Excellent Schiavo Post
Samizdata.net, a libertarian group blog, has an excellent post by Robert Clayton Dean from Texas about the Schiavo case. Since BJU students cannot access Samizdata.net (”Free web hosting” again), I’ve decided to copy his post in its entirety:
Various precincts of the US body politic are obsessed with Terri Schiavo, a young woman who has been at the center of an ongoing familial, legal, and now, sadly, political dogfight.
In very broad terms, Terri Schiavo is unable to make decisions for herself. She is apparently brain damaged, and has been in some degree of coma or “persistent vegetative state” for years. Her husband wants to withdraw artificial life support and let nature take its course. Her parents want her kept on life support indefinitely in the hopes that some day she will make some degree of recovery. As ever, you can find a medical expert to present just about any side of this that you want. This situation is, sadly, all too common.
The uproar around Terri Schiavo illustrates rather nicely the key distinction between libertarians and, well, everyone else. For libertarians, the critical question is “who decides?”, based on their belief that you should be able to make your own decisions in life. Most other folks, it seems, don’t care “who decides” nearly as much as they care about “what decision is made,” and particularly, “whatever decision is made, it —- will better be one I approve of.”
In Terri’s case, this means that all sorts of folks who you think would know better than to invite the state to participate in medical decision-making are doing exactly that, because Terri’s husband has made a decision that they do not approve of.
So, not only have we been treated the spectacle of the Governor of Florida, Jeb Bush, trying to elbow his way to Terri’s bedside so he can dictate what care she will receive, we also have various Florida legislators trying to insert the State of Florida into the mix. Now the US Congress, apparently not satisfied with embarrassing itself* in its ongoing investigation into steroid use in major league baseball, is preparing to abuse its subpoena power to block the decision made by Terri’s husband.
A fundamental principle of health care law, and one dear to the hearts of libertarians, is that you must give informed consent to any treatment before it is administered to you (with an exception in cases of emergency when you are unable to communicate, in which case the caregivers are allowed to assume you want life-saving treatment). A doctor who treats you without your consent has committed assault and battery. It is your right to refuse any treatment at all, even if it will mean your death, and so long as you are a competent adult no court or legislature can intervene to force treatment on you.
When the patient is not a decisional adult, someone who will make decisions on their behalf must be located. You can appoint your own surrogate decision-maker, via a health care power of attorney (which I strongly recommend). Some states have lists of “deemed” surrogate decision-makers on the statute books, such as spouses, parents, siblings, etc., in rank order so everyone knows who has authority in a given case. As a last resort, a court will appoint a guardian.
The whole process is focused on the proper issue of identifying “who will decide.” Once the decision-maker is identified/appointed, they stand in the shoes of the patient. The state retains (or should retain) only the most limited role, to ensure that the decision-maker does not abuse their power. Clearly, the decision to withdraw life support is a decision that Terri Schiavo could make for herself. Indeed, my wife has told me that if she were in Terri’s position, that is exactly what she would want. Her husband’s decision to make it in her stead is by no means an abuse of his power as her surrogate decision-maker - such decisions are made routinely, every single day, across the country by people charged with the heavy burden of making health care decisions for someone else.
What we have in the Schaivo case, then, is the legally appointed and recognized decision-maker making a choice that is well within his purview. Multiple court reviews have concluded that he is the right person to make the call, and his decision should be honored. To this libertarian, that is the end of the matter, because the very essence of being a libertarian is respecting the decisions of others even when you might decide otherwise. To a broad spectrum of conservatives, however, the fact that medical decision-making should be private is of no concern when the decisions made are decisions they disagree with.
*While at the gym yesterday, I caught a few minutes of the steroid hearings. It was painfully embarassing to see the solons of American governance earnestly seeking noted idiot Jose Canseco’s advice on public policy. A quick survey of the fellows in the locker room revealed that this latest Congressional exercise in nannying competent adults and chasing headlines is not being well-received by the public. The universal sentiment was, “Don’t they have anything better to do?”
March 20th, 2005 at 12:43 pm
But again, no one knows what Terri’s situation is. She is alive, and just needing nutrition, like small children and elderly. She is not on a ventilator or a respirator or life support. She’s not being allowed to die peacefully, she is being starved to death like a communist inmate.
March 20th, 2005 at 1:05 pm
That’s interesting; you say “no one knows what Terri’s situation is,” and then you proceed to describe what her situation is.
And then you use the term “communist inmate,” which comes pretty close to invoking Godwin’s Law. (If you had said “Nazi” instead of “Communist,” it would have been a proper invokation.)
And how, exactly, is a feeding tube so different from a respirator. One gets food to people who can’t swallow, and the other gets food to people who can’t breathe. It’s the same thing.
This all misses the entire point of the post I quoted, which I advise you go and re-read:
This is Michael Schiavo’s decision to make. Not yours or mine or Terri’s parents’. The courts have consistently come down on Michael’s side over the past several years. If you disagree with his choice regarding his wife’s, that’s OK. But you don’t get to make the decision for her.
March 20th, 2005 at 3:12 pm
It is not Michael Schiavo’s decison to make to deny her feeding. A person’s life is at stake here. If her heart were pumping but she had no brain activity and no hope of recovering any, that would be a different thing. But she has attained a measure of recovery and responsiveness. To deny her feedling now would be to take her life.
I’s suggest reading the “myths about Terri” link on the terrisfight.org web site mentioned on another post.
Also in the book I mentioned elsewhere, When Is It Right To Die? by Joni Eareckson Tada, she discusses the difference between sustaining life and prolonging death
March 20th, 2005 at 3:50 pm
Um… I think something happened to part of your comment; did the end of it get cut off somehow?
But, yes, it is absolutely Michael Schiavo’s decision. In the absence of a living will, an incapacitated person’s closest relative gets to make medical decisions on his or her behalf. Terri’s closest relative is her husband Michael; ergo, Michael gets to make those decisions.
March 20th, 2005 at 5:03 pm
Medical decisions, yes. Ending her life, no, not at this stage. If she were basically dead and hooked up to machines, yes. But she’s not “basically dead” — she’s responsive and aware.
I read somewhere that he had “started another family.” If that’s the case, then his opinion doesn’t matter any more, anyway.
March 20th, 2005 at 10:36 pm
Blog Jones,
You’re right that ordinarily the husband would have the legal right to decide what to do with his wife, but considering the cloud surrounding his culpability/innocence, I think there are good reasons (moral if not legal) not to let him kill her off so fast. Whatever her exact condition, we do know that a lot of people have serious questions about the whole business. Why not allow those who want to, preserve her life until some of these questions can be answered? What good reason could the husband have for wanting her dead now, when her case has attracted so much attention? If he’s waited years, he can wait a few more weeks. His refusal to accept the million bucks proves nothing other than he’s not a complete fool.
March 21st, 2005 at 12:02 am
Go to drudgereport.com and listen to the audio of Terry responding.
March 21st, 2005 at 12:27 am
Barbara: Whether or not he “started another family” does not change his legal position as her husband and legal guardian.
Austin: No court has found Michael Schiavo guilty of any wrongdoing. The accusations of Terri’s desperate parents are illegitimate as evidence against him.
Besides, I would think that if Michael had actually committed any wrongdoing, it would have come before a court by now. The parents have only had 14 or 15 years to dredge up whatever they could about him. The fact that all we have is some amorphous “cloud” of doubt instead of actual hard evidence indicates to me that there was never any wrongdoing in the first place.
Why does the husband “want her dead”? The phrasing of that is interesting. It makes Michael look like some sort of deranged figure gleefully anticipating his wife’s death, a caricature that is wholly unwarranted as far as I can tell.
To answer the question: I’m sure that, given the option, Michael would rather have Terri alive and whole again; that’s never going to happen. Ever. There’s a huge hole in her brain where her cerebral cortex has been replaced with spinal fluid. Her higher brain functions are gone forever.
So, because A) She isn’t coming back and B) Michael believes that his wife would not want to be kept alive this way, he has sought after ending her life mercifully instead of prolonging it by artificial means.
Again, the courts have consistently come down on Michael’s side over the past several years. Legally, this is a no-brainer, no pun intended.
It’s time to let her go.
March 21st, 2005 at 9:00 am
I would agree that it is his decision if she were brain dead, if she had not regained consciousness in all these years and were not responsive. She is conscious and responsive. Part (most?) of her brain is functioning. She is severely disabled, not brain dead. That is the difference. Just as a parent is the decision maker over a child’s care, but should not have the right to abort them, or, if they are born severely disabled, let them starve.
March 21st, 2005 at 11:25 am
I voiced my wishes on this subject to my husband years ago. I would not want to live this way. It is NOT in writing but I would hope my husband would fight the Republicans “NO SPOUSAL RIGHTS” bill and support what MY wishes were.
March 21st, 2005 at 1:28 pm
I think it would probably be best to get it in writing to avoid arguments and legalities. From the viewpoint of the hospital adminstration, anyone can say, “She told me she wanted this,” but they don’t have any proof of that.
Mu husband and I haven’t really talked about it. I’d be part put to say what my wishes would be, because there are no real clear dividing lines. It seems like a case by case situation. When my dad had a stroke, my almost-sister-in-law did not want him put on a ventilator. But, thankfully, she wasn’t the one in charge. He was only on a vent 10 days. He got out of the hospital and lived 6 more months. That might not seem like a lot, but God did a lot in that 6 months. He and my brother reconciled and he lived with my brother those last months, happily, though he was in a wheelchair. So I’d never say, “No machines or artificial life support.” It would just depend. And I don’t think I’d ever say, “No feeding tube.” That is sentencing someone to starve and in my book ranks just barely below taking active measures to kill them.
March 21st, 2005 at 7:18 pm
Actually, what I asked was, what good reason could he have for “wanting her dead now.” I think you’re reading too much into my question: I don’t think of him as a “deranged figure.” But the point’s the same: why rush her death now, instead of letting the storm blow over? Your answer seems to be:
You may be right about A. If he’s waited years, how will a few more weeks affect B? Assuming he’s innocent and she’s truly brain dead, a few weeks will let all the activists run out of steam. But starving her now can’t help him, as far as I can tell. And assuming the above, it won’t matter to Terry either, because she’s already “gone.”
March 21st, 2005 at 9:52 pm
Austin: Oh, my bad. That makes sense.
At this point I’m starting to think Instapundit’s position is best:
March 22nd, 2005 at 11:06 am
It is none of my business in the sense that:
I am not a resident of Florida and have no vote on that states “right to die” policies.
It is my business in that:
Morally, I think it’s wrong to starve anyone to death. It’s murder.
Yes, her husband has the right to end life support. But not to starve her. You’d die if we stopped feeding you too. Does that mean we have the right to let you starve?
I believe that even brain damaged people have a right to live. God gave them a life, what right do we have to take it from them? You have no idea if and what they will recover, or even what is going on in their minds. You also have no idea of the influence that has on people around them. People grow through suffering, their own or that of their loved ones. That doesn’t mean we seek it, but we take it when it comes. If we start picking off the mentally disabled, how far behind are the blind or lame or terminally ill (such as AIDS patients who are ill but mentally fine)?
There is a certain extent to which each person has a right to a choice. But there are choices that have consequences. You choose to kill someone else, you must pay the penatly for it. And those that stand by and let such things happen, because ‘hey, it was his choice, are just as guilty.
March 23rd, 2005 at 9:19 pm
1) Doctors have come forward that the diagnosis is faulty
2) Never did she say in writing that she wanted to starve herself
3) Supposedly she told her husband once something.
4) She has not received the best care, and her trust fund has been mismanaged.
March 24th, 2005 at 12:49 pm
Excellent, rational post by Robert Clayton Dean. It appears that many people wanting to keep Terri alive understand neither the law nor the science involved. Unfortunately, Terri is not in a coma, she’s in a persistent vegetative state. You can always find a doctor who will say otherwise, say anything, but that doesn’t make it so. Terri isn’t being “killed” or “starved to death” because Terri isn’t there. I feel very sorry for Terri’s parents and the grief they’re feeling. If the chose to understood the true condition their daughter is in (as he husband has) they’d much better be able to cope with their grief and move on.
March 25th, 2005 at 10:12 am
Bob: How do you define when a person “isn’t there”?
I was just asking to make sure I understand what you’re basing your statement on.
I’m not basing mine on what the doctors said, but what I have seen of her. Her own brain is controlling her own body, and she responds to people. From my experience that means she is still there.
March 26th, 2005 at 2:19 am
I’m sorry momtoast, but as many many doctors have explained by now, and as all the judges who have reviewed the case seem to understand, she does not “respond to people.” Her body may react to various stimuli from time to time, but one need not have a mind in order for that to happen. In fact, if you like, plants “respond” to the light by turning themselves toward the sun. That doesn’t mean a plant can think or that it has a soul. I know that example may sound disturbing, but it is not an inaccurate comparison.
I would really encourage you to read up extensively on the science behind the persistant vegetative state diagnosis. It is not the same as a coma. Part of her brain is controlling her body, you’re right. But the part of her body which controls cognition (conscious thought) is apparently dead. The brain is a very complicated organ and different parts of it are used for differ things.
May Terri finally rest in peace.