January 29, 2005

Schiavo Case: Right to Die?

The case of Terri Schiavo, the incapacitated woman whose husband is trying to starve to death and whose parents are trying to obtain custody over, is a sad one. It has looked many times as though she may die, and at least a few times she has been taken off her feeding tube.

She has received no rehabilitation in over a decade after a massive loss of oxygen to her brain - possibly caused by a potassium imbalance - rendered her more or less incapacitated. The husband got, both on her behalf and separately for himself, a number of jury awards and settlements for medical malpractice issues. In order to do so, he argued that Terri 1) COULD be rehabilitated with the money and 2) WOULD be rehabilitated with the money.

A few months after getting it (in the early 90s) he decided that she could not be rehabilitated and spent a huge portion of the roughly $2mil-plus awards on lawyer fees since that date, fighting the parents. In 1993 he ordered the nursing staff not to treat Terri for a simple infection that could have become terminal if untreated. Naturally this was denied as inhumane and illegal.

What's interesting about this story is that some mainstream media types present it as a "right to die" case. I think AP, Reuters or one of the other wire services must have done this because it shows up in the more superficial teasers, bylines and ticker-lines and in a myriad of different media sources. Unfortunately, it's wrong.

Terri didn't leave a living will indicating she wanted to die. Her prior statements on the issue , as given by friends and family, are contradictory (if true). It's relatively clear that her husband Michael was initially correct: Terri is not in a permanent vegetative state and could be rehabilitated with time and attention. Why is this presented, then, as a right-to-die case?

In part, because of the lawyer representing Terri's parents and fighting to get Terri rehabilitative care. He's trying to frame it as a religious liberty issue; Terri's religious liberty is supposedly violated here. That's just silly, since her perspective on the issue is not explicitly available. And if it were then it's silly to make it religious liberty. If somebody puts in a living will "please don't pull the plug on me" then they don't need to be religious to have that granted. He's obscuring the issue and making it political when he needs to be making it on more mainstream legal arguments.

I think the remainder of the issue is the ignorance and superficiality of the wire service reporters. It's only right to die if Terri wants it. She didn't put it in a living will and she's not able to communicate her choice. It's the husband's right to terminate. The lack of good reporting on the issue is embarrassing; for example, the fact that Michael Schiavo has been living with a woman since 1995 and has been engaged to her since 1997 is rarely mentioned - not to mention the fact that they live together with their two kids.

But going so far as to characterize it as "right to die" is absurd. She's not trying to call in Kevorkian to ease her pain. She doesn't want to end it all. Her opinion has not been clearly communicated as a result of her state.

What is especially heinous is the larger issue - a woman will be denied her right to rehabilitation, which is guaranteed by Florida statute, and will be starved to death. Her only means of mechanical assistance is a feeding tube, since she can't swallow. More accurately, her ability to swallow has not been tested, because Michael Schiavo contends it would be rehabilitative and therefore he refuses it. That's highly suspicious in itself. He refuses all rehabilitation to an almost pathological degree. When a nurse placed a cloth in Terri's hand for a moment Michael said it was rehabilitation and took it out. He's had the blinds pulled shut in the room so that she wouldn't get the stimulation of sunlight or outside. It's absurd - if she's so incurable why would he refuse these two examples, both of which cost no money?

It appears he fears her being cured. I could make some guesses about why - like he fears a divorce hearing, he wants to keep all the money from their marriage and from the settlements, or even something crazy like he caused the accident through abuse and he's covering up the crime. My guess is it's just selfishness: he figures she's gone and there's no reason he shouldn't keep the money, but the longer she hangs around, the longer he waits to marry his current fiance.

Frankly, I think he has a clear divergent interest. He is, in practical terms, her ex-busband. He is doing all the activities of marriage with his new fiance, except the legally binding license and ceremony. They live together, they have and raise children together, and they have even been connected together in various Terri-related legal proceedings. I don't think there's a whole lot to be done to fix this situation, but he's basically her estranged husband and he should not possess guardianship over her - besides which, he stood to gain over a million bucks in 1993 when he first started trying to have the nurses kill Terri.

Well, it must be fairly obvious I think she shouldn't be killed. What's interesting is they're not just removing the feeding tube, as the court order says, but actually denying her food itself (which is probably not allowed and certainly not in the court order explicitly). But the larger issue is clear - the Florida statutes already mandate that, in the absence of a living will, she gets access to both support and rehabilitation. The conflict is really over whether Terri wanted to die in this situation or not. Since it's not clear what she wanted and she left no living will, we should rehabilitate her and then ask her.

A bunch of doctors and neurologists have examined her and determined that she is not in a permanent vegetative state and that she could be rehabilitated. I think that's more than enough expert opinion to warrant at least SOME efforts to rehabilitate her. Let's hope a thinking, living person isn't going to be extinguished out of the selfish wants of her adulterous estranged husband.

For more on the issue, check out my expository article on it here.

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