Thursday, March 24, 2005

And yet they call this Friday good

I haven't blogged in many days. I've been busy, of course, with the resumption of classes after our Spring Break. What spare attention I've had has been drawn to the case of Terri Schiavo, who will -- barring a miracle -- be dead a few days from now.

I understand about the terrible and tragic decisions we sometimes face at the end of life. Life often does not end neatly, or quickly, or easily. We use our medical skill to hold on to life, but sometimes we are left holding nothing but a few tattered fragments, just the ruins of a life really, held together for a little while by technology. When that happens, the right thing to do may be to open our hand and let those last pieces go.

I do know something about this. When my father died, it was like that. He heart stopped -- a stray blood clot, perhaps -- and it took too long for the ambulance to arrive. Though the paramedics were able to restart his heart, his tissues had by that time gone without oxygen for too many minutes. Over the next few days, it became apparent that his brain had largely died. His organs began to fail one by one. And so the family decided to turn off his life support and let the last embers of his life go out. This was, I think, the right thing to do.

Yet I think that the Schiavo case is different. I do not want to spend this whole post laying out the arguments for this position, since I have little to contribute to what others have done along that line. My own arguments would be based on doubt: the real doubt about the exact degree of Terri's brain damage; doubt about her treatment over the last many years; and doubt about the justice of taking Michael Schiavo as the sole spokesman for her interests.

There is also debate about Terri's previously stated wishes. As I understand it, a few people (including her husband) say that, while watching a TV movie about Karen Ann Quinlan, Terri said that she wouldn't want to live like that. Even if this is a perfectly accurate account -- and it did not come up until after Michael had won his million-dollar lawsuit to provide for Terri's long-term care -- the remark hardly seems like a considered and unambiguous instruction about her treatment in this situation. I had dinner once with Stephen Hawking. I wouldn't want to live like him. Who would? Yet I would try to do it, with some fraction of Hawking's humor and courage, if that lot befell me.

It might be that a more careful examination (which will not be allowed) would show that Terri's damage is as completely devastating as advertised. It might be that the choices made about Terri's care over the years (such as neglecting her teeth, or forbidding the nurses from turning on a TV in her room to give her stimulus, or deciding not to treat dangerous infections with antibiotics) were all reasonable. It might be that Michael Schiavo is the ideal guardian of Terri's interests (despite the appearance of possible conflict between those interests and his own). And it might be that Terri, if she had only thought of it, would have left careful instructions that she should be starved to death if she were ever in such a dismal state. All possible, I guess. So put these issues aside. These are not the things that make me heart-sick, anyway.

I am, first of all, upset and alarmed about the role of the judiciary in this. Even when the Congress, in a truly remarkable effort, passed a law instructing the federal court to hear de novo a petition on Terri's behalf, the judge managed to find a way to thumb his nose at the plain intent of the legislature. This amazing decision was upheld (though not unanimously) on appeal. There will be no de novo review, and no replacement of the feeding tube while it takes place. Whether or not the law Congress passed was wise and good -- and I do have a few worries about that, though the bill passed was admirably narrow -- the willingness of a federal judge to ignore its meaning is breathtaking. The judicial branch of our government is now out of effective control. (One of these days I will blog about this, which I take to be a central issue of our time. It is the other side of the coin of the increasing power of unaccountable multi-national bureaucracies like the EU. The will of the actual people, expressed in elected parliaments and popular law, must not be permitted to get in the way of human progress. We will be ruled by our betters, whether we will it or no.)

It also does seem to me that advocates for Terri's death are trying to have it both ways. They say that she is a vegetable, incapable of conscious experience of any sort. When you look at Terri, they say nobody is home. On the other hand, to cause her death is a merciful end to suffering. But either Terri has no more capacity for experience, in which case it does not matter whether the thing that she once was is kept alive or not, or else she does have the capacity for experience, in which case the years of neglect and the days of dying by starvation and thirst are very possibly torments. "Have pity on her. Let the poor thing die," they say. But if no one is home, why is she a more proper object of pity than, say, my car? Why not have pity on her parents, and let those poor people care for that empty husk of a human form?

In a similar way, the death advocates want me to accept Michael Schiavo as the sole legitimate spokesman for Terri's wishes and interests, because he is Terri's husband. But they do not want me to condemn Michael for living with another woman for the last decade and starting a new family with her. OK, fair enough. I do not really blame him, though it would seem to me to have been more honorable to divorce Terri first. But Michael has had to face years of terrible stuff, and I'm an understanding sort of person. Yet surely he can hardly claim the powers and priviliges of being Terri's husband, if he has in effect laid down that office in every way but name.

When people try to have it both ways in an argument, then the real basis for their position lies elsewhere. In this case, I think that many people -- including Judge Greer, the Florida judge who has had charge of the case -- simply believe that Terri ought to die, and Michael seems to be the one who is willing to do the right thing. So his authority cannot be called into question, or the parents' pleas entertained, or the essential facts examined afresh. This is, in other words, about euthanasia. It is a good thing for some suffering people to die.

Of course, they will try to argue that they are just respecting Terri's wishes, but once again the thinness of the evidence for those wishes does not match up against the implacability of the insistence that she die. When people insist so firmly on such weak evidence, their real principle lies elsewhere. Terri ought to die; but the unfortunate fact is that our society and legal system place a great weight on her expressed wishes on the matter. So we must fix on any scrap of evidence that she wanted to die, so that we can achieve the right outcome.

Anyway, the whole "right to die" argument seems profoundly wrong-headed to me. Suppose a friend of mine is very sad and unhappy with his life, and he announces his intention to commit suicide. Should I say, "I respect your choice, and if necessary I will help you"? I don't think such a response would be compassionate or rational.

Many people who face severe problems with their physical health also face severe depression. In other words, their present wishes are bent out of true shape. Now, an evil man (yes, I will call him that) like Jack Kevorkian can prey on this. Rather than try to treat the depression, as an ethical physician would, they exploit the patient's despair. Of course, it all masquerades as compassion and respect. The patient is suffering and wants to die. Why not let him choose to do so with "dignity"? So rather than try to ameliorate the suffering -- and we can do quite a lot of that these days, more than we sometimes do -- rather than helping the patient find a way to accept the care and compassion of others, we can just end the terrible problem in an afternoon. It is easier for them (because it is always easier to give into despair), and it is certainly a good deal less trouble and mess for us.

This is why doctors used to swear in the Hippocratic Oath that they would prescribe no deadly drug, even if a patient asked for it. A person's wish to destroy themselves is itself a sign of an illness of the soul, and it is a doctor's business to fight illness. (When the doctor and the illness are on the same side, the patient is in serious trouble. Hippocrates knew this. A surprising number of doctors remember this, even today.)

There is a terrible mystery here. We would like to think that there is a part of us that remains untouched, that can coolly make free and rational choices no matter what sickness afflicts us. But we know that this is a lie. The drug addict is not simply free to kick his habit. The suicidally depressed cancer patient cannot simply make a rational calculation about ending it all. Those of us who are Christians know about this from the teaching on Original Sin. The slave to sin (and we are all born so) is not simply free to stop sinning and henceforth lead a pure life. The effects of addiction and mental illness and sin are deep, deep. They corrupt the very means by which we think and feel and make decisions. Our wills can be in such bondage that we cannot by our own power even will to be free. Only grace can deliver us, and that must come from outside ourselves.

Early tomorrow morning I will be taking my turn at our church's prayer vigil for Good Friday. The timing is, in its horrible way, exquisite. I will pray for Terri Schiavo, and for the rest of us.

Addendum (Saturday, 26 March, 3:30 pm): This piece by Orson Scott Card pretty much speaks for me; read it.


Anonymous Ron said...

Having read your post and found it moving and thoughtful, I turned to Orson Scott Card's piece with some eagerness. After all, he's not just a good writer; he's a superb writer who has written some things that have moved me and stayed with me as no other.

Now, I'm not very good at critiquing a written argument while I'm reading it; I'm a very sympathetic reader. But Card's piece is just diatribe. I think the straw that finally broke my camel's back of willing acceptance was this statement about half way through:

"The people who love Terri Schiavo apparently do not include her husband, who seems awfully impatient to get rid of her."

Can he be serious? This just flies in the face of all facts. It should be a clue that his article is not what it seems. Then, the very next sentence:

"And under our bizarre laws, he has the only vote, and her parents and brothers and sisters are completely disregarded."

Those bizarre laws? Does he mean the laws that say:

"For this cause shall a man leave his father and mother, and shall be joined unto his wife, and they two shall be one flesh." (Ephesians 5:31)

referring to an older passage:

"Therefore shall a man leave his father and his mother, and shall cleave unto his wife: and they shall be one flesh." (Genesis 2:24)

I remember my marriage vows. It would be very easy to say that Michael Schiavo has not lived up to his in many ways, but does that mean that those vows--and the responsibilities inherent in them--are to be ignored? You can question Michael's judgment in this matter, but not his right.

This sort of thinking strikes daggers at the heart of Christian marriage. Get thee behind me, Orson.

4:07 PM  
Blogger Kerry said...

Hi Ben. Your phrase "There is a terrible mystery here" sounds strangely similar to Yeats' line from his poem, Easter 1916, "A terrible beauty is born"

9:26 AM  

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