They're Asking the Wrong Question

I keep hearing on the news the poll question, "Who should decide if Terri Schiavo's feeding tube should be removed?" The choices are the spouse, the parents, the courts, etc. I think this is the wrong question.

The Terri Schiavo case is being lumped in with some very different cases. As we who support protecting Terri's life consider these things, we often, (and I include myself in this), find ourselves disputing the facts of the case. I'm not saying that shouldn't be done, as the facts are very questionable. But we also need to stand back and see the big picture.

I've mentioned before that my grandmother could not be fed in her last dying days. A stroke left her unable to swallow. An infection had taken grip at the site of her feeding tube. Every time an IV was attempted, her diabetes-ravaged veins collapsed. Diabetes. Heart attacks. Strokes. Cancer. Gramma had survived so much, but clearly, this was the time of her end. As agonizing as these decisions are, families do have to decide at some point when it is no longer possible to do good for a patient. We need to recognize that God is calling this person home, and the best we can do is offer what comfort we can.

Curtis Neeley shared his story with us. In many ways his situation was much like my grandmother's. He had been in an automobile accident. His injuries were severe and he appeared to be a man who could not survive. He was dying. Or so it seemed. When his wife made the decision to stop ventilating him, he feels, and I agree, that she made a reasonable and loving decision. In our human frailty we are still sometimes bound to make such decisions and sometimes, as in Curtis's case, they may have to be based on imperfect information that may later prove to be wrong. Curtis was able to communicate enough to correct the error in time and his life was spared. In other cases that may not have happened. We have to do the best we can and trust God in these things.

Terri Schiavo's case, however, is not like Gramma's and not like Curtis Neeley's in one very important way. Terri Schiavo is not dying. There is no question whether or not Terri will live out the night or the month or the decade because of the injuries she suffers under. Her life is as stable as mine. In fact, she may very well be healthier than I am in many ways, though she also suffers from muscle cramping and atrophy, severe tooth decay, and other such ailments because of the neglect of routine care.

No one has suggested that Terri should be "allowed to die" because she is dying anyway. What is being suggested  is that she should be caused to die because her life is not worth living. "I wouldn't want to live that way," people are fond of saying. Well, thanks for sharing, but that's not really the point, is it? What if I decided that I wouldn't want to live as a diabetic with all the challenges that disease presents. Does that then justify me killing a diabetic child or spouse? Dare I argue that to suggest otherwise is to interfere with "a personal family decision?"

Terri Schiavo is a very disabled woman. As much as we wish to accurately reflect her condition and refute those who make it out to be worse than it seems to be, we must still acknowledge that hers is a life that many people might not want to live. As with many of life's trials we often think we could not endure them, until God thrusts them upon us and also gives the strength and endurance we need. I probably said or would have said at one time that I would rather die than to endure the death of one of my children. Yet two of my children are dead and I endure and live and thrive with a strength that is not my own, but God's.

Terri's situation is important, not only because of her precious life, but also because her case takes our country a step over an important line. That is the line between avoiding fruitless efforts to save a dying person and withdrawing efforts to sustain a person who is not dying, on the basis of our assessment of his or her "quality of life." The truth is, many people are killed because someone decides their life would not be worth living. It happens to disabled newborn babies all the time. It happens to disabled children and adults. The difference in Terri's case is that it is happening in full public view.

There is at least some hope for our culture when so many people, even if they do not ultimately prevail, have stood up to defend Terri's life. That willingness to stand is also crossing other cultural barriers that divide us. I, an Evangelical Christian, stand with Roman Catholic, mainline Protestant and Eastern Orthodox Christians, as well as people of other faiths or no faith at all. Democrats and Republicans have spoken out for Terri. Advocates for the disabled who can't be described as right-wing or pro-life have pleaded Terri's cause.

The question, then, is not "Who should decide?" The question is whether or not, in a case like Terri's, there is any decision to be made. Is it really going to be, (or should I say, remain), legal for anyone to decide that the life of another person is not worth living and ought to be terminated?

Is it? That's the real question.

Comments

[Maggie4life]

Dory,

I love reading your comments. It is true that we have crossed divides to stand side by side. I am an Australian Catholic, and I am doing whatever I can to pray for Terri and to write about the issues that are involved in her case.

As you are aware there are several agendas at play in this case. You pointed to your grandmother's case and what you say is correct, that there is a time when it is not medically correct to insert a feeding in certain circumstances. My dad had a feeding tube during the months of his last illness. He could not feed himself and he could not talk because of the damage to his brain after a stroke. My mother stood up to the doctors who were trying to advise her to end his life much sooner than it ended.

I am involved in Terri's fight because I have recognized that there are wider implications for the community as a whole. The more reading that I have done, the more I realise that there is something very wrong about the decisions of George Greer.

However, back to Michael Schiavo for a moment, because I have just picked up on something else that makes this case unique. In looking at the reports that I have seen on what happened the night that Terri collapsed, I had not realized that the hospital had said that her glucose level was also low. The nurses who have come forward with information about Michael Schiavo's attempts to complete the process of murdering his wife mentioned that after his visits she seemed to be suffering from hypoglycemia. A thought just struck me, that Michael might have administered something to his wife that might have affected her in such a way that she fainted (the thud when she collapsed).

This is just a thought, because I am also certain from the evidence that has been provided that Michael Schiavo also attempted to strangle his wife on the night of her collapse.

Maggie

[jpe]

Her life is as stable as mine. In fact, she may very well be healthier than I am in many ways

You write pretty well for someone with no cerebrum. Just think how smart you'd be if you only had a brain!

[Maggie4life]

I have just finished reading the transcript from the Larry King Show. Michael Schiavo has finally compromised himself with his contradictions. He has admitted on national TV that he did not know what Terri's wishes are and that it is his wish for her to be dead. Whoa, that is a big admission. I hope that it does not escape the attention of the MSM.

Something else that I have noticed about the inconsistencies that keep cropping up is that Michael seems to be taking a lot of advice from George Felos. It is as though he is being coached to make those statements so that he can get his way to complete the homicide of his wife. I was checking the transcript of a deposition where Michael stated that he was keeping guardianship to get back at the Schindlers. He was then told something by his lawyer and slightly amended his statement. I wonder why that was necessary.

Take no notice of the previous comment. The writer belongs to a blog that should not be taken too seriously.

[Dory]

Maggie, When was this Larry King interview? Is the transcript available on the net?

[Dory]

I answered my own question.
The transcripts are here: http://transcripts.cnn.com/TRANSCRIPTS/0503/18/lkl.01.html
and this is what was said:

KING: Do you understand how they [the Schiavos] feel?

M. SCHIAVO: Yes, I do. But this is not about them, it's about Terri. And I've also said that in court. We didn't know what Terri wanted, but this is what we want...

[shokenjii]

A feeding tube is NOT an extraordinary means to preserve life. The percutaneous endoscopic gastronomy (PEG) tube is simply a tool which enables food delivery for a person with swallowing impairment -- it is currently used by thousands world wide, including Terri Schiavo. Food delivered via PEG tube directly into the stomach is either the basic diet, or a supplement to oral feeding, manufactured by food and drug companies. Normal diets may be liquefied or pureed in a blender, and passed through the tube with assistance from a large syringe. The PEG tube, together with medical science, has enabled food to be delivered directly into the stomach, bypassing the mouth and throat. This is now a very ordinary way of feeding, implemented and maintained by and for ordinary people. PEG tube placement requires minor surgery; but costs to provide and maintain nutrition are very affordable for average families.

It seems to me that providing food for another human being, in a nation so blessed with riches, is not an extraordinary gesture -- one would expect no less of a humane person from a community of shared values. We need not intellectually explore great moral questions, nor to determine what constitutes life in this instance -- we need only to provide basic food for a person whose body continues to utilize nutrition and maintain life. Is it too much to ask to allow God and/or Terri Schiavo's own body to determine the end date?

[Rita]

My first reaction to the question when posed was... GOD should decide. It seems to me that so far His decision has been obvious. When Terri suffered the initial "incident" that caused the condition she is in God did not allow her death. Through all of these years of hospitalization, illnesses, being denied rehabilitation, physical therapy, and medication while she's been ill God has made His wishes known simply by the fact that Terri is still very much alive.

The answer is God. The answer is NOT Michael Schiavo.

[Meredith B.]

Great post Dory. I will be passing it on to others in order to make them aware of the truth in this case and the broader implications.

Blessings.

[Dustin]

Just make sure that you understand by taking this stance you are taking a pro-life stance in ALL cases!

When a terminally ill patient (one who has, say brain cancer, 100 years old and in failing health or any number of life ending illnesses) comes into a hospital, then ALL life saving measures have to be taken...including pounding on the rib cage which can break a rib and puncture a lung, being put on a respirator, being injected with drugs to help your heart continue beating, electric shock, etc.

Those of you beating this drum that Terry needs to be kept alive better start beating the drum in ALL cases of extending human life. Not just the one the media throws out to you. Make sure you are lining up outside of your local emergency rooms when a doctor pulls someone off a respirator, or when a doctor's orders are not to try to revive someone who has asked not to be put through that misery.

If we would put as much effort into educating the public about the thousands and thousands of innocent, healthy little babies that are murdered every week, we might get somewhere with the abortion debate.

I won't even go down the pandora's box of setting a legal precedent for courts and lawyers to look back upon from here on out. Your life is no longer in your families hands...it is in the Federal Courts!

Please come back Lord Jesus!

[Greg]

jpe: "You write pretty well for someone with no cerebrum."

Maggie doesn't lack a brain, but jpe appears to lack a heart.

[Dory]

Greg, I think jpe meant I was the one with no cerebrum. Otherwise I would have deleted the comment, as I don't like to have my guests insulted. Sometimes remarks say more about the speaker, though, than the subject, so I chose to let it remain;-)

Dustin, One of the points that I was trying to make is that I believe ethically there is a distinction between efforts to keep a person from dying on the one hand and causing the death of a disabled (but not dying) person on the other. It is a distinction our laws, in my opinion, ought to recognize. There is a time to acknowledge the futility of trying to save someone and withhold further treatment. However, no human has the authority to judge another human life to be of such low quality that even though the person is otherwise well, they can be killed by withholding basic sustenance. By confusing these two different types of cases, we run the risk of crossing the line between letting dying people die and euthanasia. Terri is not being allowed to die. She is being euthanized. It would be kinder to admit that that is what is happening and give her a fatal injection. Of course we can't do that, because then we DO have to admit what we are doing.

[Alnot]

Thanks for the link to Curtis I enjoyed his journal and pictures. Not bad for being severely brain damaged. I know a lot of people with no excuse like brain damage who do not do as much. LOL

[Maggie4life]

Justin, I support what Dory is trying to say here. Terri's case is not about someone who is near death, it is about a disabled woman being denied her basic human rights by her husband who is her guardian.

Since I have been investigating this issue I have linked to several sites that have a variety of information that needs to be digested (slowly of course). One of the sites mentioned the manner in which the issue is decided in Texas. They do give the family a right to remove the loved one from the hospital if a decision has been made that no further treatment is viable.

If someone is really and truly brain dead (and Terri is not brain dead) then that person will have no vital signs indicating any form of movement. Sometimes hospitals keep patients who are brain dead alive so that they can reap the body parts to benefit other human beings. This is keeping a person on a machine when it serves no other useful purpose. It is in fact ok to pull the plug when someone is brain dead.

I will follow Dory's lead and give another family example here. My grandmother was one month away from turning 99 when she had a series of fatal heart attacks. I was not present when she died because I live in another state here in Australia. A member of the family did not want to see the plug being pulled on my grandmother but that was for his own selfish reasons. The series of heart attacks meant that Nana's time had in fact come and she was being called to God. It was time to let her go. Up until those heart attacks Nana had continued to be quite healthy, although considering her age dementia had set in. Keeping her on a machine would have been futile, and was not in the family's best interests.

When my friend Nita passed away, she had suffered a gall bladder attack and she was rushed to hospital for a serious operation. It was after the operation that she had a heart attack and she was put on life support. The prognosis for Nita was that she was brain dead, and the family waited for all to be present when the decision was made to end the life support.

My dad had suffered a series of strokes before he died. When he suffered the second major stroke he nearly died from aspiration pneumonia but he pulled through. When I went to visit him he was not able to talk but he could communicate. If Dr. Cranford's definition of life and death was to be accepted then my father, who held me in his arms was already dead, yet he knew who I was when I entered that hospital room. His time when he had another more fatal turn. His blood sugar had skyrocketed at the time. He was rushed from the nursing home to the hospital but the doctors decided that nothing more could be done for him and he was returned to the nursing home so that he could die in peace. He had a feeding tube attached during the months after the second stroke and before death. He needed to have the tube because he could not feed himself. On the day that he died he was allowed to slip away quietly. The doctor had given him a dose of morphine and other members of the family stood by as his breathing became more shallow.

Terri is not dying. Her case is different. To withdraw nutrition and hydration from her is to deliberately set out to kill her. It is not the same as making a medical decision for someone who is in fact dying.

[Dustin]

I appreciate all of your posts on this issue, I really do! There is just a fundamental disagreement I have with most on this issue...that is that one doctor (paid for by Terry's parents) and other doctor's (court-appointed independent doctors) have differing opinions. That is one of my reasons for differing from the status quo on this one. Also, and not to be taken lightly, the FEDERAL courts and the FEDERAL Congress have no right, and it is actually un-constitutional for them to be involved (10th ammendment). It is a sad state when the Federal Congress wants to interject its opinion and legislate to score political points with the public.

This decision has far-reaching proportions and will set a very frightening legal precedent that will be endured by all.

The one good thing about this is my wife and I are very clear on our status if we were to be in a situation like this.

My wife is a Physician and is specializing in Oncology here at IU. We both feel the same about this. And she brings up very valid points. The interesting thing here is that every person who brings up the "terminally ill" and saying it is okay to "pull the plug" are really killing life. You may believe in your mind you aren't, but there is a chance, a chance that you might come out of that state of being brain-dead! So in the case of the terminally ill, you are still stopping the life sustaining actions that a person could undergo to live a little longer.

Life is life. And if you are going to take the position that all life is sacred, then take the position that ALL...ALL life is sacred. Don't say that some people will not come out of their state of being brain-dead, because with God, ALL things are possible.

Besides, we have at least 25% of the United States Senate that are brain-dead and they are still breathing! HA!

[Anomalocaris]

Helpful links:

Understanding and misunderstanding persistent vegetative state

History of Schiavo case

Terri's Guardian's view

[tripthetics]

I can't believe that people like you are so close minded. Precious life...There is no life in her...she's just a body. Her parents want her to body to be kept alive in order for them to see her in any state. They dont care that the person that was once full of life has no life in her anymore. She cant eat...or speak....or recognize anyone that is there. The only thing working in her body are her involuntary movements. If you cut a chickens head off it remains moving but there's no life in that chicken. Greedy people I tell you....the only thing I really disagree with is the manner they are doing it...I dont believe she should be starved to death...euthanizing is much more humane.

[shokenjii]

[I began these comments late in March, and set them aside; but after watching televised news portions of the Schindler's Memorial Service for Terri, I have decided to complete my thoughts today, 6 April, 2005]

For most of us who have had the good fortune of discovering Wittenberg Gate and Dory's thoughtfully written passages, we find ourselves an overwhelmed minority in the Terri Schindler Schiavo polls; and however, we may want to raionalize this position, it is disappointing. Someone from my home town, voicing majority sentiments, emailed this week to say, "I want government to stay out of my business; and I don't want them telling me how and when to die." Within a structured, consensus society (democracy), it IS necessary for us (government) to set the height of the bar -- and to have rules for how NOT to die.

In all states, limited legal options on dying (terms for non-intervention or refusal of care) are confirmed by the government. And, in my opinion, this is where Florida let us down -- judges deferred to Terri's now distant husband, without sufficient review, to find that she had refused (any and all forms of)life support -- with the very finite nature of human life, Florida could easily have (and should have) left this case for God to decide.

I personally object to two reasons people give for refusal of care and non-intervention -- one is, "I don't want to live with tubes in my body," and the other, "I don't want to be a (financial) burden to my family." Florida judges found that Terri decided to refuse life support, sometime before the age of twenty-six years -- too often an age without seasoning, and probably without a broad perspective on what life support means. Some people "would rather die" than be seen with a feeding tube; and the same people would be uninformed on how commonplace a feeding tube is today (possibly a misplaced sense of pride -- and naivete).

A few years ago, an ambulance waited outside for an affirmative decision on a coronary by-pass operation for a family friend, who confided that he wanted to die because he did not want to encumber his family with future care, nor erode his estate. Fortunately, he changed his mind, and lived into his nineties.

My economist brother believes that voluntary refusal of care, within our society, is motivated primarily by financial reasons, with the presence of pain (emotional or physical) and the absence of love (or loved ones) as nearly equal considerations. Approaching 89 years, coupled with a number of disabling conditions (and with a cardiac pacer and feeding tube, like Terri), my mother is totally dependent for her well being and personal care; yet she wants very much to live. She understands that her life, or death, is equally important to both, her and her family -- it is not entirely a personal matter -- and she knows that it is God who continues to give her breath. Apparently, He wants Mom to remain (active and) with us a while longer (and WE, with obedience and joy, defer to that highest of courts).