Bioethics, healthcare policy, and related issues.
Paul Root Wolpe, a highly respected bioethicist, was working awfully hard at the UPenn Bioethics Conference last weekend to picture the Schiavo case as a glass half full. Bioethics.net quotes him:
The real truth – the one hidden in the invective and hostility that infected so much of the debate over the case – is that both sides were right. Terri Schiavo found herself in a medical limbo that left her person and nonperson, severely damaged yet not really suffering, awake and moving yet not perceiving or feeling. That is precisely what makes these cases so tragic. . . .
If we conduct [these debates] without bitterness, assuming our opponents’ good faith, and in a spirit of working toward solutions, perhaps it won’t be quite so hard to die in America.
Good luck with that, Paul.
The same story links to a post about the protesters circulating outside the conference site:
Brandi Swindell, National Director of Generation Life who stood in solidarity with Terri by entering a 15 day hunger strike in Florida, states, “We are going to this symposium to say that Terri Schiavo did not die with dignity. Rather, she died a barbaric death . . . .”
Edel Finnegan, a spokesperson for the Pro-life Union, says, “It is a total outrage that the University of Pennsylvania is celebrating the cruel murder of Terri Schiavo, an inspirational and courageous woman. The 10th Anniversary Symposium is a one-sided event that attempts to give credibility to the murderous actions of Michael Schiavo and Judge Greer. We are standing witness to remember Terri and all the other disabled Americans whose lives are threatened by activist judges like George Greer and selfish family members like Michael Schiavo.”
Yeah, it really sounds like there’s a decided lack of bitterness in that crowd.
But what gets me about this – what has been the overwhelming issue in the Schiavo case, and to one degree or another in the many right-wing end-of-life causes célèbres that have followed – is, beyond the anger, the sheer falsity of the charges, and the factual descriptions of the cases, traded in by conservative protesters. The absurd and mind-boggling distortions of the Schiavo case, promulgated by the Schindler family and their legions of greasy hangers-on, are fresh in the mind, but they still continue to this day. After the absolutely shattering results of the autopsy were made public, right-wingers are still claiming her death was “barbaric”; when court after court resoundingly and overwhelmingly rejected the Schindlers’ endless motions and affirmed the trial court judge’s rulings in ringing language, they call that judge a “murderer” as if the utter vacancy of their own side of that case was irrelevant. And the vindictiveness is reaching bizarre levels: the wild accusations and crazy charges made against Michael Schiavo during the Terri Schiavo saga were bad enough; now they’re stalking him for revenge. Disgruntled members of the failed conservative team have demanded he be arrested over a claimed discrepancy on a job application from years ago; others have petitioned the Catholic church to have his recent marriage annulled on some technical point of canon law. Why does his marriage matter to them, more than a year after Terri Schiavo died? It’s merely a way of punishing Michael Schiavo, whom they can’t seem to let go. The judge comes in for it, too: his appearance at the UPenn conference addressing the Schiavo case – surely something he has expertise on – has prompted an official complaint to the administrative office of the state judiciary, seeking to have him impeached. And it is in this environment that we are asked to take at face value another family’s heated and nearly-incredible complaints of “murder”, “conspiracy”, and other mistreatment in the Texas case of Andrea Clark, and in this environment that Paul Wolpe calls for “assuming our opponents’ good faith, and . . . a spirit of working toward solutions”.
I’m not too sanguine about that, on the basis of evidence seen.
I’m not too sanguine about it, however, on more important grounds as well. First, let me say I’m a bit surprised to hear Wolpe describe Schiavo as “person and nonperson”. Whether or not “both sides were right” about some aspects of the case, no bioethicist would say anyone is both person and non-person. The concept of personhood was intended to be categorical. If it is as ambiguous as Wolpe (speaking informally, obviously) implies, it will be unable to do the work intended for the concept that term was intended to embody. But that is a minor point of language (I think – I’m assuming he didn’t mean it in a strict sense). He belies his own seeming confusion on the personhood issue by saying straightforwardly that Schiavo was “severely damaged . . . not really suffering . . . not perceiving or feeling.” If we flesh out “severely damaged” in the clinically accurate way – suffering near-total neocortical degradation (as evidence both before and after autopsy) – and add to “not perceiving” the also-relevant and also-obvious fact: “entirely lacking voluntary stimulus responses”, we get a much clearer picture of the situation. Terri Schiavo lost her personhood no later than the point at which it became obvious her therapy was not helping, and likely at or shortly after her original collapse. This is not to deny the heartfelt wishes, or even beliefs, of the Schindlers to the contrary, but even Wolpe – while insisting that “both sides were right” – can come up with nothing stronger on the Schindler’s side of the balance than that she was “awake” (by which he clearly does not mean “conscious”, “self-aware”, or “possessed of explicit interests and desires”). In fact, he description of her as “severely damaged” is apparently intended to be accounted to the Schindlers – hardly a ringing endorsement of their expectations that she would recover. The truth is that both sides were not equally right. There were certainly important facts and values to be adduced to the Schilndlers’ position, but the morally relevant facts almost entirely supported Michael Schiavo’s perception of the case.
I think it is not coincidental that almost the same remarks can be made about most of the other cases the right wing has elevated into public controversies. Invariably, the controversy is between their insistence on inflexible principles of their own devising and the actual facts of the individual case, and invariably those facts are distorted and sensationalized by the well-practiced right-wing media machine. I see little spirit of compromise, and little hope of addressing any of these issues on a ground of shared values or beliefs.
And finally, I note that Wolpe gives his own game away with his use of the term “so hard to die”. The right wing – the “pro life” right wing – active in the Schiavo case, and the various Texas futility cases, and so many others – is explicitly dedicated to making it hard for everyone to die. “Pro life” to them means no one can ever die easily, and certainly no easy death can ever be acquiesced in. Their outrage in the Schiavo case is not that they themselves tortured her body until it died, or that they made her death such a circus – it is that she died. They would have been perfectly happy to continue the circus as long as necessary if it would prevent her from dying, and would have preferred to keep her body mechanically functioning without the circus, indefinitely. Under their care, it would always have been hard for Terri Schiavo to die, no matter how badly off she became. That is their goal. Wolpe, in hinting that there’s something bad in a hard death, merely identifies himself as their enemy, another would-be murderer. He can expect precious little “spirit of working toward solutions”, I fear.
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