Saturday, March 19, 2005

Congress and Terry Schiavo

I have two papers to write for school, one on Aeschylus' "Agamemnon" and one on Aquinas on Natural Law, so not much time. Yet I wanted to submit the proposition that you all really don't want the Congress getting too mixed up in the Schiavo case. It can only complicate matters.

The pro-life carrying-on that is in all the newspapers now is, in my opinion, quite inappropriate and short-sighted. The last thing we want is the government weighing in more heavily in these issues. What the non-medical public seems to be forgetting is that decisions to remove feeding tubes, or to not put them in, or to not resuscitate, or to not treat in other ways, are made every day by families and physicians and individuals all over the country, and there is rarely any problem. Right now, somewhere, a feeding tube is coming out. Right now, some ER physician is deciding not to attempt to resuscitate someone. People die every day, and everyone has to die of something.

I am pro-life, have always voted pro-life...just to get my "credentials" out there. Yet, if I were Terry Schiavo, I would NOT want that tube put back. And I put feeding tubes in every week. Most of the time, I hate myself for doing it. I shove some smelly rubber tube through a weeping hole in some completely debilitated human being's abdomen, and wonder, "Why can't we accept that this person's race is run? Why can't we let her go in peace?" For, you see, I believe quite strongly that just as God placed within us certain mechanisms by which we are born (such as the foramen ovale and the ductus arteriosus that close at birth to allow us to become air-breathers), so He placed within us certain mechanisms by which we die when we are sufficiently broken. We stop eating. We stop breathing, or breath inadequately. We dehydrate. We die. That's how Grandma used to die, in her room off to the side. She "went off her feed", had insufficient oral intake of calories and water, weakened, and died, perhaps of an infection that today we would aggressively treat. This is dignified. This is the proper end of life.

Want to treat Grandma with respect and dignity? Keep her at home. When she is unable to feed herself, feed her, with a spoon. When you are unable to feed her enough, when she refuses food, (and it is not simply...and I say simply...depression) then make her comfortable, for she is in the process of dying. Clean her, keep her comfortable, and wait. It is the way we have been dying for millenia.

It is the same with devastating accidents. We have a built-in shut-off mechanism. I have seen a man cut in half, across the pelvis. Could such a man be saved? There is a chance. Would I honor such a man's request to let him go? Most certainly. These are admittedly more complex decisions, but my point is that they are not the kind of decisions that a government can make. Usually they are made in the midst of flashing lights and squirting blood, often by gut feelings about what is salvageable. Sometimes by a soon-to-be widow or widower standing by in tears.

The end of life is as holy a time as the beginning, and just as mysterious. Perhaps more so. To pretend to understand it, to regulate it like traffic or interstate sales, is to tread where we should not tread.


  1. Dr. Kearns,

    Thank you for your thoughtful post. I have some of the same reactions as you do regarding the feeding tube and "going in peace" and I rarely see them voiced.

    Christie G.

  2. I have to acknowledge not having paid much attention to the Schiavo situation over the past few years, as it's occasionally appeared in the media & as it's been promoted as a cause by Focus on the Family & voices like it. I'm leery too both of medicine becoming a means for some to deny or inappropriately resist the inevitability of dying, and of medical cases becoming political instruments or tokens for positioning ourselves in cultural conflict.

    But as this thing has been getting heavy press in the past couple of weeks, it's seemed to me that this is not strictly a case of whether someone should be allowed to die or allowed to live. Evidently there is no way here to know what "Terri wants", and I think there can be no proper valuing of the continuation of her life against the discontinuation of it, if we can't say conclusively that in effect she is already dead. Slippery terms like 'dignity' as applied to a person's quality of living or dying under others' oversight don't seem to me to help much for clarifying her interests. There is no right or wrong in medicine being available & applicable, where we are in history. Who can say what should be considered excessive care? She is still alive: the only questions here seem to be whether she can be cared for in her invalid state and whether someone's willing & able to do it. And what horrifies me and so many others, I think, in our gut, seeing (the end of?) this story played out in the media now, is to find that Mrs Schiavo should be prevented from being cared for by those who are willing & able to do it, for the sake of someone who has clear interests in seeing her dead (not least, now, I imagine, for the vindication of his pride).

    In this case, whatever extraordinary intervention under the law can be made in order to correct the injustice of this man's 'guardianship' of his wife, I think we have to support.

  3. Very good post, Dr. I would like to hear more about dignity and dying from your point of view. I have been thinking about how when my time comes I hope that it is peaceful and full of dignity and not in a hospital.

    By the way... I was going to use the Elliot quote for my blog and now have discovered that I wasn't clever enough to find it first. Good quote, though.