My irregular musings on city life, politics, baseball, roller derby, and whatever happens to be getting my goat today.

Tuesday, March 22, 2005

The Terri Scenario

Starbuck: I thought you were dead.
Apollo: I thought you were in hack.
Starbuck: It's good to be wrong.
Apollo: You should be used to it by now.
Starbuck: Everyone has a skill.

I've been meaning to write something about the Schiavo situation for some time now but I've just been too busy. Which is a lucky break for me, because I've been dead wrong.

My gut reaction was "oh, great, they've found something else to beat us up with. Look at the elitist bullies who don't value human life wanting to pull the plug on this poor defenseless woman so her cheating husband can remarry." Because this is what happens when your opponents control the agenda. They pick the battlefields to make you look as bad as possible. This case is definitely not where right-to-die proponents want fight this battle. For one thing, there's no clear documentation of what the patient would have wanted, with conflicted stories being yelled rather than rationally discussed, and the whole thing being fough out by lawyers, none of whom really represent the patient, for obvious reasons.

Understand that I come at this from a strange perspective for an American. For once, I don't have a dog in this fight. There's never going to come a time when I beg for death, not even if the Constitution is changed and George W Bush wins a third term as President. Don't talk to me about my suffering being too great to go on. Please. I was raised in New Jersey.

On the other hand, I find the whole debate about death to be terribly dishonest and farcical. It's your right to "decline treatment" but not "kill yourself," and food counts as "treatment?" Come off it already. And this debate in the paper about whether starvation is a painless death? Get a grip. It's the only one that's legal. You want something you're sure won't cause suffering? Shoot her in the head at close range. That's pretty damn painless. Too barbaric? How about an overdose of something fun. An ecstasy/heroin cocktail? The opposite of suffering.

But we don't even want to talk about death, about the shot clock running down for all of us. So this becomes about refusal of treatment, and not about death. And there may be good reason for this. When I worked at a suicide hotline, the fact that suicide is technically illegal allowed me to call the police in cases where someone was threatening to kill themselves, or had already ingested an overdose. Since most suicide attempts are made during a temporary, extreme mental state brought on by an underlying mental health condition, in every case I remember the person involved was grateful afterward for being rescued. Death wasn't really what they wanted. And if we all had an unconditional "right to die," death is what they would have gotten.

On the other hand, should hopelessly terminally ill people be forced to keep living if they don't want to? If they are no longer able to do the things they valued in life? Why? And what about this "persistent vegetative state" thing? What is it? How is it different from being "brain dead?" Why hasn't anybody made a zombie movie spoof called "Brain Dead" yet? Or did I miss it?

I find myself completely unable to answer these questions. And if I can't answer them, then I'm pretty sure Tom DeLay can't answer them either. But at the very least, I thought it was good politics for Republicans.

Boy, was I wrong. At least if you believe the ABC News poll published on Monday. Seventy percent of those polled said that congressional intervention in the case is inappropriate, while 67 percent said they believe lawmakers became involved in the Schiavo case for political advantage rather than the principles involved. Furthermore:
Sixty-three percent of those surveyed in the ABC poll said they support the removal of Schiavo's feeding tube.

Among two core Republicans constituencies, 54 percent of conservatives said they support removal of the tube, while evangelical Protestants divide about evenly with 46 percent support.

According to the poll, conservatives and evangelicals also were more likely to support federal intervention in the case, although the support did not reach a majority in either group.

Whoops. Both on my part, and on the part of Republican strategists. We both seem to have underestimated the extent to which Americans just don't want the government to butt into their personal business, their family disputes, or their health care decisions (remember "Hillarycare?"). The public's reaction to all this can be summed up as "Don't Tread on Me."

Sometimes I love this country more than I can express in words. I haven't been this proud since reading Justice Kennedy's opinion throwing out sodomy laws, which also brought patriotic tears to my eyes.

Even some Republicans are starting to have doubts about the Schiavo situation. From today's Tribune:
Though some GOP strategists have argued that the issue is a political winner for the party because it appeals to religious conservatives, other Republicans warn that the bold maneuver risks alienating swing voters as well as Republicans worried about government invasions of individual privacy.

"It goes beyond shameless politics," said Tony Fabrizio, a Republican pollster. "It becomes a more crystallized proof point that we are no longer the party of smaller government. We have become a party of 'It doesn't matter what size government is as long as it is imposing our set of values.' "

Rep. Christopher Shays (R-Conn.), before voting against the bill Bush later signed, asked: "How deep is this Congress going to reach into the personal lives of each and every one of us?"

Still, some Republican analysts say the immediate poll results — and the concerns raised by Shays and others — are not politically significant because the activists pushing to keep Schiavo alive care more passionately than those opposing that view.

It's good to be wrong.

Just one other thought on the case, because I feel I haven't quite been controversial enough today. This case exists at all because of a dispute between Terri Shiavo's husband and her family of origin over what her wishes would have been. So if Terri were gay, there would never have been a case, because her partner would have no legal right in Florida to have a say in her treatment decisions. Chew on that one for a while.


stupidman101 said... you think that Terri's husband has a right to pull the plug or not? Where do we define "life"? Who has the right to controll "life"? Should the parents or husband have more controll?

stupidman101 said...

P.S. My URL--

Trope said...

Here I am, wading into legal issues I know very little about...

stupidman101--I'm hugely uncomfortable stating that either the parents or the husband in this case should have more control over the woman's life. If the Republican "con men" (as Frank puts it) were a little smarter, they'd frame the debate by saying that neither party should have power to refuse treatment on her behalf, since she didn't leave specific written instructions. The "small government" that Repubs claim to desire should not have the power to intervene and force anyone to withhold treatment against their will. Thus, she lives--albeit vegetatively. Instead, they're making this into a "pro-life" issue, and if we're not careful they will end up making policy that hinders those who are terminally ill and have very clearly stated their wish to die. Plus, the federal government is making a mockery of state judicial process in Florida, with the help of the Bush brothers. Nobody will win here.

Elwood Grobnik said...

Good question, stupidman101. And the answer is, I don't know. "Life" is easy to define, but "a life" is difficult. Life has been around for billions of years. In that time, all life has come from other life, either through sexual or asexual reproduction. In that time, nothing new that was not alive has become alive, to my knowledge. It's a continuous cyclical process. So, the existance of a discrete, individual life, my life, for example, is a human construction. That's why people can disagree about it so profoundly. There's no "truth" to find. It's a human-made line, like the border between Illinois and Indiana.

A similar question, more relevant to the Schiavo case I think, would be "What is 'Terri Schiavo?'" Asking whether she's "alive" is sort of silly. She's breathing, she has a pulse, she's not decomposing. She's alive. But is she still Terri? In other words, is anybody home? I don't know that. I don't know that much about her actual medical condition. And just as importantly, I'm not sure what makes somebody . . . somebody. There's a human body there, but is there a person? I suspect not, but I'm not sure.

If not, we seem to be wasting health care resources that could be spent on other needs, like glasses or immunizations for poor kids. But economics can be brutal. Would we argue that we should kill old people and the disabled because they're unproductive and are soaking up resources that would be more efficient if we invested them in children instead? Of course not. To advocate that would be the darkest evil. But the elderly and disabled are clearly people just like we are. Is Terri Schiavo? Or is she, in a word, a vegetable?

Like I said, I don't want to die. But if I'm already gone, what's the point in keeping my corpse all hale and hearty?

Trope said...

Mary Roach, in her book "Stiff," has the best exploration I've read on brain death vs. body death (the backdrop was a discussion on organ donation and "living corpses"). El, if you're interested in reading it, I'll work on getting the book back from Sarah.

Excellent post, by the way. Interesting, well-written, concise.

Wells said...

Go to One Good Move or the link from the Tally Ho for last nights Daily Show clip on Terri. All I have to say is save Terri! Sorry, my opinion is simple, the US government has no right to intervene. So health care for the 41 million Americans that don't have it is less important than one individual being kept alive on a feeding tube - according to the GOP led congress. I don't even want to talk about it. I just wanted to comment on the Tribune quotes. Keep in mind that Shays is one of the most vulnerable Republicans in the House - not terribly popular with the Hastert/Delay cabal or his district in CT. I always enjoyed listening to Tony Fabrizio. He is a Republican pollster to follow.

Stockton&Tweed said...

What is life?

Does it really matter what my or your answer to that question is?

The real question is: does a person have the right to determine that his or her life is no longer worth living, such that the power of the state can be used to enforce that determination?

- Tweed

Elwood Grobnik said...

Tweed, much to your annoyance and the annoyance of most civil libertarians I know, I'm going to have to answer - no. Suicide kills more people annually than murder does in this country, and my professional background is in combatting it. Most people try to kill themselves in a brief period of crisis, usually due to an ongoing mental health condition. If the person does not "succeed" at suicide, generally the crisis passes within hours or days and subsequently the individual is quite relieved not to be dead. Treating a symptom of mental illness as a rational decision someone has the "right" to make is nonsense.

The situation with terminally ill people is somewhat different (although honestly, we all have a "terminal" condition - life ends in death). Is shortening your life by two weeks morally or legally equivalent to shortening it by five years, or fifty? I really don't think so. And certainly you have the right to refuse treatment in cases where it will prolong life without fixing what's wrong with you. The touchy subject comes when we are talking about overdosing etc as opposed to simply refusing treatment. Right now the law is drawing a line there, which in practice is silly. Dead is dead is dead.

My questions regarding Terri Schiavo are two: Is she still a person at all, if her personality, thoughts and memories are gone? And if it's legal to pull her feeding tube and starve her to death, why isn't it legal to poison her with something pleasant like morphine, in case she can feel something after all?