A Classy Response to the Schiavo Case

[Roadtoad]

After reading the commentary, all I can say is that was one damn classy response to the whole miserable episode. Thanks, Mr. R.

 

[bouch]

I've got to confess that I was a little confused by this statement:

I am deeply grieved and dismayed that we, as a community, could admit and accept that she died fifteen years ago, that we kept her tissue functioning for all that time, and then opted to starve her body until it failed

What part dismayed him? That she was kept alive for 15 year, that she was starved to death, or both?

I also disagree with the idea that as a community we accepted that she died 15 years ago. There seemed to be a large number of people, both involved and "protestors", who insisted that she was still quite alive, just minimally responsive.

(and for the record, I think she died 15 years ago, but her body just didn't realize it)

 

[Beady]

I also disagree with the idea that as a community we accepted that she died 15 years ago. There seemed to be a large number of people, both involved and "protestors", who insisted that she was still quite alive, just minimally responsive.

(and for the record, I think she died 15 years ago, but her body just didn't realize it)

In hindsight yes, she died 15 years ago. 15 years ago, however, the situation was both immediate and mostly unknown; the sole objective was to save her life. At the very beginning, everyone was hoping/praying she could at least partially recover, and there seemed to be at least a chance it could happen. I have no idea when it became apparent that recovery wouldn't happen; apparently it never became apparent to the Schindlers.

I vaguely remember the beginning of the debate about when legal death occurs, whether it was when the heart stops beating or when the brain stops. Problem is, I don't really remember the "When." I know that ECGs are comparatively new, and the debate didn't start until their use had become fairly common, and people realized that such a definition was now possible. I had, apparently mistakenly, thought that brain death was now the universally-accepted criteria.

At any rate, I'm loathe to voice a judgment on any of the principles. It's a decision I'm bloody glad I didn't have to make, myself. I'm also glad that our state's senators were against Federal intervention (and annoyed that only one of them voted against it - the other apparently wasn't present). The wife and I are making out living wills so that we and our own families will be spared having to make a similar decision, and our state legislature is formalizing the process for making the decision in the abscence of a living will.

 

[Hawk one]

At any rate, I'm loathe to voice a judgment on any of the principles. It's a decision I'm bloody glad I didn't have to make, myself. I'm also glad that our state's senators were against Federal intervention (and annoyed that only one of them voted against it - the other apparently wasn't present). The wife and I are making out living wills so that we and our own families will be spared having to make a similar decision, and our state legislature is formalizing the process for making the decision in the abscence of a living will.

Pardon my ignorance, but I would like to have this part about your living will clarified. Are you saying that you will make such a will so that it will bascially be the doctors (or a medical committee) that will make the final decision, or (more likely) did I completely misunderstand you now? And if the latter occured, would you mind correcting me?

 

[BillyJoe]

Living wills are almost impossible to write up.
You would have to think up every possible scenario and then come to a conclusion as to what you would want done in each case.

 

[bouch]

Originally posted by Beady
In hindsight yes, she died 15 years ago. 15 years ago, however, the situation was both immediate and mostly unknown; the sole objective was to save her life. At the very beginning, everyone was hoping/praying she could at least partially recover, and there seemed to be at least a chance it could happen. I have no idea when it became apparent that recovery wouldn't happen; apparently it never became apparent to the Schindlers.

I agree completely. When it first happened, keeping her alive in hopes of a recovery was clearly the correct decision, and the problem is when is the "point of no return".

I'm glad that I've never been involved with having to make a decision like that, and hope I never do. Quite a mess, and no one involved came out looking very good IMHO.

 

[Beady]

Pardon my ignorance, but I would like to have this part about your living will clarified. Are you saying that you will make such a will so that it will bascially be the doctors (or a medical committee) that will make the final decision, or (more likely) did I completely misunderstand you now? And if the latter occured, would you mind correcting me?

After rereading what I wrote, I think it's my bad. What I meant to say was that we are making out living wills so no one can question what we want, and whichever of us survives and our families won't have to go through the crap the Schaivos and Schindlers did.

 

[Beady]

Living wills are almost impossible to write up.
You would have to think up every possible scenario and then come to a conclusion as to what you would want done in each case.

Bull. It's very simple: My spouse is delegated and authorized to make any and all decisions in my stead regarding the prolongation of my life, should I be unable to make my wishes known. In her absence, it is my desire that no heroic or longterm actions are to be taken to sustain my life if, in the opinion of my primary physician, supported by any advisors s/he chooses to consult, such prolongation would not likely result in my ability to live as a normal adult with no more than minimal human or mechanical support.

 

[Hawk one]

After rereading what I wrote, I think it's my bad. What I meant to say was that we are making out living wills so no one can question what we want, and whichever of us survives and our families won't have to go through the crap the Schaivos and Schindlers did.

That and the following post cleared it up for me. Thanks.

 

[BillyJoe]

Beady,

Bull. dust It's very simple: But is it really? My spouse is delegated and authorized to make any and all decisions in my stead regarding the prolongation of my life, That is a very heavy burden to place on your spouse. What if her views change? What if pressure is made to bear on her by family and friends? should I be unable to make my wishes known. In her absence, it is my desire that no heroic What would you classify as heroic? or longterm How long is long term? actions What about INactions? are to be taken to sustain my life if, in the opinion of my primary physician, What would your primary physician do in each and every situation you may find yourself in? supported by any advisors Ditto for thre advisors s/he chooses to consult, such prolongattion would not likely How unlikely is unlikely? result in my ability to live as a normal adult How normal is normal? with no more than minimal How minimal is minimal? human or mechanical support.

And really this is only the beginning of the questions that must be thought and answered.

BillyJoe

 

[Beady]

And really this is only the beginning of the questions that must be thought and answered.

I'm not going to respond to the bulk of your comments, since any adults who would be in a position to act on my instructions could be expected to find what I wrote to be perfectly understandable and reasonable. As Hawk one apparently has.

The bit about laying a burden on my wife, however, speaks volumes about you. There's more to mariage than sex. When you get married, there are certain responsibilities you agree to take on; taking care of your partner is one of them, and making the ultimate decision is implicit. If you or your partner would refuse such a job, or would refuse to act as the other wishes in such a situation, then the only thing that means is that you or they can't be trusted to assume the final responsibility. Whether you choose to entrust yourself to someone like that is a personal preference upon which I will not comment. My wife and I have both married people we can trust.

 

[BillyJoe]

Beady,

I have to say, I was a little surprised by your response

I was not saying that "living wills" should not be attempted. They are certainly better than no will at all. But they are not simple and they do require a great deal of thought. And you will never be able to cover every contingency no matter how much effort you put in.

But I am happy you and your wife are both happily married.

regards,
BillyJoe

 

[Beady]

And you will never be able to cover every contingency no matter how much effort you put in.

The purpose of a living will is to avoid the necessity of being explicit in advance about every contingency, by naming people you trust to act and make decisions in your stead, and to give them enough information so they can make a reasonable estimate as to what you might want done. The short version is, you pick people you trust, you brief them, and then you trust them.

 

[Roadtoad]

I find all this fascinating, particularly since, having just had my head battered about like a ping pong ball inside my car, (you can look it up later), my wife is having to take on a lot of family type business I would normally be handling.

In the past, I've had to do the same for her, and it comes down to this being what we agreed to when we said "I do" twenty years ago. I'm not happy that I can't handle things like calling the Mortgage Company to try and make some arrangements regarding the house payment, (since I'll be off work for a bit), or that I'm needing to rely on my bride to handle things like dealing with my abusive boss when he calls to demand that I come it to work, (like you want some guy with a head injury driving an 18-wheeler... Smart!) But that's part of this whole business.

I don't like Michael Schiavo. There's just too much that creeps me out about this guy, and his using his wife as a weapon against his in-laws just adds to it. But, the bottom line remains: his wife was dead fifteen years ago, and he accepted the final responsibility for Terri's care. It was his responsibility, and no one else's, once it was all said and done. Preserving the body just because it made someone feel good accomplished nothing, save for depriving others who could have been helped needed resources.

 

[Beady]

I don't like Michael Schiavo. There's just too much that creeps me out about this guy, and his using his wife as a weapon against his in-laws just adds to it. But, the bottom line remains: his wife was dead fifteen years ago, and he accepted the final responsibility for Terri's care. It was his responsibility, and no one else's, once it was all said and done.

I'm not sure why you feel about Schaivo the way you do, but then I've made it a point not to follow the case too closely. Otherwise, I agree completely.

Looking at what BillyJoe said:

That is a very heavy burden to place on your spouse. What if her views change? What if pressure is made to bear on her by family and friends?

The burden is part of the job she and I agreed to when we decided to get married. We didn't place it on each other, we took it up voluntarily. That's part of what getting married means. As for the What-Ifs, that's the part I meant about picking someone you can trust, and then trusting them. If you can't trust them to follow through, then you married the wrong person. Dealing with family and friends is part of it; I didn't marry a weak woman, and our extended family already know our views on the matter.

Pretty much ditto for the rest of his objections. A living will is meant to handle all the myriad and unnamable contingencies by vesting decision-making powers in people you trust, and by putting enough in writing that those people feel reasonably comfortable making those decisions (btw, copies of our living wills are in our medical files, and our doctors know about them).

I suppose BillyJoe is right in one respect. If you don't know anyone you trust that much, then a living will is probably not a realistic option. Thinking about it, in such a case it's probably not necessary, either; you won't know what's happening, and there probably isn't anyone in your life close enough to care all that much.

 

[BillyJoe]

Beady,

When I was talking about "living wills", I was speaking generically (not specifically - about your personal situation about which, nevertheless, I am very happy as I said before) and I stand by my statement that they are not simple matters and that, on the contrary, they require a great deal of knowledge, thought, and discussion about the various situations in which such a "living will" might need to be activated.

regards,
BillyyJoe

 

[Beady]

I stand by my statement that they are not simple matters...

Then how do you explain the thousands, if not millions, of living wills that have been in existence and already executed? How do you explain that they readily stand up in court, even though not written by lawyers? How do you explain that the central problem in the Schaivo case was the abscence of a living will? How do you explain that several states provide generic forms, less complicated in many cases than drivers' license applications? I just looked up my own state's generic form -- there's no text to write, you just download and sign the form and have it witnessed. Is that your idea of complicated? Most states don't even require a specific form, just a simple paragraph such as what I wrote several posts ago.

...they require a great deal of knowledge, thought, and discussion about the various situations in which such a "living will" might need to be activated.

What part of "should I be unable to make my wishes known" are you having a problem with?

BTW, here's the pertinent wording from the Vermont Right-to-Life"fill-in-the-blank" version:

...meaning that a reasonably prudent physician, knowledgable about the case and the treatment possibilities with respect to the medical conditions involved, would judge that I will live only three months or less, even if lifesaving treatment or care is provided to me, the following may be withheld or withdrawn...

So, the thousands or millions of us who have drawn up living wills don't find it complicated. The various states provide generic forms that require either a minimal amount of information or none at all, and many don't even require a specific form. Even the Right-to-Life organizations have criteria for life-support withdrawal that can be expressed in a single sentence.

But you translate all of this to mean: "You would have to think up every possible scenario and then come to a conclusion as to what you would want done in each case."

Just exactly what is your problem?

 

[Roadtoad]

If I'm reading this right, I think BillyJoe is referring more to the fact that in a litigious society as the U.S., the mere presence of a living will may not be enough any more. The reality being that such a document can be challenged, and in turn, rendered invalid by those who want to keep someone "alive."

Sadly, a living will, I suspect, may not be enough to satisfy a family that desires to keep someone "alive." For that matter, I suspect in some cases, this desire is more a means of punishing a family member who has somehow "transgressed," rather than trying to save someone who might otherwise be lost.

Too often, we turn to the courts when common sense ought to prevail. We're trying to duck out of the consequences of our actions, and the consequences of the lives we lead. Sorry, that doesn't happen. You do pay for what you do in the end.

In Lodi, I think it was, we had a recent case where the wife of a man injured in an accident wanted to allow her husband to die. He was in even worse shape than Terri Schiavo, and yet, the courts went along with the man's mother and sister, and he's now in their care. Frankly, it's a miscarriage of justice, plain and simple, (I'm sure Rouser2 would disagree), and while there was no living will, it should have been left for the wife to decide.

There was also an undercurrent of racism inherent in this case. IIRC, the wife was of Asian ancestry, while her husband's family was white. That simply made things worse.

 

[Beady]

If I'm reading this right, I think BillyJoe is referring more to the fact that in a litigious society as the U.S., the mere presence of a living will may not be enough any more.

It has been, so far. The two cases you cite did not involve living wills at all, and I've never heard of a living will being successfully challenged; this isn't to say that it couldn't happen, but it must be somewhat rare. Every commentator I've heard on the subject has agreed with all the others that a living will would have altered the Schaivo case considerably, possibly even preventing it, altogether.

As I understand it, the Schaivo case turned on whether Teri's rights were being violated. If she had signed a living will, this central issue would not have existed. Even if the Schindlers had been able to wrest guardianship from her husband, the presence and provisions of a living will would by then have been public knowledge and they would have had to justify violating their daughter's known wishes.

I suppose, if you wanted to safeguard against a possible challenge, you could insert a type of what in Vermont is called a "tripwire" clause, which is used in the "normal" kind of will. Briefly, if anyone challenges the provisions of a will, and loses, they are disinherited; this turns a challenge into a win-or-lose gamble. It's all boilerplate and can be pasted into a document in seconds.

But as for having to provide in writing against every possible eventuality, that just isn't true. Essentially, a living will is a power-of-attorney, giving a designated person full signatory rights in the stead of and on behalf of the principle. If the document gives authority to the agent to pull the plug at his discretion, then how are you going to explain to the judge that the agent has abused his authority by pulling the plug at his discretion?

 

[BillyJoe]

Beady,

You obviously have very strong views in favour of a "living will" (they are known by another name which I can't seem to recall ). Who knows, you may even be right. But I don't know why you are so confrontational about it. A simple discussion of the merits of your case would have been much more productive I would have thought. Nevermind.

BJ