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March 21, 2005

Comments

Frank McGahon

"There is no evidence whatsoever that Terri Schiavo ever claimed while sentient that she wanted a "death with dignity", other than the claim of her (self-interested) husband"

That's true, but it occurs to me that it's not so neat, even if she had. We seem to all share this assumption that the wishes of pre-vegetative state Terri ought to take precedence, but that "person", or at least that particular version, is no longer here and it might not necessarily be in the best interests of 2005 Terri to carry out the wishes of an earlier version of herself. Imagine a person terrified of, say, being confined to a wheelchair who expresses a wish that in the event of being paralysed from the waist down he be allowed "die with dignity". Now, in the event that he is paralysed, nobody would seriously argue that those previously expressed wishes ought to take precedence over what he can actually tell you he wants now. Why is it different in this case? One might attempt the argument that it's in the interests of 2005 Terri to "die with dignity", but this an entirely separate argument to "what she would have wanted" and ought to based on inferring her best interests here and now. Another example - I'd hate the thought of developing Alzheimers. Ask me now and 2005 era I will say that I'd have no problem being euthanised in that event. But, if I did get Alzheimers, I might not be completely competent, but I'll wager that I wouldn't actually want to be euthanised. I don't see why some old man should die to save the earlier version of himself from worrying about a future loss of dignity.

Andrew

"there is no evidence whatsoever that Terri Schiavo ever claimed while sentient that she wanted a "death with dignity", other than the claim of her (self-interested) husband"

But the original ruling back in 2000 says:

"Also the statements she made in the presence of Scott Schiavo [Michael's brother] at the funeral luncheon for his grandmother that 'if I ever go like that just let me go. Don't leave me there. I don't want to be kept alive on a machine.' and to Joan Schiavo [Michael's sister-in-law, wife of a different brother] following a television movie in which a man following an accident was in a coma to the effect that she wanted it stated in her will that she would want the tubes and everything taken out if that ever happened to her are likewise reflective of this intent."

The court acknowledged previously that there might be some issue of credibility if Michael were the only witness testifying to this, but this wasn't the case. "The court has reviewed the testimony of Scott Schiavo and Joan Schiavo and finds nothing contained therein to be unreliable. The court notes that neither of these witnesses appeared to have shaded his or her testimony or even attempt to exclude unfavorable comments or points regarding those discussions. They were not impeached on cross-examination." etc.

http://abstractappeal.com/schiavo/trialctorder02-00.pdf

Also the ruling indicates that Terri's parents have plenty of conflict-of-interest themselves so it hardly seems fair to imply that Michael's testimony is not usable simply because he has some self-interest at stake.

I realize that this line of argument won't convince you, since you don't accept testimony about informally expressed wishes. But still, the evidence isn't as weak as you say.

Also, a minor quibble: this ruling doesn't really "set a precedent." My sense is that this kind of ruling, in which the court examines testimony to decide whether there is "clear and conclusive evidence" of intent in one direction or the other, is standard practice in cases where the patient has not left a living will. It doesn't seem like we are headed down the slippery slope to forced euthanasia, insofar as legal procedures about refusal of treatment have not been changed by this case.

Abiola Lapite

Andrew,

I think Frank's statements suffice as a rebuttal to the verbal statements others claim Terri Schiavo made while she was alive: talk is cheap, and lots of people say that kind of thing when the prospect of death seems a distant prospect. In any case, she's braindead, and I see no reason why her claimed wishes to die "with dignity" ought to be respected if she's in no position to care.

"Also, a minor quibble: this ruling doesn't really "set a precedent." My sense is that this kind of ruling, in which the court examines testimony to decide whether there is "clear and conclusive evidence" of intent in one direction or the other, is standard practice in cases where the patient has not left a living will."

This is precisely my problem: it simply ought not to be within the power of the courts to make rulings in favor of death where no living will exists. As I said before, where there is doubt, we should always err on the side of life.

Andrew

Two points on Frank's argument:

-Interests are not the same as desires. Jehovah's Witnesses refuse blood transfusions, even if "objectively" speaking (as one would have to be if one were a court ruling on whether medical treatment was in someone's "interest") that goes against their interest. What matters for patient autonomy is desire - you have the right to choose what medical treatment you will submit yourself to and what you will not.

-It seems pretty clear that there is a qualitative difference between a someone in a wheelchair with still-intact mind, or even someone with Alzheimer's disease with a compromised mind, versus someone whose cerebral cortex has almost completely disappeared. Terri Schiavo no longer has any desires. Therein lies the dilemma.

Consider another example: a woman says informally that she wants to be cremated after she dies; when she dies, her husband tries to get her cremated but her parents insist that she be buried in a coffin. The woman herself can no longer say what she wants - shouldn't her previous wishes be respected?

Andrew

"where there is doubt, we should always err on the side of life."

But there is always doubt, even with a living will. If you adopt Frank's view, the person who wrote the living will is never the same person as the one who is undergoing (or not) last-ditch medical treatment. Sounds like your position is that you're only inclined to accept a certain amount of doubt and that Terri Schiavo's case exceeds that limit.

Abiola Lapite

"Sounds like your position is that you're only inclined to accept a certain amount of doubt and that Terri Schiavo's case exceeds that limit."

Yes. If we can bend over backwards to give every doubt to people being tried for murder, why accept anything less for those who happen to be incapacitated? For me to accept this sort of thing, I'd not only want there to be a "living will", but make it mandatory for said document to be periodically reaffirmed every few years, expiring by default if no action is taken. I wouldn't go along with the decision to kill a 40 year old based on a document he wrote when he was 20; how many people don't change their views at all in the course of their lives?

In any case, Terri Schiavo is braindead and in no position to know or care whether her wishes are being respected, so I see no reason why we ought to defer to her husband's desire to see her dead as opposed to her parents' wishes to see her alive. Blood is thicker than water, and life is too precious to throw it away just to satisfy some claimed need for "closure" of a guy who's already started a new family.

praktike

but you said she is "indeed effectively dead"

Abiola Lapite

It's not the same as being *actually* dead, otherwise Michael Schiavo wouldn't be so eager to pull her feeding tube.

Andrew

But it's not to satisfy the husband's desires - the court has ruled that Terri would have wanted to end the useless medical care. Obviously you disagree with that decision, but the husband's need for closure doesn't really come into it. As her guardian, he could have decided on his own to end life support, but instead went to a third party, the courts, to make his case.

Anyway, there's no need to overstate your argument by basing it on Michael's need for closure or lack thereof - if life's precious, it just is, and that's that.

Andrew

Or that is to say, Michael's need for closure is important only insofar as Terri might have thought that she wouldn't want to be an emotional burden on her family by lingering on in a limbo between life and death (that could be one reason for refusing last-ditch medical treatment, alongside other classics like dying with dignity and so on). In any case, the court's decision rests on Terri's desires, not Michael's.

Abiola Lapite

"But it's not to satisfy the husband's desires - the court has ruled that Terri would have wanted to end the useless medical care."

Since when were courts infallible again? A court also found for Plessy v. Ferguson once, so spare me the bullshit about court rulings.

"Obviously you disagree with that decision, but the husband's need for closure doesn't really come into it."

Utter bullshit. He was willing to keep her alive while he fought with the insurance company for her care money, and if he didn't want her dead, he could just have handed her over to her parents.

"Anyway, there's no need to overstate your argument by basing it on Michael's need for closure or lack thereof - if life's precious, it just is, and that's that."

Maybe you ought to read more carefully in future: it isn't I but those defending the right to kill Schiavo who are making the argument that her husband is owed "closure" on the issue by having her dead.

"In any case, the court's decision rests on Terri's desires, not Michael's."

Rubbish: the court's decision rests on what Michael Schiavo and two other people *claimed* were her desires. Nobody with half a brain would agree to sentence an accused murderer to death based on mere eyewitness testimony, which is notoriously unreliable and susceptible to suggestion, but when it comes to the Schiavo case we're suddenly supposed to throw all standards of evidence out the window. How convenient.

Andrew

"if he didn't want her dead, he could just have handed her over to her parents."

If he wanted her dead, he could have just withdrawn the life support himself. He is her guardian, after all.

"Rubbish: the court's decision rests on what Michael Schiavo and two other people *claimed* were her desires."

I wasn't claiming that the courts are infallible. I was saying that if you want to criticize the court's decision, you should do so on its own terms. All court decisions are based on what witnesses (or forensic experts, or whatever) *claim*. Since you think the court has been too uncritical of the witnesses, just say so, rather than imputing other motives onto the judge. (Unless you think that the decision is so absurd that it can't possibly rest on the basis that it claims to rest on (clear and conclusive evidence that Terri wouldn't have wanted the life support), that no reasonable person could possibly make this decision, therefore the judge must have other motives. E.g. for the Plessy v. Ferguson case we would say the judges were probably racist.)

Abiola Lapite

"Since you think the court has been too uncritical of the witnesses, just say so, rather than imputing other motives onto the judge."

Would you care to point out where I've done any such thing?

Andrew

"life is too precious to throw it away just to satisfy some claimed need for "closure" of a guy who's already started a new family."

? (I guess that doesn't refer specifically to the judge though.)

I suppose what I meant was that I had said, 2 posts back, that Michael's putative need for closure doesn't really come into the court's decision (perhaps I am guilty of pronoun vagueness? I said "doesn't really come into it," where by "it" I meant the court's decision), insofar as the court's decision is based on the judge's findings of Terri's desires. Then you called that argument "utter bullshit." So I guess I assumed that you were arguing that the court's decision was based on something other than (or in addition to) Terri's putative desires, namely on Michael's need for closure.

Abiola Lapite

"So I guess I assumed that you were arguing that the court's decision was based on something other than (or in addition to) Terri's putative desires, namely on Michael's need for closure."

No, my point was that Michael Schiavo's defenders who cite his need for "closure" don't have a leg to stand on. To quote:

"And damn any superstitious ninnies who get in the way of allowing her to find peace and closure and dignity because they think my idling quasi-corpse needed salvation."

João da Costa

This case makes me wonder about the meaning of "vegetative state", "coma" and even other minor unconscious mental states (for example the ones artificially induced by total anestesia) and their relation to PAIN.
I tend to agree with Abiola that if you have doubts, please, opt for life, because its too precious, etc.
Anyway the "impossibility of recovery" is a relative concept: relative to the stage of development of medicine. Things that are impossible today can be possible tomorrow. I remember reading somewhere about some (rich) people who wanted to (deep) freeze their bodies to avoid dead by now, and wait until the stage of medicine science enables them to awake again and be cured of their current ailments. (Maybe this is yet another "urban legend" or just "science fiction"! I don't know and actually I didn't search for a confirmation or refutation!)
But sometimes I doubt: how sure are we that some of those conditions are really totally pain-free and shielded of some kind of "suffering"? The data gathered until now or the modern knowledge about the brain mechanisms underlying pain suffices to gives us a garantee?
Because if the answer is negative, creatures in some of such states could want badly to die immediately.
Pardon, if I speculated to much...

Randy McDonald

Michael Schiavo, despite his partnership with another woman and his parenting of two children with her, might well want to let his wife die because he just doesn't want her body.

I'm skeptical whether there's enough proof to justify ceasing feeding. I think her parents, though, and the opponents generally, are making very bad arguments and doing short-sighted things, whether passing federal legislation directed towards a single person or making unsupported charges of spousal abuse.

Abiola Lapite

"Michael Schiavo, despite his partnership with another woman and his parenting of two children with her, might well want to let his wife die because he just doesn't want her body."

Then why doesn't he just walk away? Nobody's asking him to maintain any responsibility towards her.

"I think her parents, though, and the opponents generally, are making very bad arguments and doing short-sighted things"

If you were a parent and the courts wanted to put your child to death, wouldn't you reach for any and every argument at your disposal as well? It's a bit much to expect parents to be thinking about "states rights" as opposed to keeping their daughter alive; that they've gone to such lengths is just evidence of how much more they seem to care about her than the stranger who married their daughter and now wants her dead, having started a new family of his own.

Andrew

Don't assume that Michael doesn't care about Terri because he wants to remove her feeding tube - if anything, he cares about her a great deal because he wants to respect her wishes about what medical treatment she would have wanted to receive. If he didn't care about that complicated issue so much, why would he have gone to all this trouble of submitting to the court's decision rather than just removing the feeding tube himself? If he didn't care about his wife, why would he have spent several years searching for a way to cure her, and indeed still visit her regularly?

Abiola Lapite

"Don't assume that Michael doesn't care about Terri because he wants to remove her feeding tube - if anything, he cares about her a great deal because he wants to respect her wishes about what medical treatment she would have wanted to receive."

This is a ridiculous statement which assumes what it seeks to prove. How eactly do you know that he's actually choosing to "respect her wishes"? That's precisely the problem to begin with - that it's just his word and that of some friends that he's doing any such thing. We wouldn't even be having this conversation if we really *did* know for certain what her wishes were. This has to be the third or fourth time in this thread where you've pulled this stunt of assuming your conclusion.

"If he didn't care about that complicated issue so much, why would he have gone to all this trouble of submitting to the court's decision rather than just removing the feeding tube himself?"

Maybe 'cause the insurance settlement required it?

"If he didn't care about his wife, why would he have spent several years searching for a way to cure her, and indeed still visit her regularly?"

Rubbish. That's why he's refused to allow her to recieve therapy, why he's had her put in an isolated room with the windowshades drawn, and why a nurse is recorded as saying he asked why "the bitch" wouldn't die ... Spare me the desperate apologetics for this guy; it's an insult to my intelligence to assume I can't see through such transparent nonsense.

Abiola Lapite

Read this before subjecting me to any more excuse-making on behalf of Michael Schiavo.

http://www.theaustralian.news.com.au/common/story_page/0,5744,12616010%5E7583,00.html

[Looking after the interests of Terri or Michael? "Michael Schiavo has not been a model husband," observes New York commentator Deroy Murdock. There are claims by Terri's family about his violent nature and questions about the circumstances of her collapse. There are his girlfriends and children with his present live-in. There is his failure to fund rehabilitative care that some doctors say could be effective and his reported comments on how he planned to spend the almost $US1.6 million legal judgment theoretically won for Terri. And there is his extraordinary question to nurse Carla Iyer: "Can't you do anything to accelerate her death?" Iyer, with no apparent stake in the case, says Michael also asked: "When is that bitch going to die?"]

There's your devoted, caring husband for you.

Andrew

"This is a ridiculous statement which assumes what it seeks to prove."

And how do your statements not assume what they seek to prove? (I mean those that say that Michael doesn't care about his wife, he just wants her dead to be rid of her, only took care of her in order to claim insurance money, and so on.) And on the parents - the Schindlers have their own conflict of interest, which is that they want Michael to divorce Terri, after which they will be her legal guardians and become her heirs. You have about as much basis in accusing Michael of being a heartless bastard who just wants Terri dead out of his own selfishness, as I would have in accusing the Schindlers of trying to steal Terri's estate from Michael.

"Maybe 'cause the insurance settlement required it?"

That's the first I've heard of that - can you point me to a link? [not intended as a sarcastic challenge, I just want to see for myself]

"That's why he's refused to allow her to recieve therapy, why he's had her put in an isolated room with the windows down"

Maybe he put her in an isolated room with the windows down to keep out all the publicity and preserve some of the dignity that you say she no longer has? Maybe he's refused to allow her to receive therapy because he believes she wouldn't have wanted it, now that he realizes that her condition after 15 years is almost certainly irreversible? According to the court's decision I linked to, "By all accounts, Mr. Schiavo has been was [sic] very motivated in pursuing the best medical care for his wife, even taking her to California for a month or so for experimental treatment. It is undisputed that he was very aggressive with nursing home personnel to make certain that she received the finest of care." Apparently even the parents don't accuse him of stinting on treatment for Terri.

On the nurse's quote - given your skepticism of eyewitness testimony, I'm surprised that you took that at face value.

I just read the article you linked to. Please, give me a break. "Michael conveniently didn't note her alleged sentiments when requesting money for her rehabilitative care." Uh - Maybe that's because he thought/hoped she still had a chance of recovery and didn't want the insurance company to deny the money on the basis that she didn't want treatment? "Further, a former girlfriend says that he admitted that he and Terri never talked about the issue" -- you're asking Michael's EX-GIRLFRIEND? Oh, there's a neutral witness. Also, the article's dismissal of the persistent vegetative state is completely wrong. See here: http://respectfulofotters.blogspot.com/2005_03_01_respectfulofotters_archive.html#111120735448873570 For example, the video which putatively shows Terri "responding" to her environment was 4 min 20 sec culled from 4 1/2 *hours* of tape. None of the affidavits by doctors claiming that Terri is not in PVS are by doctors who have actually examined her. And so on.

On the bits about Michael - who on earth is Deroy Murdock and why is he supposed to know anything about Michael Schiavo? Terri's family claims he abusive, but why should we take that more seriously than Michael's claims that she said she didn't want to be kept in a vegetative state? After all, Terri's family has a conflict of interest as well (as stated above). Failure to fund care that "some" doctors say "could" be effective? Most likely the same quacks who say she isn't in a persistent vegetative state. Seriously - this is just some random columnist in Washington. How is this any more authoritative or credible than a court that actually examined witnesses?

Andrew

Oops, that link didn't come through. Let's see if this works:

http://respectfulofotters.blogspot.com/2005_03_01_respectfulofotters_archive.htm
l#111120735448873570

William

I don't see why we should immediately presume her husband is only interested in cashing in. It's in the parents' interest that this guy is thrashed. In Europe there's regularly a euthanasia case in the news, and in the subsequent yes-no discussion, you never hear anyone claiming "the guy's just after the money". Kind of distorts the real discussion to be honest.


With regard to the fact that the court does not grant the parents'wish: once people are married, courts presume that husbands/wives are closer to each other than to their respective parents as they share a daily living situation, a family, job, etc. As they live closely together, courts presume that they will know their partner's wishes best. (until facts prove otherwise of course, or if someone other than the partner had a closer relationship).

Vaz Lube

For argument's sake, she has to live as vegetate state as ordered by some entities (be it government, court, church parents, doctors et al), then when the day comes that her body has reached at age that body naturally dies off of old age. But she's being held alive by machines, so it could be conceivable that it's keeping her alive 100+ years old?

Once she reaches 65? 70? 80? 85? 90? years old, take the feeding tube out or not?

There's no escaping playing god. We are gods.

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