Jack “The Ripper” Kevorkian when you need him?
Terri Schiavo is scheduled to begin a most inhumane route to death today at 5:00 p.m. today. But she may yet live another week or two after abuse allegations may finally be investigated.
From PennLive.com:
The Department of Children & Families is seeking a 60-day stay on the removal of Terri Schiavo’s feeding tube while it investigates new allegations of abuse and neglect, an attorney for her parents said Thursday.In an 11-page confidential document detailing why the social services agency wants to intervene in the case, the DCF said it needs the time to adequately investigate allegations that the 41-year-woman at the center of a life-or-death legal battle between her husband and parents has been mistreated….
The Schindlers attorneys have included the allegations of abuse and mistreatment in their effort to oust Michael Schiavo as his wife’s guardian. More than two years ago, one of the Schindlers former attorneys told Greer that a 1991 bone scan showing several fractures raised questions about whether Terri Schiavo had been beaten.
Blogger Don Hawthorne has rounded up all the important pieces of information in the ongoing drama.
More from Pearl, David Limbaugh, and My Vast Right Wing Conspiracy…
Hyscience links to the column of a journalist who no longer believes Terri’s feeding tube should be removed.
Update: A commenter links to information at The Empire Journal.
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One piece of activism we can do is get Floridians aware that Charlie Crist (St.Att’y Gen who wants to be the next Gov. of FL) and Bernie McCabe (State Att’y for Pinellas cty) are alleged to have covered up previous investigations. The article above is long and detailed with information.
If FL citizens call & write, letting them know they are aware of allegations, and stating that they are being watched carefully may get these men to advance the investigation rather than frustrating it. No one wants to be watched closely, especially politicians who aspire to higher office. Getting as many letters with this information to voters, and then editors in Fl papers & papers everywhere, radio shows etc can go along way to getting Terri (and those elderly & disabled who will be sentenced to die after her) justice.
The big problem with the entire Terry Schiavo situation is not that no one knows whether she is in a persistant vegetative state or in some other brain damaged disabled state, It is rather what she would want us to do regardless of a or b. The limited, choppy and out of context video I have seen leads me to believe she is not in fact in a PVS. The allegations of abuse and denial of rehabilitation further cloud the issue. Ultimately, this is an issue best resolved by the family members and physician’s supporting them. As a physician, the first rule of medicine is total respect for the patient’s right to determine their own plan of care, including not accepting any care at all. If the patient is unable to do this, we are obligated to rely on surrogates to communicate their sense of the patient’s wishes to determine care. In this case, the surrogates vehemently disagree about the patient’s current state of health as well as her wishes. What the rest of country, politicians, physicians, priests and pastors need to remember is that no one outside of the circle of family knows Terry well enough to advocate for her wishes and should therefore butt out. If, as her husband asserts,Terry would never have wanted to be kept alive in a pvs, discontinuing her feedings and hydration is absolutely the right thing to do. It is ethically the same as not initiating feeding/hydration via the surgical or endoscopic placement of a gastric feeding tube at the time of initial injury/insult. It is not murder! It is the act of a surrogate asserting the patient’s sacrosanct right to determine her own fate, and what she deems acceptable. Having been involved in many of these discussions myself, I can assure you that they are not easy. Furthermore, pt’s who are technically brain-dead or in PVS, do not suffer, in the traditional sense, when nutritional support and hydration are cut off. By definition and supported by medical understanding, they cannot percieve the abstract concept of hunger/starvation, these are our “crosses to bear”. What they will do is drift further into a comatose state and electrolytic abnormalities will cause biologic functioning to cease long before starvation becomes as issue. Is it pretty, absolutely not. Is it ethical, I believe so based on my understanding of the writings of many philosophers, both secular and religious. There is a whole specialty of medical thinking, called bioethics, that struggles with the conundrums that our aging population and continued medical advances have created, and I encourage all who are interested to search this area out. However, as her parents have indicated, two big if’s remain. The first is the state of Terry’s neurologic functioning. I have(as an interested bystander) serious doubts about the worst case descriptions put forth that she is in a PVS. She is no doubt neurologically devastated and will never regain any more than a whisper of her former function/interaction with the world at large. However, that is really not the point. The second and more important issue is that of what Terry’s wishes would be. I doubt, being a thirty-one year old married person myself, that Terry and Michael engaged in the end-of-life discussions that I as a physician encourage all my geriatric patients to have with their loved ones simply because the odds of a loved one needing that information is much higher than the thirty-something crowd. If she did express her wishes and they were to not exist as she does now, regardless of the quibble over her neurologic status, by all means, please grant her the dignity she requests and stop all artificial means of sustaining her life. Though her parents would not want that, they should respect her wishes and allow her final wishes to be carried out, and not interject their own feelings into it. If, however, she did not express unequivocal wishes on the subject and her husband is just tired of caring for her, by all means, please allow her parents to takeover the care and move on with your life. Split the money, I don’t care, the settlement was as much about her injury and ongoing care needs as it was about Michael’s loss and both parties are entitled to an equitable distribution. What we are left with is a game of she said/she said and no one besides the Almighty knows for sure. In that case, I always say, err on the side of life. Terry has people who are willing to assume her care. Allow them to do that without hesitation and allow Michael the dignity of moving on without regret or recrimination.
Dear Mario,
A couple of reactions.
First, the only testimony to Terri’s “wish” not to exist in her current state is . . . her husband Michael, who seems to be pretty eager to get rid of her. The family doesn’t agree with Michael. So, at the very least, prudence would suggest erring on the side of life, as you put it.
Second, people don’t have a “sacrosanct right” to commit suicide, or to have others help them commit suicide.
Otherwise, why should we stop the depressed fifteen year old from jumping off a building? Just because she’s not terminally ill? But if terminal illness (or something analolgous) is our criterion, then aren’t we really saying, under the guise of defending the sacrosanct right to choose, that some lives are not worth living?
True, this doesn’t mean that there’s an obligation to keep anyone alive whatever the cost. There’s a venerable distinction in bioethics between ordinary and extraordinary means.
But food and water ain’t extraordinary means. So we are talking about suicide . . . or murder . . . by starvation.
Adrian
Having been ‘deprived’ of his wife’s ’services’
as defined in old English Common Law, the husband
is no longer obligated to provide for his wife’s
welfare; in essence, he is divorced under those
canons. Therefore, he has no standing, legally
or morally and Terry’s care and welfare should
revert to her NOK, ie, her parents. The only
arguement that could be posed against this, is a
lack of ability to do so. It has been shown such
a lack does not exist. Therefore, Terry Schaivo
should become a ward of her natural parents.
Period of sentence. NO MORALITY INVOLVED. NO
RELIGION INVOLVED. Just the @#%$^ law. I grow
weary of this case. It has become a sort of moral masturbation and all involved parties have lost sight of the LAW. The judge in this case is …
incompetent. He should recuse himself if he tires
so. And a judge with the spine to make a stand
should REMOVE the husband from the case. Return
Terry to her parents and be done with it.
Who is paying for her care [24 hour care is not cheap] – is this the best use of money?
Dear Walter—
You are joking, right?
Adrian
Money spent for one good cause is unavailable for another good cause.
Yeah, but if the only way we have to save money is to starve people to death—because that’s what’s happening here, you know: Terri is not a vegetable, and does not require any fancy treatment, just a feeding tube—then I say let’s go bankrupt.
Adrian
Adrian, if we go bankrupt lots of children will starve. Our banning of DDT has caused 2 million deaths a year from malaria. Our sybaritic demand for beachfront vacations lured tens of thousands of Southeast Asians down to the waterfront to be tsunami’d to death. And if you don’t think Terri requires any fancy treatment, just find out how much 24 hour care costs. The Soviet Union spent millions to preserve Lenin’s and Stalin’s bodies. Terri is dead. How many children are you willing to sacrifice to animate a dead carcase?
Dear Walter,
First of all, the facts are that Terri is not a dead person being artificially kept alive to satisfy the crzay maximalism of idealistic pro-lifers. She’s a brain-damaged woman, to be sure, but she’s not a vegetable, and she sure ain’t dead. Thus, I’m not talking about diverting scarce resources from the needy in order to keep a corpse looking alive. I’m saying that we shouldn’t starve an innocent person to death just because she’s brain damaged and a nuisance.
Obviously, I don’t want us to go bankrupt, and I want us to have lots of resources to help those who need it. My point was that, if we’re willing to sacrifice an innocent person—and not a living corpse—in order to economize, then we’ve lost our moral compass.
I mean, if one innocent person is negotiable, then why should we be so concerned about the fate of others? Are we saying that some lives are not worth living and others are?
I repeat: there’s a venerable distincion in bioethics between extraordinary and ordinary treatment. I accept that distinction. Nor do I believe that we should always try to keep people from dying. But that’s different from actively killing people, which is what is at stake in the Schiavo case.
Now, it’s always possible that my facts are wrong, and that Terri is being kept alive entirely by a machine, etc. But even if my facts are wrong, the principle is the same: you don’t take innocent human life for any reason, period.
Finally, I want to make it clear that I am not making some slippery slope argument: “well, next they’ll be. . .” I’m not making any predictions. What I am saying is that, if we can justify starving Terri Schiavo to death because she’s brain-damaged, etc., then we have NO principled reason to be concerned about any other human life.
To starve Terri to death is itself already to have slid down the whole slippery slope, at least as far as the logic of the thing is concerned.
Cordially,
Adrian
The first time we accepted a slippery slope argument, we were on the slippery slope to – today. The assumption that you can write laws that remove the need for judgement is a slippery slope to chaos. If private individules wish to take on the cost of maintaining Terri, more power to them. All you have to do is pull a Kennedy and annul the marriage.
One point I feel is lost in all this brouhaha is that people should realize that life doesn’t always go according to plan. The unexpected can happen and people should seriouusly think about getting a living will so we don’t have to have disastrous situations like the one in Florida. That is the best common sense thing to do. Regardless about how you personally feel about this case.
Walter:
I’m not for laws that try to replace judgment. I’m against starving an innocent person to death.
The issue isn’t “keeping her alive.” It’s “killing her (by starvation”—or, let’s hope, not.
Adrian
I disagree that Terri is alive, but I offer the challenge to annul the marriage and let those who disagree take her. Do not, in pursuit of your one goal destroy the life of another.
Walter:
Apparently, Terri is able to respond to stimuli, like her parents coming into the room. Sounds alive to me.
But the point I’m making is not tied to the facts of this case. For the point is that you don’t starve someone to death. You don’t take innocent life. That’s called murder.
Adrian
Sorry for the absence, work and all. First, I would like to refute the comparision between a neurologically devastated individual and a 15year old who is depressed. The 15year old cannot make judgements regarding the consequences of his actions for two reasons, his age and his mental illness and therefore, I would never “allow him to die”. I would work vigorously to treat his depression up to and including hospitalizing him against his “will” to prevent him from taking his own life because I know he cannot understand what he is doing. My support for Terry’s or anyone’s “right to die” comes from my belief that people of sound mind should determine their own fate. The arguement that I or anyone want to “kill” Terry because she is a nuisance misses the point that bad things do happen to people, our capacity to treat physical ailments has far outstripped our understanding of the consequences of treatment and we rightfully allow people and their surrogates to make these decisions. If Michael, or whoever ends up making decisions for Terry can’t say that she would not want to live this way, kept alive by extraordinary means, that also means that the patient whose kidneys have failed cannot decide whether to begin dialysis treatments or terminate them if they cannot tolerate them; or the cancer patient will no longer have the right to chose not to take chemotherapy; or the family member cannot say that her 84yr old mother, crippled by alzheimer’s and failing round the clock nursing and feedings, would not want to be tied down all the time so we can feed her through the surgically implanted tube which she, in her demented state, will likely pull out. And when did a feeding tube become an ordinary intervention. It is not just food and water, it is the life-support that allows someone who cannot eat/drink/swallow to continue living long after misfortune took those abilities from her. I further state that no one is “coming for Ryan next”. His parents, acting in good conscience as his surrogates have decided that they want to continue the extraordinary means by which he is supported. I would be the first to defend anyone’s right to determine their care. I look forward to your comments and thank you for your time.
Dear Mario,
Didn’t I say that I accept the distinction between ordinary and extraodrinary means?
This distinction, however, comes into play ONLY in cases where, so say, death is inevitable and fairly imminent FOR REASONS OTHER THAN THE WITHDRAWAL OF THE CONTEMPLATED TREATMENT, and this treatment would, so to say, only prolong the dying process.
As I understand the facts, this isn’t Terri’s case. She’s not in a “persistent vegetative state,” and is not otherwise in danger of death. Thus, it makes no difference whether or not the feeding tube is replacing missing physiological functions. It’s not an extraordinary means in this case (as it would be in the case of the alzheimer’s patient).
The force of my point about the 15 year-old depends entirely on the claim that, in a case like Terri’s, a feeding tube is not an extraordinary means, and that removing it would be tantamount to murder/suicide. In other words, I’m not suggesting that, in other cases, refusal of treatment would be tantamount to murder/suicide.
What I am suggesting is this: if we cannot distinguish between cases like Terri’s and cases like the alzheimer’s patient’s, then we cannot distinguish between legitimate refusal of treatment and suicide, and so have no LOGICAL REASON to say “No” to any suicide.
Let me put it another way. We have to make decisions, but the criteria for the decisions isn’t just “my right to decide when to end my life.” Because, if that were the ONLY criterion, as you seemed to suggest it was in your first post (”sacrosanct right to determine her own fate”), then there is no reason NOT to say No to the 15-year-old’s suicide. Why not?
As you say, the 15-year-old is not in her right mind. But, if the sacrosanct right to determine one’s own fate is the only criterion, then why should that matter? The only way in which it CAN matter is if we recognize that our decisions to end our own lives have to be limited by standards of right and wrong that aren’t simply reducible to one’s supposed sacrosanct right to decide one’s own fate.
Now, these standards of right and wrong don’t require a crazy maximalism about prolonging life at all costs. That’s not what I’m advocating. But they do forbid suicide. And, given the facts of the Schiavo case, that’s the ballpark we’re in.
Of course, I may have the facts wrong. But what concerns me in this post is the principle of the thing, which I hope to have made clear.
All the best.
Adrian
Adrian, we are so close to being on the same page. Suicide is verboten, as is murder. I also agree with you that Terry should live, and I further agree with you on the principle of the existence of right and wrong. I therefore find myself in the awkward position of being for and against something. I believe that Terry’s parents should take over care if they feel so strongly that she would wish to continue her life-sustaining feedings. This belief stems from my distrust in Michael Schiavo’s advocacy for his wife. I retract the use of the word sacrosanct as the “right to die” does not trump all other “rights”. I do not retreat from my stance on self-determination. I also compelled to grant someone who has the knowledge to be an appropriate surrogate the right to determine Terry’s fate as she cannot and defend that right vigorously and vociferously and then help them make the best decision for Terry as well as her family. Its muddy water at this end of the pool and the line between right and wrong(which I believe exists) is tough to see. In the way of disclosure, I am a physician and senior internal medical resident who has had “something more than one hundred” (as I am not counting) of these discussions w/ patients and family and they are never pretty but I can usually look myself in the mirror and say I did right by my patient and my God after they are done.
Dear Mario,
Thanks for your candid response. I also know from personal experience that these sorts of questions are not easy ones.
I don’t mean to deny that a patient’s wishes have to be respected, to the extent permissible. If that is what you mean by self-determination, then I am for it, too.
I also don’t mean to minimize the importance of prudential judgment calls. My point is just that prudence is the virtue that links the universal with the particular, and it can’t do that if there’s no universal.
I also agree that surrogates should be able to make decisions when necessary and appropriate. The problem in this particular case is that (a) the situation is not really analogous to the other ones you mention (e.g. the alzheimer’s patient);(b) therefore, even assuming a right to die in the current acceptation, in the absence of any explicit statement of the wish to die by Terri, we should err on the side of letting her live; (c) Michael Schiavo doesn’t inspire much confidence.
Anyway, I’m glad we’ve got some convergence here.
I respect the work you do and wish you the very best in it.
Adrian
Here’s the part I really hate in this whole tragic case — There’s way too much demonization of the folks involved.
Michael Schiavo is a young man that was dealt a pretty awful hand by life. Is it too much to believe that he actually wants his wife wanted, and possibly told him? Is there really a need to accuse him of abuse, of wanting her dead for money, possibly of murder (not all of these on this discussion)?
Also Judge Greer comes in for lots of abuse for ruling against the Schindlers and for Michael. Is it just possible that he’s interpreting the law in a very hard case? Too many websites that I agree with usually have run screeds on how he’s in the pocket of Schiavo’s attorneys.
This case has become the Conservative equivalent of Election 2004 on the way out left wing sites. No intelligent person acting in good faith can agree with the results therefore [insert favorite conspiracy theory here]. That’s unfortunate.
Let me add that I’m not referring to anybody in this string of posts, which has been very intelligent and respectful.
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