Of Death and Life

I have been doing a great deal of thinking lately about Terri Schiavo, the Florida woman who for fifteen years has hovered somewhere between life and death in what is called a persistent vegetative state. Her body lives, her heart beats and her lungs breathe, but her brain is dead, asphyxiated by a 1990 heart attack that cut off the blood flow. After years of attempts at therapy and rehabilitation, it became painfully apparent that no recovery was possible. Since then, her husband Michael has fought tenaciously to remove her feeding tube and allow her to die, claiming she told him she would not want to live like this. Her parents, Bob and Mary Schindler, have fought just as tenaciously to keep her feeding tube in place, insisting that their daughter is still alive in there somewhere.

Her doctors beg to differ, pointing out that the part of her brain that made her an individual person, with loves and dreams, is not only dead but atrophied, replaced with spinal fluid. With the issue being fought in Florida state courts for years, judge after judge has consistently ruled that Terri is in a persistent vegetative state with no hope of improvement. With no medical evidence to the contrary nor proof of spousal abuse or neglect, Michael has the right to determine his wife’s medical treatment in accordance with Florida state law.

The dispute is loud and rancorous. The Schindlers accuse their son-in-law of wanting his wife out of the way so he can marry his girlfriend, and indeed recently filed divorce papers on her behalf. Michael in turn accuses his in-laws of ignoring their daughter’s wishes and refuses to divorce his wife, saying that doing so would be abandoning her to a fate worse than death.

The truly disgusting part of this whole sorry saga is how every sanctimonious holier-than-thou from Tallahassee to Washington is taking advantage of the family’s agony as an excuse to grandstand under the cover of keeping Terri alive. A House subcommittee even issued a subpoena to get her testimony on the issue. It just so happens that she cannot speak or even reliably respond to external stimuli, but that’s irrelevant. Florida state law puts the spouse in charge of medical decisions when the patient cannot make them for him or herself, but that’s irrelevant too. There are political points to be scored, and scored they must be, regardless of the consequences.

The absolute nadir of this political hijacking (so far) is a memo from a Republican apparatchik which can be described only as grotesque. Leaked over the weekend, the memo not only crows that “the pro-life base will be excited that the Senate is debating this important issue,” but actually salivates over the prospect of using the family’s torment as “a great political issue” to bludgeon Democrats in the next election.

Meanwhile, religious and “pro-life” groups around the nation have taken up the cause, circulating carefully selected four-year-old pictures of Terri seemingly responding to her mother. (Senate Majority Leader Bill Frist, who is a physician but not a neurologist, used these edited highlights to declare that she is not in fact in a vegetative state. Of course, if he were to issue an actual diagnosis based solely on watching a video clip, he would rightly lose his medical license.) The far more numerous and tragic images of her simply lying there insensate are ignored, as is her doctors’ nearly-unanimous diagnosis that no improvement is possible. Instead, such groups hurl the epithet of “Nazi” at Michael and his supporters, and claim that if Terri is allowed to die, anyone who is brain-damaged would be marked for death and should instead be kept artificially alive ad infinitum.

Putting aside the revolting and deliberately inflammatory comparison, consider for a moment what could happen if the laws envisioned by such people become reality. What if by some unimaginable tragedy your spouse or parent or child winds up in a hospital bed, just lying there, unresponsive to all entreaties of love or anguish? Let’s suppose you know that they would not have wanted to be kept alive in this way and would instead want to die with dignity and grace, but they never wrote it down in a living will.

And then someone you have never met and who doesn’t know your situation walks in and orders you to keep your loved one suspended in a permanent living death. Not a very pleasant scenario, is it?

(Fortunately, you can help prevent this from happening to you by filling out a living will, directing whether or not you want to be kept alive artificially. Living will forms for your state can be accessed for free at http://www.uslivingwillregistry.com/forms.shtm.)

Even more than the political and legal questions, this single-minded pursuit of keeping Terri alive leads one to ask: what does it mean for a human being to be alive? Does it mean only that the heart has to beat, the lungs have to breathe? Does it mean that the person has to be able to speak or respond to questions? Or is it something in between, or indeed totally different? And finally the biggest question of all: is it cruel to keep someone biologically alive long after all that made them a person has died?

Good men and women have been wrestling with these questions for a very long time, and I cannot pretend to have the answers. But I do know that everyone who has forced his or her way into this agonizing family decision, from politicos to pundits to simple pests, needs to bug off.

Terri Schaivo’s situation is a truly dreadful one, and there can be no winners, even if one side or the other eventually wins a definitive court judgment. But, sadly and reluctantly, I have to agree with her husband. After so many years in limbo, she deserves a dignified death, not the circus to which she has been subjected. Fifteen years is enough. It’s time to let her go.