I have been reading stories about the oral arguments in the Supreme Court yesterday in Gonzales v. Oregon. It is often said that predictions cannot be made based on oral arguments. Bunk. In every appellate case in which I have been involved or observed, it was easy to discern at least the general state of play. And from what I have read, it looks like a closely divided court. Indeed, the swing vote may be Justice O’Conner or her replacement.
Justice Ginsberg’s response to the truth that non controlled substances could be used in assisted suicide thereby permitting Oregon’s law to continue on got me thinking about something. She responded that these other methods might not be so gentle. Whether true or untrue, that becomes a policy decision, not a judicial one.
Ginsberg is an elite member of the elite, as are most members of the Supreme Court and the federal judiciary. This is why, particularly with social or cultural issues, the courts so often reflect the cultural values of the upper strata. (Again, this is a general statement, not an all-inclusive one).
Assisted suicide is a policy of privilege. Contemporary proponents are relatively few, but very committed. They tend to be upper middle class or higher–often women. Barbara Coombs Lee, a former managed care vice president wrote the Oregon law. Kathryn Tucker, the attorney for the gooey euphemistic euthanasia group Choices and Compassion (formerly Hemlock Society), is an attorney for an elite corporate firm. Betty Rollins, the television journalist, has for years pushed assisted suicide after helping kill her mother and she is part of the Manhattan ruling class. Dr. Timothy Quill, qualifies. They also are almost always white and have social structures in place so they can be sure they will not be pushed out of the lifeboat. (The prime exception is Jack Kevorkian, who while non elite, was embrace wholeheartedly by the elites. For example, he was feted at Time magazine’s 75th anniversary where Tom Cruise rushed up to shake his hand.)
Opponents, with some exceptions, are not elitists. Disability rights advocates, are prime examples. They understand that gaining access to quality health care is the real challenge for many Americans and that assisted suicide targets the disabled. Pro lifers are hated by the elites. The Catholic Church, while certainly wealthy, is under constant attack by the cultural elites, particularly in the media. Advocates for the poor who see a great threat to indigent, uninsured patients if we transform killing into a medical treatment are not part of the ruling class. Civil rights advocates, such as LULAC, the largest Latino civil rights organization in the country advocate for farm workers and others and oppose assisted suicide.
I believe under the law, the U.S. Government should win this case. But assisted suicide litigation has always been steeped in the politics of privilege, leading to some overtly political results. So, I am taking no bets.
With all due respect to the sensibilities of pro-lifers, the question of whether or not Physician Assisted Suicide is right or wrong is not the central question of this case. PAS is clearly, in my opinion, wrong. Absolutely wrong. Indefensible even.
However, if it is wrong – what is the underlying crime committed? Helping people kill themselves is assisting murder. There is no federal statute against murder. That is a state crime. Oregon has duly enacted a law, which I believe to be totally wrong, but which is clearly the province of that state to exempt certain actions from prosecution. The onus is on the good people of Oregon to do something about it.
The Federal government’s attempt to make PAS illegal through substance control laws, who are themselves Constitutionally suspect, is simply an unwarranted interference in the rights of a sovereign state. We had a discussion over conservative judicial activism, and whether or not such a thing was possible. I think that it is possible, especially in a case like this. The liberals on the court may be tempted to uphold this federal meddling because it will increase the power of the Federal government. This is a liberal aim – stripping power from the states. The conservatives on the court will be tempted to uphold this federal meddling on the basis that this usurpation of Oregon’s sovereign power is being done for a ‘just cause.’
This is the broad way that leads to even more perdition. Oregon legislators made a terrible mistake. Oregon voters should force them to clean it up.
Glen writes: “Helping people kill themselves is assisting murder.”
Not quite following this. The role of the physicians is first, to ascertain whether the person qualifies for PAS, and second, to write the relevant prescriptions. The physician is not required to be present, nor to assist the person in any other way. In many cases, the patient obtains the lethal prescription but chooses not to take it. The physician has no prior knowledge of whether a patient will or will not take it.
Glen: “This is the broad way that leads to even more perdition.”
Of the tens of thousands of people who have died in Oregon since the inception of the program, only 208 have ended their lives through PAS. There were dire predictions beforehand, none of which have come to pass. A typical PAS patient is a college educated white male with health insurance, dying of cancer. Most patients are already in hospice programs. Oregon didn’t turn into the west coast Auschwitz. The program is utilized by a very few, terminally ill patients. There have even been a number of good effects, including better care for dying patients, more hospice referrals, more attention to adequate pain management.
Glen: “Oregon legislators made a terrible mistake. Oregon voters should force them to clean it up.
The people voted for it twice, the first time by a small majority in the context of an initiative petition, the second time with about 60 percent approval as a legislative ballot measure. They had to vote a second time because Oregon legislators put the issue on the ballot a second time, apparently not trusting the people’s judgement the first time around.
Glen: “PAS is clearly, in my opinion, wrong. Absolutely wrong. Indefensible even.”
Indefensible in what sense? Sixty percent of voters in Oreogon voted for it — twice — even with well-funded negative campaigns. The program has worked exactly as predicted. I think at this point the main problem for opponents is that the sky didn’t fall.
One important, though unmeasurable, effect is that many terminally ill patients just feel better about having the program around even if they never use it. In other words, they probably won’t be interested in it, but it’s there if they need it.
Another unmeasurable effect is that it is likely that PAS actually extends the lives of many terminally ill patients. Just because a state doesn’t have PAS doesn’t mean that terminally ill patients won’t kill themselves. With PAS at least the patient can broach the topic with a doctor. Without PAS, that conversation probably isn’t going to happen.
Remember Janet Adkins, Dr. Kevorkian’s first “patient?” The day before her death, there was another death, virtually unknown, but no less significant. The day before Adkins died, Mr. George Ott was found dead on Mount Hood. He was a terminally ill cancer patient who felt himself going downhill. He took a bus to a lodge on the mountain, and the next day went out and died of exposure. His wife knew that when he went to the mountain he wouldn’t be coming back.
From my point of view, it would have been much better for Mr. Ott to die at home, surrounded by family and friends, at a time of his own choosing. But at the time, that option was not open to him. Now your position seems to be that it would have been better for him to die naturally, even if that meant debilitation, helplessness, nausea, and intractable pain, and even if that process took months.
Now I can understand how you might pick that option for yourself, given your other beliefs. What I can’t understand is why you would want to pick that option for Mr. Ott, a man who didn’t share your beliefs, and who had no interest in that kind of death.
What howls of protest we hear from the Christian right every time the Supreme Court strikes down a state law resticting abortion or sodomy. Yet now the Christian right is promoting the very exercise of federal power over states it only recently denounced as tyranical judicial activism. This flexible and situational intepretation of the constitution is dangerous because it turns the law into a weapon of partisan abuse rather than a shield against it.
I don’t agree that assisted suicide for terminal patients is always wrong. In some situations keeping a terminal patient alive to endure excruciating pain (or a morphine-induced delerium) is sadistic and pointless. Of course careful restrictins and safeguards to prevent abuse are essential, and I believe the Oregon law includes them.
In my line of work I study health care economics. It’s true that roughly five percent of of the very sickest patients are responsbile for more than fifty percent of overall health care expenditures. Among the sickest five percent are those very expensive terminal patients being kept alive by artifical means. As state governments struggle with limited budgets and exploding Medicaid costs, difficult choices have to be made. Does keeping one Terry Schiavo alive mean the elimination of health care funding for hundreds of other current Medicaid recipients?
I don’t think it’s unreasonable to question the morality of health care priorities that dictate that fifty million Americans can go without health insurance and the preventative care provides, but if their uncared-for health deteriorates to the terminal stage then we must give them all the care possible to keep them alive whether they want it or not.
There is a difference between witholding medical treatment in a terminal case rather than prolong life (of ‘pointless’ suffering) and to actively kill someone, which is what assisted suicide is.
The author of this article seems not to be in possession of most of the facts related to physician-assisted suicide. The idea is that PAS is an “elitist” thing. This is part of the right-wing mythology that liberal ideas originate in elitism and arrogance, in contrast with plain old down-home folksy wisdom of the common people, who in right-wing mythology are conservatives.
The truth here is that the Oregon law was presented to voters in 1994 as the result of an initiative petition. At that time the law was approved 51 to 49 percent by the common people. Thereafter followed various legal challenges by religious and socially conservative elitists; those challenges failed.
After that various elitist conservative legislators in Oregon figured out that the people of Oregon didn’t understand what they were voting for, and so in 1997 they offered voters the opportunity to repeal the law they had voted for just three years earlier. This repeal was rejected by a 60 to 40 percent margin, even though the proponents of the law were outspent on the campaign by over a 3 to 1 margin, right-wing religious elitist money opposing the measure having flooded the state. Again, the common people of Oregon had spoken.
Seven years later, after the law has worked exactly as it was suppose to, here come elitists from the federal government once again trying to overturn the will of the common people of Oregon.
These are the facts of the situation, all of which have been conveniently omitted from the article. To read the article you’d never know that anyone even voted for the law! In the article PAS was somehow imposed on Oregon by elitists, even as they “targeted” the “disabled.”
The use of such 1984-doublespeak language is common with the right wing. Terri Schiavo, a woman in a persistent vegetative state missing over half of her brain and with minimal electrical activity in what remained, was recently described in this venue as “cognitively impaired.” In this article, people dying from terminal metastatic cancer are “disabled.” They’re not disabled. They’re dying, either now or in the near future, sometimes in great suffering.
Wesley Smith is a senior fellow at the Discovery Institute, a supposed “non-partisan think tank.” The Discovery Institute is basically means by which people such as Smith can get a paycheck while cranking out propaganda. Articles such as this — that lack even the most basic facts of the situation — demonstrate that it’s not a non-partisan think tank at all, but right-wing propaganda mill.
Now I have no problem if someone opposes PAS. This is an issue on which reasonable people can and do disagree. I do have a problem if the case against PAS is based on intentional misinformation and propaganda. The question I have is this: do conservatives even care about the truth and the facts any more? If so, then why are articles such as this not denounced rather than embraced?
To fail to distinguish a difference between active and passive PAS is to miss something vital. Passive assistance is to provide the knowledge and possibly the means to take one’s life, whereas active assistance is to take a physical action in assisting someone to die. The worst thing a physician should ever be accused of in passive assistance is criminal negligence, and even that’s a stretch, even if the intent of the physician is clear. A patient can take their life with a standard prescription of stockpiled Valium and a plastic bag. To suggest that the physician’s role in this is akin to murder is too strong a statement, IMO.
I’m very wary of active assistance. However, with passive assistance, it should be permitted on several conditions:
a) the patient has been provided sufficient opportunity for the alleviation of pain through traditional methods (morphine, Vicodin, etc.) .. which means that it’s also provided through subsidized assistance if the patient is without insurance (*let’s be consistent here*)
b) emotional pain should never be considered as a reason for passive assistance
c) the patient has been diagnosed as terminal and given a relatively short timeframe before death
I think that given these conditions, the number of PAS in passive terms would be a pretty rare event, sufficiently rare even to satisfy those who find suicide morally unconscionable.
I disagree with the attempt to over turn the PAS law in Oregon on Constitutional grounds as does Glen. However, those that put Roe v Wade in the same basket are wrong. Roe v Wade was the liberals successful attempt to take a state issue and make it a federal one. So you liberals, if you object to the overturning of PAS, consistency demands that you also object to the continuance of Roe v Wade which, if overturned, would return the question to the states. That would result in some states in a “local option” approach. That is the state would authorize metropolitan districts within the state to determine their own policy on the matter.
Constitutional conservatives should object to the attempt to overturn PAS. However the moral absolutists don’t see a contradiction in pushing for PAS to be overturned.
The liberal moral ethic demands that the governemnt assume power for the good of the people as only the government has sufficient resources and authority to help.
The politically conservative moral ethic is that people themselves are quite capable of taking care of themselves if government will leave them alone.
Then you have the political moral absolutists on both sides who want the state to enforce their particular view of a just society.
The confusion occurs, in part, because most of us have a mixture of all three parts and assume that they are one coherent position. We then tend to pick out the part we least like in the other person’s position and attack that. Such confusion does not make for good debate and it makes for even worse public policy.
Many people think that Christianity is a moral system and that that morality should be enforced on pepole and society for our own good. Both assumptions are incorrect. Jesus took great pains to clearly state that morality was the effect of living a Christian life, not the way to live a Christian life. The Law leads to death. Therefore, he does not demand conformity to a particular system. He simply and emphatically states the consequences of the choices that lead us away from Him and the blessedness that results from choices that lead toward Him. The conformity demanded lies in the fact that He is both the goal and the path. If we desire to share in His victory over sin and death, we must submit to His love and be obediant to the dictates of that love in our life following the Holy Spirit. We are assured that if we do so the results are predictable and certain, but they are not identical for each person. They are not identical in large part, because we are incapable of the obedidance required. Only by the Grace of God is it possible. As Christians,we face difficult and serious questions as to how we should act in a non-Christian society such as we have now, but it is clearly not Christian to support solutions that lead to tyranny.
Lest anyone think that I am supporting a person’s right to choose in the typical liberal way or that I believe that we must avoid “forcing our morality down others thoats”, I am not. Both of those policital formulations deny any consequence to the choices made and effectively deny morality founded on an absolute standard of good and evil. All choices are morally equivalent in those formulations. Any attempt to deny moral equivalency is met with absolute wrath.
If the federal government looses the PAS case, the consequence will be a concerted push outside of Oregon for assisted suicide laws, because it is now a federal “right” that must be guranteed in the individual states. The moral absolutists win in either case. The rule of law and the Constitution are further eroded and only more tyranny will result.
Michael,
I do agree that this can be something of a quandary. I don’t want a PAS law in my state of Florida. I will fight it tooth and nail. It may, of course, hurt that cause to have a rejection of Federal meddling in the State of Oregon somehow spun as a ‘right to PAS.’ If the Feds had stayed out of this to begin with, then we wouldn’t be in this mess.
Roe v. Wade struck down duly enacted state laws against abortion under the guise of a Federal ‘right’ that usurped the ability of state laws to regulate certain behavior. This is wrong. So is using drug control statutes to attempt to regulate PAS. I hope the experiment of PAS in Oregon fails and that it fails so spectacularly that we see its demise as a movement in the United States. However, I’m more than willing to let the good folks of Oregon experiment with this if they see fit. It’s called freedom and self-government.
I agree with Dean wholeheartedly. It is hypocritical of the Right to decry Roe in favor of states’ rights, and then to attempt to pummel Oregon into doing what the Feds want. That is, of course, one of the major problems with conservative ideology at this juncture. Do we believe in States’ rights? That means some states will do things we don’t like, including some things we think are immoral. Or, are we ‘big government’ conservatives? Meaning that we support wholesale consolidation of power in Washington so that we can use Sauron’s ring to force everyone to do what we think best?
I come down on the side of local governments to make good decisions, bad decisions, and indifferent decisions.
From: Physicians for Compassionate Care
12 Lessons from Oregon
Lesson # 1: Know your enemy.
Lesson # 2: Assisted-suicide proponents are capable of deceit.
Lesson # 3: Pro-Life doctors need to stay involved in organized medicine.
Lesson # 4: Confused voters favor “choice.”
Lesson # 5: Well-reasoned dialogue can be effective.
Lesson # 6: Broad based coalitions of support and funding work the best.
Lesson # 7: Physician-assisted suicide (PAS) deprives the terminally ill of protections the rest of us enjoy.
Lesson # 8: Financial incentives for doctors favor assisted suicide.
Lesson # 9: There are no real safeguards, particularly for the elderly.
Lesson # 10: In Oregon the “right to die” is becoming the “duty” to die.
Lesson # 11: When doctors and nurses have the ability to kill as well as heal, confidence in the ‘doctor-patient’ and ‘nurse-patient’ relationships are compromised.
Lesson # 12: Once the door is open to physician-assisted suicide lethal injection or euthanasia will follow.
The Top 10 Dangers: It’s Not What you Think
* No family notification required.
* No direct state supervision required to prevent abuse.
* No real safeguards to ensure that a request was voluntary.
* No safeguards to ensure that requests for physician-assisted suicide would be based on sound well-informed decisions.
* No safeguards to ensure that only terminally ill patients could request and receive a physician’s assistance in committing suicide.
* No safeguards to ensure that the lethal medication was properly handled and distributed.
* No requirement that physicians be present when their patients take lethal medications, leaving them unattended should complications arise.
* No requirement that a patient actually learn about options other that physician-assisted suicide.
* No requirement that complications, violations, or abuses be reported to law enforcement regulatory authorities.
* Because physician-assisted suicide is inexpensive, health maintenance organizations (HMOs) could encourage a patient to take his/her own life rather than request more expensive palliative care options.
Not Analogous to Roe
This is a highly compressed commentary that skips over a number of important but subordinate ideas, hopefully to allow me to get to the point. I just looked at what the government filed in Gonzalez vs. the State of Oregon and the issues in this case are NOT analogous to those in Roe. Glen you may be able to support the federal government on this.
Gonzalez vs. Oregon is about the relationship of a federal law, the Controlled Substances Act (CSA), and an Oregon State law, the Death with Dignity Act (DWDA). Oregon is challenging the Attorney General’s (AG) position that……[quoting brief]
dispensing drugs for the purpose of hastening a person’s death is not within “the usual course of professional treatment” or for a “legitimate medical purpose” within the meaning of the longstanding regulation that establishes the prerequisites for a lawful prescription under the Controlled Substances Act. See 21 C.F.R. 1306.04(a). [end quote]
Oregon is talking about the proper interpretation and application of a federal regulation.See 21 C.F.R. 1306.04(a). The State of Oregon either wants the AG to change the long-standing position that assisted suicide is NOT a “legitimate medical purpose,” OR Oregon wants the AG to conclude that the federal CSA doesn’t override and interfere with the state DWDA under the doctrine of pre-emption. The doctrine of pre-emption states that a proper and constitutional federal statute overrides any state statute on the same topic. Oregon is arguing about the application of the pre-emption statute, it is not arguing that the federal government has actually overstepped its constitutional bounds in enacting the legislation in the first place. Anyone still awake out there?
I think the AG’s interpretation is solid. There exists substantial legislative history behind the CSA and the particular implementing regulations. The DWDA is a legal innovation of recent vintage. There is just no reason to believe that Congress intended to allow controlled substances to be used for assisted suicide when these very long standing regulations were adopted. That intention would have been a major departure from past policies and it would have required substantial public discussion. The public discussion, committees reports and transcripts of Congressional debates would be available for review on this topic. There aren’t any, to my knowledge. This isn’t a generalized debate about what SHOULD be, it is a debate about the intent of Congress at the time that the regulation was passed, this is a matter which is FIXED in time.
The reason that AG’s interpretation “conflicts” with the Oregon DWDA, is that the Oregon DWDA attempts to authorize the use of federally controlled substances by physicians to assist the suicide of their patients. Suicide is assisted through the use of controlled substances in the morphine family. Those drugs are subject to federal regulation under the CSA. Physicians who have been using federally controlled substances to assist suicides have been doing so “off label” and could lose their federally issued license to prescribe controlled substances if the matter were brought to light.
DIFFERENT FROM ROE
Conservative objections to Roe are based on a different set of considerations. There are at least two major types of objection to Roe. The first is that it created a “right to privacy” out of whole cloth IN ORDER to strike down state abortion laws. It is described as legislating from the bench.The objection was based on the idea that within the federal government the judges were doing the job of legislators. Secondly, it is also based on the idea that no rational argument can be made that the Framers would have remotely envisioned enshrining an “right” to terminate another human life, something which deeply offends the Judaeo-Christian tradition. In other words, when a large group of Christians get together to write a Constitution, they are unlikely to decide that something deeply offensive to their moral philosophy should given given Constitutional protection. There is a real logical absurdity factor in play here. All you can do is throw up your hands or slap your forehead.
By contrast, the Oregon PAS case is about the fine points of the doctrine of pre-emption. Unlike Roe there is no suggestion that one branch of a government (executive, legislative, or judicial) has stepped outside its proper role and encroached on the proper role of another branch of government. To the contrary, the PAS case is a difference of opinion on the application of the doctrine of pre-emption. Oregon has not challenged the federal government’s constitutional power to create a legislative scheme controlling potentially dangerous drugs. Oregon has not rejected the doctrine of pre-emption. Oregon just thinks that in this case, an exception should be crafted into the general principle of pre-emption to allow Oregon to legitimize the use of controlled substances for a single particular purpose, assisted suicide.
Does this make sense?
Missourian writes: “Suicide is assisted through the use of controlled substances in the morphine family.”
Small point, but actually barbiturates are used.
Missourian: “I think the AG’s interpretation is solid. ”
In an important sense, there’s nothing to interpret. If congress wanted, they could simply amend the CSA. A single sentence would suffice. They haven’t done so. We’re not talking about some clause in the Constitution written 200 years ago. We’re talking about a law that could be changed at any time.
But more importantly, you have to remember that people can commit suicide without the use of controlled substances. There are things that are actually more effective, including intravenous potassium, breathing a high concentration of inert gas, etc. And if you don’t mind things messy, there is the Glock or shotgun method.
The use of controlled substances thus puts the potential suicide within the context of medicine. This means having a conversation with a physician. When the patient has that conversation, that is an opportunity for the physician to explore other options. Is the patient depressed? Uncomfortable? In pain? These and other issues can be addressed, and in many cases PAS is not the option selected. I mean, PAS has been around for 7 years, and in that time only 208 of the tens of thousands of terminally ill Oregonians have exercised the PAS options. So there are a lot of other people choosing other options.
But eliminate controlled substances as an option, and you’ve now moved the potential suicide outside of the realm of medicine. That conversation with a physician may not happen. There’s no reporting. There are no criteria to be met. There are no controls whatsoever.
This is better?
Fr. Hans writes: “Lesson # 8: Financial incentives for doctors favor assisted suicide.”
How so? Most doctors are paid on a fee for service basis. A doctor would make more money treating a terminally ill patient for several more months.
Fr. Hans: “Lesson # 9: There are no real safeguards, particularly for the elderly.”
If people want more protections, then write them into the law. If the law needs improvement, then improve it. I don’t think anyone would object to that, not even the proponents of PAS.
Fr. Hans: “Lesson # 10: In Oregon the ‘right to die’ is becoming the ‘duty” to die.’
Utter nonsense.
Fr. Hans: “Lesson # 11: When doctors and nurses have the ability to kill as well as heal, confidence in the ‘doctor-patient’ and ‘nurse-patient’ relationships are compromised.”
Hasn’t happened yet. Also, under PAS the physician writes a prescription; he or she doesn’t kill.
Fr. Hans: “No family notification required.”
Family notification is not required for any medical option. This may come as a surprise, but your dad could have a heart transplant, and you wouldn’t have to be informed about it at all. But again, if you want family notification, write it into the law.
Fr. Hans: “No direct state supervision required to prevent abuse.”
Again, change the law, change the law, change the law.
Fr. Hans: “Because physician-assisted suicide is inexpensive, health maintenance organizations (HMOs) could encourage a patient to take his/her own life rather than request more expensive palliative care options.”
Most hospice care is paid for by Medicare or Medicaid. Even managed care plans that have a hospice benefit often have caps on the amount that will be paid out. Palliative care per se is not expensive.
But more importantly, this is a non-issue. Look, HMOs could go around saying “you know, I really don’t think that quadruple bypass is a good idea,” or “I don’t think you’ll like that artificial heart valve,” or “chemotherapy sucks, don’t bother.” Sure, it could happen, in the sense that anything could happen. But it doesn’t.
Constitutionality 101: What people are arguing about.
Federalism:
Federalism refers to the relationship between the federal and state governments under the Constitution. State governments are the actual foundational buildling blocks of our system. This is because colonial governments existed for decades before the Revolutionary War and they functioned quite well. The federal government as defined by our current Constitution came a good deal later.
The state governments are considered sovreign powers. They are assumed to have all the powers of a sovreign that were not transferred to the federal government in the Constitution. The federal government is a government of “enumerated powers.” As a practical matter, the federal government’s most frequently used power is the Commerce Clause, the power to regulate interstate commerce. Small government conservatives have criticized the trend in the federal courts to define the Commerce Clause so broadly that there is no effective limit on federal power. There has been a small contraction in the expansive interpretation of the Commerce Clause but not much. On those rather rare occaisions in which legislation has been struck down as exceeding the scope of the Commercie Clause liberals have decided to appropriate the term “judicial activism.” I don’t think that is correct use of the phrase.
Blurring of the Lines between the Judicial and the Legislative.
Conservatives greatest complaint is “judicial activism.” This means that judges step outside their proper role as interpreting the law and use their power to legislate. This can occur on the state or federal level, or both. Roe vs. Wade was legislation and not very good legislation at that. The complaint was the the Court conjured a “right to privacy” from thin air. I think the proper use of the term “judicial activism” should be restricted to this type of situation. I think it is correct that many aspects of the liberal agenda could not succeed through electoral politics but have to been jammed down society’s throats through the Courts. If Roe were overturned the issue would be thrown in the laps of state legislature where it resided prior to Roe.
There is a rather unpleasant possibility that Roe could be eroded by advances in medicine as the viability point for unborn children moves closer and closer to conception. I would prefer to see a clean reversal of the whole concept of the invented “right to privacy.” I think it is pernicious at its core. We’ll see what comes up.
I am not really sure that rejecting Harriet Miers would be the end of the world. I would love Bush to have a chance to nominate a solid constitutional scholar like Luttig or McConnell. It will be interesting.
Hope this is helpful.
Note 12. PAS is a monumental cultural shift where doctors become killers instead of healers. Dress it up anyway you want, killing is still killing.
It’s also a slippery slope. You argue the slope doesn’t exist, but you also argued for the forced dehydration Terri Schiavo. Your assurances are cold comfort I’m afraid.
I don’t want to see the pro-death crowd subvert the power of the state to determine who lives and who dies. They tried it almost a century ago. Now they are trying it again. See: War Against the Weak: Eugenics and America’s Campaign to Create a Master Race.
Fr. Hans writes: “It’s also a slippery slope. You argue the slope doesn’t exist, but you also argued for the forced dehydration Terri Schiavo. Your assurances are cold comfort I’m afraid.”
And how is the post-Schiavo slippery slope in Florida? Are they dragging disabled people out of nursing homes and group homes and herding them into extermination camps? Are they euthanizing everyone with a brain injury? Culture of death lawyers lined up at the courthouses all ready to withdraw care from thousands of people? How exactly is the slippery slope manifesting itself down there?
I don’t live there, but frankly I haven’t heard of anything like that. And this is a problem. With PAS we keep hearing about the slippery slope, but nothing has happened. There are no initiative petitions in Oregon designed to expand PAS. There is no interest in the legislature for expanding PAS. In fact, other than the efforts of the feds to basically overturn the Oregon law, no one even talks about it. In other words, there has been exactly ZERO slippery slope effect from PAS. My guess is that the Schivo case has had exactly zero slippery slope effect in Florida. My question is this: at what point does the slippery slope argument finally go away?
Speaking of the Schiavo case, I didn’t argue for the death of Terri Schiavo. I argued that her wishes concerning continuation of care should be honored, inasmuch as those wishes could be determined.
What you had in the Schiavo case was a woman in a condition, PVS, which in Florida law was defined as a terminal condition. You had various brain scans and other test that supported a diagnosis of PVS. (Later, you had autopsy results that revealed an underlying brain pathology that was consistent with the diagnosis of PVS.) You had a legal process that was followed. You had a judge — a conservative Southern Baptist — who found at the level of “clear and convincing” evidence that Terri Schiavo’s wishes would not have been to be maintained in that condition. You had a woman kept alive by a feeding tube, that was legally seen as a medical intervention, and not as routine or ordinary care.
Post-Schiavo, has there been ANY change in any of the laws or procedures relevant to the Schiavo case? If not, why not?
Jim,
Does being in a PVS state make someone less human?
Note 15: “Post-Schiavo, has there been ANY change in any of the laws or procedures relevant to the Schiavo case? If not, why not?”
I’m sure that some would urge the criminalization of suicide even though it would be intrinsically impossible to implement (although the Catholic Church will at times refuse a Christian burial for a suicide). My point is that suicide is seen as immoral in any circumstance and never a “right”, so anyone assisting that (or really even encouraging it) is seen as aiding and abetting something that is sinful.
I’m not sure why I haven’t heard the argument framed in these terms, perhaps because it would be viewed as absurd. It’s not just that there’s no right for the physician to assist, but I doubt that many believe there’s even a right for the patient to do it themselves, either, with or without anyone’s assistance.
Jim, Bad Side of Human Nature Doesn’t Take Much Encouragement
Jim, I have done probate estates and seen adult siblings tear each other up over a small amount of property. Seniors can be very difficult to care for, especially if they are severely disabled. Sometimes people can linger for years and years. It isn’t a pretty side of human nature, but, many people would welcome the “death with dignity” rationalization for eliminating burdernsome relatives and hastening the day of the cash inheritance.
An elderly person might not want to confide in his or her doctor IF the information would be used to support a “death with dignity” termination of their lives. If I were elderly I wouldn’t want to give ammunition to that loving family of mine who is waiting until I am too weak to fight back. LOVELY.
We are society that has shown a willingness to eliminate inconvenient babies, what makes you think we won’t do the same with inconvenient older folk. Especially if we come into some money after the oldster dies. SHUDDER.
Note 15. You objections are historically and culturally naive. When abortion was first advocated, we heard that only “necessary” abortions would occur, such as the unborn children of mothers who were poor, children subject to child abuse (as if abortion isn’t child abuse), Down’s Syndrome children, etc. Abortion advocates marshalled the language of benevolence and concern to make abortion appear as sympathetic an act as possible.
Move ahead thirty years and we are crushing the skulls and sucking out the brains of the partially born. In the interim we were dismembering live unborn children in the womb. This is civilized?
And now you want us to believe that PAS will be limited to killing just the infirm in chronic pain? If you can’t muster the strength to oppose abortion, you certainly will not be able to stand against the inevitable expansion of killing the aged. You already defend the killing of Terri Schiavo. It’s a short step to killing someone less infirm than her, then another step to killing even healthier people — all reasonably defended with the terminology of benevolence of course, but killing nonetheless.
Politics follows culture. Because no new legislation appeared between Terri Schiavo and today says nothing about the destructive potency of the ideas you defend. Life is devalued in the culture through ideas and language first; the actual killing follows later. Look at Holland. All the fine logic you use to defend PAS and the Schiavo killing is the same logic the euthanasia crowd uses in Holland — and they’ve slipped a lot farther down the slope than Oregon. No barriers to killing exist in this logic because it draws from an alien well in which there is no ultimate regard for life.
“Thou shalt not kill” exists only in the Judeo/Christian moral tradition. Thus, when you assure us that the killing will be limited, you borrow from the Judeo/Christian tradition, albeit surrepititiously, not aware it seems that the acts you defend, and the borrowing of the language and concepts that makeup your defense, are not morally congruent. On the other hand, if you do realize the incongruency, then your defense of the killing becomes diabolical.
We’ve seen this road before: reasonable people defending all sorts of unreasonable acts sublimely convinced it leads to a more perfect and just society. You can read about it here: Darwin and the Road to Hitler.
JBL writes: “Does being in a PVS state make someone less human?”
Not less human, but I think in the case of PVS that the person has gone. In other words, Terri Schiavo was gone, even as her bodily functions continued.
Missourian writes: “It isn’t a pretty side of human nature, but, many people would welcome the ‘death with dignity’ rationalization for eliminating burdernsome relatives and hastening the day of the cash inheritance.”
I’m sure that’s possible. But there are other things that can also hasten death. When my mother found out at age 83 that she had lost the blood supply to her bowel, one of the options was surgery. But the doctor said that with all of her other health problems that he did not believe that she would survive the surgery. Her first choice, which I talked her out of, was surgery, precisely because she thought that it would kill her. My mother was a nurse all of her life, and thus not unfamiliar with the dying process. But I, the good son, talked her out of that option, and thus began a six-week period where she starved to death in a nursing home. But the point is that risky, end-of-life procedures can be a form of physician assisted suicide as well.
But it’s not just PAS in which family member could be problematic. Family could persuade a cancer patient to discontinue chemotherapy, or to opt out of a beneficial surgery. In other words, the potential bad influence of family extend to areas other than PVS.
In the case of the Oregon law you’re talking about patients who generally have less than six months to live. So the care of such a patient is not going to be of long duration, and no thinking doctor is going to engage in expensive treatments. So in the real world I think that financial considerations are not going to be very important. By and large these are people to whom a doctor has said “we can’t do anything more for you.”
Fr. Hans writes: “And now you want us to believe that PAS will be limited to killing just the infirm in chronic pain?”
There is a very important distinction here. Abortion has been held to be a constitutional right. No such right exists with PAS. PAS exists only inasmuch as the law permits it. Thus any alteration to PAS can occur only with the consent of the people or their elected representatives. At the point at which people would vote, for example, to euthanize the disabled, the homosexuals, and the Jews, you’ve got a bigger problem than PAS. The problem at that point is not PAS, but the fact that the people have become nazis. You would argue that PAS helped to desensitize people and thus helped turn them into nazis. That seems like a tremendous stretch to me.
I don’t want to make an extreme statement, but when the nazis appear next, they will be wearing crosses and spouting proof-texts from the Bible about how the unbelieveres need to be destroyed. “Unbelievers” in this context may very well include Orthodox.
Look at the Christian Reconstructionist beliefs and tell me that they are not second cousin to nazi philosophy. Just a different enemy, that’s all. You’re worried about PAS. I’m worried about a religious movement gaining strength every day, and that even has followers in the government. Even conservative Christians are concerned about Reconstructionism:
“The significance of the Reconstructionist movement is not its numbers, but the power of its ideas and their surprisingly rapid acceptance. Many on the Christian Right are unaware that they hold Reconstructionist ideas. Because as a theology it is controversial, even among evangelicals, many who are consciously influenced by it avoid the label. This furtiveness is not, however, as significant as the potency of the ideology itself. Generally, Reconstructionism seeks to replace democracy with a theocratic elite that would govern by imposing their interpretation of “Biblical Law.” Reconstructionism would eliminate not only democracy but many of its manifestations, such as labor unions, civil rights laws, and public schools. Insufficiently Christian men would be denied citizenship, perhaps executed. So severe is this theocracy that it would extend capital punishment beyond such crimes as kidnapping, rape, and murder to include, among other things, blasphemy, heresy, adultery, and homosexuality.”
http://www.rapidnet.com/~jbeard/bdm/Psychology/cor/notes_on.htm
Fr. Hans: “Politics follows culture.”
Yeah, well look where the religious culture is going. You see PAS, a miniscule, barely-utilized program in a single state, and want to sound the alarm. But look at the small army of reconstructionists, some of whom hold public office and all of whom are intent on dominion. Thirty years from now, when you and I are lined up against a wall and shot by Christian fascists for the crime of heresy, PAS isn’t going to seem very important.
Jim Holoman wrote: “Not less human, but I think in the case of PVS that the person has gone. In other words, Terri Schiavo was gone, even as her bodily functions continued.”
so to you a rat is a pig is a dog is a boy?
Because a person cannot reason then they have no reason to live, thus it’s justifiable to deprive them of food and water. Starvation is a solution to those deemed less than in society?
Thanks for proving Hannah’s point of the “banality of evil”.
JBL writes: “Because a person cannot reason then they have no reason to live, thus it’s justifiable to deprive them of food and water. Starvation is a solution to those deemed less than in society?”
PVS is substantially more severe than how you put it. In the case of PVS the tissue of the cerebral cortex has died. That is the part of the brain that allows all the higher functions of awareness, cognition, memory, and so on. It’s basically just one step away from total brain death, except that the body’s autonomic functions still operate, as well as certain reflexes. It is a condition so severe that in Florida law it is considered terminal, even though the body can be kept in that condition for years. There is no awareness of self or of the environment, and there is no cure or recovery.
Even so, we don’t automatically discontinue care for PVS patients. However, patients can opt not to be maintained in that condition indefinetly, through an advanced directive or through a proxy. And that is what happened with Terri Schiavo.
JBL: “Thanks for proving Hannah’s point of the ‘banality of evil’.”
This may come as a surprise to you, but as an Oregon resident I have no power over what transpires in Florida. I did not know Terri Schiavo. I was not a party to the case. The Schiavo case was governed by Florida law and legal procedure. I don’t live in Florida, but as far as I can tell the case was handled in accordance with Florida law and the legal decisions were consistent with the best available evidence. The legal case went on for years, and the decisions were consistently on the same side of the case, at all levels of the various courts that were involved.
It is the same law that is still on the books, the same law that would apply to a similar case today. The people of Florida or their elected representatives could have chosen to change the law, but apparently they are not interested. Since Fr. Hans is a Florida resident, I suggest you direct your “banality of evil” comment to him, since he is in a position to do something about it.
Jim my comment about the banality of evil has nothing to do in reference to where you live. But it’s the reasoning song and dance routine you perform to justify the starvation of a woman. You can talk about the mental capability all you want, but you cannot avoid the fact that those starved like Terri, those aborted by the millions each year are still human beings. Your willingness to accept these practices as “normal” makes you a willing accomplice.
And your routine of the “legalityâ?? justifying Terri’s starvation is false. Just because the court has decided an issue doesn’t necessarily translate into the decision being morally correct. We can go back through the 20th century and look at how legal decisions around the world resulted in some of the greatest evil being committed in the history of mankind.
I was under the impression that the Constitiution protected us against a Government taking away our rights that were given to us by our Creator. If so, is it true that God gives us the right to kill those he knit in the womb ?
“Thirty years from now, when you and I are lined up against a wall and shot by Christian fascists for the crime of heresy, PAS isn’t going to seem very important. ”
If the all-mercyfull God would grant us such a privilage, to give our life for confessing His Truth it should be a gift received with great joy.
But evidently we do not use the remaining time for repentance, to clear our minds from the darkness that makes inhumane, evil, monstrous deeds look justified.
I am afraid the only death we will suffer will be the one where the devil will be dancing laughing with fearful hatred, delighted to finally torment us eternally, thus thanking us for contributing to his causes.
For matters concerning life or death,procedures and organ donations, “rights” and the often forgotten obligations, especially those that affect other people too, we better humbly ask the opinion of much more saintly and wise men, rather than seek the wisdom of the world.
We do agree that the wise of the world are fools in the eternal things, right?
JBL writes: “Jim my comment about the banality of evil has nothing to do in reference to where you live. But it’s the reasoning song and dance routine you perform to justify the starvation of a woman. . . . And your routine of the “legality” justifying Terri’s starvation is false. Just because the court has decided an issue doesn’t necessarily translate into the decision being morally correct.”
As you can imagine, the Schiavo case was a topic of much discussion in this venue. So as not to repeat much of what has been said before, I’ll try to be as brief as possible.
You are correct that the mere fact of a legal decision doesn’t mean that the decision is moral. But I would point out that the legal decision in this case had certain features that we should pay attention to.
As you know, the Schiavo case caused a great deal of controversy. I personally spent a lot of time and effort trying to understand it. What I found out was that a lot of the stuff that you read on the internet was factually incorrect, either intentionally or unintentionally. What I observed was the material from the Schindler side of the issue was often accepted as gospel, even when it was flatly contradicted by the legal record.
So what do we get from a legal process? We get cross-examined testimony under oath. With the Schiavo case, outside of the legal process, we got unsubstiantiated allegations, rumor, innuendo, misunderstanding, misinformation, and speculation.
No offense intended, but I assume that you haven’t spent a lot of time with the actual legal documents related to the case, and that most of what you “know” about the case comes from right-wing propaganda and Schindler family spin. I can only say that there is no substitute for the legal documents, most all of which are freely available on the internet to all who want to know the facts of the case. Let me put it this way: probably most of what you’ve heard isn’t true.
Jim wrote: “No offense intended, but I assume that you haven’t spent a lot of time with the actual legal documents related to the case, and that most of what you “know” about the case comes from right-wing propaganda and Schindler family spin. I can only say that there is no substitute for the legal documents, most all of which are freely available on the internet to all who want to know the facts of the case. Let me put it this way: probably most of what you’ve heard isn’t true.”
Please don’t make that assumption you have no knowledge about. I was following the Schiavo case for several years, before it became the sensationalized news story. My argument is not based upon what the Schindlers have stated. Nor, is my argument based upon what Michael has said either. So to clarify your misconception I have read, and I am very familiar with, the legal documents. I’ve also spent time reading legal opinions on both sides of the argument — which you can easily find across the internet.
My concern is that the U.S. court system ordered the death of (to clarify gave a death sentence to) a woman through starvation based upon testimony less than the legal standard for sentencing a serial murderer to death. (And if you as knowledgeable about the legal documents as you claim you would know that the only proof Michael offered was a hearsay statement by himself, his brother, and his sister-in-law.)
The way Terri was treated and murdered by the state would send an individual to prison for treating their dog in the same manner.
You can sing your song about having a fuller knowledge of the case, claiming that enlightened view than the rest of us don’t seem to grasp. Just because something comes through the courts doesn’t mean the decision is a pure, or noble, act. Just look at Courts other wonderful enlightened decisions such as Dred Scott, Jim Crow, and Lynchburg (where Supreme Court Justice O.W. Holmes jr. thought it was wonderful to sterilize the disabled and poor).
You can dance about how she really “wasn’t there” (a euphemism meaning that she’d lost her humanity) to justify her death through a brutal means.
In the end though, you are still compromising with evil.
JBL writes: “So to clarify your misconception I have read, and I am very familiar with, the legal documents.”
Great, that makes it much easier to talk about the main issues.
JBL: “My concern is that the U.S. court system ordered the death of (to clarify gave a death sentence to) a woman through starvation based upon testimony less than the legal standard for sentencing a serial murderer to death.”
I see what you mean. But I think there is a fatal problem with this kind of argument. You need to compare like cases. In this instance we need to compare the Schiavo case with other end-of-life or terminal cases. Every day in the U.S. there are probably hundreds of end-of-life decisions made by the families of incapacitated patients. In many cases this consists of nothing more than “grandpa wouldn’t want to live like this.” This was essentially the process followed by the Tom Delay’s family when his father was starting to deteriorate after a serious brain injury.
So in the vast, overwhelming number of these cases there is no trial, no sworn testimony, no panel of physicians, no appeals. At most you might have a hospital ethics consult or a review of the case by the hospital ethics committee. But that’s as formal as it’s going to get. The Schiavo case is really quite unremarkable, except for the family disagreement and subsequent extensive legal battle. In that sense the Schiavo case actually received much more due process than almost any other such case.
JBL: “And if you as knowledgeable about the legal documents as you claim you would know that the only proof Michael offered was a hearsay statement by himself, his brother, and his sister-in-law.”
In this case hearsay evidence was admissible. If it weren’t, the Schindler family could have raised that issue on appeal, but they didn’t. I’m not a lawyer, so I have to rely on the opinions of lawyers in this matter. Matt Conigliaro’s excellent Abstract Appeal web site has a good discussion of the issue of hearsay evidence and the Schiavo case. I’ll quote only a brief passage:
“Terri had, and every Florida citizen has, a constitutional right to privacy that includes the right to decide that certain medical treatments should not be used to prolong her life. The Florida Supreme Court has clearly decided that this right can be exercised through written and oral statements. In the landmark 1990 case In re Browning, Florida’s high court explained that a surrogate attempting to determine what the ward would do can rely on the ward’s written or oral statements.”
That’s the constitutional aspect. Conigliaro also lists several evidentiary reasons why hearsay evidence was allowed in this case, which I won’t go into here. The link to his site is
http://abstractappeal.com/archives/
2005_03_01_abstractappeal_archive.html#111167384435979940
JBL: “You can sing your song about having a fuller knowledge of the case, claiming that enlightened view than the rest of us don’t seem to grasp.”
I’m not particularly enlightened. It’s just that most of what people were reading about the Schiavo case was factually wrong and failed to reference any of the court documents or reports of the guardians ad litem. That made it difficult to have a discussion.
JBL: “Just because something comes through the courts doesn’t mean the decision is a pure, or noble, act.”
Yes, that’s true. But in this case I don’t see any evidence of any miscarriage of justice. Judge Greer was the trier of fact. He is not a secularist, but a Southern Baptist Christian. Judge Greer was raked over the coals, but the people who know him were outraged by such comments. From the St. Petersburg Times:
– – – –
Local Republicans had their own words for Judge George Greer, who, as presiding judge in the Terri Schiavo case, ordered the removal of her feeding tube on March 18.
Conscientious. Honest. Compassionate. A good Christian. An outstanding lawyer.
“Those folks that are saying anything bad about Judge Greer, they don’t know him, and apparently they don’t understand the law and the separation of powers,” said state Rep. Everett Rice, R-Treasure Island, who stood behind Greer’s decision last week in Tallahassee.
– – – –
http://www.sptimes.com/2005/03/22/Northpinellas/
Local_Republicans_bac.shtml
We weren’t at the hearing; at least I wasn’t. The Christian judge heard the testimony under oath, observed the witnesses, noted their demeanor, listened to the tone of each voice, and made a ruling that he stated was based on “clear and convincing” evidence. You come along later and disagree. Ok, fair enough. But I hardly see how your disagreement with Judge Greer’s decision somehow shows that I am “compromising with evil.”
Again, please keep in mind that the overwhelming majority of such cases do not even reach the courts. The Schiavo case had much more consideration and review than 99.999 percent of similar cases, and I don’t see any compelling reason to believe that the judge got it wrong. Of course, we can second-guess any legal opinion, but so what? Because I don’t go along with your second-guessing I’m compromising with evil? I don’t think so.
Whether or not the words came from Republicans, the term oxymoron comes to mind.
Rdr Christopher writes: “Whether or not the words came from Republicans, the term oxymoron comes to mind.”
If you were the judge in this case, sworn to uphold Florida law, and you truly believed that clear and convincing evidence showed that Ms. Schiavo would not want to be maintained in that condition, what would you have done?
Believing in something and following a law neither makes it right, nor Christian. How should a Christian decide whether to uphold his secular office faithfully or follow the commandments of the Lord ? Shall he simply wash his hands of the sin and claim that he followed the law, the will of the people enacted by legislature. If all our laws were just and Christian this would be no problem, but sadly that is not the case. This is of course one of the reasons that clergy in the Orthodox Church are prohibited from holding such positions.
I do know that should I have made the same decision as Greer, I could hardly be described as a being good Christian.
Rd. Christopher writes: “I do know that should I have made the same decision as Greer, I could hardly be described as a being good Christian.”
The whole point of the legal proceeding in the Schiavo case was to determine what her wishes would have been were she able to articulate them. Not what her parents wanted, not what her husband wanted, not what Judge Greer wanted, not what the Catholic church wanted, not what Focus on the Family wanted, but what *she* wanted.
If a judge in such a case truly believes that clear and convincing evidence shows that she would not want to be maintained in that condition, then I would argue that the judge has a moral *obligation* to order the removal of the feeding tube. To say that a Christian judge would not do such a thing would be equivalent to saying that the Christian thing to do would be to force her to be maintained in that condition against her wishes. With all respect to your position, I cannot understand how that would be the moral thing to do, much less the Christian thing.
Perhaps it is because you do not understand that to remove food and water would be killing her. As she was unable to do so herself, rather than assisting in her suicide (which is immoral and a sin in itself) , those who starved and dehydrated her were complicit in murder. I do not understand how anyone has a *moral* obligation, much less a Christian one, to actively end someones life.
Rdr Christopher writes: “Perhaps it is because you do not understand that to remove food and water would be killing her. . . . those who starved and dehydrated her were complicit in murder. I do not understand how anyone has a *moral* obligation, much less a Christian one, to actively end someones life.”
In the U.S. people have the right to discontinue medical interventions. This happens every day, hundreds of times a day, either through the patient’s personal request, through an advanced directive, or through the statements of family members. The intervention may be dialysis, chemotherapy, a respiration, a feeding tube, or whatever.
What I cannot understand is why out of the hundreds of daily occurrences, this ONE case, the Schiavo case, is “murder” and killing.
I mean, in the time it has taken me to write the above sentences, probably 10 or 20 respirators have been turned off, feeding tubes disconnected, IVs unplugged. Family members are mourning, and very shortly mortuary staff will arrive and drive off with the bodies of the loved ones. This happened not with people already dead, but with people whose bodies could have been maintained through modern medicine for months or years more.
Nonetheless, somehow, in some mysterious way, the Schiavo case is different. When it comes to Schiavo, anyone who says that the removal of HER feeding tube is complicit in “murder.” Anyone who is not outraged by HER death is part of the “culture of death.” The feeding tubes of a thousand other people don’t matter. The respirators of ten thousand other people don’t matter. But somehow Schiavo is the dividing line between the “people of faith” and the “culture of death.”
to Jim: Just because it may happen on a daily basis doesn’t make it morally correct either. No one is suggesting that there shouldn’t be any outrage at the removal of “thousands of other feeding tubes” or “the switching off of respirators”.
It’s an extension of that culture of death that began with the sterilization of the handicap, that continued with legalizing of infanticide, that has now moved to the execution of the handicap. It’s only a matter of time before it moves to the acceptance of senilicide.
It was not a right to die case, it was a case about the rights of the disabled. Terri as a disabled person was denied the dignity to be considered human.
Some thoughts on Terri’s case:
http://www.thenation.com/doc/20050502/hershey
http://www.notdeadyet.org/docs/drmwants0305.html
About Not Dead Yet and The Resistance
People with disabilities have an opportunity to lead society from the isolation and despair of today into a renewed recognition of belonging and community for all. The idea that people with disabilities are not worthy of society’s acceptance or resources is not new. We see this form of hatred throughout history, often masked as benevolence. But for the first time in history, people with disabilities are organizing our community to fight back, to demand the equal protection of the law.
— Diane Coleman, J.D., Founder, Not Dead Yet
Since 1983, many people with disabilities have opposed the assisted suicide and euthanasia movement. Though often described as compassionate, legalized medical killing is really about a deadly double standard for people with severe disabilities, including both conditions that are labeled terminal and those that are not.
Disability opposition to this ultimate form of discrimination has been ignored by most media and courts, but countless people with disabilities have already died before their time. For some, a disabled person’s suicidal cry for help was ignored, misinterpreted, or even exploited by the right-to-die movement. For others, death came at the request of a family member or other health care surrogate. This is not compassion, it’s contempt.
Not Dead Yet was founded on April 27,1996, shortly after Jack Kevorkian was acquitted in the assisted suicides of two women with non-terminal disabilities. In a 1997 Supreme Court rally, the outcry of 500 people withdisabilities chanting “Not Dead Yet” was heard around the world. Since then, eleven other national disability rights groups have joined NDY in opposing legalized assisted suicide and euthanasia, chapters have taken action in over 30 states, and we helped put Jack Kevorkian behind bars in 1999.
People already have the right to refuse unwanted treatment, and suicide is not illegal. What we oppose is a public policy that singles out individuals for legalized killing based on their health status. This violates the Americans With Disabilities Act, and denies us the equal protection of the law. Some bioethicists have even started to argue that intellectually disabled people are not persons under the law. That hasnâ??t happened since slavery was legal.
Legalized medical killing is not a new human right, it’s a new professional immunity. It would allow health professionals to decide which of us are “eligible” for this service, and exempt them from accountability for their decisions. Killing is not just another medical treatment option, and it must not be made any part of routine health care. In these days of cost cutting and managed care, we don’t trust the health care system, and neither should you.” http://www.notdeadyet.org/
JBL writes: “Just because it may happen on a daily basis doesn’t make it morally correct either.”
JBL also: “What we oppose is a public policy that singles out individuals for legalized killing based on their health status.”
Well, sure. But it seems to me that you’re arguing for a radical, monumental change in how we deal with end of life issues. I’m not even sure what you’re suggesting at this point.
It seems to me that under your view, inasmuch as I understand it, we wouldn’t even “pull the plug” on someone who is brain dead. Do we end up maintaining brain dead people on life support indefinetly? Is that what is morally required? Apparently so, because between PVS and brain death we’re only talking about what part of the brain has died, and degrees of difference.
You see, this is the problem that I’ve always had with opponents of the Schiavo outcome. Schiavo becomes the furthermost tip of the hair on the tip of the tail that ends up wagging the dog of everything else having to do with end of life care. In order to avoid another Schiavo everything related to end of life care has to change.
Is your elderly father unconscious and suffering from multiple organ failure? No problem, we’re going to keep him on a respirator. If his kidneys fail he’s going on dialysis. If his heart stops, we’ll give him a heart transplant. If he’s brain dead, no matter, we’re going to keep him on a respirator anyway. He’s going to get every possible treatment, drug, and surgery. And if he wouldn’t want that, too bad, we’re going to do it anyway. And if you wouldn’t want that for him, that’s too bad too, because we’re not going to listen to you. We’re going to pull out all the stops, keep him alive as long as possible, and what his wishes would have been are utterly irrelevant. Because to do anything less is murder.
The opponents of the Schiavo outcome seem to want nothing less than this. But this is madness to me. It makes no sense. We couldn’t possibly operate this way. But it reflects the kind of situation that the opponents of the Schivo case seem to want.
Jim wrote: “Well, sure. But it seems to me that you’re arguing for a radical, monumental change in how we deal with end of life issues. I’m not even sure what you’re suggesting at this point.”
I’m not arguing for a “monumental change.” I’m arguing for a return to the concepts we used to hold as a society for a respect for life. The “radical, monumental change” came when we as a society decided that those less than human loose their right to live. It’s better for whom? Not for those who are handicap, but their caretakers who don’t want to have the burden they don’t want to be inconvenienced
Jim H. wrote: ‘It seems to me that under your view, inasmuch as I understand it, we wouldn’t even “pull the plug” on someone who is brain dead. Do we end up maintaining brain dead people on life support indefinetly? Is that what is morally required? Apparently so, because between PVS and brain death we’re only talking about what part of the brain has died, and degrees of difference.’
We need to clarify that there is a difference between being brain dead (which is the cessation of brainwave activity) and being in PVS. A person who is truly brain dead, is dead because the brain has ceased and the body is kept functioning by machinery. When the machinery is ‘switched off’ the body ceases to function.
There are still brain functions with someone who is PVS. Their body only needs nourishment and hydration through the assistance of others. The only reason Terri had a feeding tube was she had lost the ability to swallow (believed caused by the tracheotomy. Which is common for most people who’ve had one) and it could have been restored to her IF Michael had allowed the proper physical therapy.
And as far as the issue of the brain’s atrophy, that was the state of the brain at the autopsy. It doesn’t account for the brain’s condition for close to fifteen years. And it’s hard to determine what her condition she was in with the lack of MRIs (all that had been done was a Catscan) or other medical assessments during that time period. (A doctor associated with Michael’s lawyer George Felos in the right to die movement did the only determination that Terri was PVS for the court’s findings of fact. This was the basis for every court decision after it).
As long as you argue that people are brain dead who are breathing on their own you are denying them a sense of humanity. Terri’s case was not originally a right-to-die case, it was turned into one by Michael.
Jim: ‘You see, this is the problem that I’ve always had with opponents of the Schiavo outcome. Schiavo becomes the furthermost tip of the hair on the tip of the tail [the rest clipped for repetitiveness]
You distort and confuse the issue. Let’s be clear on that one thing TERRI SCHIAVO WAS NOT TERMINAL. It wasn’t a matter of just turning off a machine and just slowly drift off. It took two weeks to painfully die from starvation and dehydration.
When you cite examples of end-of-life issues where people are just heart beats away from death and Terri’s case you do so either because you’re confused and ignorant about the complexities of end-of ‘life issues. Or, you have bought into the selfish nature that has permeated our society about doing away with the helpless because we can’t be burdened with them. I would hope that as a Christian it’s misguided ignorance.
Let also be clear that Terri’s case was not about anyone’s wish to die. It was a bigger issue about the power a caretaker has in determining a patient’s ultimate outcome, especially if there is a conflict of interest. The tragedy is the courts in the end forced a painful death upon a non-terminal patient and many in society sided with evil through their support of this heinous injustice.
JBL, suicide has traditionally been illegal
The entire concept of “death with dignity” and “right to die” is antithetical to Anglo-American legal tradition. What today is referred to as “right to die” would is simply described as suicide in American and English Common law. Suicide has traditionally been illegal.
There are two reasons that suicide was illegal. The first is that it violated the Judaeo-Christian moral tradition. The second if that if suicide was a felony, then so was assisting a suicide. The common law did not want to provide an excuse for people murdering their grandparents to get their hands on an inheritance OR murdering their sick spouses to allow them freedom for a new relationship.
It is easy for me to imagine someone smothering grandmother then claiming that he was simply honoring her wish to die. After all grandmoter is 89 years old, weak and fuzzy minded and going to die soon anyway. The Anglo-American legal tradition “cut this off at the pass” by declaring suicide itself a crime and anyone who assisted a suicide was a criminal. In practice, prosecutors never filed cases against failed suicides, they had better things to do, but, the law provided a defense against murders of the weak, which is what we have here.
Missouri wrote: “It is easy for me to imagine someone smothering grandmother then claiming that he was simply honoring her wish to die. After all grandmother is 89 years old, weak and fuzzy minded and going to die soon anyway. The Anglo-American legal tradition “cut this off at the pass” by declaring suicide itself a crime and anyone who assisted a suicide was a criminal. In practice, prosecutors never filed cases against failed suicides, they had better things to do, but, the law provided a defense against murders of the weak, which is what we have here.”
Tragically it already happens in our country. There have been several cases where a relative, usually a spouse, have ended the life of an invalid because it was the “merciful thing” to do. And instead of being reviled by society, it’s celebrated as the noble act. I don’t thing Orwell could have imagined a better example of reality’s distortion from the ministry of truth.
I believe that many people pursue the “easy way out” because of a lack of faith. They ultimately place their trust in themselves, saying in essence that I’ll do it my way. They do it probably for a number of reason, because of a fear of pain, fear of the unknown, etc. Ultimately being unlike Paul they don’t want to accept God saying to them, “My grace is enough” and decide to do what they want.
I believe that families push it primarily out of selfish reasons. They don’t want the burden or responsibility. And deep down I believe there are some selfish, greedy motivations.
I can’t tell you how many times I ‘ve seen situations where someone needing nursing home care has been delayed by the family because of a fear they’d loose money from their inheritance to pay for it. I believe pushing a family member to do the “noble thing” is only an extension of this mentality.
What amazes me is this notion that somehow calling for a respect for life is considered a radical, monumental change to society. To make a statement shows a lack ethical knowledge and how murdering of self has become ingrained in our society.
JBL writes: “I’m not arguing for a ‘monumental change.’ I’m arguing for a return to the concepts we used to hold as a society for a respect for life.”
First of all, these ethical problems related to end of life issues arose in recent decades as a result of advances in medicine enabling the continuation of bodily in circumstances that years earlier would have been fatal. Not many decades ago Terri Schiavo would have been dead within a few weeks of her brain injury. There were no feeding tubes, and she either would have started or died from aspiration pneumonia.
You’re not arguing for a monumental change per se, but it seems to me that the results you want would entail monumental changes. More on that later.
JBL: “We need to clarify that there is a difference between being brain dead (which is the cessation of brainwave activity) and being in PVS.”
Yes, correct.
JBL: “A person who is truly brain dead, is dead because the brain has ceased and the body is kept functioning by machinery. When the machinery is ‘switched off’ the body ceases to function.”
The notion that brain death constitues death per se is a culturally-determined notion that is not accepted in all cultures. In other words, it’s a kind of operational definition that is widely accepted in the U.S. and other western nations. But it is not that way everywhere. For example, see the Hastings Center report “Reconsidering Brain Death : A Lesson from Japanâ��s Fifteen Years of Experience” http://www.lifestudies.org/reconsidering.html
In other words, there are different views of what constitutes death. In Florida law PVS is considered a terminal condition. If you want the traditional view, then that would be when the blood circulation and respiration permanently ends. “Brain death” is a fairly modern view. In my view shutting off a respirator on a brain dead person is morally equivalent to withdrawing a feeding tube from a PVS patient.
JBL: “As long as you argue that people are brain dead who are breathing on their own you are denying them a sense of humanity.”
The mere fact that someone can or cannot breathe on his own has no particular moral significance. What I’m saying is that when the cerebral cortex is gone the person is gone. True, the lower functions of the brain continue to operate, but there’s no person.
JBL: “You distort and confuse the issue. Let’s be clear on that one thing TERRI SCHIAVO WAS NOT TERMINAL. It wasn’t a matter of just turning off a machine and just slowly drift off. It took two weeks to painfully die from starvation and dehydration.”
Again, the state of Florida defines PVS as a terminal condition, as do other states. You define “terminal” as being a condition that leads to immediate death upon withdrawal of life support. That’s your definition, but it’s not the definition that was operative in Terri Schivo’s state of residency, and is STILL operative.
JBL: “When you cite examples of end-of-life issues where people are just heart beats away from death and Terri’s case you do so either because you’re confused and ignorant about the complexities of end-of ‘life issues.”
No, it’s that I reject the time factor as being the ultimate determinant of what is or is not terminal. Look, you can have a person who is on a respirator, but is fully alert and functional in other ways. We wouldn’t call call that patient “terminal,” even though the patient is a few minutes from death as soon as the respirator is turned off. That’s why I completely reject time as the determining factor.
JBL: “Or, you have bought into the selfish nature that has permeated our society about doing away with the helpless because we can’t be burdened with them.”
I’m saying that in cases of brain death OR PVS the patient is in a terminal condition. For me “terminal” refers to whether or not there is a person still there, and whether there is hope of recovery, and further interventions are medically futile. Unlike coma, in cases of PVS and brain death there is no hope of recovery. And if you’re going to say that we really don’t know definitively when someone is in a PVS, I would have to point out that there are different definitions of brain death, and so in many cases we really don’t know with absolute certainty the condition of the patient.
But here’s a simple question that would help me a great deal in understanding your position: other than brain death, are there any other conditions in which it is morally acceptable to withdraw life-sustaining medical interventions from a patient? If so, when?
Jim you continue to dance around the issue. You want in your heart of hearts to believe that it’s okay for medical experts to kill the helpless, because it’s some kind noble act to ease discomfort or cut the cost these people’s burden bring on the wallet.
You continue to confuse morality with legality. (If prostitution were made legal tomorrow would you also find it morally acceptable?)
You can talk about the fine points of what defines brain death or not etc. But the ultimate stance you take is death is the solution. That the first and best solution is to kill the invalid.
So it doesn’t matter what I believe is the acceptable level in which to kill a person. What ever I post would only concede to you view. And I will not concede that death is a solution.
The real issue is your acceptance of the world’s evil that killing people for the “good of society” is acceptable. And you want to have it legally done to comfort yourself that it’s okay.
Euthanasia in the Third Reich: Lessons for Today?
J A Emerson Vermaat
‘At this stage I do not feel that I am going to die, but I don’t want to die away later with my body being reduced to a little more than a lump. Please, promise to help me before this moment comes.’ Today, many physicians are familiar with incurably ill patients requesting them to end their lives because of unbearable suffering. In the case of the above quote the request for euthanasia is not made by a desparate twenty-first century patient. One finds it in the Nazi film Ich Klage an (I Accuse) which was produced in 1941. The message of the the two hour long film was that doctors who submit to an incurable patient’s death wish act legally and morally.
Hanna, the beautiful young wife of professor Thomas Heyt, is suffering from multiple sclerosis. Her husband, the newly appointed director of the Anatomical Institute of Munich University, knows that there is little hope for his wife. Hanna first asks her personal physician and family friend Bernhard Lang to end her life should the moment of unbearable suffering occur. Lang refuses and says: ‘I am your best friend, but I am also a doctor, and as such I am a servant of life. Life must be preserved at any cost.’
Hanna then approaches her husband Thomas in a very emotional way: ‘You must help me. I want to remain your Hanna till the very end, I don’t want to become somebody else who is deaf, blind, and idiotic. I wouldn’t endure that. Thomas, if you really love me, promise that you will deliver me from this beforehand.’
Hanna’s medical condition rapidly deteriorates. Thomas and Bernhard realize she has only a few weeks to live. One day they are together at Hanna’s bedside. Hanna kindly asks Bernhard to leave the room. She wants to be alone with Thomas. Bernhard goes to the piano in the living room where he starts to play. While the piano music can be heard in the bedroom Thomas fetches a bottle containing a sedative and poors a fatal dose into Hannna’s glass. Before passing away Hanna says, ‘I feel so happy, I wish I were dead.’ Thomas replies, ‘Death is coming, Hanna.’ Hanna responds, ‘I love you, Thomas.’ ‘I love you, too, Hanna,’ says Thomas.
Bernhard is furious when Thomas informs him what has happened. Domestic servant Bertha then accuses Thomas of murdering his wife and takes him to court. At issue is: can a doctor be allowed to cause the death of a terminally ill patient after that person explicitly requested him to do so? One of the witnesses is Bernhard. He says that he initially also opposed Hanna’s request, but now he sees things from a different perspective. ‘Thomas, you are not a murderer!’ he says loud and clear in the courtroom. Thomas himself then accuses (‘I accuse!’) those doctors and judges who by adhering to strict rules fail to serve the people. ‘Try me! Whatever the outcome, your judgment will be a signal to all those who are in the same position like me! Yes, I confess: I did kill my incurably ill wife, but it was at her request.’
From a propagandistic point of view the film was a success. The Gestapo, the secret state police, reported that the film received much attention in the whole Reich. A Dutch woman living in Düsseldorf at the time told me in an interview: ‘All my colleagues were impressed by the film. They suddenly understood the dilemma of a doctor who is confronted with an incurable disease.’3\
Hitler’s ‘Euthanasia Decree’
This remarkable propaganda film presents a case and a logic with which today’s medical profession is quite familiar. It is not the crude Nazi ideology of killing ‘worthless life.’ Rather it makes a smart plea for a terminally ill patient’s right to a ‘humane’ way of dying. Sixty years ago the Nazis occasionally used similar arguments as today’s humane and sincere advocates of euthanasia. Karl Brandt, the head of Hitler’s euthanasia program, claimed at his trial after the war: ‘The underlying motive was the desire to help individuals who could not help themselves and were thus prolonging their lives of torment.’ However plausible or humane this may sound, the reality was far from humane. Indeed, the Nazis went far beyond killing the incurably sick, and few of the ‘individuals’ Brandt had in mind actually made a request that ‘their lives of torment’ should not be prolonged.
‘Euthanasia’ in the Third Reich was even a prelude to the Final Solution (Endlösung). Euphemistic terminology and covering up was the rule. Hitler’s Euthanasia Decree (‘Erlass’) of 1 September 1939 ordered his personal physician Dr. Karl Brandt and Reichsleiter Philip Bouhler, head of the Reich Chancellery, ‘to enlarge the authority of certain physicians to be designated by name in such a manner that persons who, according to human judgment, are incurable can, upon a most careful diagnosis of their condition of sickness, be accorded a mercy death (Gradentod).’
Similar criteria were later found in Ich Klage an: Mercy killing (Gnadentod is in Nazi language synonymous to Erlösung) for those whose suffering could not be prolonged. However, the decree did not refer to the need for a specific request by the patient, in most cases persons with mental disorders. Karl Brandt later said in Nuremberg that ‘incurably sick persons’ primarily meant ‘insane persons.’
see full article here: http://www.ethicsandmedicine.com/18/1/18-1-vermaat.htm
JBL writes: “You want in your heart of hearts to believe that it’s okay for medical experts to kill the helpless, because it’s some kind noble act to ease discomfort or cut the cost these people’s burden bring on the wallet.”
The issue in the Schiavo case is not mercy killing, but the right of a person to refuse medical treatment, whether personally, in writing, or through a proxy.
JBL: “You can talk about the fine points of what defines brain death or not etc.”
These are NOT fine points. In a situaiton in which we can keep a physical body alive for weeks, months, or even years through various medical interventions, there are very real questions as to what constitutes “death,” and when medical interventions are “futile.” And these are not abstract issues, but practical issues that patients, medical practitioners, and family memebers have to deal with every day.
JBL: “But the ultimate stance you take is death is the solution. That the first and best solution is to kill the invalid.”
Not my position at all. The point is to do what the PATIENT wants, as much as we can determine that. Listen, had Judge Greer found that Terri Schiavo’s wishes would have been to be maintained in a PVS, then I would have agreed with that, and opposed any other option.
JBL: “So it doesn’t matter what I believe is the acceptable level in which to kill a person. What ever I post would only concede to you view. And I will not concede that death is a solution.”
It’s not a matter of conceding anything to me. We are talking about very real decisions that physicians, patients, and family HAVE TO MAKE every day. It’s unfair to criticize my position, which I have laid out in detail, and say that I’m cooperating with evil — and then when it’s your turn to say what you would do, you punt.
The Schiavo case and all other similar cases are governed by an entire system of laws, practice guidelines, and accepted ethical considerations. You can’t just say “oh, here’s the Schiavo case, we’ll just change things around to get the outcome we want and forget about everything else. And everyone who doesn’t agree with that is evil.” It doesn’t work that way.
So lay your cards on the table. If you think that no patient should ever be able to discontinue any medical intervention, then say so. If you think that no respirator should be turned off, no feeding tube ever discontinued, then say so. If you think that patients’ wishes are irrelevant, then say so. Or whatever you think about these issues. Then we can look at the impact that your suggestions would have on the larger picture of end of life care. Sure, it’s cheap and easy to characterize a position such as mine as evil — but difficult to formulate your own solution. Which is probably why months after the Schiavo controversy Florida laws in this area remain unchanged.
The question stands: what would you do?
There is no solid proof that Terri’s wish would be to be killed other than the testimony of Terri’s husband, his brother, and his sister-in-law, evidence that is less than the standard for a murder trial. There is no written document that said, “I Terri want to die if I were to become a vegetable.” If there was then the feeding tube would not have been put in the first place.
That’s were Michael’s real problem is, he insisted on doing things that preserved her life. Then he remembered several years later that she wouldn’t have wanted to live that way. If her wish was to really die from the beginning the feeding tube would not have been used. Like I said earler Terri’s case was not about a patient’s right to refuse medical treatment. It was about what a caretaker can or cannot do in deciding the ultimate fate of the person they are in charge. In Terri’s case it was especially crucial because there was a conflict of interest with the caretaker.
Jim because Judge Greer found a reason doesn’t make starving invalid people ok. Judges found that abortion was okay too. But I wouldn’t say it makes sucking babies out of wombs, or burning them alive, or scrambling their brains, okay.
A patient has the right to refuse medical treatment. The problem is the patient has the right, in Terri’s case we don’t know for sure what her wishes were because they were never clearly laid out. As I pointed out the evidence for it was flimsy at best and there was evidence that contradicted the evidence that Judge Greer chose to follow.
Judges can make mistakes and so can legislators. Even ethicists can have a bias that clouds sound judgment (Do you really believe with Singer that a child is no better than a rat? Are you going to choose the drowning puppy over the drowning down-child?) The law instituted by men is not infallible. We can go through the past century and see how laws were used to justify inhuman acts against millions (can you cite what Soviet law Stalin broke when he starved several million Ukrainians? Or, what law did Mao break when he began the great leap forward?).
I state your position is evil because it is. It has nothing to do with stating my position or not. You seek the easy solution that diminishes peoples’ humanity and life to nothing more than bad laws and expenditures. In truth it is an antichrist mentality, because it seeks death as a friend and not the enemy it has been to mankind.
JBL writes: “There is no solid proof that Terri’s wish would be to be killed other than the testimony of Terri’s husband, his brother, and his sister-in-law, evidence that is less than the standard for a murder trial.”
Yes, but unfortunately this is very common in end of life cases. The doctors have to rely on the recollections and impressions of family members. The problem is that if you disallow such information in the Schiavo case, how then do you allow it in other cases? If you don’t allow it in other cases, you’re going to have a situation in which all medical care consists of a relentless “pull out all the stops,” which would be an unworkable situation.
This is what I referred to before — we can’t establish a procedure for the Schiavo case that does not apply to all other cases. The procedures have to be consistent across all such cases.
JBL: “There is no written document that said, “I Terri want to die if I were to become a vegetable.” If there was then the feeding tube would not have been put in the first place.”
Not necessarily. Her prognosis was not clear at first. The diagnosis of PVS is something that is developed over time.
JBL: “That’s were Michael’s real problem is, he insisted on doing things that preserved her life. Then he remembered several years later that she wouldn’t have wanted to live that way. If her wish was to really die from the beginning the feeding tube would not have been used.”
Again, Terri Schiavo’s prognosis is something that became clear over time. Michael Schiavo actually continued with efforts at rehabilitation long after the physicians had told him that she would not recover. Jay Wolfson, appointed guardian ad litem to Terri Schiavo by Gov. Jeb Bush, described the situation thus:
“In late Autumn of 1990, following months of therapy and testing, formal diagnoses of persistent vegetative state with no evidence of improvement, Michael took Theresa to California, where she received an experimental thalamic stimulator implant in her brain. . . . Despite aggressive therapies, physician and other clinical assessments consistently revealed no functional abilities, only reflexive, rather than cognitive movements, random eye opening, no communication system and little change cognitively or functionally. . . . By 1994, Michaelâ��s attitude and perspective about Theresaâ��s condition changed. During the previous four years, he had insistently held to the premise that Theresa could recover and the evidence is incontrovertible that he gave his heart and soul to her treatment and care. This was in the face of consistent medical reports indicating that there was little or no likelihood for her improvement. . . . It had taken Michael more than three years to accommodate this reality and he was beginning to accept the idea of allowing Theresa to die naturally rather than remain in the non-cognitive, vegetative state. It took Michael a long time to consider the prospect of getting on with his life â�� something he was actively encouraged to do by the Schindlers, long before enmity tore them apart.”
JBL: “In Terri’s case it was especially crucial because there was a conflict of interest with the caretaker.”
But this is the case with most end of life decisions. Physicians regularly rely on the recommendations of people who have a potential financial relationship with the patient in question. Once again, if you’re going to disallow information from people who have a potential conflict of interest, then what is the effect of that on all the other tens of thousands of end of life cases?
JBL: “Jim because Judge Greer found a reason doesn’t make starving invalid people ok. Judges found that abortion was okay too.”
The distinction here is that Judge Greer’s ruling did not change any point of law, nor was he ruling on the constitutionality of any law. His ruling was part of an evidentiary hearing, designed to discover certain facts. I accept his ruling because he, not I, was there. He was the man on the ground, and it was his job to make a determination. Had he ruled otherwise I would have accepted that. We can second-guess any judge’s ruling, but in this case I don’t see any reason to. In other words, the fact that you don’t like the ruling isn’t evidence that it was a bad ruling.
But let me ask you this: if you thought Greer made the right call — if the evidence, at a clear and convincing level, really did demonstrate that Terri Schiavo would not have wanted to be left in that condition — would you then support the ruling?
JBL: “As I pointed out the evidence for it was flimsy at best and there was evidence that contradicted the evidence that Judge Greer chose to follow.”
Well, there’s almost always contradictory evidence in such cases. If there weren’t there wouldn’t be a hearing in the first place. It’s the judge’s job to hear both sides and make a determination.
But look, just from a common sense point of view — how many 25 year old women would WANT to be maintained permanently in a PVS. In other words, if you asked 100 25-year-old women how many would want to be kept in a permanently unconscious state with no hope of any recovery, bedridden, diapered, living off of water and artificial nutrition delivered through a tube implanted in their stomachs, how many would want that? My guess is close to zero. I think most would say that they would want someone to try to bring them back, but when that was hopeless, pull the plug. Which is exactly what happened in the Schiavo case.
JBL: “Judges can make mistakes and so can legislators.”
Judge Greer’s ruling survived appeals at several different levels. That’s no guarantee that he made the right call, but had any another judge wanted to overturn his ruling, there was ample opportunity.
JBL: “I state your position is evil because it is. It has nothing to do with stating my position or not.”
If I understand correctly, my position is evil because I accept the ruling of a fully-qualified Christian judge who was actually present during the hearings and personally heard all the evidence. Your position is not evil, because you think he was wrong. My position is evil, because I look at the case in the context of all other similar cases. Your position is not evil because you look at this case in isolation from all other similar cases. Did I get that right?
JBL: “You seek the easy solution . . . ”
No, YOU seek the easy solution. You don’t like that outcome in that case. Forget the law. Forget the process. Forget the entire body of medical ethics and standards of practice. Forget all the other cases. You want a different outcome, pure and simple. You figure out what’s good and what’s evil, and then it’s Miller Time.
JBL: ” . . .that diminishes peoples’ humanity and life to nothing more than bad laws and expenditures.”
Trying as much as possible to determine what an incapacitated person would have wanted is an affirmation of that person’s humanity, born out of respect for the person. You reduce the complexities of the actual situation to simple moralistic statements that demand a particular outcome without giving us the details on how we’re supposed to get to that outcome or how the process is supposed to work in all other cases.
I think what we have here are different views of what morality is all about. The opponents of the Schiavo outcome start with a set of specific moral outcomes that are acceptable, and every particular case has to fall into one of those outcomes. This is seen as an affirmation of “humanity,” but it is really an affirmation of a particular religious or ethical dogma. In other words, the wishes of the individual must be sacrificed so as to preserve the religious or philosophical principle in question.
The proponents of the Schiavo outcome start with the wishes of the individual, and do not demand a particular outcome up front. They presume that the individual is primary, and that moral principles are there to guide us into the right outcome for that individual person.
Note 45. Jim writes: “Yes, but unfortunately this is very common in end of life cases. The doctors have to rely on the recollections and impressions of family members. The problem is that if you disallow such information in the Schiavo case, how then do you allow it in other cases? If you don’t allow it in other cases, you’re going to have a situation in which all medical care consists of a relentless “pull out all the stops,” which would be an unworkable situation.”
This is utter nonsense. Doctors don’t decide when to stop heroic measures, the family does. Even where a written living will exists, there still has to be family concensus before decisions are made. (Don’t think that living wills are the final word on anything. They indicate intention, and in that sense they can be valuable, but they certainly are not binding.)
Having said that, it is clear that you want to redefine medicine so that medical practioners are both agents of death as well as nurturers of life. In some ways the culture has made a dramatic shift in this direction already; doctors perform sophisticated pre-natal care while other doctors kill the unborn. You want an ideology that justifies this moral confusion by removing the distinction between killing and saving life. The euthansia practices of Holland for example, constitutes cultural progress to this of thinking.
This collapses the Terri Schiavo debacle into the larger box of end of life decisions as if there is one workable solution for every situation. There isn’t. I’ve been involved in enough of end of life decisions to know this. Your approach indicates you have minimal experience — the real blood and emotion of real human trauma — with these decisions.
Further, Terri Schiavo was not an end of life decision in the commonly understood sense. Terri was not facing imminent death. She died through forced dehydration and starvation.
You approve of the Schiavo killing for two reasons: 1) she was ostensibly PVS; and 2) a Judge ruled she should die. JBL is right. You do seek the easy solution. You show it by masking her killing in a larger discussion about the difficulty of making end of life decisions rather than facing the ugly fact of how she was killed.
This thinking is quite at home with the Dredd Scott decision where the Supreme Court decided the black man was undeserving of constitutional protection. Heck, we had a whole cadre of judges deciding that one. True, the black slaves were not PVS, but prejudices shift all the time. Just turn the contempt for the black man onto the infirm and the process is the same.
You write: “Trying as much as possible to determine what an incapacitated person would have wanted is an affirmation of that person’s humanity, born out of respect for the person. You reduce the complexities of the actual situation to simple moralistic statements that demand a particular outcome without giving us the details on how we’re supposed to get to that outcome or how the process is supposed to work in all other cases.”
The simplistic moralism here is that all cases are the same. There is no “one size fits all” to most human dilemmas, regardless of what the technocrats like to think. Human communities are not machines. They don’t respond well to forced solutions by self-appointed elites. If Terry Schiavo shows us anything it is what low regard there exists for human life in some judicial quarters, and to what length the culture of death apologists will go to defend their ideology in the face of such conflicting testimony and paucity of evidence.
I don’t think you will ever be convinced that Terri Schiavo did not need to be killed. If you can’t even frown on the most heinous abortions (partial birth abortions for example), you won’t flinch at the dehydration of another life that was deemed not worth living, but neither will you be able to stand up against any unjust death when it comes along. Culture of death advocates will soon be calling for even more killing, and you will raise your placard high defending those ideas as well. It’s all the same package. You have assimilated the logic that death is life.
Fr. Hans writes: “Having said that, it is clear that you want to redefine medicine so that medical practioners are both agents of death as well as nurturers of life.”
JBL said that there was no “solid proof” that Terri Schiavo would have wanted the feeding tube disconnected. My point is that there’s as much “solid proof” in the Schiavo case as in many other cases. In many of these cases all we have are the unsworn, unverified statements of family. If we require some kind of “proof” in these cases without which medical interventions will continue, then you are going to pull out all the stops in order to keep someone alive.
Fr. Hans: “Your approach indicates you have minimal experience â�� the real blood and emotion of real human trauma â�� with these decisions.”
Yes, I have only had the pleasure of watching my mother, my last family memeber, starve to death over a six week period in a nursing home. Maybe if I get a couple more starvations under my belt I’ll have a better idea about this stuff.
Fr. Hans: “Further, Terri Schiavo was not an end of life decision in the commonly understood sense. Terri was not facing imminent death. She died through forced dehydration and starvation.”
The “commonly understood sense” is irrelevant. Florida law considers PVS, end-stage, and terminal conditions as different aspects of the same thing, in that they are permanent and offer no reasonable medical probability of recovery. The law distinguishes between them in a technical sense, but the same laws govern all of them.
Which is one reason why I don’t understand why some of the folks here call MY position evil. I mean, you and several others on this blog live in Florida. This is your law, your judges, your courts, your legal procedures. The last guardian ad litem, Jay Wolfson, who largely agreed with the Michael Schiavo side of the case, was appointed by your governor. You vote for these people; your taxes support them; they operate in your public buildings.
From what I heard, all sorts of people in Florida were all het up over the Schiavo case. And yet you tell me that there hasn’t been a single change in Florida law with respect to this situation.
I don’t even know what changes to the law the folks in this venue want. Are you advocating the “lobster trap” approach to medicine, in which once someone gets into a feeding tube they can never get out of it? Are you saying that a relative shouldn’t be allowed to request that a feeding tube be discontinued? That some extraordinary level of evidence or documentation would be required to document a patient’s wish that a feeding tube be disconnected? What is the proposal?
Frankly, the Schiavo discussions are always a little irritating to me. That’s because I lay out my position in great detail, in thanks for which it is characterized as “evil.” But on the other side people rarely if ever make any concrete proposals as to how they think these cases should be handled. There’s a lot of energy going into characterizing my position as evil, and very little energy going into concrete proposals detailing what should be changed.
Fr. Hans: “You approve of the Schiavo killing for two reasons: 1) she was ostensibly PVS; and 2) a Judge ruled she should die. JBL is right. You do seek the easy solution.”
First of all, she wasn’t killed. She died after a feeding tube was removed. Or, if she was killed, then so was Tom Delay’s father. Why no outrage over that? We don’t even know if he was in a common-sense “terminal condition.” He could have lasted for months or years hooked up to a respirator, but we’ll never know because the family had him disconnected early on. But somehow Schiavo is culture of death, and Delay is no problem.
I approved of the outcome because 1) the medical concensus was that she was in a PVS, as confirmed by the long duration of the condition, and the condition of the brain at autopsy. 2) all reasonable measures were undertaken to rehabilitate her, without success. 3) all legal processes were followed. 4) the decision was made by a qualified (and Christian) judge after hearing all of the evidence (during a hearing at which neither you nor I were present). 5) The judge’s decision withstood a number of appeals at different levels. 6) it is entirely reasonable to believe that a young woman would not have wanted to be maintained in a permanent unconscious state with no hope of recovery. 7) all of the above were confirmed by an independent guardian ad litem appointed by the governor of Florida.
So let me try something. Here’s the Florida law, your state’s law:
http://www.flsenate.gov/statutes/index.cfm?
App_mode=Display_Statute&URL=Ch0765/ch0765.htm
First, what EXACTLY would you change? Second, how do you think those changes would affect other similar cases?
If you think that the Florida law should be changed, then detailing those changes would be a good exercise, yes?
Fr. Hans: “Your approach indicates you have minimal experience — the real blood and emotion of real human trauma — with these decisions.”
Jim: “Yes, I have only had the pleasure of watching my mother, my last family memeber, starve to death over a six week period in a nursing home. Maybe if I get a couple more starvations under my belt I’ll have a better idea about this stuff.”
Yes, you probably would. You certainly may understand a bit better the injustice of killing an infirm person when her parents pleaded for her life, willing to take all the responsibility for her care. You also would learn a little more about how death really works, and how no law is capable of addressing the complexity of death in any rational way except as prohibtion.
This complexity is why your call for a one stop approach is, well, a bit naive. That’s how I know your experience is limited. The fact is that when people are terminal they often stop eating and drinking. In cases where this is volitional and death is imminent, these decisions are part of the dying process and it is entirely moral not to intervene. This is a far cry however, from removing water and food from a person who is incapable of feeding or drinking on their own but not terminal — a distinction you are unwilling to make. They cannot be equated except by twisting any notion of the inherent sanctity of life into an unrecognizable shape.
Fr. Hans: “Further, Terri Schiavo was not an end of life decision in the commonly understood sense. Terri was not facing imminent death. She died through forced dehydration and starvation.”
Jim: “The “commonly understood sense” is irrelevant. Florida law considers PVS, end-stage, and terminal conditions as different aspects of the same thing, in that they are permanent and offer no reasonable medical probability of recovery. The law distinguishes between them in a technical sense, but the same laws govern all of them.”
“Which is one reason why I don’t understand why some of the folks here call MY position evil. I mean, you and several others on this blog live in Florida. This is your law, your judges, your courts, your legal procedures. The last guardian ad litem, Jay Wolfson, who largely agreed with the Michael Schiavo side of the case, was appointed by your governor. You vote for these people; your taxes support them; they operate in your public buildings.”
All true. But just because something is legal does not make it right. Look at Oregon. They’ve started on the black road toward euthanasia. Legal? Yes. Right? No.
“Commonly understood sense” is more powerful than you want to believe I think. If it were not, the outrage over the Schiavo killing would not have taken place.
So when a hospital throws some hapless, uninsured person out on their ear because they have neither the insurance nor the funds to be sustained in a vegetative state indefinitely, this is being consistent with a “respect for life”? Is this how that works?
If vitally important health care is a “right”, why should it not extend to everyone whether they can afford it or not? If it’s a “privilege”, let’s say so and drop the pretense that “everyone’s life is as valuable as anyone else’s”, because telling someone that they don’t get the feeding tube because they can’t afford it is indeed implying that they really just don’t matter.
If it’s a “privilege”, let’s say so and drop the pretense that “everyone’s life is as valuable as anyone else’s”, because telling someone that they don’t get the feeding tube because they can’t afford it is indeed implying that they really just don’t matter.
Well said. Around the time that Schiavo’s fate was being decided, I remember hearing about a case in Texas, in which life support was removed from an infant over the objections of the parents.
Quoting:
Republican Congressmen who are championing due process for Terri Schiavo were AWOL last week when the Texas Christian Hospital in Houston removed a six-month old infant from the ventilator keeping him alive. According to the HealthLawProf blog, “this is the first time in the United States a court has allowed life-sustaining treatment to be withdrawn from a pediatric patient over the objections of the child’s parent.” The legislation making it possible for the hospital to discontinue the child’s life support was signed by then-Governor George Bush; the National Right to Life Committee co-drafted the bill, giving hospitals the right to discontinue life support over the objections of families … if the families cannot pay.
http://uspolitics.about.com/b/a/155266.htm
Culture of life??