Life Support and Terri Schiavo:
Is It Right
to Pull the Plug?
How valuable is a human life? The question on its face seems
absurd, but there are times when the various influences in our
society collide and force us to again reexamine the worth of an
individual. Bioethics issues are becoming more and more
controversial, as our technology outpaces our discernment. To make
matters worse, we have increasingly debated these issues in the
courts, making judges the ultimate authority on such problems.
Because these landmark cases will set a precedent to possibly affect
thousands of people, a proper understanding and handling of them
becomes paramount.
One such example that has recently received a lot of media
attention is the Terri Schiavo case. In 1990, Schiavo collapsed from
a heart attack that left her brain starved for oxygen. Severely
brain-damaged, she cannot move or communicate and requires a feeding
tube to receive nourishment and water.
Some doctors have classified Terri as being in a "persistent
vegetative state," which means she is awake but not conscious or
able to interact with her surroundings in any meaningful way -
basically just short of a coma. Because of this, Terri's husband has
sought to remove her feeding tube and let her die - claiming that
her quality of life is nonexistent.
However, Terri's parents and family hold that she smiles when her
mother enters the room, she follows a balloon with her eyes, and she
grimaces when a swab is inserted into her mouth. They say these are
clear-cut signs of Terri having awareness of her surroundings. Some
doctors agree, while others have classified these movements as
either random or reflex actions that don't prove consciousness (1).
In examining the Schiavo case, one sees quickly that much of the
debate hinges on Terri's ability to be aware of her surroundings.
The opinions are varied and sometimes heated. However, I believe
there are some basic principles that we can apply to this situation
to help in determining a proper course of action.
1. The Intrinsic Value of Life
Much of the media and popular discussion have used "quality of
life" arguments in making their case as to whether they feel Terri
should continue to be supported with a feeding tube or left to die.
I don't believe this is the proper starting point. The primary
principle in any discussion on human life is that human beings have
value in their very existence. Human beings have an intrinsic worth,
one that is above all material value.
Because human life is intrinsically valuable, it is paramount
that we are not too quick to deny life from anyone. Now, this does
not mean that there are no circumstances whereby we shouldn't allow
someone to die or that capital punishment is always wrong. But it
does mean that we cannot judge whether or not to allow a person to
die on the basis that much of his or her ability to experience life
in the same way as you or me has been lost. Just because a person
has a diminished capacity does not diminish that person's value as a
human being.
By reducing questions of life and death to whether an individual
has the "right kind" of experiences, we cheapen the idea of
humanity. In fact, this same argument was used early in the 20th
Century to mandate forced sterilizations of the mentally ill (2). It says a person who is disabled
is not as worthwhile a human being as one who is "fully functional".
If human life is intrinsically valuable, then these types of
arguments are flawed.
2. The Use of Life-Supporting Machines
A second issue that has arisen from the Schiavo case is the
proper use of artificial life-support systems in sustaining the
life. Schiavo's primary functions are operating perfectly with no
medical assistance. She can breathe, her heart can beat, and she
passes wastes. The only treatment under question is the provision of
food and water to her through a feeding tube inserted into her
stomach.
Michael Schiavo maintains his wife did not want to be kept alive
"on anything artificial."(3)
However, should the provision of food and water really be considered
supporting life by artificial means? We all need food and water;
they are considered basic necessities of life, not "heroic measures"
or "extraordinary means". Providing nourishment is normally
considered basic care.
Now, it's true that Terri is being fed through a tube and this
isn't "natural". However, many infants who are born with an
underdeveloped swallow reflex are also fed through a feeding tube,
and no one categorizes that as being kept alive artificially. The
question of whether Terri can swallow independently (or learn to
swallow) has never been answered, as her husband has not permitted
doctors to test this function. If food and water were provided by a
spoon and a straw instead of a tube, would the debate be
different?
I do acknowledge there may be certain situations where the
sustained use of a feeding tube would be considered unwarranted -
depending on the ultimate prognosis of the patient as well as the
family's capability to provide ongoing care for the individual, both
monetarily and emotionally. But I feel we must examine the question
of providing medically-assisted nutrition and hydration in a
separate category from life supporting technologies such as
respirators and we should be much more cautious to discontinue such
treatments since they are basic to us all.
3. Erring on the Side of Caution
Lastly in this debate, we come to the question of whether Terri
has any awareness of experience. A few doctors say she does; many
say she does not. They claim that although some of the videotaped
actions and expressions of Terri seem to be showing signs of
sentience, they are really reflexes. This may be so. However, I
think we err grievously when we approach situations where there is
some ambiguity and make definitive claims.
I believe that if we are to err, we need to err on the side of
caution. If the chances for recovery of an individual are
questionable or if their state of consciousness is debatable (and
that certainly seems to be the case here) then we are morally
obligated to do all we can to preserve the life of that individual.
This is consistent with the actions we expect in other facets of
life. Firefighters routinely risk their lives entering buildings
aflame to make sure that no one has been trapped inside. They do
this even when there have been no reports of individuals so caught.
We recognize that human life is of such worth that our civil
servants risk their own lives on the possibility that another life
may be in danger.
I believe we have similar circumstances here. If Terri Schiavo
retains some cognitive ability - if that possibility is a
possibility - then we as a society have a responsibility to protect
her life. To do any less would marginalize human life.
What are your thoughts on this case? Do you see any exceptions
here? Write us at newsletters@comereason.org
and let me know. Until next month, God bless. |
