Monday, April 25, 2005

Terri's Fight was just the beginning!

These stories show there's a lot more to do to protect people with cognitive disabilities from those who would call them non-persons.

Ethical discussions based on the theories of Peter Singer could suddenly put anybody who can't talk to a TV reporter in Terri's position. Those of us who value our "imperfect" lives need to
find a way to impact public opinion before this idea of shifting
"personhood" across the lifespan solidifies in American thought.


trampoline said...
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trampoline said...

Hey there, Cynthia...

This is kind of an off-the-cuff response, so it wouldn't surprise me if some of my premises are faulty, but it's what I'm thinking at the moment.

Upon first glance at Peter Singer's theory, I was appalled. Then I thought more about it. I'm not sure I understand what he's getting at (based on the very little research I did just now) -- let alone agree with it -- but it occurred to me that no one has really sat down to try to articulate what those on the other side of the Terri argument are getting at.

Perhaps I'm not that person, but I feel like giving it a try... I think it's an oversight to view those who would support euthanasia or the cessation of life support in PVS cases as brutal or inhumane. In many cases, their view stems from precisely the opposite urge -- one of mercy.

That notion of 'mercy' is easier to fathom in some cases than in others (euthanasia vs. life support, etc.), but I think it's strong and worth noting.

I think the real argument arises, however, in PVS cases. We can all see how it seems like you're killing a person when you allow their heart to stop beating -- but I would argue that those who would vote to allow it are no less humane than those who would rail against it. What is at stake is the idea of personhood, which you alluded to in this post.

It seems to me that one side of the argument sees personhood as inextricably linked to a heartbeat, while the other side sees it as a function of consciousness. This does not mean that we lose part of our "personhood" when our physical functions change. A blind person is no less whole or important than a sighted one. The rub comes when someone loses consciousness entirely. I'm not talking about a temporary loss of consciousness like a coma, or a partial loss of consciousness, like brain damage. I'm referring to complete, permanent loss of all life functions -- particularly those pertaining to cognition.

When a dog is old or ill, we "put it to sleep." Of course people are not dogs, but the idea of "putting something to sleep" has interesting connotations, because it describes the way a lot of people view PVS cases: asleep. Permanently.

I don't know anything about Terri's husband (he sounds like a real catch), but to him, her family, and her loved ones, Terri lost all semblance of personhood when she permanently lost consciousness. The only difference between her loss of consciousness 15 years ago and her loss of "life" last month was the disappearance of a physical presence.

We all agree that her death was tragic -- but those on the other side of the issue contend that that death occurred when she lost all reasoning and cognitive ability.

In my own personal opinion, the greatest irony of this discussion of sanctity-of-life discussion is the tie-in to religion. As a serious Christian, I have always been taught that my identity is God-ordained and immortal, and that it transcends a mere physical body. It seems completely incongruous with the teachings of the Bible to reduce something spiritual and transcendant down to the function of a beating heart. Most Christians believe that after death, people continue experiencing things in one capacity or another (even if we don't understand what that is) -- so why wouldn't it be the most Christian thing to do to release someone from their limitations and allow them to continue "walking with God"?

Just some thoughts. As always, I'm open to discussion.

(By the way, I'm sorry if this got a little heavy on the religion...)

cynthia said...
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cynthia said...

Hey Trampoline,

Thanks for diving into this. You make excellent points. In fact, I agree 100% that if someone has lost consciousness permanently, it would not be cruel or brutal to stop feeding them.

I do agree that Christians have things to look forward to after death, and I think the pro-life argument is weakest where it depends on physical presence for its justifications. Even if a beating heart indicates life, a life limited to a beating heart is not compelling.

In general, I don't think a family member is brutal or cruel for trusting the doctor's assessment of the situation. (Although, to be honest, I usually think they are making a terrible mistake.) It's obvious I don't have cuddly feelings for Michael Schiavo; I heard too many things in his interviews and his quotes from court documents that bothered me. In all fairness, that may have more to do with me than Mr. Schiavo.

My disagreement with removing feeding tubes from people who've been diagnosed with some type of non-conscious life stems from my deep distrust of medical diagnoses.

(Here's the slanted, personal part of the argument-- feel free to skip ahead if you'd rather stick to the rhetorical argument.) I was born at 24 gestational weeks rather than the normal 40. I weighed two pounds, and I survived. That was nearly unheard of in 1970, and the doctors who took care of me and my mother expected I'd be a "vegetable," or at least "never walk or talk." My parents were told "Don't worry about it. You're young-- you can have more." Mom and Dad ignored them, thankfully. The walking part turned out to be mostly true. The rest was wrong.

These stories, and half a dozen more, get re-told every year on my birthday. SO, unsurprisingly, I often disbelieve and distrust doctors' predictions, even when I like and trust the guy or gal in the lab coat. From where I sit, the only mercy I can see is to give everybody who might want it the chance at life. (End of personal experience rant)

I hear people give the lie to doctors' predictions all the time when I talk with other people who have significant disabilities; As a group, we live a big chunk of our lives in the gap between what somebody thought we could do (usually not much) and what we hope to do(usually as grandiose as anybody.) We have proven that no one could accurately predict what we were capable of. It makes sense that we don't accept predictions for those in PVS, either.

Is it possible that we may know something that others-- the ones who've been to the doctor for, say, a broken leg, some tonsils, and the occasional sinus infection so far-- haven't had the opportunity to learn? If so, don't we have a responsibility to make sure that the things we know are part of the public discourse; to challenge assumptions and _make sure_ that decisions about mercy are based on rigorous evidence instead of an educated guess?

At least so far, the Peter Singer stuff is still pretty much a fringe theory. What scares me is how financially attractive that theory is likely to be to hospitals in the face of 24 hour nursing, ventillators, and whatever, in the age of managed care. You can bet I won't stop yelling until I find a voice loud enough to counter it.

trampoline said...

Wow. That's amazing (from a triumph-of-the-human-spirit standpoint) and interesting (from a logical-argument standpoint). I must say, I did have an inkling when I saw that we were two Geminis that there would be a lot of "yeah, I can see what you're saying."

What makes that especially interesting to me is that I'm a Christian Scientist. (I only linked that so that it wouldn't get confused with Scientology...) You may have seen references on the RCFYA blog to my religious views (or my religious weirdness) and the fact that I don't take medicine or go to the doctor. I've never been to a doctor, for anything -- and that includes broken bones, illness, etc --and I am as healthy as anyone I know. I know people who have been diagnosed with life-threatening illness, and have healed them through prayer. As such, I agree very strongly with your position of distrust toward medicine.

I'll try to stay off the soapbox, but what I'm trying to say is I'm with you. I'm with you 100%. Which might lead you to question why I was writing such over-the-top things about Terri when you first found our blog...

What put me so firmly in the "pull the tube" camp was a response to the political climate it created. I was completely disgusted with the politicization of Terri's case. I know I've gone into this before, but it affected me on a lot of different levels. For one thing, I think there is an increased push for government to invade the personal lives of citizens. Those same beliefs that put me "with you 100%" also make me very wary of government involvement in my health care. Of course, in Terri's case, it was weaselly Michael Schiavo's word against the Schindler's wishes -- with contradictory medical diagnoses pleading both sides of the case -- so it was very murky; but in more conventional (that's probably the wrong word) cases, I feel very strongly about my right to choose to forego medical treatment.

And the other thing is, the politicization of the whole thing. I think most of America (at least, many lefties) viewed this intense human drama as apolitical. But when certain politicians seized on the opportunity to further stratify our nation, I was infuriated. Many of them appeared to be acting inconsistently at best and hypocritically at worst. And it turned into a new chance to infuse religion into politics -- which is something I am strongly opposed to.

What is ironic about all of this is the fact that I (and many other lefties) saw the politicization of this issue as insincere, absurd and reactionary... and I (we) responded by being more reactionary and further politicizing the issue. That led to you reading ridiculous, heartless statements about Terri and the Pope in our blog that really had nothing to do with the fact that each of us is at heart very sensitive and caring.

In fact, a lot of what we complain about is a reactionary attitude to what we see as inconsistencies -- like a concern for the life of a first term fetus and a simultaneous disregard for the lives of hundreds of thousands of Iraqis.

But I digress.

pc93 said...

Terri Schiavo: Charts Show Discrepancy Of More Than 2 Hours Re: Terri's "Collapse" And Time Michael Schiavo Waited In Seeking Help - His accounts proven to be farcical making him complicit in what happened to her.

Please provide me feedback re: charts,. I created

Schiavo "Collapse" More Than Two Hour Discrepancy Proven By Charting

Juan V Schoch
Lake Mary, FL

cynthia said...

Hi Juan,

Your charts are interesting; unfortunately I doubt there will be any further developments in the Schiavo case-- since the state court of Florida condoned Michael's decision to pull the tube, and the Supreme Court decided not to hear the case (perhaps very delicately endorsing the state ruling) it would be rather chaos-inducing for any court to permit his indictment on any count pertaining to Terri.

In my view, there is a more frustrating aspect to the whole drama than the lack of censure for Michael Schiavo: The case may well cause more people in our society to believe that witholding food or water is the "right" course of action following severe brain injury. There are many minimally-responsive people in the world, and some of them are conscious.

As a society and as individuals, we all have a responsibility to use caution when making decisions for others.

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