EDITORIALS
By Dave Andrusko

The Essence of Civilization

"The handicapped have complained for years that they are not treated as whole people and that they don't receive the benefit of the law. The Schiavo case is exhibit A to that. We have starved a woman to death because she didn't measure up to somebody's subjective standard of perfection."

Attorney Ken Connor, who worked for Florida Gov. Jeb Bush to try to save Terri Schiavo

"Many across our state and around the world are deeply grieved by the way Terri died. I feel that grief very sharply as well. I remain convinced, however, that Terri's death is a window through which we can see the many issues left unresolved in our families and in our society. For that, we can be thankful for all that the life of Terri Schiavo has taught us."

Gov. Jeb Bush

"The essence of civilization is that the strong have a duty to protect the weak. In cases where there are serious doubts and questions, the presumption should be in favor of life.''

President George W. Bush

When we attend the theater, it is part of the tacit bargain we strike to suspend disbelief, to pocket our critical faculties to enjoy a production that would otherwise strain credulity. And while no theater buff, I've never had a problem accepting that a makeshift stage is the deck of a mighty ocean liner or the courtyard of an Austrian abbey.

But it's quite another thing to agree to put my brain and my heart on hold while a defenseless woman dies an unimaginably barbaric death. To do that would not be like shelling out $8 at my local cineplex but more akin to accepting money - - about 30 pieces of silver.

When I was in college I took a course in the history of American Puritanism. The lesson that sticks in my mind almost forty years later is Professor Putnam's explanation of why the Puritans banned bear-baiting. It had less to do with the fate of the animals, as I recall he said, than it did a sober realization of the price the Puritans would pay for such wanton acts of cruelty - - what we call in today's parlance desensitization.

Terri was not an animal, although the rhetoric that floated around often treated her as if she were sub-human. Profound brain injuries made her no less one of us - - a fellow member of the human community - - who was loved with heroic faithfulness by her blood family. Terri, alas, paid the ultimate price for making a terrible mistake in choosing a spouse.

I will spend only a few paragraphs talking about the media coverage of the battle her parents and her siblings waged with her estranged husband, Michael Schiavo. You know the general contours as well as I do, maybe better.

At one level, the most obvious dilemma Bob and Mary Schindler faced was two sides of the same coin: trying to make the media unlearn the lessons it absorbed early on and convincing them to treat evenhandedly the evidence brought forth by the two sides.

For example, with exceptions, the media accepted as if carved in stone the conclusion that Terri was in a "persistent vegetative state" (PVS). But that diagnosis was never as black and white as George Felos, Michael Schiavo's attorney, and George Greer, the trial judge, would have you believe.

An op-ed by James Smith, Jr., executive editor of the Florida Baptist Witness, appeared the week Terri died. It illuminated the double standard brilliantly. Near the end of Terri's life, an eminent Florida neurologist was called in by the Department of Children and Families. In his affidavit, Dr. William P. Cheshire concluded Terri was likely not in a PVS but rather was "minimally conscious."

Felos and the usual pro-death bioethics witnesses sneered at and derided Cheshire, "aided," Smith writes, "by his opponents in the medical community, [who] began the assault on Cheshire's credibility because he was an evangelical Christian, suggesting his professional judgment was questionable."

The same sort of dismissive back-of-the-hand awaited neurologist Dr. William Hammesfahr, who was very optimistic about what could be done for Terri if she were given active and systematic therapy. Dismissed as another quack.

The star witness for Michael Schiavo, Dr. Ronald Cranford, has made a career out of traveling from one "right to die" case to another. In virtually all cases, he finds the patient to be in a PVS. The treatment? Withdrawing food and fluids. He has suggested more than once that feeding patients with advanced Alzheimer's "borders on barbaric and cruel," as he wrote in an opinion piece for the Minneapolis Star-Tribune.

Cranford examined Terri once, for 45 minutes. Hammesfahr examined Terri on three occasions, for a total of ten hours. But Cranford is the "expert," whose hastily-arrived-at judgments are given all the more deference because he can make 'em so quick.

Likewise, Felos, a character if ever there was one, was given a free pass. As Smith tells us, in his 2002 book Litigation as Spiritual Practice, "Felos writes about a 'soul-speak' conversation with a comatose woman and a talk with his yet-to-be-conceived unborn son."

We could go on at length about the other major issue: Terri's alleged wish not to live "artificially." But it boils down to this.

The only three people who said Terri spoke that way were Michael Schiavo, his brother, and his brother's wife. That allegation did not surface until after the Schiavos won a medical malpractice suit of over $1 million. Friends who had known Terri for years testified to the contrary. Greer uniformly dismissed their testimony with extreme prejudice.

Terri by no means met the Florida criteria for PVS, nor was there "clear and convincing evidence" that she would rather have been starved and dehydrated to death. It is scandalous that she was put to death on such flimsy "evidence."

The myth-making endured to the bitter end. A round of polls, some more loaded than others, were cited as proof that the American people were angry at Congress for passing a federal "Terri's law" that gave her parents a chance to vindicate her constitutional rights in federal court.

As so often is the case, the truth emerged when the questions were asked in context and straight-forwardly.

For example, in a poll first reported on Fox News, Zogby asked, "If a disabled person is not terminally ill, not in a coma, and not being kept alive on life support, and they have no written directive, should or should they not be denied food and water?" This is exactly Terri's situation.

I remember snapping to attention when the numbers flashed on the screen: 79% said the patient should not have food and water taken away. Only 9% said they should!

Zogby also asked, "When there is conflicting evidence on whether or not a patient would want to be on a feeding tube, should elected officials order that a feeding tube be removed or should they order that it remain in place?" Less than one in five (18%) said remove the feeding tube, while 42% said the tube should remain in place.

Equally intriguing as we consider the fate of other vulnerable people is the issue of what we should presume when information is lacking. Zogby asked what if a person becomes incapacitated and has not expressed what his or her preference is for medical treatment.

We learn that 43% said "the law [should] presume that the person wants to live, even if the person is receiving food and water through a tube." Just 30% disagreed with that life-affirming presumption.

Terri died a ghastly death by dehydration, a fate, literally, we would not inflict on a dog. But we know the family is drawing strength from its strong faith. And I suspect a secondary source of succor will be that because there was so much so wrong so regularly about the process that culminated in Terri's death, there will be reforms.

Custody: When the husband starts a new life with another woman by whom he fathers two children, how can anyone conclude he is the best judge of his injured wife's best interests? Why weren't her parents allowed to take Terri home and care for her? To give a spouse absolute unchecked sway in such circumstances is preposterous.

Access to the federal courts: Surely if mass murderers on death row are allowed to appeal to federal courts, why not someone like Terri whose family completely disagreed with her husband over what her treatment wishes were? And not just a rehash of what (usually) one judge found, but a more systematic look to see if a patient's rights under the Constitution are being abridged.

Legislative protection: No one would mistake Rep. Barney Frank (D-Mass.) for a right to lifer. Frank managed the floor debate for the opponents of the federal Terri's law and insisted, "Procedurally, there was a great deal of due process" in the courts.

However, "he did not rule out the possibility that Congress could examine whether states were upholding civil rights," according to the New York Times. "'Have the states failed in their responsibilities in any way comparable to the way they failed in the civil rights era?' he asked. 'If they have, what are the remedies?'"

And, finally, there is the issue that pro-death proponents thought had been permanently put to rest: making the use of feeding tubes optional by defining them as "medical treatment." Even if we persuade ourselves that a few feet of plastic tube is "treatment," oughtn't we demand that if they are to be withdrawn, resulting in a death by dehydration and starvation, it is only when the patient has a paper trail demonstrating that IS what she or he would want?

(Please see pages 25 through 29 for a description of NRLC's "Will to Live." This legal document will make it clear what medical treatment you would want if you can no longer speak for yourself.)

There is a movement afoot, a backlash to injustice and intolerance toward the less-than-perfect. Terri, horribly victimized, is the face of that cruelty played out in real time.

This reform movement brings together a broad coalition whose membership ranges from the very conservative to the very liberal, from the aggressively agnostic to the deeply devout, and everyone in between. By my way of reckoning, it will be formidable force when, as happened, Jesse Jackson and Sean Hannity could find common cause in standing up for this helpless woman.

For all that, the battle will by no means be easy. There is a widespread death constituency within the bioethics community and they will do everything they can to hold back a reexamination of the slope down which we have slipped.

R. Alta Charo is a professor of law and bioethics at the University of Wisconsin. "If you go back to [the 1990 Supreme Court case of Nancy] Cruzan, the presumption was in favor of extending biological life," she told the Times. "Over the last 30 years, the presumption has slowly shifted toward allowing people to die. What we are seeing [in the response to Terri's death] is the counterinsurgency." (My emphasis.)

And there are many Democrats, alas, who will oppose anything that President Bush supports. Moreover, to be fair, there are some who genuinely, if mistakenly, believe this is a "private" matter that shouldn't be addressed legislatively.

But Terri's ordeal has sparked a new conversation about what legal protections ought to be extended to absolutely vulnerable people whose lives are now being taken with nary a voice raised in their defense.

It is a long overdue conversation, and one to which millions of people, just like the readers of National Right to Life News, will be a party.

God bless Terri. God bless her parents, her brother, and her sister. Their courage and faithfulness will never be forgotten. Nor, under any circumstances, will Terri.