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"...public opinion deserves to be respected as well as despised" G.W.F. Hegel, 'Philosophy of Right'

the poverty of ethical thinking « Previous | |Next »
March 24, 2005

I've been watching the reverberations in the media in Australia of the Terri Schiavo case in the US. In this tragic case, because the family has split on the decision to "pull the plug", the case has gone to court, where there is a well-established body of law on the subject. The Schiavo case has been litigated for seven years, with the verdict to pull the plug upheld at every level (including the U.S. Supreme Court, by refusing to hear arguments).

So what do we have now? The US Congress and the US President have intervened in the medical treatment of Terri Schiavo in Florida. They have kicked the case to a Federal judge after the state courts had all ruled in favor of the husband. But what on earth is the federal government doing intervening into a private family matter about painful personal decisions? Surely it is not intervening on behalf of, and defending, Terri Schiavo's Roman Catholicism?

The Florida state is also intervening big time. It has gone another round in taking on Florida's courts so as to gain custody of Terri Schiavo. Jeb Bush, the Florida Governor, has relied on a medical opinion by a neurologist from the Mayo Clinic, who had not examined the dying woman, but believed she was not in a vegetative state after watching a video.

We can only infer from this that Terri Schiavo has become a political pawn in a Republican Party values campaign. Is not the US all about keeping politics and state-endorsed religion out of the private lives of individuals?

So what is going on in Australia by way of commentary?

The less said about the op.ed. by Doug Bandow The Australian downloaded from the Cato Institute the better. That piece attacked the character of the husband.

I heard Bernadette Tobin, director of the Plunkett Centre for Ethics in Health Care at Sydney's St. Vincents Hospital and Rosanna Capolingua, Perth GP and chair of the Australian Medical Association's Ethics and Medico-Legal Committee on Radio National Breakfast on Wednesday morning and read Tom Noble's 'The Hardest Choice' in The Age on Wednesday. This was the better of the two commentaries, even though the photo implied that Terri Shiavio was a conscious person, even though she has irreversible brain damage from fifteen years ago.

I was suprised at the absence of philosophers in this issue in Australia. Ethical issues are involved in this case, including the value and purpose of life, the moral obligations among family members, the significance of personal autonomy, and what it is to be a person etc.

Instead we had doctors doing ethics and they doing public philosophy very badly. None of the presuppositions were addressed.

The two doctors who were presented as experts on Radio National were pushing a right-to-life position on an euthanasia issue. This presupposed Terri Shiavo was a conscious person who could respond to those around her.

I was struck by this dishonesty, as Terri's life as a person ended long ago, and she would have no awareness of suffering from the lack of food and water. I was also shocked by the ignorance of the American legal situation about the patient having a right for her medical treatment to be guided by the court's judgement of her wishes.They ignored the principle of autonomy!

My ears picked up on that. I started sniffing the wind for a campaign? The case was being presented as medical neglect and as euthanasia, with both being judged to be wrong. The "culture of life" language was being deployed to say that pulling the plug on human life was wrong ---akin to a death sentence. The two doctors implied that consciousness was still present in a patient after 15 years in a persistent vegetative state,(meaning she cannot think, emote or remember; and they dismissed the viewpoint and expertise of the American doctors who had examined Terri Shiavo.

It was falsely implied that Terri was a young woman who lives with a very serious disability. So why would Australian medical experts dismiss the judgement of American medical experts who had examined the patient? Politics surely. It is the right-to life crowd pushing their barrow.

The ABC just went along with the Catholic right-to-life push. Now why didn't that suprise me? Still there should have been some form of balance to counter the tacit claim that the left are a bunch of moral relativists who can't be trusted to do what's right.

| Posted by Gary Sauer-Thompson at 8:44 PM | | Comments (5)
Comments

Comments

This is all being played out just down the highway from here - and it comes down to these two facts.

Ms. Schiavo is dying.
And We are a nation of laws.

So there you have it.

An interesting website that comes from a very biased point of view is www.terrisfight.org. This is the site authorized by the patient's parents. It's worth a look.

Dave
Thanks. I've had a look at Terris fight.org As you say it is biased.

Consider this:


"Terri is purposefully interactive, alert, curious, lovely young woman who lives with a very serious disability. She lives free of any life support machines and receives nutrition through a tube that is connected only at meal times."

This is very much at odds with the medical consensus of a persistent vegetative state.

It is painful to see this woman. In the videos put forth by her parents as evidence of her alertness and responsiveness, she seems at best very bad off. Even still, at what point, medically and ethically, do we decide how "bad off" is TOO bad off?

Without a living will, it is impossible to know if Ms. Schiavo would have wanted to live this way. When we poll the public to gauge "should they remove the tube?" the response is overwhelmingly on the "yes" side. What those respondents are saying is, "I wouldn't want to live that way."
Those who say "no" are more than likely saying "We mustn't let this woman die. It is not our place to decide."

But if she is in this persistent vegetative state, then she can't possibly care if she lives or dies. So as long as there are people in her life who want her to live and will care for her, what harm can there be in allowing that?

And here comes the law, necessarily objective and heartless, which states the spouse gets to determine the end. In this case, the spouse has moved on and is not what many of us would call a spouse anymore. (This is why some will call his character into question.) Is he being loving, reasonable, caring and looking out for what he says were his wife's wishes? I'm sure he is. How many of us wouldn't move on and try to find resolution?

The law is the law. This is a fight between the parents and the husband - and mercy is the only thing that will end it. Someone has to give up. I can see these parties bickering long after her death.

Whose mercy though? Mr. Schiavo would say it is merciful to allow his wife to die, while the parents would prefer he show mercy by handing over custody. Or the Schindlers can mercifully resign themselves to their daughter's fate, which is not a propostion very many parents could face.


Dave,
The existential conflict you refer to is explored in great depth by Lori Leibovich. A lot of the anguish is caused by a divided family. It's a tragedy.

The with the Republican rught to life position of Frist and Jeb Bush is that their case rests on a diagnosis of Terri Schiavo's condition. on watching "an hour or so" of video footage of Schiavo and on conclusions being based not upon the time-honored technique of examining the patient in question. What sort of medical practice is that? I would consider it unethical to give a medical opinion without examining Terri Schiavo.

Secondly, bioethics in the US has shifted from medical paternalism to the autonomy of the patient, and rightly so. The case ought to centre on this principle, not the feelings of a bitterly divided family.

In a case of conflict and contestation about what Terri said about pulling the plug the courts are the best guide, not the politicians or the opinion polls. The courts have weighed the evidence and made a judgement in terms of the constitutional law of the US. I cannot see why that reliance on the legal/political principles of the US is "heartless."

I do not see that the character of Terri Schiavo's husband he has very much to do with this. Terri Schiavo's husband is her legal guardian. Her parents have not succeeded in challenging this status of his. As long as he is the guardian, the decision on removing the feeding tubes is between him and their physicians. Her parents have not succeeded in having this responsibility moved from him to them.

If it is a fight between the parents and the husband as you say, then the Republican politicians (it's a Republican Congress) should butt out and not use the issue for political advantage to affirm their support amongst Christian conservatives.

They have decided to play politics with it and in doing so the Republican Party has repudiated its classic principle of giving states maximum autonomy to decide issues within state borders.

In such cases it is the courts who stand for, and defend, public reason

Terri's husband should have left her alone, to live out the rest of her life!!! What should he have to say on the matter? Looks like he chose another relationship (while being a married man), he should have returned all rights back to her parents/family that loved her! I really have to wonder what was going on in her precious mind, when she saw what he and others, were doing to her! The medical field tries to save people by organ transplantation, but when someone doesn't have the fullest of quality life, that doesn't seem to matter. And the way, she left this world..... I can't believe this happened in America!!! I pray for her family! They loved her, so much!!! They carried the true meaning of love and devotion. "'God' bless them and also for our fine President Bush, for all that they tried to do for her!!!" They will be blessed!!! I have followed the story closely, and I as a medical student, want to say, I'm so sorry to see that life today, has turned this way!!!