Keep Schiavo alive?

[blaise]

The US Congress has subpoenaed Terri Schiavo to appear as a witness. I'm sure her testimony will be highly enlightening.

House Majority Leader Tom Delay asserts there is nothing wrong with Schiavo even though her electroencephalogram has looked like a flat line for 15 years and that she should be regarded as just another handicapped person.

Senate Majority Leader Frist, an erstwhile cardiac surgeon, avers she is capable of meaningful responses.

So why do these savants neglect all meaningful legislation while they furiously concoct lbills to overrule the judges and physicians who have reviewed her case and give their green light to pulling the plug? Politics, dear boys and girls. They are courting the votes of the religious right in 2006 and 2008. Maybe they'll even run Terri Schiavo for governor in Florida when Jeb Bush decides to step down.

In my considered opinion, a tadpole would outscore her on an IQ test. Heck, even a typical Maple Leaf fan would too.


BadCompany: I changed the title of this thread out of respect. Referring to somebody as being in a "vegetative state" is appropriate. Demeaning them as "vegetables" is not.

[BadCompany]

Its a more fundamental issue than a simple IQ test score, Blaise. Its a quality of life argument. Congress isn't going to demand answers from Schiavo, they simply want to see her, for themselves, before making a decision. You know, an "informed" decision. Will it be the only basis for their decision? I would hope not, but I am sure that any sane person, if charged with such a decision - for whatever reason the charge ended up in their laps - would want to at least see the person for whom they are making such a monumental decision.

From personal experience, I can tell you straight out that flat-lined cortical activity does NOT always mean zero mental capacity. I knew a baby girl, who from about two weeks after birth, who showed zero mental activity, on every known measuring instrument. "Entire upper brain is gone" they said. "No cortex" they said. "No frontal lobe" they said. "Won't live longer than a 4 minutes, if the plug is pulled" they said. All in their considered opinion. Emphasis on "opinion." So, the plug was pulled. For 9 months, she kept on breathing, even though there was nothing that said she should have been able to do so. Recognized her mother (confirmed using standard psychological tests), responded to audio stimuli (though they said she was deaf), responded to visual stimuli. Even learned simple motor responses, such as holding her head up, and indeed, sitting. Never once did an EEG show any activity.

She eventually died, and I would never for a second argue that her quality of life was anything remotely close to being acceptable, but its not always about test scores on our (still) primitive neuro machinery.

The brain itself is still poorly understand. The machines used to study the brain are still in their infancy. Who knows what they are missing. Is Terri Schiavo being used as a political pawn. Sure. So what? Do we disregard a life simply because its too political? Is legislation more important than life? Isn't legislation supposed to be about life?

[blaise]

To what purpose is she being kept in such a hopeless state? She is not handicapped, she is vegetative. She is subsisting essentially on a brainstem level, with preserved respiration and pupillary responses. She cannot swallow because she would choke. Fifteen years is a long time to look for the slightest sign of arousal. I for one would not wish to be prolonged in this manner. Incidentally, it costs well over a million dollars a year to keep her alive. Her parents aren't paying for it. The Congress has no mandate to overrule the many doctors, bioethicists, and judges, not to mention her legal guardian (i.e., her husband), who have already decided in this matter.

It is interesting to note that the Republicans have conducted their focus groups and found that this is a hot button issue to keep their religious right voting base active and the contributions coming in during the lull between elections.

[Habs_fan_in_LA]

I really don't think this is about Schaivo. She is one person and her medical status is not the kind of issue the US Congress should get involved in. I am not an expert in brainwave patterns of the cortex nor are most members of congress.

The real issues are:

1. Right to life.
2. Right to elect to terminate ones life.
3. Who acts as executor, parents of spouse?


1. I disagree with President Bush that a fetus has a right that superceedes the rights of the mother in making the already difficult choice concerning the termination of a pregnancy. It is a personal individual decision of the woman assisted by the advice of her doctor. It is not an issue for legislators or the judicial branch.

2. I believe strongly in individual rights. It is the right of the individual to make decisions concerning both the way he/she wants to live or if they want to live. To the extent that those decisions do not harm other members of society, it is the right of the individual that superceedes the desires of the group.

3. When a person leaves their parents home, circumstances may place the parents in a supportive role, a tolerant role or an adversarial position. The individual made a conscious decision (good or bad) to move on and entered a new union apart from the rule of the parents. The spouse is now closer than the parents and that is the new family unit.

There should be a better faster way than starvation to end a life.

If one tries to extend this ruling about quality of life to severely retarded patients (there is no universally accepted definition of severe or quality of life) the problem becomes much more difficult.

I would much rather be discussing a two for one trade to get a power forward than Karen and so would most HabsRUS members. Settle the d@#m agreement Betenough!

[BadCompany]

Blaise said:

To what purpose is she being kept in such a hopeless state? She is not handicapped, she is vegetative. She is subsisting essentially on a brainstem level, with preserved respiration and pupillary responses. She cannot swallow because she would choke.

Hence my "its a quality of life argument" statement.

Blaise said:

Fifteen years is a long time to look for the slightest sign of arousal.

Her parents argue they have seen many signs of life. Thus the whole dispute.

Blaise said:

I for one would not wish to be prolonged in this manner.

I hope you have a living will then. Something Ms. Schiavo did not.

Blaise said:

Incidentally, it costs well over a million dollars a year to keep her alive. Her parents aren't paying for it.

What price, a life? "If it costs $800,000, we'll keep her alive... but if it costs $800,001..."

Blaise said:

The Congress has no mandate to overrule the many doctors, bioethicists, and judges, not to mention her legal guardian (i.e., her husband), who have already decided in this matter.

You are misrepresenting facts here. Several doctors, arguing on behalf of the parents, have disagreed with the doctors arguing on behalf of the husband. And several judges have disagreed with several other judges on the matter as well. As well, her parents have tried to have her husband removed as legal guardian. Given the conflicting opinions expressed by all concerned here, I think its only right that all due process be examined. Its not like everybody agreed to pull the plug and Dubya suddenly swooped in to save the damsel in distress. Its been a court fight for several years now. One judge says its okay to pull the plug, another overturns that decision.

The reason it ended up in the laps of the politicians is precisely because the doctors and lawyers and judges COULDN'T agree on whether there is enough life there to warrant being saved. When all else fails, it usually ends up in the hands of the elected. Is that right? Perhaps not. But that is the system we live in.

Blaise said:

It is interesting to note that the Republicans have conducted their focus groups and found that this is a hot button issue to keep their religious right voting base active and the contributions coming in during the lull between elections.

Any source for this? Or are you merely dumping everything back into an "us versus them" argument?

[jkr]

Mr. Schiavo does not appear to have anything to gain from her death and has always maintained that this is something that Terri would not want. Unfortunately there is no documentation, only the belief that they discussed this before her heart attack. He has moved on with his life and has a child with another partner yet he continues to pursue this. It would be easy for him to back away but I believe he cannot let this go because he really feels that Terri does not want to continue in this state.

The cynic in me says that after 15 years, conservative politicians are involved because they will be favorably perceived by the electorate.

[jkr]

Blaise said:

In my considered opinion, a tadpole would outscore her on an IQ test. Heck, even a typical Maple Leaf fan would too.

Can you be a little less callous please.

[franko]

As I wade in to the debate, I acknowledge my philosophy of natural life to natural death colours my judgement. Thankfully this will not -- at least should not -- be an issue for my own family, as I have a living will, which stipulates that heroic actions shall not be taken to prolong my life. Of course, my belief in an afterlife also influences me.

Which is why I have such a problem with many evangelicals who will do just about anything to prolong their lives for an extra second (and just because I believe in an afterlife/heaven does not mean that I am going to jump in front of a Mac truck and yell "Take me!", and it does not mean that Blaise should suggest that GW do it either ).

I disagreed with Robert Latimer's active involvement in the death of his daughter (quality of life was the issue there too) . . . but I had more problems with the doctors who would operate on her without anaesthetic because she might have died. I say if death happens in such an operation it happens. But to treat her with such disrespect as to break bones with her fully aware and awake, with no paain killers? No! Someone who has full mental capacities would not have been forced to undergo such an atrocity, nor should she have been.

With Schiavo, whether it is a dollar or a million, keeping her alive just to keep her alive is wrong. But it does beg yet another question be answered: if she is not going to be fed, and if she is going to slowly starve to death, and if it is going to take 10 days to 2 weeks for her to finally die, and if she is going to suffer horribly during this time, why not hasten the process?

I continue to work through this debate on a personal level, as I recently sat with the family of a man who was in the last stages of cancer. Once his body became so ravaged by the disease that his functions continued only by reflex actions it took 5 days before his body finally gave in. Five days of sitting watch in the hospital, him so strongly medicated that he couldn’t respond to anything . . . in fact, the only time he moved was when the medication was wearing off and he twitched trying to give himself another shot. Five days of a family in agony, just watching a once active and healthy man waste away to nothing and gasp for breath until his heart finally gave out.

How active should we be in hastening the inevitable? My philosophy/theology says not much but . . . my heart ached for the family and asks why not?

On a lighter note, has anyone read Amsterdam by Ian McEwan?

[HardCap]

Interesting read from the Wall Street Journal:
Killing Terri Print Mail



By James Q. Wilson
Posted: Monday, March 21, 2005

ARTICLES
Wall Street Journal
Publication Date: March 21, 2005

Terri Schiavo is not brain dead as far as anyone can tell. If you are brain dead, you have suffered an irreversible loss of all functions of the brain. If agreed to by at least two physicians, that means you are legally dead, such that your organs can be harvested to help other people.

Instead, Ms. Schiavo is in what many physicians call a "persistent vegetative state" (PVS). That means that she lacks an awareness of her self or other people, cannot engage in purposeful action, does not understand language, is incontinent, and sleeps a lot. To be clinically classified as being in a PVS, these conditions should be irreversible. But from what we know, some doctors dispute one or more of these conditions and believe that it is possible that whatever her symptoms, they are not irreversible.

Her condition is hardly unique. In 1995, when the American Academy of Neurology published its report on people in a persistent vegetative state, it found that there were as many as 25,000 adults and 10,000 children in this country who suffered from PVS. Based on the best studies the Academy could find at the time, some adults in a vegetative state 12 months after a devastating injury or heart failure could recover consciousness and some human functions. The chances that such a recovery will occur are very small, but they are not zero.

If they are not zero, then withdrawing a patient's feeding tubes and allowing her to die from a lack of water and food means that whoever authorizes such a step may, depending on the circumstances, be murdering the patient. The odds against it being a murder are very high, but they are not 100%.

* * *

Many people, myself included, have allowed life-support systems to be withdrawn from parents who have no hope of recovery. My mother was going to die from cancer, and after all efforts had been made to help her, my sister and I allowed the doctors to withdraw the devices that kept her alive. She was dead within hours.

My case, and that of countless other people who have made that decision, differs from that of Terri Schiavo in two important ways. First, the early death of my mother was certain, but no one can say that Ms. Schiavo will die soon or possibly at any time before she might die of old age. Second, all the relevant family members agreed on the decision about my mother, but family members are deeply divided about Terri.

These differences are of decisive importance. When death will occur soon and inevitably, the patient does not starve to death when life support ends. Since there was no chance of our mother living more than a few more days, what my sister and I did could not be called murder. When death will not occur soon, or perhaps for many years, and when there is a chance, even a very small one, that recovery is possible, people who authorize the withdrawal of life support are playing God.

And in Terri's case, they are playing God when they do not have to. Her parents have begged to become her guardians. Her husband has refused. We do not know for certain why the husband has refused. I doubt that he wishes to receive for himself the money that still exists from her insurance settlement and, apparently, he has offered to donate that money to charity. Perhaps, being a Catholic, he would like her death to make him free to marry the woman with whom he is now living. Or perhaps (and I think this is the most likely case) he does not want his wife to live what strikes him as an intolerable life.

The intolerable life argument has support from many doctors and bioethicists. They claim that a person can be "socially dead" even when their brains can engage in some functions. By "socially dead" they mean that the patient is no longer a person in some sense. At this point their argument gets a bit fuzzy because they must somehow define what is a "person" and a "non-person." That is no easy matter.

By contrast, physicians have unambiguous ways of determining whether a person is brain dead. This means that brain death is a very conservative standard and, if it errs, it errs on the side of preserving life.

Some people believe that all of these issues can be resolved if everyone signs a living will that specifies what is to be done to them under various conditions. The living will is supposed to determine unambiguously when a "Do Not Resuscitate" sign should be placed on a patient's hospital chart. Terri Schiavo had not signed a living will. If she had, we would not be facing these issues.

* * *

But scholars have shown that we have greatly exaggerated the benefits of living wills. Studies by University of Michigan Professor Carl Schneider and others have shown that living wills rarely make any difference. People with them are likely to get exactly the same treatment as people without them, possibly because doctors and family members ignore the wills. And ignoring them is often the right thing to do because it is virtually impossible to write a living will that anticipates and makes decisions about all of the many, complicated, and hard to foresee illnesses you may face.

For example, suppose you say that you want the plug pulled if you have advanced Alzheimer's disease. But then it turns out that when you are in this hopeless condition your son or daughter is about to graduate from college. You want to see that event. Or suppose that you anticipate being in Terri Schiavo's condition at a time when all doctors agree that you have no chance of recovering your personhood and so you order the doctors to remove the feeding tubes. But several years later when you enter into a persistent vegetative state, some doctors have come to believe on the basis of new evidence that there is a chance you may recover at least some functions. If you knew that you might well have changed your mind, but after entering into a PVS you can make no decisions. It is not clear we would be doing you a favor by starving you to death. On the contrary, we might well be doing what you might regard as murder.

There is a document that is probably better than a living will, and that is a durable power of attorney that authorizes a person that you know and trust to make end-of-life decisions for you.

Terri Schiavo's case could be decently settled by a judge who recognizes that there is some small chance of recovery and that several family members are willing to take responsibility for managing that process in hopes that a recovery of even small human features will occur. The judge in Florida ignored this and ordered her feeding tubes removed. The Florida appellate courts have not stayed his hand, and the U.S. Supreme Court, perhaps for want of jurisdiction, has not intervened.

This is a tragedy. Congress has responded by rushing to pass a law that will allow her case, but only her case, to be heard in federal court. But there is no guarantee that, if it is heard there, a federal judge will do any better than the Florida one. What is lacking in this matter is not the correct set of jurisdictional rules but a decent set of moral imperatives.

* * *

That moral imperative should be that medical care cannot be withheld from a person who is not brain dead and who is not at risk for dying from an untreatable disease in the near future. To do otherwise makes us recall Nazi Germany where retarded people and those with serious disabilities were "euthanized" (that is, killed). We hear around the country echoes of this view in the demands that doctors be allowed to participate, as they do in Oregon, in physician-assisted suicide, whereby doctors can end the life of patients who request death and have less than six months to live. This policy endorses the right of a person to end his or her life with medical help. It is justified by the alleged success of this policy in the Netherlands.

But it has not been a success in the Netherlands. In that country there have been well over 1,000 doctor-induced deaths among patients who had not requested death, and in a large fraction of those cases the patients were sufficiently competent to have made the request had they wished.

Keeping people alive is the goal of medicine. We can only modify that policy in the case of patients for whom death is imminent and where all competent family members believe that nothing can be gained by extending life for a few more days. This is clearly not the case with Terri Schiavo. Indeed, her death by starvation may take weeks. Meanwhile, her parents are pleading for her life.

Mr. Wilson is the chairman of the Council of Academic Advisers at AEI, has taught at Harvard, UCLA and Pepperdine, and is the author of The Moral Sense (Free Press, 1997).

[MC Habber]

jkr said:

The cynic in me says that after 15 years, conservative politicians are involved because they will be favorably perceived by the electorate.

If that's the case, they may have made a major misjudgement:

But a new ABC News poll on Monday showed Americans strongly disapproved of the intervention by Congress and two thirds believed lawmakers were using her case for political gain. Seventy percent called it inappropriate.

- source

[blaise]

MC said:

If that's the case, they may have made a major misjudgement:

But a new ABC News poll on Monday showed Americans strongly disapproved of the intervention by Congress and two thirds believed lawmakers were using her case for political gain. Seventy percent called it inappropriate.

- source

THe Republicans in Congress are not concerned about those who disapprove of their actions. They care mainly about their political base, their activists and contributors. They know what they want but they are making reprehensible mischief in the process by inflicting their views upon the nation. Congress is not elected in a national vote. It is done on a district basis. It is not possible for someone living in California or Massachusetts to vote against Tom Delay, only those who vote in one Houston suburb. If they do not reject him (and that would be highly unlikely because of the funds at his disposal), he will continue to impose his will upon the entire country whether they like it or not. For him the Schiavo affair is a welcome diversion from his personal ethical problems, which might lead to his indictment.

Is no one impressed by the fact that Terri Schiavo has an irreparably damaged cerebral cortex, the seat of intelligence and presumably of "the soul"? It has had 15 years to repair itself but has shown no evidence of arousal from persistent coma. The ocular movement that has been cited as a sign of her brain activity is controlled at the level of the brainstem, specifically the medial longitudinal fasciculus interconnecting the 6th and contralateral IIIrd nerve nuclei. The stereotyped posturing exhibited by Schiavo indicates severe dysfunction of the corticospinal system. She is capable of nothing more than reflexive movement produced by noxious stimuli.

The prognosis for regaining mental faculties after several months of submersion in a vegetative state is practically nil. Fifteen years is a long trial period, n'est-ce pas?

[BadCompany]

Blaise said:

Is no one impressed by the fact that Terri Schiavo has an irreparably damaged cerebral cortex, the seat of intelligence and presumably of "the soul"? It has had 15 years to repair itself but has shown no evidence of arousal from persistent coma. The ocular movement that has been cited as a sign of her brain activity is controlled at the level of the brainstem, specifically the medial longitudinal fasciculus interconnecting the 6th and contralateral IIIrd nerve nuclei. The stereotyped posturing exhibited by Schiavo indicates severe dysfunction of the corticospinal system. She is capable of nothing more than reflexive movement produced by noxious stimuli.

The prognosis for regaining mental faculties after several months of submersion in a vegetative state is practically nil. Fifteen years is a long trial period, n'est-ce pas?

I assume then that you yourself have examined her? Read her case file, studied her, performed the necessary tests?

Two doctors who HAVE examined her, have testified that in their professional opinion, they feel she CAN recover, that the cortex is not damaged to the extent claimed by others, that she HAS shown signs of arousal from her vegetative state (she is not in a coma). Three others have testified that she cannot. These are people with direct contact with Shiavo, and not people who are attempting a long range diagnosis, perhaps tainted with an ulterior agenda/bias. Your textbook quoting is impressive for its spelling accuracy, but hardly relevent in this matter, nor all that convincing to anyone who has studied neurology, and neuropsychology. The fact is, as any neurosurgeon worth his salt will tell you, the brain is still very poorly understood, and the methods for studying it still in their infancy. It was not that long ago that phrenology was considered advanced medicine.

Her parents claim that she smiles, laughs, cries, moves, and makes child-like attempts at speech, that she attempts to say "Mom" or "Dad" or "yeah" when they ask her a question. They claim that when they kiss her, she looks at them and sometimes "puckers up" her lips. They cite the testimony and affidavits of 33 physicians and therapists (including 15 neurologists), who, after reviewing video segments provided by her parents, believe that Mrs. Schiavo should receive further tests and/or would likely respond to therapy.

en.wikipedia.org/wiki/Terri_Schiavo

Personally, I do not know what her actual level of consciousness is. Nor do you. Nor, apparently, do even the people closest to her. Hence the whole bloody mess. I am uncomfortable with the idea of euthanasis, but not for the religious reasons you sneer at. That does taint my perspective on the case, but I also like to review all the information available, and when the information is as convoluted and as disputed as this one seems to be, and has been for 8 years now, I think its much better to err on the side of caution. After all, what's to lose? Money? Time? A hospital bed? Big whoop. Small price to pay, in times of uncertaintity.

Its one thing to have an opinion, its another to mock those who disagree - apparently knowing the case a little better than you, biological explanations aside - simply because "they" (being the Republicans) do not feel the same way as you do.

[MC Habber]

Blaise said:

Congress is not elected in a national vote. It is done on a district basis. It is not possible for someone living in California or Massachusetts to vote against Tom Delay, only those who vote in one Houston suburb. If they do not reject him (and that would be highly unlikely because of the funds at his disposal), he will continue to impose his will upon the entire country whether they like it or not.

That's a good point, but I think this could reflect on the Republican party as a whole and potentially have implications for future elections. That said, I don't think this is about votes. I think that either people really believe they are doing the right thing, or else this is a test of the waters, an attempt to establish a precedent for the government to intervene in individual cases where the courts have already ruled. It seems to me that the US government has been trying to see how much abuse of power (both at home and elsewhere) they can get away with, and this might be another example of that.

Either way, I'm uncomfortable with this sort of intervention and I find it somewhat disturbing that so much effort and expense on the part of congress should be put into possibly saving a single life, while so many Americans die preventable deaths all the time. Either people have their priorities severly screwed up or there is a lot more going on here than just this single case, as HFLA suggested.

[blaise]

BadCompany said:

I assume then that you yourself have examined her? Read her case file, studied her, performed the necessary tests?

Two doctors who HAVE examined her, have testified that in their professional opinion, they feel she CAN recover, that the cortex is not damaged to the extent claimed by others, that she HAS shown signs of arousal from her vegetative state (she is not in a coma). Three others have testified that she cannot. These are people with direct contact with Shiavo, and not people who are attempting a long range diagnosis, perhaps tainted with an ulterior agenda/bias. Your textbook quoting is impressive for its spelling accuracy, but hardly relevent in this matter, nor all that convincing to anyone who has studied neurology, and neuropsychology. The fact is, as any neurosurgeon worth his salt will tell you, the brain is still very poorly understood, and the methods for studying it still in their infancy. It was not that long ago that phrenology was considered advanced medicine.

Her parents claim that she smiles, laughs, cries, moves, and makes child-like attempts at speech, that she attempts to say "Mom" or "Dad" or "yeah" when they ask her a question. They claim that when they kiss her, she looks at them and sometimes "puckers up" her lips. They cite the testimony and affidavits of 33 physicians and therapists (including 15 neurologists), who, after reviewing video segments provided by her parents, believe that Mrs. Schiavo should receive further tests and/or would likely respond to therapy.

en.wikipedia.org/wiki/Terri_Schiavo

Personally, I do not know what her actual level of consciousness is. Nor do you. Nor, apparently, do even the people closest to her. Hence the whole bloody mess. I am uncomfortable with the idea of euthanasis, but not for the religious reasons you sneer at. That does taint my perspective on the case, but I also like to review all the information available, and when the information is as convoluted and as disputed as this one seems to be, and has been for 8 years now, I think its much better to err on the side of caution. After all, what's to lose? Money? Time? A hospital bed? Big whoop. Small price to pay, in times of uncertaintity.

Its one thing to have an opinion, its another to mock those who disagree - apparently knowing the case a little better than you, biological explanations aside - simply because "they" (being the Republicans) do not feel the same way as you do.

My spelling accuracy derives from the fact that I studied neuroanatomy for one year and neurophysiology for another year and am in the medical field. At least give me credit for knowing a hell of a lot more about the subject than your average (or sub-average) politician.

Prolonged vegetative state is a poor diagnosis, at least in the case of Terri Schiavo. It should actually be permanent vegetative state.

As for my feelings about the premature end of life, I had the sorry experience of watching my wife as she was disconnected from life support, so my feelings are based on quite a bit more than detached analysis. Therefore, from both an academic and an emotional standpoint, I believe strongly in what I am saying. I hope it registers with you despite the fact that I have not examined Terri Schiavo. However, most physicians who have examined her (or even heard about her case) would concur with my conclusion--unless they put the bible ahead of their professional training, in which case it would be hopeless to persuade them.

I question those physicians you cite who say belatedly that she should receive further tests. If she did not receive adequate testing in the past, then what in blazes explains such professional neglect on the part of their colleagues over the course of 15 years? Assuming that Schiavo was not tested and treated, then a lot of people should be sued for malpractice.

[franko]

Blaise said:

However, most physicians who have examined her would concur with my conclusion (unless they put the bible ahead of their professional training, in which case it would be hopeless to persuade them).

Expand your horizons . . . expand your mind . . . not everyone who is against the removal of the food tube is one of "them thar Biblethumpers" -- some have deep philosophical reservations about the act. And not everyone who is for the removal of the food tube is a Bible-burner.

[Cranky]

Qualtiy of life? Yes.

But.........

BC brings up a point of not knowing with out a shred of a doubt if that person is concious or not.

This is one hell of a decision and should only be taken by a loved one. Unfortunatly, that decision is so traumatic that it may hurt the person who is deciding and scar them for life.

There has to be a better way..................

[Cranky]

franko said:

Expand your horizons . . . expand your mind . . . not everyone who is against the removal of the food tube is one of "them thar Biblethumpers" -- some have deep philosophical reservations about the act. And not everyone who is for the removal of the food tube is a Bible-burner.

For whatever little it's worth.........

I have respect for those who oppose euthanasia on personal moral grounds. I have contempt for those who try to impose their will based on ink spread on a page.

[Habs_fan_in_LA]

Mr. said:

For whatever little it's worth.........

I have respect for those who oppose euthanasia on personal moral grounds. I have contempt for those who try to impose their will based on ink spread on a page.

Quality of life is a difficult issue.
When I was young and played hockey and football for hours daily, I was sure that if I lost my legs, I would certainly want to die.
Later in life, playing football for hours on end seems less important.
Seeing parents moving from their home to assisted living and then to intensive care, I have seen them reduce their expectations and hold on to what they have cherishing the limited joys they have left. Seeing other patients confined to wheelchairs, sitting day after day in hospital corridors, losing faculties, diminished eyesight and limited hearing, I see patients hold on to what little they have left. As quality slowly diminishes they find pleasure in what they have left. It's hard to judge for someone else.
I would hate to be confined the way Steven Hawking is, but he maximizes his ability and continues to be productive, There do not appear to be any universal standards that can be applied.

I initially favored the termination of the life of Schiavo and thought death by starvation was grotesque. After seeing video of her interraction with her parents, I'm no longer as certain as I was. She appears to be responsive and have reactions to outside stimulus.

Killing the infirm, retarded, physically challenged and intelectually impaired is wrong. I don't want to be the judge.
Is money spent on the Schaivos of the world better spent on schooling of children who need improvements in education? Military jet plane$ vs. highway$. $chools vs hospital$, pen$ions vs foreign aid? All tough calls. Maslows heirarchy of needs is of some help and no matter what priorities you assign you'll alienate more than you satisfy.

[MC Habber]

Habs_fan_in_LA said:

I initially favored the termination of the life of Schiavo and thought death by starvation was grotesque. After seeing video of her interraction with her parents, I'm no longer as certain as I was. She appears to be responsive and have reactions to outside stimulus.

According to some, those "reactions" are random movements and noises and she exhibits similar behaviour when noone else is present, and often shows no reaction when people are present. Of course, that doesn't prove she can never recover, but much of her brain has supposedly liquified.

[BadCompany]

MC said:

According to some, those "reactions" are random movements and noises and she exhibits similar behaviour when noone else is present, and often shows no reaction when people are present. Of course, that doesn't prove she can never recover, but much of her brain has supposedly liquified.

Personally, having studied brain anatomy and neuro-psychology for two years (since it seems necessary to establish one's educational credentials here), and having watched two newborns of a dear friend die after losing brain function (in both cases the mother had to remove life support), I highly doubt there is any chance of recovery. Since I am not overly religious, don't even go to Church, I'm not holding my breath, waiting for divine intervention (which, to me, anyways, would seem counter-productive - wouldn't it be better for her to die and go to heaven?).

However, for me, that is not the issue. Its an issue of quality of life, and an issue of personal will. Christopher Reeves had no chance of recovery, and many would have argued that his quality of life was nil, but he didn't seem to think so. Is Terri Schiavo anywhere close to Reeves in mental capacity? Of course not. But where do you draw the line? Her parents say there is enough life there to warrant continuing it. Her husband argues that not only is there not enough life there, but Schiavo wouldn't have wanted it that way anyways. Who is right? Is there a right answer? Its an awful and permanent decision, from which there will be no peace. There can be no Solomon decision here, that will appease everyone.

The most recent judge ruled this morning in favor of the husband, despite the opinion by some that he was only brought in to issue a Bush-favorable verdict. Appeals will be launched, and Bush may yet get a chance to overrule, but so far the system is working as it should. Is that good? I don't know. Its the way our world works. I have yet to see a better system, and while this one certainly has its flaws, until somebody comes up with a better one, I'm not sure there is much else we can do.

[franko]

Reasoned and reasonaable debate on an issue . . . a nice change, no?

BadCompany said:

Since I am not overly religious, don't even go to Church, I'm not holding my breath, waiting for divine intervention (which, to me, anyways, would seem counter-productive - wouldn't it be better for her to die and go to heaven?).

I am religious (hate the term); all of us "religious-types" get lumped together as unthinking and uncaring Luddites. Too bad . . . as I've said over and again, the paint brush is too wide.

I agree wholeheartedly: counterproductive indeed.

However, for me, that is not the issue. Its an issue of quality of life, and an issue of personal will. Christopher Reeves had no chance of recovery, and many would have argued that his quality of life was nil, but he didn't seem to think so. Is Terri Schiavo anywhere close to Reeves in mental capacity? Of course not. But where do you draw the line?

Ah, there's the rub.

Her parents say there is enough life there to warrant continuing it. Her husband argues that not only is there not enough life there, but Schiavo wouldn't have wanted it that way anyways. Who is right? Is there a right answer? Its an awful and permanent decision, from which there will be no peace. There can be no Solomon decision here, that will appease everyone.

I'm an unabashed pro-lifer. I am against active euthanasia. Firmly. And yet knowing that she will slowly starve to death is appaling. And yet to force-feed her through a tube so that she has some sort of bodily existence is equally appalling. And yet she reacts to external stimuli. And yet these reactions may be merely involuntary. And yet . . . I feel like Tevye: on the other hand . . .

There are indeed no easy answers. There is no purely black and white, right and wrong, left and right. And emotions cloud the issues. In the end, we don't have to make a decision. This time. And I hope/pray that I never have to.

[Habs_fan_in_LA]

BadCompany said:

Personally, having studied brain anatomy and neuro-psychology for two years (since it seems necessary to establish one's educational credentials here), and having watched two newborns of a dear friend die after losing brain function (in both cases the mother had to remove life support), I highly doubt there is any chance of recovery. Since I am not overly religious, don't even go to Church, I'm not holding my breath, waiting for divine intervention (which, to me, anyways, would seem counter-productive - wouldn't it be better for her to die and go to heaven?).

However, for me, that is not the issue. Its an issue of quality of life, and an issue of personal will. Christopher Reeves had no chance of recovery, and many would have argued that his quality of life was nil, but he didn't seem to think so. Is Terri Schiavo anywhere close to Reeves in mental capacity? Of course not. But where do you draw the line? Her parents say there is enough life there to warrant continuing it. Her husband argues that not only is there not enough life there, but Schiavo wouldn't have wanted it that way anyways. Who is right? Is there a right answer? Its an awful and permanent decision, from which there will be no peace. There can be no Solomon decision here, that will appease everyone.

The most recent judge ruled this morning in favor of the husband, despite the opinion by some that he was only brought in to issue a Bush-favorable verdict. Appeals will be launched, and Bush may yet get a chance to overrule, but so far the system is working as it should. Is that good? I don't know. Its the way our world works. I have yet to see a better system, and while this one certainly has its flaws, until somebody comes up with a better one, I'm not sure there is much else we can do.

Quality of life is difficult and subjective.
As you point out, non of us would like the quality of life that Christopher Reeves had at the end eventhough he had money, a loving family, friends, travelled extensively.
None of us would trade places with Stephen Hawking despite his fame and intellect.
We could extend the QOL issue to starving in Etheopia, If we deem them to be suffering, is it up to us to put them out of their misery? I don't think so.
I make an exception for Leafs fans who suffered enough and should be put out of their misery, but that's an issue for non-habs hockey.

[blaise]

The judge ordered alimentation removed from Schiavo because he accepted the medical opinion that she is brain-dead. An appeal has been filed, and the case may reach the Supreme Court. If the justices fail to reverse the decision, that's it. Bush has no constitutional right to intervene further. Otherwise it would amount to overturning the constitution, which is grounds for impeachment, trial, and removal from office. He might not be convicted by a Republican Congress, but the chances for any Republican candidate in the 2008 presidential election would be severely compromised because the public would probably not stand for usurpation of power by a Republican President and Congress.

[blaise]

franko said:

Reasoned and reasonaable debate on an issue . . . a nice change, no?


I am religious (hate the term); all of us "religious-types" get lumped together as unthinking and uncaring Luddites. Too bad . . . as I've said over and again, the paint brush is too wide.

I agree wholeheartedly: counterproductive indeed.


Ah, there's the rub.


I'm an unabashed pro-lifer. I am against active euthanasia. Firmly. And yet knowing that she will slowly starve to death is appaling. And yet to force-feed her through a tube so that she has some sort of bodily existence is equally appalling. And yet she reacts to external stimuli. And yet these reactions may be merely involuntary. And yet . . . I feel like Tevye: on the other hand . . .

There are indeed no easy answers. There is no purely black and white, right and wrong, left and right. And emotions cloud the issues. In the end, we don't have to make a decision. This time. And I hope/pray that I never have to.

A person doesn't need a cerebral cortex to respond reflexively to certain external stimuli. A robot could do as well with a single circuit board, some primitive sensors, and a few moving parts. Instead of battery power, Terri Schiavo exercises these functions with the aid of externally administered total alimentation. Returning to an analogy that was termed insensitive, at least a tadpole can feed itself and, more important, know how to seek food.

[Toronthab]

HardCap said:

Interesting read from the Wall Street Journal:
Killing Terri Print Mail



By James Q. Wilson
Posted: Monday, March 21, 2005

ARTICLES
Wall Street Journal
Publication Date: March 21, 2005

Terri Schiavo is not brain dead as far as anyone can tell. If you are brain dead, you have suffered an irreversible loss of all functions of the brain. If agreed to by at least two physicians, that means you are legally dead, such that your organs can be harvested to help other people.

Instead, Ms. Schiavo is in what many physicians call a "persistent vegetative state" (PVS). That means that she lacks an awareness of her self or other people, cannot engage in purposeful action, does not understand language, is incontinent, and sleeps a lot. To be clinically classified as being in a PVS, these conditions should be irreversible. But from what we know, some doctors dispute one or more of these conditions and believe that it is possible that whatever her symptoms, they are not irreversible.

Her condition is hardly unique. In 1995, when the American Academy of Neurology published its report on people in a persistent vegetative state, it found that there were as many as 25,000 adults and 10,000 children in this country who suffered from PVS. Based on the best studies the Academy could find at the time, some adults in a vegetative state 12 months after a devastating injury or heart failure could recover consciousness and some human functions. The chances that such a recovery will occur are very small, but they are not zero.

If they are not zero, then withdrawing a patient's feeding tubes and allowing her to die from a lack of water and food means that whoever authorizes such a step may, depending on the circumstances, be murdering the patient. The odds against it being a murder are very high, but they are not 100%.

* * *

Many people, myself included, have allowed life-support systems to be withdrawn from parents who have no hope of recovery. My mother was going to die from cancer, and after all efforts had been made to help her, my sister and I allowed the doctors to withdraw the devices that kept her alive. She was dead within hours.

My case, and that of countless other people who have made that decision, differs from that of Terri Schiavo in two important ways. First, the early death of my mother was certain, but no one can say that Ms. Schiavo will die soon or possibly at any time before she might die of old age. Second, all the relevant family members agreed on the decision about my mother, but family members are deeply divided about Terri.

These differences are of decisive importance. When death will occur soon and inevitably, the patient does not starve to death when life support ends. Since there was no chance of our mother living more than a few more days, what my sister and I did could not be called murder. When death will not occur soon, or perhaps for many years, and when there is a chance, even a very small one, that recovery is possible, people who authorize the withdrawal of life support are playing God.

And in Terri's case, they are playing God when they do not have to. Her parents have begged to become her guardians. Her husband has refused. We do not know for certain why the husband has refused. I doubt that he wishes to receive for himself the money that still exists from her insurance settlement and, apparently, he has offered to donate that money to charity. Perhaps, being a Catholic, he would like her death to make him free to marry the woman with whom he is now living. Or perhaps (and I think this is the most likely case) he does not want his wife to live what strikes him as an intolerable life.

The intolerable life argument has support from many doctors and bioethicists. They claim that a person can be "socially dead" even when their brains can engage in some functions. By "socially dead" they mean that the patient is no longer a person in some sense. At this point their argument gets a bit fuzzy because they must somehow define what is a "person" and a "non-person." That is no easy matter.

By contrast, physicians have unambiguous ways of determining whether a person is brain dead. This means that brain death is a very conservative standard and, if it errs, it errs on the side of preserving life.

Some people believe that all of these issues can be resolved if everyone signs a living will that specifies what is to be done to them under various conditions. The living will is supposed to determine unambiguously when a "Do Not Resuscitate" sign should be placed on a patient's hospital chart. Terri Schiavo had not signed a living will. If she had, we would not be facing these issues.

* * *

But scholars have shown that we have greatly exaggerated the benefits of living wills. Studies by University of Michigan Professor Carl Schneider and others have shown that living wills rarely make any difference. People with them are likely to get exactly the same treatment as people without them, possibly because doctors and family members ignore the wills. And ignoring them is often the right thing to do because it is virtually impossible to write a living will that anticipates and makes decisions about all of the many, complicated, and hard to foresee illnesses you may face.

For example, suppose you say that you want the plug pulled if you have advanced Alzheimer's disease. But then it turns out that when you are in this hopeless condition your son or daughter is about to graduate from college. You want to see that event. Or suppose that you anticipate being in Terri Schiavo's condition at a time when all doctors agree that you have no chance of recovering your personhood and so you order the doctors to remove the feeding tubes. But several years later when you enter into a persistent vegetative state, some doctors have come to believe on the basis of new evidence that there is a chance you may recover at least some functions. If you knew that you might well have changed your mind, but after entering into a PVS you can make no decisions. It is not clear we would be doing you a favor by starving you to death. On the contrary, we might well be doing what you might regard as murder.

There is a document that is probably better than a living will, and that is a durable power of attorney that authorizes a person that you know and trust to make end-of-life decisions for you.

Terri Schiavo's case could be decently settled by a judge who recognizes that there is some small chance of recovery and that several family members are willing to take responsibility for managing that process in hopes that a recovery of even small human features will occur. The judge in Florida ignored this and ordered her feeding tubes removed. The Florida appellate courts have not stayed his hand, and the U.S. Supreme Court, perhaps for want of jurisdiction, has not intervened.

This is a tragedy. Congress has responded by rushing to pass a law that will allow her case, but only her case, to be heard in federal court. But there is no guarantee that, if it is heard there, a federal judge will do any better than the Florida one. What is lacking in this matter is not the correct set of jurisdictional rules but a decent set of moral imperatives.

* * *

That moral imperative should be that medical care cannot be withheld from a person who is not brain dead and who is not at risk for dying from an untreatable disease in the near future. To do otherwise makes us recall Nazi Germany where retarded people and those with serious disabilities were "euthanized" (that is, killed). We hear around the country echoes of this view in the demands that doctors be allowed to participate, as they do in Oregon, in physician-assisted suicide, whereby doctors can end the life of patients who request death and have less than six months to live. This policy endorses the right of a person to end his or her life with medical help. It is justified by the alleged success of this policy in the Netherlands.

But it has not been a success in the Netherlands. In that country there have been well over 1,000 doctor-induced deaths among patients who had not requested death, and in a large fraction of those cases the patients were sufficiently competent to have made the request had they wished.

Keeping people alive is the goal of medicine. We can only modify that policy in the case of patients for whom death is imminent and where all competent family members believe that nothing can be gained by extending life for a few more days. This is clearly not the case with Terri Schiavo. Indeed, her death by starvation may take weeks. Meanwhile, her parents are pleading for her life.

Mr. Wilson is the chairman of the Council of Academic Advisers at AEI, has taught at Harvard, UCLA and Pepperdine, and is the author of The Moral Sense (Free Press, 1997).

That was an excellent post Hardcap. People want to kill Terri Schiavo because they see no value in her. Some, but not all would be deterred from this course if theyt had to stab her in the heart. Better to starve her to death and of course drug her up so we won't be disturbed and upset by the terrible sight of such monstrous behaviour. No one has the "right" to kill an innocent human being. All of histroy's monsters are not deterred by this most fundamental moral principle. The term "brain death" is of course but a seriously misleading analogical phrase.

Human rights are intrinsic not toys for our disposition du jour. No fundamentally immoral request or "living will" is binding. It always involves a "duty" fro someone else to carry it out. No one has such a duty.

[Toronthab]

Mr. said:

For whatever little it's worth.........

I have respect for those who oppose euthanasia on personal moral grounds. I have contempt for those who try to impose their will based on ink spread on a page.

Well, at least you did suggest it was worth but a little. I am not a fundamentalist Christain and indeed, I often find them a huge irrational embarassment in the face of the immense and continuing spiritual, historical, and intellectual fecundity of Christianity.

That said, I believe people do genuinely discover at least the beginnings of a spiritual life and often are doing their level best to live with integrity according to the lights they are given.

Assuming your "I have contempt for those who try to impose their will based on ink spread on a page." refers to the above, I am always struck by how blind people who manifest such a simplistic and bigotted are. It is almost invariably employed by people who want to kill other people through abortion and other homicides. The ultimate imposition of ill will.

Your poetic or romantic use of the term "philosophical" is also unintentionally ironic. Inclusive and fully reasonable philosophical positions are for the most part theistic. One is ohterwise generally adrift in the moral relativism and unintelligibility if Rousseau's "contrat social", so-called "secular humanism" and of course the social darwinism operative in this issue.

You would do well to temper your contempt.

[MC Habber]

Toronthab said:

People want to kill Terri Schiavo because they see no value in her.

The current course of action is not to kill her but to stop feeding her. You may say I'm splitting hairs but you are implying that society has a duty to provide the care she requires at the expense of literally hundreds of other lives. Why do you not compel us to feed the starving millions in Africa, to shelter the homeless who freeze to death every winter in Toronto or to help people suffering from terminal addictions? Why is this one person worth so much more than so many others?

[MC Habber]

Toronthab said:

No fundamentally immoral request or "living will" is binding. It always involves a "duty" fro someone else to carry it out. No one has such a duty.

That is debateable, but the question in this case is not whether her husband has a duty to end her life, it is whether he has the right. Had she left a living will, or given power of attorney to her husband, I think most people would agree that he would have that right.

[Toronthab]

Habs_fan_in_LA said:

I really don't think this is about Schaivo. She is one person and her medical status is not the kind of issue the US Congress should get involved in. I am not an expert in brainwave patterns of the cortex nor are most members of congress.

The real issues are:

1. Right to life.
2. Right to elect to terminate ones life.
3. Who acts as executor, parents of spouse?


1. I disagree with President Bush that a fetus has a right that superceedes the rights of the mother in making the already difficult choice concerning the termination of a pregnancy. It is a personal individual decision of the woman assisted by the advice of her doctor. It is not an issue for legislators or the judicial branch.

2. I believe strongly in individual rights. It is the right of the individual to make decisions concerning both the way he/she wants to live or if they want to live. To the extent that those decisions do not harm other members of society, it is the right of the individual that superceedes the desires of the group.

3. When a person leaves their parents home, circumstances may place the parents in a supportive role, a tolerant role or an adversarial position. The individual made a conscious decision (good or bad) to move on and entered a new union apart from the rule of the parents. The spouse is now closer than the parents and that is the new family unit.

There should be a better faster way than starvation to end a life.

If one tries to extend this ruling about quality of life to severely retarded patients (there is no universally accepted definition of severe or quality of life) the problem becomes much more difficult.

I would much rather be discussing a two for one trade to get a power forward than Karen and so would most HabsRUS members. Settle the d@#m agreement Betenough!

What a load!

!. Existence is logically and actually prior to deciding. It is an actual human being in a fetal development state that you would have killed.

2. You do not believe in "individual rights". You are just another person cowed into allowing the powerful to inflict death on the powerless. Millions of "individual" human beings are sacrificed in what has been perfectly described as "a crime against humanity" and this is fine with you.

Lastly, as to a better faster way to kill people we find inconvenient or useless, maybe we could group them together and use...oh I don't know...say ....ovens.

Gotta love this new humanism...so sensitive...caring
t

[blaise]

Toronthab said:

What a load!

!. Existence is logically and actually prior to deciding. It is an actual human being in a fetal development state that you would have killed.

2. You do not believe in "individual rights". You are just another person cowed into allowing the powerful to inflict death on the powerless. Millions of "individual" human beings are sacrificed in what has been perfectly described as "a crime against humanity" and this is fine with you.

Lastly, as to a better faster way to kill people we find inconvenient or useless, maybe we could group them together and use...oh I don't know...say ....ovens.

Gotta love this new humanism...so sensitive...caring
t

Ya gotta just love the politicians who wanna keep Terri Schiavo alive because it rallies the fetus-lovers while simultaneously slashing finds for school lunches and preschooling and home care assistance that permirt single parents to live a halfway decent life. But when it comes to the entrenched Mammon-worshipers, they are sooo sensitive and caring. They reduce the favored ones' tax burdens to make ocean-going yachts and third limousines for conveying their fur and diamond-adorned guests more affordable. Nothing beats an elected dictatorship that sucks up obscenely large political contributions.