An Open Letter to Michael Schiavo

NEW YORK, March 25 /Christian Newswire/ — Fr. Frank Pavone, National Director of Priests for Life, and an eyewitness to Terri Schiavo’s final hours, released the following open letter to Michael Schiavo tonight. Fr. Pavone will read it to a worldwide audience on an internationally broadcast religious service on Sunday morning, March 26.

Dear Michael,

A year ago this week, I stood by the bedside of the woman you married and promised to love in good times and bad, in sickness and health. She was enduring a very bad time, because she hadn’t been given food or drink in nearly two weeks. And you were the one insisting that she continue to be deprived of food and water, right up to her death. I watched her face for hours on end, right up to moments before her last breath. Her death was not peaceful, nor was it beautiful. If you saw her too, and noticed what her eyes were doing, you know that to describe her last agony as peaceful is a lie.

This week, tens of millions of Americans will remember those agonizing days last year, and will scratch their heads trying to figure out why you didn’t simply let Terri’s mom, dad, and siblings take care of her, as they were willing to do. They offered you, again and again, the option to simply let them care for Terri, without asking anything of you. But you refused and continued to insist that Terri’s feeding be stopped. She had no terminal illness. She was simply a disabled woman who needed extra care that you weren’t willing to give.

I speak to you today on behalf of the tens of millions of Americans who still wonder why. I speak to you today to express their anger, their dismay, their outraged astonishment at your behavior in the midst of this tragedy. Most people will wonder about these questions in silence, but as one of only a few people who were eyewitnesses to Terri’s dehydration, I have to speak.

I have spoken to you before, not in person, but through mass media. Before Terri’s feeding tube was removed for the last time, I appealed to you with respect, asking you not to continue on the road you were pursuing, urging you to reconsider your decisions, in the light of the damage you were doing. I invited you to talk. But you did not respond.

Then, after Terri died, I called her death a killing, and I called you a murderer because you knew – as we all did – that ceasing to feed Terri would kill her. We watched, but you had the power to save her. Her life was in your hands, but you threw it away, with the willing cooperation of attorneys and judges who were as heartless as you were. Some have demanded that I apologize to you for calling you a murderer. Not only will I not apologize, I will repeat it again. Your decision to have Terri dehydrated to death was a decision to kill her. It doesn’t matter if Judge Greer said it was legal. No judge, no court, no power on earth can legitimize what you did. It makes no difference if what you did was legal in the eyes of men; it was murder in the eyes of God and of millions of your fellow Americans and countless more around the world. You are the one who owes all of us an apology.

Your actions offend us. Not only have you killed Terri and deeply wounded her family, but you have disgraced our nation, betrayed the Gospel of Jesus Christ, and undermined the principles that hold us together as a civilized society. You have offended those who struggle on a daily basis to care for loved ones who are dying, and who sometimes have to make the very legitimate decision to discontinue futile treatment. You have offended them by trying to confuse Terri’s circumstances with theirs. Terri’s case was not one of judging treatment to be worthless – which is sometimes the case; rather, it was about judging a life to be worthless, which is never the case.

You have made your mark on history, but sadly, it is an ugly stain. In the name of millions around the world, I call on you today to embrace a life of repentance, and to ask forgiveness from the Lord, who holds the lives of each of us in His hands.

— Fr. Frank Pavone

Priests for Life is the nation’s largest Catholic pro-life organization dedicated to ending abortion and euthanasia. For more information, visit www.priestsforlife.org.

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35 thoughts on “An Open Letter to Michael Schiavo”

  1. Amen, Fr. Frank Pavone.
    I’m still sad and angry about Terri. Here in Cyprus, everyone I have spoken to feels the same way as you. We wonder that if America couldn’t save one of its citizens at home then what hope is there for others elsewhere.Today I will light a candle for Terri and Mr. Rahman. Why are their deaths so imperative? May Terri’s soul rest in peace and may God help Mr.Rahman.

  2. Just when you think the extreme right has sucked all the juice out of the Schiavo situation, they open it up again, this time in the form of an “open letter” to Michael Schiavo.

    My guess is that at this point, people like Frank Pavone don’t carry a lot of weight with Michael Schiavo. Michael Schiavo was the target of a massive disinformation and propaganda campaign, in which every rumor and conjecture that could possibly be used against him was trumpeted as fact, even as the actual facts of the case were completely ignored. Everything that showed up on the Schindler web site was taken as fact, even as the findings of fact, by a conservative Christian judge were ignored. This attack on Michael Schiavo continued on into the halls of congress, even as the allegations against him had already been utterly discredited by Terri Schiavo’s guardian ad litem, appointed by Gov. Jeb Bush.

    What happened to Michael Schiavo represented a hideous and utterly immoral attempt at character assassination. I say “attempt,” because the great majority of Americans fortunately saw through the fraud, and the Republican sycophants of the “religious” right backed away from the case faster than a nudist from a hornet nest.

    Comes now Fr. Pavone, with yet another attack. Of course, he can’t accuse Michael Schiavo of very many things any more, because all of the lies about him have been utterly discredited. The cause of truth would have been better served had Fr. Pavone written an open letter of apology to Schiavo, but at this point we all know better than to expect a concern for the truth from the “religious” right.

    So all Fr. Pavone can do is to wrap himself in the gospel and accuse Schiavo of being a murderer. But note that in his “open letter’ he references not a single legal principle, not a single finding of fact, not a single principle in medical ethics, not a sentence from the autopsy report, not a word from Terri Schiavo’s guardian ad litem. He can’t reference any of these things because to do so would be to undermine his case. So he simply ignores them.

    Instead, in feigned wonderment he “scratches his head” over why Michael Schiavo would not let Terri’s parents continue to maintain her in a virtually brain-dead state. For the autopsy report is completely consistent with a diagnosis of PVS — that her brain had deteriorated to the point that a large portion of it was actually gone, liquified — that in fact she could not “see the balloon,” and so on.

    Indeed, Michael Schiavo had to rescue Terri from her own parents. The report of Terri’s guardian ad litem, appointed by a Republican governor, stated that her parents intended to keep her alive “at all costs.” When presented with various hypothetical situations they said that they would spare no ghoulish intervention, even up to amputating all of her limbs if necessary. The report of the guardian ad litem further stated that “Schindler family members stated that even if Terri had told them of her intention to have artificial nutrition withdrawn, they would not do it.” In other words, this was about what THEY wanted, not what she wanted.

    The simple answer to Pavone’s fake bafflement is that Michael Schiavo truly believed that his wife would not have wanted to be maintained in such a condition. A conservative Christian judge, upon hearing all the witnesses and reviewing the facts of the case, agreed. In the end, most of the country agreed.

    But the worst thing is that the basic premise in Pavone’s “open letter” is utterly false. Michael Schiavo did not “decide” that his wife should die. If Pavone knows this, but intentionally disregards this fact, then he is a liar who ignores the facts in order to pursue a libel against Mr. Schiavo. If he doesn’t know this, then he is writing from a position of ignorance, and we should ignore him because he doesn’t know what he’s talking about.

    Matt Conigliaro, a Florida attorney, has compiled extensive information on the Schiavo case. He notes that

    Rather than make the decision himself, Michael followed a procedure permitted by Florida courts by which a surrogate such as Michael can petition a court, asking the court to act as the ward’s surrogate and determine what the ward would decide to do. Michael did this, and based on statements Terri made to him and others, he took the position that Terri would not wish to continue life-prolonging measures. The Schindlers took the position that Terri would continue life-prolonging measures. Under this procedure, the trial court becomes the surrogate decision-maker, and that is what happened in this case.

    The trial court in this case held a trial on the dispute. Both sides were given opportunities to present their views and the evidence supporting those views. Afterwards, the trial court determined that, even applying the “clear and convincing evidence” standard — the highest burden of proof used in civil cases — the evidence showed that Terri would not wish to continue life-prolonging measures.

    . . . Recently, Michael received an offer of $1 million, and perhaps a second offer of $10 million, to walk away from this case and permit Terri’s parents to care for her. These offers, assuming there were two, were based on a misunderstanding of the situation here. Michael lacks the power to undo the court order determining Terri’s wishes and requiring the removal of her feeding tube. He did not make the decision and cannot unmake it. The court made the decision on Terri’s behalf. Nonetheless, Michael apparently rejected each offer.

    http://abstractappeal.com/schiavo/infopage.html

    But who cares? These are only facts, and Pavone can’t be bothered with them.

    So today Frank Pavone is not the only one suffering from “outraged astonishment.” I also am outraged and astonished at the parade of propagandists who cannot be bothered with the actual facts of the case. And why they continue to be given space on this web site is beyond me.

    That said, I don’t have a problem with someone who disagreed with the Schiavo outcome. Certainly this is an issue on which reasonable people can disagree. But the disagreement has to be based on the facts of the case, not on falsehoods, whether propagated intentionally or through ignorance.

  3. JBL writes: “So Jim it’s morally justifiable to starve someone to death?”

    Depending on the circumstances, yes.

    People have the right to refuse any and all medical interventions. If you’re a diabetic you have the right to eat candy bars and refuse insulin. If you have cancer you have the right to refuse chemotherapy. If you cannot eat, you have the right to refuse a surgically-implanted feeding tube. And so on.

    The right to refuse medical treatment does not end simply because you are unconscious or cannot express your wishes at that time. You can also express your wishes through an advanced directive. In the event that someone does not have an advanced directive — a common occurrence — then we have to look to prior expressions of the patient’s wishes, if any.

    In the Schiavo case, a conservative Christian judge, upon hearing witnesses and considering all the evidence, found by “clear and convincing” evidence that Terri Schiavo would not have wanted to be maintained by a feeding tube in a PVS state. Frankly, this does not surprise me, since most people wouldn’t want to be.

    Again, this was a determination made by a conservative Christian district court judge. On appeal, the appeals court found that the orignial judge had sufficient information on which to base that decision.

    But to the point of my post: Michael Schiavl did not decide that his wife’s feeding tube should be removed. Fr. Pavone says that this was Michael’s decision: “Your [Michael’s] decision to have Terri dehydrated to death was a decision to kill her.” This is fase. This was not Michael’s decision.

    Even the Court of Appeals noted this:

    In this case, however, Michael Schiavo has not been allowed to make a decision to disconnect life-support. The Schindlers have not been allowed to make a decision to maintain life-support. Each party in this case, absent their disagreement, might have been a suitable surrogate decision-maker for Theresa. Because Michael Schiavo and the Schindlers could not agree on the proper decision and the inheritance issue created the appearance of conflict, Michael Schiavo, as the guardian of Theresa, invoked the trial court’s jurisdiction to allow the trial court to serve as the surrogate decision-maker.

    http://abstractappeal.com/schiavo/2dcaorder01-01.txt

    What Michael Schiavo did was to initiate a process by which a determination of his wife’s wishes could be made. He was only one of several witnesses in that proceeding, and the result could just as easily have been different.

    If Fr. Pavone claims that Michael “decided” that his wife should die, then either a) he knows the truth and is lying, or b) he is sadly misinformed about the facts of the case. So he is either intentionally or unintentionally propagating a falsehood about Michael Schiavo. Given the extent of his involvement in the Schiavo case, and given that the facts of the case are freely and easily available on the Internet, it is hard to understand how Pavone could not know that. If he is outraged over the outcome of the case, the proper response is not to spread lies. One wonders why the “open letter’ is not addressed to the State of Florida, since it was under their laws and procedures that the outcome occurred. I guess Michael Schiavo is an easier target.

  4. Jim your so-called Conservative Christian judge may have heard witnesses etc. But he didn’t base his opinion upon that evidence. Under Florida law he was limited to the findings of fact that were done by the lower court, a process that denied Terri her own lawyer or guardian to safeguard her rights as being human. It was the same situation with every court afterward; they were limited by the initial court’s findings of fact.

    You can talk about the court all you want, but because a court makes a decision doesn’t necessarily translate to that decision being morally right. Using your logic Dred Scott and Lynchburg were morally acceptable decisions. I could see you now after Lynchburg was decided; “Yup lets round up those half-wits and sterilize them so we can keep them from breeding. That Judge Holmes and the Supreme Court says it’s morally right. Because they’re ‘socially inadequate’.”

  5. Killed by Prejudice
    Laura Hershey

    Terri Schiavo died on March 31, 2005, not from her 1990 brain injury but because of prejudice, the common assumption that life with a significant disability is not worth living.

    Unable to speak for herself, Schiavo became the subject of a noisy debate open to anyone with a microphone or an Internet connection. “She wouldn’t want to live like that,” many said. “She wouldn’t want to die like that,” said others.

    Did Terri Schiavo understand what went on around her? Did she feel love, hunger pangs or the desire to live–or to die? I don’t know, and I don’t think anyone knew for sure. Experience has made me skeptical of physicians’ pronouncements and prognostications, especially about people with disabilities. I know several dynamic individuals who were once written off by doctors as terminal, vegetative or otherwise hopeless. Some would be dead today if not for the efforts of someone who believed in their right to live. Maybe Schiavo could have recovered too–or maybe not. But her odds for recovery should not determine her continued support, at least not in the absence of a clear advance directive. Making the promise of improvement a prerequisite for food and water reveals a profound bias against disabled people. more

  6. JBL writes: ‘Jim your so-called Conservative Christian judge may have heard witnesses etc. But he didn’t base his opinion upon that evidence.”

    Everyone is entitled to his or her own opinion. The Court of Appeals found that the district court heard sufficient evidence upon which to base a decision. If you want to doubt the district court’s findings, all I can say is that judge Greer was there, heard the testimony, and made a decision.

    JBL: “Under Florida law he was limited to the findings of fact that were done by the lower court . . . ”

    Well, judge Greer was the judge of the lower court that made the decision. So I’m not sure to whom you refer here.

    JBL: . . . a process that denied Terri her own lawyer or guardian to safeguard her rights as being human.

    In this case the district court acted as the surrogate decision-maker for her. So an additional guardian or representative would have been redundant.

    JBL: “It was the same situation with every court afterward; they were limited by the initial court’s findings of fact.”

    This is how it works. Again, the Court of Appeals found that the District Count judge based his opinion on evidence that rose to the “clear and convincing” standard.

    JBL: “You can talk about the court all you want, but because a court makes a decision doesn’t necessarily translate to that decision being morally right. Using your logic Dred Scott and Lynchburg were morally acceptable decisions.”

    Sure, courts or juries can make a mistake. In this case it is not clear to me that a mistake was made. In other words, just because you disagree with the outcome doesn’t mean that there was a mistake. Based on the testimony of all the witnesses, the judge found by clear and convincing evidence that Terri Schiavo would not have wanted to be maintained in that condition. I wasn’t there, and I neither heard the testimony nor observed the witnesses. But there is nothing in the decision that leads me to believe that the judge made a mistake. If anything, judge Greer’s active and conservative Baptist background would have predisposed him to the opposite decision.

    JBL quotes: “Terri Schiavo died on March 31, 2005, not from her 1990 brain injury but because of prejudice, the common assumption that life with a significant disability is not worth living.”

    Not true at all. Medical interventions were withdrawn because a judge who personally heard all the evidence determined that she would not have wanted to be maintained in that condition.

    JBL quotes: “Unable to speak for herself, Schiavo became the subject of a noisy debate open to anyone with a microphone or an Internet connection. “She wouldn’t want to live like that,” many said. “She wouldn’t want to die like that,” said others.

    The vast, overwhelming amount of material on the Internet and on TV was on the Schindler side of the case. Thousands of web sites took that position. In my observation there were maybe only four or five web sites that took the opposite position. So this is a totally bogus argument in my view.

    JBL quotes: “Did Terri Schiavo understand what went on around her? Did she feel love, hunger pangs or the desire to live–or to die? I don’t know, and I don’t think anyone knew for sure.”

    We knew to a medical certainty that she did not. Medical certainty is not absolute certainty — but then nothing in medicine is absolutely certain.

    JBL quotes: “I know several dynamic individuals who were once written off by doctors as terminal, vegetative or otherwise hopeless.”

    Certainly the autopsy confirmed Ms. Schiavo’s condition. Most of her brain was gone — not damaged, but gone.

    JBL quotes: “Maybe Schiavo could have recovered too–or maybe not.”

    There is simply no basis in medicine for this statement. The hope of the Christian is that in the life to come cognitive functions will be restored, but not in this life. To be blunt, you don’t grow a new brain. I’m very sorry about what happened to her. But there was nothing that was going to bring her back.

    But let me get back to my original point: there is absolutely no basis for calling Michael Schiavo a murderer, and to do so requires either an intentional or unintentional ignorance of the legal facts of the case.

  7. The law allowed Terri Schiavo to die. No question about that. Judge Greer acted well within his legal capacity. See: The Legal Death of Terri Schiavo.

    Still, the eagerness of some to see her die is very troubling, especially given her parents fight until the end to save her life. What is legal is not necessarily moral, and the means of her forced dehydration amounts to nothing more than a court-sanctioned killing. Over 17 disability rights groups protested her killing clearly seeing that the line towards the increasing devaluation of life has shifted toward their direction.

    She did not have to die.

    As for the autopsy, read a bit more about the effects of dehydration on the brain. Terri Schiavo’s Autopsy: The Blind Spot

  8. Mr. Jim Holman,
    Can you tell me what would happen to me if I was found starving my pet dog because I felt that he didn’t want to live? After all I am its guardian and the dog doesn’t have a voice!! I think your courts would put me in jail for a very long time. And so they should!

  9. Fr. Hans writes: “Still, the eagerness of some to see her die is very troubling, especially given her parents fight until the end to save her life.”

    Eagerness? Well, the case lasted for years, over ten years as I recall. Michael Schiavo prevailed in every court, at every level. How long does a case have to be litigated until finally resolved?

    Fr. Hans: “What is legal is not necessarily moral, and the means of her forced dehydration amounts to nothing more than a court-sanctioned killing.”

    No, it amounts to the withdrawl of a medical intervention, namely a feeding tube surgically inserted. If you don’t think a feeding tube is a medical intervention, try one out sometime. Or ask your doctor for one and see what he or she says.

    Fr. Hans: “Over 17 disability rights groups protested her killing clearly seeing that the line towards the increasing devaluation of life has shifted toward their direction.”

    I don’t believe that for a minute. Look, every day in the U.S. feeding tubes are removed, ventilators disconnected, medications discontinued, etc. I would guess that there are at least hundreds of such cases every day. Tom Delay and family pulled the plug on his own father, without even waiting a few months to see if a recovery was possible, and no one protested that. Terri Schiavo became a cause celebre for the right wing. But her case is no different from many others. As I pointed out before, as far as I know there has not been one single change in Florida law as a result of that case. Florida law and procedure controlled every aspect of that case, and if disability groups want to have something to protest, they should focus on Florida, not Schiavo.

    Fr. Hans: “As for the autopsy, read a bit more about the effects of dehydration on the brain.”

    Frankly, I don’t believe it. First of all, the article is authored by a couple of right wing hacks who hold forth on all sorts of topics, one of which was a defense of Rush “Oxycontin” Limbaugh. It is written by someone who never examined Terri Shiavo, never observed her, was not involved in the autopsy, never examined Terri Schiavo’s medical records, is not a specialist in PVS, and was not a party to the case. It is heavy on speculation and conjection, and light on references to medical research. Where the author does refer to a published article the reference pertains to the amount of decrease in brain weight due to dehydration. According to the article (as cited) such loss turns out to be one-half of one-percent every two days. Translating that into Terri Schiavo’s situation, that would account for somewhat less that four percent of brain loss. But in Schiavo’s case there was at least 50 percent of the brain tissue missing.

    Most importantly, the condition of Terri Schiavo’s brain at autopsy showed not merely a lower weight, not merely less substance, but extensive loss of particular sections of brain tissue — a loss that had been previously documented by MRI scans. It’s like the difference between someone losing weight because of dehydration, or losing weight because both legs have been amputated.

    The article goes on to talk about hemispherectomy, a procedure that has absolutely nothing to do with Schiavo’s situation.

    I could go on, but why bother. This article is nothing but smoke and mirrors, designed to give the right-wing at least the appearance of an argument on this issue. And like virtually all of the articles quoted in this venue, it has not been published in a peer-reviewed journal. Instead, like almost all articles here, it shows up in a right-wing web site. Mainstream physicians and researchers don’t bother responding to this stuff, because it’s not worth responding to.

  10. The following is from an interview last year with Jay Wolfson, who was appointed guardian ad litem for Terri Schiavo by Gov. Jeb Bush:

    “After spending hours with Terri, getting to know her parents and siblings and her husband, and reviewing all of the evidence, my conclusion was that the competent medical evidence provided in the the case, following the Florida rules of civil procedure and evidence, and according to the Guardianship law in Florida, which was carefully crafted over fifteen years of bipartisan political and religious efforts — indicated by clear and convincing evidence that she was in a persistent vegetative state, according to the most credible science and medicine.

    “I also concluded that based on the same Florida laws and rules, the trier of fact appropriately determined that Terri had expressed, while she was competent, the intention never to be kept artificially alive under such circumstances. The evidence supporting this included competent legal evidence demonstrating that she personally expressed those intentions at the funerals of two family members who had been on life support — so it was contextual.”

  11. Note 11. Read the rest of the article

    From: Jay Wolfson- and the Terri Schiavo Case

    That independent doctor (Wolfson) reported there was no hope for her recovery.

    Wolfson said that after examining her medical records, spending time with Terri Schiavo and consulting with experts nationwide, he, too, believes she is ina persistent vegetative state.

    But even in his report to the courts, Wolfson wrote of the difficulties in reaching that conclusion, noting Terri Schiavo’s “presence” when he was around her.

    “Her eyes are not shut, she’s breathing on her own and she makes noises,” he said. “You want so much to say, ‘Terri, give me a sign!’ It’s not a cucumber lying in a bed.

    “The two sides were close to a deal when Michael Schiavo backed out, Wolfson said, saying he couldn’t agree to anything Wolfson proposed because it came under the auspices of “Terri’s Law,” which Michael Schiavo was challenging as unconstitutional.

    It was that law that came to its end Tuesday when the U.S. Supreme Court refused to consider it. The Florida Supreme Court had previously struck down the law as an unconstitutional.

    Wolfson is not alone among experts in suggesting new, independent reviews of Terri Schiavo’s condition.

    Arthur Caplan, a director of the Center for Bioethics at the University of Pennsylvania and one of the nation’s leading experts on end-of-life care, said last week he too believes a panel of independent doctors should have been asked to evaluate her.

    “I don’t know why that never happened,” Caplan said. “It’s been way too long to not have more, independent medical opinions about her diagnosis.

    “Wolfson said the Schiavo case has the potential to drag on for years more as the parents continuously reframe their arguments in new legal filings.

    “The process has not benefited anybody, it certainly has not benefited Terri,” Wolfson said.

    The quote you supplied is certainly not as conclusive as you would have us believe.

  12. Fr. Hans: “Over 17 disability rights groups protested her killing clearly seeing that the line towards the increasing devaluation of life has shifted toward their direction.”

    Jim H: I don’t believe that for a minute. Look, every day in the U.S. feeding tubes are removed, ventilators disconnected, medications discontinued, etc. I would guess that there are at least hundreds of such cases every day.

    What the Disability Rights Movement Wants
    Eight things that need to happen to safeguard against non-voluntary euthanasia in the U.S.

    ——————————————————————————–

    MEANINGFUL FEDERAL REVIEW
    Congressional action along the lines developed by Senators Harkin and Martinez in the U.S. Senate, providing for federal civil rights review of contested third party decisions to withhold treatment in the absence of an advance directive or personally appointed surrogate.

    CONGRESSIONAL INVESTIGATION OF NON-VOLUNTARY EUTHANASIA, ESTABLISHMENT OF SAFEGUARDS
    Congressional hearings or other examination of the appropriateness of further federal action to protect people from non-voluntary euthanasia based on the decisions of statutory guardians or health care providers.

    EQUAL TIME IN AN OPEN PUBLIC DISCUSSION
    An open public discussion: Nothing about us without us- disability rights movement experts should have equal time in media debates with bioethicists like Art Caplan. Media must stop following the right vs. left script given them by the bioethicists decades ago. Accordingly, the disability rights movement’s experts should be given the same media airtime as spokespersons for the religious right.

    STATE-BY-STATE POLICY REFORM
    Funding for state-by-state review of guardianship and health care decisions laws by protection and advocacy systems and other disability rights legal advocates to develop reforms to safeguard against non-voluntary and involuntary euthanasia.

    PUBLIC EDUCATION BY PEOPLE WITH DISABILITIES
    Funding for public education about the perspectives of people living with significant disabilities on the difference between end-of-life decisions and decisions to end the lives of disabled people who are not otherwise dying.

    PARTIAL MORATORIUM ON DEHYDRATION/STARVATION
    A moratorium on the removal of food and water from people diagnosed in “persistent vegetative state” and “minimally conscious state” in the absence of new diagnostic processes discussed in recent medical journal Neurology, or a written advance directive/power of attorney by the person.

    OLMSTEAD IMPLEMENTATION, PASSAGE OF MICASSA
    Implementation of the rights of people with disabilities to long-term supports in the community under the U.S. Supreme Court decision in Olmstead. We call for passage of the Medicaid Community Attendant Services and Supports Act, which would allow people receiving Medicaid funding to have a life in the community instead of being forced into a nursing home.

    CONTINUATION OF GOVERNMENT FUNDED HEALTH CARE PROGRAMS
    Conservatives who honestly supported efforts to protect the life of Terri Schiavo should work on a bipartisan basis with moderates and liberals to ensure continued appropriate funding of Medicare and Medicaid. Proposed budget cuts threaten to result in a less-public, but very real, increase in the numbers of deaths of older and disabled people, even more prolonged and agonizing than the one experienced by Terri Schiavo, through lack of access to needed healthcare.
    Not Dead Yet

  13. RIGHTS OF PEOPLE WITH DISABILITIES TO FOOD AND WATER RESOLUTION
    Adopted at the
    NCIL Annual Council Meeting
    July 14, 2005

    WHEREAS, the right to food and water is a basic human right; and

    WHEREAS, the past few years have seen highly publicized legal battles seeking to remove restrictions on starvation and dehydration of people with cognitive disabilities; and

    WHEREAS, numerous states have enacted statutes removing restrictions on the starvation and dehydration of people with cognitive disabilities; and

    WHEREAS, many hospitals have enacted “futility” policies that enable medical providers to overrule the wishes of individuals with disabilities and their families when the medical professionals devalue the life of the person in question; and

    WHEREAS, twenty-five national disability groups have adopted a position, in response to the Terri Schiavo case in Florida, opposing nonvoluntary starvation and dehydration;

    THEREFORE BE IT RESOLVED THAT, NCIL supports legislation that restores and maintains restrictions on surrogate decisions for withholding of food and water via tube. Specifically, legislation should only allow for withholding of food and water in the presence of “clear and convincing evidence” of the person’s wishes or when the person’s medical condition renders them incapable of digesting or absorbing the nutrition and hydration so that its provision would not contribute to sustaining the person’s life.

    BE IT FURTHER RESOLVED, that centers for independent living in each state are encouraged to advocate for legislation and other public policies to establish or restore constitutional restrictions on the starvation and dehydration of people with cognitive disabilities. Release

  14. Fr. Hans writes: “The quote you supplied is certainly not as conclusive as you would have us believe.”

    Yes, Wolfson did talk about a “presence.” This is what makes his analysis interesting to me. He’s trying to make a fair, non-partisan evaluation of the situation, but one that also looks for signs of consciousness:

    In the time I spent with her I was not able to observe or experience a consistent response. I talked to her, cajoled her, played music — but there was random reflective actions — no responses. though I sure wished that I could have found otherwise.

    http://www.washingtonpost.com/wp-dyn/articles/A57781-2005Mar22.html

    He looks for a response, hopes for a response, but doesn’t find one.

    My point about Wolfson is that after looking at all the evidence he didn’t have a problem with the outcome. He recommended additional tests. But I don’t think that was because he thought there was any new information that would come of them. Wolfson was appointed Terri Schiavo’s guardian ad litem because of the dispute between the two families, so all of his work occurred within the context of that dispute. In recommending additional tests, I think he was looking for something that the two sides could agree on. He says as much in the interview:

    Due to the conflict between the parties, I suggested that additional testing could and should be done but ONLY if the parties agreed in advance as to how the results would be used.

  15. By what criteria did he conclude that more testing should have been contingent on how either party would use the results? Tests are tests. One of the strongest criticisms of his actions (and by extension Judge Greer’s) is prescisely that he limited the tests, and thereby closed the possibility for other competent professionals to weigh in. You remember of course the expert from the Mayo Clinic who challenged the findings about PVS based on the available evidence but was not allowed to testify. The “experts,” who examined Terri and were allowed to testify, it became clear, were veted by Felos first given their public record of euthanasia activism. Felos, as you know, is an extreme euthanasia idealogue — way out on the left wing. Just read his book.

    And what about Fr. Pavone’s assertion that Terri suffered while dying while Felos, — in that flat, expressionless, monotone voice of his — assured us she died peacefully, holding her teddy bear or whatever it was? Who is the liar here? (My hunch is that it was Felos. The teddy bear detail is too contrived, too calculated for public consumption.)

    How do you think Felos and crew celebrated their great legal victory? A steak dinner perhaps? A couple bottles of wine to wash it all down? Nothing like a good meal after watching someone starve to death! A home run for justice! —right?

  16. Fr. Hans writes: “By what criteria did he conclude that more testing should have been contingent on how either party would use the results? Tests are tests.”

    The following explanation is to some extent just my speculation based on my reading of Wolfson’s report and of a couple of interviews with him. I think he was looking for a way to bring the two sides together — trying to find some criteria upon which both sides could agree. I don’t believe that there was much doubt in his mind that Ms. Schiavo was in fact in a PVS. If that is an accurate description of his thinking, then any subsequent tests would not reveal anything that was inconsistent with that diagnosis. Remember, Wolfson had already reviewed the entire medical and legal history behind the case.

    Fr. Hans: “One of the strongest criticisms of his actions (and by extension Judge Greer’s) is prescisely that he limited the tests, and thereby closed the possibility for other competent professionals to weigh in. You remember of course the expert from the Mayo Clinic who challenged the findings about PVS based on the available evidence but was not allowed to testify. The “experts,” who examined Terri and were allowed to testify, it became clear, were veted by Felos first given their public record of euthanasia activism.”

    But the Schindlers were allowed to choose their own expert witnesses. They had competent legal counsel and sufficient funding to present their case. I assume that you are referring to Dr. Cheshire, of the Mayo Clinic in Florida. He filed an affadivit in the case; he observed Terri Schiavo but did not examine her, in a clinical sense. He observed the Schindler’s video, which was actually a highly edited version of interactions with Terri. He concluded that she might not be in a PVS, but in a “minimally conscious” state. The problem is that one of the physicians testifying on Michael Schiavo’s side of the case was the one who first developed the category of “minimal consciousness.” And he obviously concluded that she was not in that category.

    As far as Dr. Cheshire not being “allowed to testify,” there was a legal process in operation. And one side cannot simply introduce new witnesses at will. You can’t just say “wait, I have another witness. . . . Oh, you didn’t like that one, well, here’s another.” Michael Schiavo’s side operated under the same rules.

    Fr. Hans: “And what about Fr. Pavone’s assertion that Terri suffered while dying . . . ”

    Having read Fr. Pavone’s libelous accusation against Michael Schiavo, he has little credibility in my view. My own mother died a similar death in a nursing home, while conscious, and I was there every day. Given that no death is pleasant, I didn’t notice any extraordinary suffering in her case.

    Fr. Hans: “How do you think Felos and crew celebrated their great legal victory? A steak dinner perhaps? A couple bottles of wine to wash it all down?”

    I don’t think the sarcasm is very helpful here. I have often said that those who disagree with the Schiavo outcome should work to change Florida law, since all of this took place under Florida laws and legal procedures. As far as I know no Florida laws have been changed, nor have any changes even been suggested. You still live in Florida, yes?

  17. Jim with all your dancing about the legality of the case, you have never addressed the morality of the case.

    It doesn’t matter in the end if the court found that she should dehydrate and starve to death (truthfully very few people ever get to starvation because they usually die first from dehydration). The question you seem to avoid answering is it morally acceptable?

    It’s ironic that if Terri were a dog Michael would have been sentenced for cruelty for the way she was treated.

  18. The Right to Live
    By Sara Esther Crispe

    It’s been five days since the feeding tube was removed from Terri Schiavo. By the time this article is posted, it will either have been reinstated, or she may already be dead.

    As an American citizen, I am shocked that a woman–conscious, albeit in a severely brain-damaged state–could be starved to death. As a human being, I am horrified.

    I’ve seen the pictures of her smiling as her mother hugs her, huge eyes open wide as she surveys her surroundings. She supposedly has the responses of a 6-11 month old baby. My daughter is seven months old. She laughs, she cries. She knows joy, fear, pain, and hunger. She is far from unaware. Perhaps Terri is not even this responsive, although she is conscious and can swallow and breathe on her own. But her abilities would depend on who you ask: her husband, a man who already has two children with another woman; or her parents and siblings, who have stood by her side since that fateful day when Terri collapsed from a vitamin deficiency fifteen years ago.

    Since that day there has been no improvement — at least none that can be seen or detected. Does that mean that her condition can’t change? According to certain doctors that answer is “no, it can’t”; others believe that with the correct therapy, the answer could be “yes.” However, if she is starved to death this week, we will never know.

    In Judaism there is a law against taking one’s own life. Even if the sword is against one’s throat, we are taught that we are not allowed to despair. Why? The answer is that if we believe there is a G-d in this world, then we must believe that we can be saved, even at the last minute–even at the last second.

    Throughout our history, Jews who could have avoided painful, torturous deaths at the hands of their enemies if they had taken their own lives suffered these fates because they believed that their desperate situation could change. Many were right and lived to tell the stories of a miraculous escape, a gun that jammed, a bullet that missed its mark.

    However, Halachah (Torah law) is not cruel. It is not senseless. It is compassionate and understanding and recognizes that there are certain people who are suffering an incredible amount of pain.

    A patient on his deathbed, for whom no cure is deemed possible and death is an inevitable, immediate reality, must be allowed to die (Shulchan Aruch, Yoreh Deah, 339:1). In a case such as this, one is not required to continue treatment, unless the treatment will help ease the pain of the patient. A person in such a state is called a goses.

    But Terri Schiavo is not a goses. She wasn’t dying when the feeding tube was removed. She’s dying now only because she’s cruelly being denied food and water. She’s being starved to death simply because her husband believes that hers is a life not “worth” living.
    more

  19. JBL writes: “The question you seem to avoid answering is it morally acceptable?”

    It depends on what part of the situation you’re talking about. I don’t mean to be evasive, but let me explain.

    In a case such as this, the whole point is to carry out the patient’s wishes, as much as those wishes can be determined. This isn’t about what you would want, what I would want, what Michael Schiavo would want, what the Schindlers would want, what Judge Greer would want, or what Priests for Life would want. None of that is at all relevant.

    So one question is: is it immoral to withdraw life support from someone who would not have wanted it? My answer is no. In fact, it would be immoral to force medical interventions on someone who did not want them.

    That leads us to the patient’s choice: is it immoral not to want to be maintained in a persistent vegetative state? Personally, I would say no. You might say yes. The last poll I saw showed that around two-thirds of the people in the country would say no.

    So there are at least two morally-relevant situations here: the patient’s wish not to be maintained in a PVS, and the carrying out of the patient’s wish.

    Another morally-relevant situation concerns the extent to which we have properly evaluated the patient’s wishes. In this case the trial court found to a “clear and convincing” standard of evidence that Ms. Shiavo would not have wanted to be maintained in that condition. The appeals court found that the trial court had sufficient evidence upon which to base that decision. I was not at the trial, but in my view it’s reasonable to believe that the court properly ascertained her wishes. Others will disagree with that, but I don’t see any evidence that Judge Greer was biased or profoundly mistaken, etc. People disagree with him because they disagree with the outcome. Had he decided differently he would have been hailed as the protector of the defenseless, etc.

  20. How funny Jim that you would accept a less standard of evidence to starve a handicap woman to death than what would be necessary to execute a serial killer.

  21. JBL quotes: “As an American citizen, I am shocked that a woman–conscious, albeit in a severely brain-damaged state–could be starved to death.”

    No, she wasn’t conscious. Note the “V” in PVS.

    JBL quotes: “I’ve seen the pictures of her smiling as her mother hugs her, huge eyes open wide as she surveys her surroundings.”

    The tapes were highly edited so as to give that impression. She was not at all responsive, as Jay Wolfson, guardian ad litem, discovered. The part of the brain that processes vision was gone; thus she could not “survey” surroundings.

    JBL quotes: “Perhaps Terri is not even this responsive, although she is conscious and can swallow and breathe on her own.”

    She could swallow her own saliva, but was unable to swallow food or liquids without aspirating it. Thus the feeding tube.

    JBL quotes: ” . . . that fateful day when Terri collapsed from a vitamin deficiency fifteen years ago.”

    Potassium imbalance is the factor most often mentioned.

    JBL quotes: “She’s being starved to death simply because her husband believes that hers is a life not “worth” living.”

    No, the feeding tube was removed because her husband petitioned the court to act as a surrogate decision-maker. The court, upon a consideration of all the evidence, found that she would not have wanted to be maintained in that condition, and ordered the feeding tube removed.

  22. JBL writes: “How funny Jim that you would accept a less standard of evidence to starve a handicap woman to death than what would be necessary to execute a serial killer.”

    Dude, that’s not my standard of evidence. That’s the standard of evidence in the state of Florida — the state governed by the brother of President Bush. The state where Fr. Hans lives. Not my standard at all.

    Nonetheless, I think it’s a pretty good standard. There aren’t many things in medicine “beyond a reasonable doubt.” But more importantly, we can’t just have one standard of evidence for the Schiavo case, and another standard for everyone else. Whatever standard you apply to Schiavo has to be applied to all such cases.

    One thing to remember is that it is rare for such cases to go to court. The only reason that Schiavo went to court was because of the family disagreement. Absent that, you never would have heard about this case. For example, when Tom Delay’s father suffered a serious head injury and was on a ventilator, Delay’s family pulled the plug on him with hardly a discussion — no hearing, no evidence, no guardian, no judge. Just “he wouldn’t want to live like that,” and the plug was pulled. We’ll never know how long he could have lasted on the ventilator. No Priests for Life calling them murderers, no TV cameras, no Blogs for Life protesting in behalf of old man Delay.

    Now if you want to move all of those cases into court and require all of those people to show evidence beyond a reasonable doubt that the person wouldn’t want to live like that, then you’re going to have tens of thousands of court cases, and tens of thousands of people hooked up to ventilators and other equipment for a very long time.

    We could do that. But is that really the outcome you’re looking for? In other words, it is relatively easy to be dissatisfied with the Schiavo outcome, but relatively difficult to propose meaningful changes that wouldn’t be worse than the current situation.

  23. We could do that. But is that really the outcome you’re looking for? In other words, it is relatively easy to be dissatisfied with the Schiavo outcome, but relatively difficult to propose meaningful changes that wouldn’t be worse than the current situation.

    What could be worse than a state sanctioned starvation of a disabled woman to death?

  24. JBL writes: “What could be worse than a state sanctioned starvation of a disabled woman to death?”

    I suppose the only worse thing would be a state-enforced life that the person didn’t want.

    Look, I’m not being sarcastic here. I understand that many people are very disturbed by the outcome in this situation. But I think that at least some of the emotions related to this situation are due to an intentional misinformation campaign by one side. Throughout this whole case I have observed a tremendous amount of false information propagated by the Schindler side of the case. I don’t mean mistakes or misinterpretation, but an intentional spreading of blatently false information.

    However you look at it, this is a sad situation. But if in fact Terri Schiavo would not have wanted to be maintained in that condition — a feeling shared by two-thirds of Americans — then the outcome was the best outcome of a bad situation. I wish very much that Terri Schiavo’s collapse had never occurred. But that is the reality of the situation. The only thing to do is to is to carry out her wishes as best we can understand them. I believe that this is what happened in the process mandated by the State of Florida.

    I spent over twenty years working for a teaching hospital and medical university. During some of those years I was a volunteer with the university’s Center for Ethics. If I thought that something terrible had gone wrong with that case, I would be the first to protest the outcome. But I just don’t see it. Again, we’re talking about a situation that was sad and tragic to begin with. But forcing her to exist in a condition that she never wanted would not have made the situation any better.

    You use the term “disabled.” If being imprisoned in a body unaware, insensate, unresponsive, with no hope of recovery and nothing but organic reflexes is “disabled,” then I guess she was disabled. But that’s not the term I would use. Again, reflect on the “V” of PVS.

  25. Hmmm. We have George Felos, a euthanasia ideologue representing the Michael Schindler side, we have medical testimony limited to euthanasia advocates veted by Felos, we have conflicting testimony about Terri’s medical state not allowed in evidence, we have eyewitness testimony that contradicts Felos’ claim that Terri did not suffer when dehydrated to death, we have a family willing to take care of her in her disability, we have no written directive of her wishes — only an alleged off handed comment according to the person who wants her dead (contradicted by close friends who testimony also was not allowed),

    . . .and the real reason people object to her killing was because her defenders launched a disinformation campaign?

    Are you serious?

    Odd Felos. Michael Schiavo’s very strange lawyer.

  26. One thing to remember is that it is rare for such cases to go to court. The only reason that Schiavo went to court was because of the family disagreement. Absent that, you never would have heard about this case. For example, when Tom Delay’s father suffered a serious head injury and was on a ventilator, Delay’s family pulled the plug on him with hardly a discussion — no hearing, no evidence, no guardian, no judge. Just “he wouldn’t want to live like that,” and the plug was pulled. We’ll never know how long he could have lasted on the ventilator. No Priests for Life calling them murderers, no TV cameras, no Blogs for Life protesting in behalf of old man Delay.

    I have yet to read (here or elsewhere) responses to this point. If the only difference is that in Delay’s family everyone agreed, the moral considerations don’t seem different. Had the patient in that case left written directives? The point is not that particular case (Delay’s father) but the fact that such cases occur all the time, and most don’t go to court or get media attention.

    And what of the point that Florida law is the issue here? Is it easier to blame Michael Shiavo than to blame the Florida state legislature (and Jeb Bush)?

  27. Juli, there is a big difference between a ventilator and a feeding tube. Jim wants to place hydration and feeding under the same category as ventilation* using the criteria that both are a medical procedure and requires a doctor’s order for application and cessation. Opponents like myself argue that access to food and water are a basic human right, even if delivered through a tube.

    Terri Schiavo was breathing on her own. Apparently Tom Delay’s father was not. It is not wrong to stop some technologies such as a ventilator in some circumstances. I am not familiar with the Delay situation so I cannot speak to it, but neither should all end of life cases be thrown into the same basket. The cases are simply too varied and too complex for that. I’ve been involved with enough end of life cases to speak to this point with some authority.

    Further, these cases don’t “happen all the time” although they occur with considerable more frequency as technology progresses and as the boomer population bump grows increasingly older. Don’t fall for it. It’s a rhetorical device that diminishes the moral questions that the Shiavo death raised and which must be answered.

    As for Florida law, it clearly is inadequate, but no laws will be adequate to these situations until the moral questions are resolved. See: The Legal Death of Terri Schiavo.

    If you want to be better informed on this case, search the articles I posted on the main site (Google: Schiavo). There is a lot of good information there.

    *The Vatican released an encyclical defending food and water as a basic human right. I’m waiting for the Orthodox to follow, although two Bishops objected to the Schiavo killing at the time.

  28. Fr. Hans writes: “Juli, there is a big difference between a ventilator and a feeding tube.

    While they are different items they are both medical interventions that a patient could decide to accept or reject.

    Fr. Hans: “Jim wants to place hydration and feeding under the same category as ventilation* using the criteria that both are a medical procedure and requires a doctor’s order for application and cessation.”

    Yes, exactly. They both require maintenance by medical personnel. And the feeding tube has to be surgically implanted.

    Fr. Hans: “Opponents like myself argue that access to food and water are a basic human right, even if delivered through a tube.”

    Air isn’t a basic human right too?? Food and water can’t be withdrawn, but air can be?? See, this is where the argument falls down for me.

    Fr. Hans: “Terri Schiavo was breathing on her own. Apparently Tom Delay’s father was not. It is not wrong to stop some technologies such as a ventilator in some circumstances.”

    I don’t see the significance. You appear to have an ethic that is device-dependent or deficit-dependent — that the morality of the situation changes with the equipment required. It doesn’t for me. My argument in the Schiavo case would be exactly the same whether she were on a ventilator, feeding tube, dialysis, or on all three or any two of the three. And just to be clear, I’m not saying that the Delay family made the wrong decision — just that momentous decision were made in both the Schiavo and Delay cases. Schiavo was litigated for years, and Michael Schiavo spent years trying to bring his wife back, but that was not enough for many. Delay wasn’t litigated at all. Indeed his family barely even discussed the situation before deciding that he “wouldn’t want to live like that.” But to the religious right Michael Schiavo is evil, and Tom Delay is a hero. Go figure.

    Fr. Hans: “It is not wrong to stop some technologies such as a ventilator in some circumstances.”

    Again, why vent and not feeding tube. Surely air is just as much a right as food and water.

    Fr. Hans: “I am not familiar with the Delay situation so I cannot speak to it, but neither should all end of life cases be thrown into the same basket. The cases are simply too varied and too complex for that.”

    I agree completely. The cases are different, but the general principles that govern the cases should be the same.

    Fr. Hans: “Further, these cases don’t “happen all the time” although they occur with considerable more frequency as technology progresses and as the boomer population bump grows increasingly older. Don’t fall for it. It’s a rhetorical device that diminishes the moral questions that the Shiavo death raised and which must be answered.”

    It puts the Schiavo case in perspective. And it means that you can’t have a hand-made, custom process just for the Schiavo case, and a differernt process for everyone else. Want to have artificial nutrition and hydration considered to be part of normal and routine care? Great, then it’s that way for EVERYONE — even for those who don’t want it.

    Fr. Hans: “As for Florida law, it clearly is inadequate, but no laws will be adequate to these situations until the moral questions are resolved.”

    Inadequate? Michael Schiavo is evil, but Florida law is just inadequate? It’s Florida law that says that PVS is a terminal illness. It’s Florida law that defines artificial nutrition as a medical procedure — Florida law that defines the surrogacy process for an incapacitated person. Everything about this case flows from Florida law and legal procedure. Michael Schiavo merely invoked the process.

    Fr. Hans: “The Vatican released an encyclical defending food and water as a basic human right.”

    With all due respect to the Vatican, I don’t think they know what they’re talking about — not when they’re talking about something that involves the surgical implantation of a device in the body.

  29. Air isn’t a basic human right too?? Food and water can’t be withdrawn, but air can be?? See, this is where the argument falls down for me.

    I think yours is a good point. One possible difference is that with a feeding tube, the body is still capable of digesting food, even though the patient cannot eat or drink by normal means. With assisted ventilation, the lungs are no lunger functioning, so it’s not a matter of providing air or withholding air (which would be suffocation). It depends on whether you consider taking in food and drink by mouth to be part of the whole digestion process.

  30. Julie writes: “With assisted ventilation, the lungs are no lunger functioning, so it’s not a matter of providing air or withholding air (which would be suffocation).”

    Even with a ventilator, the body is still capable of getting oxygen into the bloodstream. Even when certain bodily functions have completely failed, as in the case of kidney disease, we can still provide some of those functions — dialysis, for example. People can live for years on dialysis in the same way that they can live for years on ventilators or feeding tubes.

    Of course the crux of the issue is whether ventilators and feeding tubes present us with different moral situations. I am unable to discern such a difference. For me, the significant differences between situations are found in things such as patient condition, prognosis, and patient wishes.

    In other words, those who oppose the outcome in Schiavo look at feeding tubes as fundamentally different from ventilators, in this sense: if grandpa has severe brain damage and cannot communicate and is on a ventilator, the family can simply stand by the bedside and decide that he “wouldn’t want to live like that.” But when grandpa has severe brain damage and cannot communicate and is on a feeding tube then we need evidence “beyond a reasonable doubt” that he wouldn’t want to live like that. In other words, they don’t want to apply the reasonable doubt standard to ventilator cases, but they do in the case of feeding tubes.

    Again, I am unable to discern any moral difference between the two situations that would justify that. One might argue that life on a ventilator is worse than life on a feeding tube. But the anti-Schiavo-outcome folks don’t want to make that argument, because to do so would imply that the life of the person on the feeding tube is worthy of greater protection than the life of someone on a ventilator. This is exactly the kind of thinking of which they accuse the other side. So I don’t think they would want to make that argument.

  31. Note 30. When a person enters the final stages of dying often they refuse food and even water, although watering the mouth with a sponge is a humane thing to do and is often done by family members to prevent the lips from drying and cracking. (Terri Schiavo was not even allowed this simple act of dignity, by the way. Her lips swelled, then cracked and bled.) There is no moral imperative to insert a feeding or hydration tube in these circumstances.

    Terri Schiavo was not dying. Moreover, her family apart from her husband, knew that the removal of the feeding tube would kill her, which it did. The argument was that because she was handicapped (there is no medical consensus on the degree of her handicap), starvation and dehydration was morally permissible. Needless to say, handicapped people are outraged, and scared, about this killing. See: Not Dead Yet

    Further, you only need to read a bit about George Felos, the lawyer who led the effort to have Terri Killed, and some of the medical experts he called, so see that euthanasia activism drove this forward. Pat Buchanan wrote a good piece on how her killing, while defended as progressive enlightenment, in fact illustrated the increasing emergence of a culture of death in American society. His views here mirror mine. The execution of Terri Schiavo

  32. Note 31. The problem with your analysis is that it is too academic. You are searching for a principle that can be applied to all situations across the board when in fact living and dying is an infinitely more complex process. Philosophy can’t give you an answer here, but morality can guide your decision making.

    The danger in your approach is that any principle shorn of respect and value for human life will end up in the utilitarian camp. Efficiency and cost-benefit ratios become the criteria about who lives and who dies. This is what drives the euthanasia advocates like Felos, although he puts his own spin on the process.

    You’ve already indicated your resistance to a moral analysis of the questions surrounding the Schiavo killing. In note 29 you wrote:

    Fr. Hans: “The Vatican released an encyclical defending food and water as a basic human right.”

    With all due respect to the Vatican, I don’t think they know what they’re talking about — not when they’re talking about something that involves the surgical implantation of a device in the body.

    Implicit in your response is that the Vatican (and by extension any Christian body) cannot respond to any situation involving a surgical procedure. Planned Parenthood would be happy with this response since it would silence Vatican criticism of their support of partial birth abortion, also a medical procedure. Do you support PBA’s? You would have to if you want to be consistent.

    In reality however, medical procedure cannot be separated from morality. All actions have an effect. All actors draw from some kind of moral well. Given that some value life and others don’t (Planned Parenthood for example), the distinction between a “culture of life” and a “culture of death” is entirely appropriate, as is the assertion that food and water are a basic human right.

  33. Fr. Hans writes: “The problem with your analysis is that it is too academic. ”

    I don’t know if it’s academic; I like to think that it’s logical.

    Fr. Hans: “You are searching for a principle that can be applied to all situations across the board when in fact living and dying is an infinitely more complex process. Philosophy can’t give you an answer here, but morality can guide your decision making.”

    The concerns that I have seen raised in connection with the Schiavo case are ultimately related to legal and social policy. As I have said all along, the Schiavo case cannot be considered in isolation. Any solution as applied to Schiavo must be considered in the context of all other cases to which it might apply. If we ignore patient wishes in Shiavo, we have to ignore them in all like cases. If we change the way that patient wishes are determined in Schiavo, we change them for all like cases. And so on. In my observation, many of the changes suggested in Schiavo simply would not work well with many other cases.

    Fr. Hans: “The danger in your approach is that any principle shorn of respect and value for human life will end up in the utilitarian camp.”

    The governing principle in Shiavo is patient autonomy, which is not at all utilitarian. It is an attempt to discern what is the appropriate course of action in a particular case; it ls not concerned with the “greater good.” Utilitarianism is a way of making ethical decisions in which the greatest good for the greatest number is the main criterion. Patient autonomy, even if universally applied, is not utilitarianism.

    Fr. Hans: “Implicit in your response is that the Vatican (and by extension any Christian body) cannot respond to any situation involving a surgical procedure.”

    They can respond, but they need to respond based on what the procedure is, not based on what it is not. What makes something a medical procedure is not the substance that is delivered, but the manner of its delivery. Having blood is a routine thing. Having a blood transfusion is a medical procedure. Eating is a routine thing. Having nutrition delivered through an invasive device, whether enteral (gastrostomy tube) or parenteral (IV line) is a medical procedure.

    Look at some of the possible complications of a feeding tube:

    * Skin infections
    * Leakage
    * Perforation of the colon
    * Separation between the gastric and abdominal wall, with intraperitoneal leak
    * Erosions to the gastric mucosa
    * Aspiration pneumonia
    * Hemorrhage
    * Necrotizing fasciitis

    We are talking about a medical device that has to be professionally maintained and monitored. If the church has an opinion on the use of such devices, fine, but they can’t call it something that it’s not.

    Fr. Hans: “Given that some value life and others don’t (Planned Parenthood for example), the distinction between a “culture of life” and a “culture of death” is entirely appropriate, as is the assertion that food and water are a basic human right.”

    I agree completely that food and water are a basic human right. The issue is that patients also have a right not to accept food and water when delivered through a surgically implanted device.

    If people who oppose the Schiavo outcome want things to work differently, then they need to do the hard work of defining how things should work. They can’t just pronounce that no matter how delivered food and water are “routine care,” end of discussion. In my view that’s a lazy answer that in fact ignores the medical reality of the situation.

  34. Jim writes:

    Fr. Hans: “The danger in your approach is that any principle shorn of respect and value for human life will end up in the utilitarian camp.”

    The governing principle in Shiavo is patient autonomy, which is not at all utilitarian. It is an attempt to discern what is the appropriate course of action in a particular case; it ls not concerned with the “greater good.” Utilitarianism is a way of making ethical decisions in which the greatest good for the greatest number is the main criterion. Patient autonomy, even if universally applied, is not utilitarianism.

    The problem with utilitarianism is that it cannot define the the good in “greater good.” It moves towards pragmatism which is usually shaped by the crisis du jour, which today is the high expense of medical care. Down the road it will be something else.

    The concept “patient autonomy” has an absolutist and dictatorial (some might say totalitarian) impulse given how it was employed to justify the killing of Terri Schiavo when no written directive existed (among other unanswered questions concerning her death). Putting aside for the moment the implied assertion that such directives preempt all other moral considerations concerning death and dying, the Schiavo case shows us that an appeal to principle for its own sake can be deadly.

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