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The
Consequences of Casual Conversations
Michael Schiavo's argument that his wife wants to die stems from an
off-hand remark she made while watching a movie. It isn't the first time
this has happened.
by Wesley J. Smith
10/27/2003 1:45:00 PM
ONE EVENING, during the second term of President Ronald Reagan, Terri
Schiavo and her husband Michael decided to watch a television movie about
Karen Ann Quinlan. Quinlan, as most readers know, had a tragic life. After
overdosing on a combination of drugs and alcohol, she fell into
unconsciousness and never awakened. Her parents won a lawsuit in the New
Jersey Supreme Court allowing them to disconnect her ventilator. Karen
didn't die immediately--she lived on for 10 more years before finally
expiring from pneumonia.
While discussing the movie, Michael claims that Terri stated she would not
want to live hooked up to a "machine" (she's not), or be a "burden" (her
parents don't consider her a burden and want to care for her). Michael's
brother, Scott, backs up his claim, while his sister-in-law, Joan, told the
court that Terri had approved of pulling the life support from the dying
baby of a mutual friend and said that if she ever wrote a "will" she would
say that she didn't want "tubes."
Little did Terri know that these purported statements, uttered under very
casual circumstances, would become the justification used by her husband in
his six-year drive to remove her feeding tube and end her life. Indeed,
based on these casual statements, Judge George Greer of the Sixth Judicial
Circuit in Clearwater, Florida ruled that Michael had established "by clear
and convincing evidence"--the highest evidentiary standard in civil
law--that Terri would rather dehydrate to death over a period of 10-14 days
than live on food and water supplied by a feeding tube.
THIS ASPECT of Terri's case deserves far more attention that it is
receiving. Most of us have undoubtedly made similar casual statements in
response to the death of a relative or the emotions generated by a movie.
But shouldn't much more be required to justify the intentional ending of a
human life? At the very least, shouldn't we demand a well thought out,
informed, and preferably written statement that not only indicates what is
desired, but also shows that reasonable alternatives have been fully
considered?
For example, if Terri did say she didn't want tubes, did she know that it
would include a feeding tube and that it could mean a dying process that
involved seizures, heaving, nose bleeding, cracked lips, parched tongue, and
the extremities becoming cold and mottled? If she did, would that have made
a difference to her? And would her opinion have changed if she knew that the
statements made to her husband and in-laws would be stretched by Judge Greer
to refuse her parents' reasonable request that before being dehydrated, she
be allowed access to rehabilitation that many medical experts believe might
permit her to be weaned from the feeding tube altogether?
And what does the statement, "I don't want tubes," mean anyway? Perhaps
Terri was thinking about the stark atmosphere of a neonatal intensive care
unit in which babies may be kept alive by battalions of beeping and buzzing
medical machines. But she isn't in that condition. Or, if she was thinking
of Karen Quinlan's circumstance, she might have conceived of herself
spending years on a respirator, which was the treatment at issue in her
case. But Terri isn't on a respirator. The only life support she needs is
food and water.
MANY DEHYDRATION CASES have involved such casual statements. The most
disturbing of these was that of Marjorie Nighbert, which, ironically, also
occurred in Florida. Marjorie was a successful Ohio businesswoman who was
visiting her family in Alabama when she was felled by a stroke that left her
disabled but not terminally ill. After being stabilized, she was moved to a
nursing home in Florida where, it was hoped, she could be rehabilitated to
relearn how to chew and swallow without danger of aspiration.
To ensure she was nourished, she was provided a feeding tube.
This presented an excruciating quandary for her brother Maynard, who had a
general power of attorney from Marjorie (not power of attorney for health
care), as a consequence of which he became her surrogate medical
decision-maker. Marjorie had once told her brother that she didn't want a
feeding tube if she were terminally ill. Despite the fact that she was not
dying, however, Maynard believed that if she were unable to be weaned off
the tube, she would have wanted to die rather than live using the tube for
nourishment. When she did not improve, he ordered the tube removed.
As she was slowly dehydrating to death, Marjorie began to ask the staff for
food and water. In response to her pleas, members of the nursing staff
surreptitiously gave her small amounts. One distraught staffer eventually
blew the whistle, leading to a state investigation and a temporary
restraining order requiring that Marjorie be nourished
Circuit Court Judge Jere Tolton received the case and appointed attorney
William F. Stone to represent Nighbert and to conduct a 24-hour inquiry, the
sole issue being whether Marjorie was competent to rescind her power of
attorney and make her own decisions. After the rushed investigation, Stone
was forced to report to the judge that she was not competent at that time.
She had, after all been intentionally malnourished for several weeks. Stone
particularly noted that he had been unable to determine whether she was
competent when the dehydration commenced.
With Stone's report in hand, the judge ruled that the dehydration should be
completed, apparently on the theory that Marjorie did not have the
competence to request the medical treatment of food and water. Before an
appalled Stone could appeal, Nighbert died on April 6, 1995.
Society's approach to the so-called "right to die" has become far too
casual. None of us should be made to die because of statements made in
casual conversations or due to misconstrued oral directives. The time has
come for the best legal minds in the country to draft model legislation that
will tighten existing laws so as to give every reasonable legal benefit of
the doubt to life rather than, as too often happens now, to slow death by
dehydration.
Author Wesley J. Smith is a senior fellow at the Discovery Institute and
an attorney and consultant for the International Task Force on Euthanasia
and Assisted Suicide. He is the author of "Forced Exit: The Slippery Slope
from Assisted Suicide to Legalized Murder."
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