Friday, April 01, 2005

Call It A Gnawing Sensation

Nothing has rocked the boat lately like thinking about the Terry Schiavo case. I go back and forth, as I hear the next ethicist or doctor or pastor weigh in. Was it murder? Well, maybe not: consider that if the parents had come to the same conclusion (she wanted no tubes) as the husband, it would not be - or at least we would not be having this dialog. Or consider Kenneth Prager, a doctor and medical ethicist (and radio talk-show host Dennis Prager's brother), no "pro-choice" euthanasiast this man. On Hugh Hewitt's radio show yesterday he commented that if the scan he had looked at was actually that of Terry Schiavo (as it was told him it was) then there was no way she had any ability to sense hunger or thirst, or know what was going on - so bad was the deterioration of the cortex.

Then there's the larger "culture of life vs. culture of death" argument, which is very persuasive. It's hard to argue that we have not become desensitized to removing unwanted people, unborn or infirm. Richard John Neuhaus, cardinal and prolific essayist, was also on Hewitt's radio show yesterday, and he spoke plainly and convincingly that as a culture we place lamentably little value on human life that does not fit our ideal.

Well anyway, everyday some new slant on the case that gives me pause. But all along something has been gnawing at me. Like millions of others, the entire affair has caused me to reflect on my own Health Care Directive and Power of Attorney for Health Care decisions. I have these documents in place - fine. I checked the box that instructs my attorney-in-fact to pull the tube if I am diagnosed as terminal. Again, fine; or is it? Reflection, spurred by the Schiavo case, has me wondering about my decision: it was made in the comfort of an office chair, with a cursory calculation of the (long) odds that the terminal condition could be my own. As it happens, it looks as if it was a tad rash, maybe even just a knee-jerk predilection to be valiant when it's so easy - i.e., when the consequences of the decision are taken to be without cost.

So as this idea of easy gallantry - gutsy (pardon the pun), and surely popular - looks the more like it was at least a part of my decision "process" (in quotes because in hindsight it doesn't look like it was much of a process at all) on the Directive, there appears a fine piece by one of my favorite writers, on just this thing. James Bowman's piece is food for thought, and will hopefully have people asking themselves some probing questions.
My guess is that you would get a very similar number of people answering "yes" to some such question as: "If you were seriously injured to the point where you lost brain function and were reduced to the condition of a vegetable" -- the English, for some reason, colloquially insist on specifying the vegetable as a cabbage -- "would you want your loved ones to 'pull the plug' and allow you to die?" Now that's not what was happening in the Schiavo case, of course, but there may be another reason for people to pretend it was than mere eagerness to let her husband "get on with his life." For one thing, it's easy to answer yes. Not only are you not in such a lamentable state when you answer, but it's very hard to imagine that you ever will be. Nor is anyone ever going to be in a position to accuse you of inconsistency if, should the hypothetical become real, you should change your mind. Either you would no longer have a mind to change, or you would be, like poor Terri, unable to signify that you had changed it.

Yet it is the culturally acceptable answer. It is thought to be both courageous and tough minded to regard life without -- fill in the appropriate mental or bodily function here -- as being not worth living.

There you have it; that's what was gnawing at me. Thank you James Bowman.
Comments:
The "attorney-in-fact" for any of us becomes the person who ultimately has control over the issues of our life and/or death in the case of our incapacitation. The question of "who will take care of me?" becomes a much more critical question than "what do I want in such-and-such a case?" As was so morbidly clear in Terri's case, the "who" far outweighed the "what". This question of "who?" can be even more unsettling than "what", because it implies a deep trust and shared value system with others, not merely a deeper reflection within ourselves of our wishes. The miriad of possibilites regarding our health cannot alwlays be addressed in a pre-planned legal document especially in light of medical advancements. Having to depend on someone else to make decisions for us when we are incapable of making our own is not even thinkable for many, so we go on discussing legal documents, how they should be worded and what should be signed. Important as these documents are, had the "who?" in Terri's case been her parents, she would still be here to laugh at the music that brought her joy...
 
The "attorney-in-fact" for any of us becomes the person who ultimately has control over the issues of our life and/or death in the case of our incapacitation. The question of "who will take care of me?" becomes a much more critical question than "what do I want in such-and-such a case?" As was so morbidly clear in Terri's case, the "who?" far outweighed the "what?". This question of "who?" can be even more unsettling than "what?", because it implies a measure of trust and a shared value system with others, not merely a deeper reflection within ourselves of our wishes. The miriad of possibilites regarding our health cannot always be addressed in a pre-planned legal document, especially in light of medical advancements. Having to depend on someone else to make decisions for us when we are incapable of making our own is not even thinkable for many, so we go on discussing legal documents, how they should be worded and what should be signed. Important as these documents are, had the "who?" in Terri's case been her parents, she would still be here to laugh at the music that brought her such joy...
 
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