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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. |