 |
Terry Schiavo:Life or Deathby Michael Dallen The tragedy of Terry Schiavo |
All over the world, as the Terri Schiavo case unfolded, people asked themselves, "what would I do if this were my loved one?" or "what would I want done if this were me?" Mrs. Schiavo is dead now. Fifteen years ago, worried about her weight, she became bulimic. The bulimia upset her body's chemistry, which caused her heart to stop, which deprived her brain of oxygen, which plunged her into a coma. She never revived. She could breathe on her own and she had reflexes, which led some people to believe that she was aware at times, but she remained vegetative. She couldn't take water or nourishment easily, so surgeons inserted a feeding tube - a PEG tube, percutaneous endoscopic gastrostomy - into her stomach. This technique was developed 26 years ago (in 5740/1979) and is now used more than 250,000 times a year in the United States alone. Liquid formula and water is fed through the tube.
Mrs. Schiavo's husband has been demonized by the media, but the record shows that, for the
first four years after his wife became comatose, he did everything he could, working with therapists and other experts, nurses and her family, to revive her. He gave up hope, apparently, only after her neurologists told
him that there was no hope. Her heart stoppage had caused irreversible brain damage. They showed him that her cerebral cortex, which controls the brain's higher functions, was liquefying, and that she would never again become conscious. Mrs. Schiavo continued to receive visitors frequently, as well as a remarkably high level
of care. In 15 years, all parties agreed, she never had a single bedsore. Nurses would get her out of bed daily, clean her, and sit her in a chair. Family members, including her husband (who, after the first four years, started another family, without divorcing Terri), massaged her, brushed her hair, and tried to exercise her muscles for her. She was loved, at least by her blood relatives, but even love couldn't revive her. She remained comatose.
In the light of Gd's Law every human life, including the life of one who is terminally ill or comatose, is sacred. G-d created man not just for the pursuit of animal pleasure and avoidance of animal discomfort but to
serve Him. We serve Him by living life until the last moment until He takes it. Our lives are not whole otherwise; no one has a right to diminish a human life by encroaching on His prerogatives. Human beings may take animal life, but our dominion doesn't extend to our fellow men. Only G-d may take an innocent human life. To die in G-d's time and at His command brings man blessing - that is, atonement. Still, one need not be conscious in order to die, and our Maker absolutely does not prevent us from administering drugs, or other appropriate
therapies, to relieve pain and suffering. We don't serve G-d with our pain but with our lives. Nothing may be done to shorten them. A "hopeless" person is never to be regarded as a dead person. However, G-d doesn't
necessarily require us to pursue heroic measures to prolong the last moments, days or years. One must try to
supply even a medically hopeless patient with life's ordinary necessities, such as food, water, air, warmth, and (by transfusion) blood, because the obligation to save or preserve human life is always paramount. Furthermore,
the patient has an obligation to accept such necessities. No one has the right to commit suicide by willfully starving or refusing liquids until death comes.
No legal arrangement or written instrument to that effect, calling for the withholding of life's ordinary necessities while one is still alive, is moral. When the time to die has in fact arrived, the patient, or the patient's representatives, may refuse, and the physician may withhold, treatment by means of surgery, drugs, artificial stimulation, or other extraordinary intervening measures. There are times when one simply doesn't try to shock a heart back into beating, for instance, or administer powerful drugs. But Mrs. Schiavo wasn't anywhere near the edge of death. Neither was there any question here of taking her off a medical device that was doing her body's work for her - a respirator, say, doing the work of her lungs, or a heart machine, pumping her blood, or a kidney dialysis device, or the like. She simply needed food and water and loving care, as she had been receiving. She was like a baby - helpless, unable to communicate, unable to feed herself, needing others' help. Terri Schiavo, after a long drawn-out battle in the courts between her husband and the rest of her family, was finally killed by dehydration.
Her PEG tube remained in her stomach but, pursuant to court order and after numerous appeals, the people attending her stopped putting anything through it. So, after almost two weeks without water, she died, still in her coma. Among attorneys, judges and legislators, one frequently hears the expression, "hard cases make bad law." Unusually unhappy or difficult factual circumstances can easily lead to bad legal decisions. Terri Schiavo's case exemplifies that principle. In the last few years, much of the worldwide medical establishment has been advocating death by dehydration - by cutting off all water - to "hopeless" patients. One should consider that if this approach to human life were valid, the cause of mercy would be far better served by simply slitting the patient's throat, or by injecting him or her with poison. Nonetheless, American jurisprudence seems to be heading in this direction especially after Terri Schiavo.
Some interpreters of Torah argue that a PEG tube is a medical device, like a respirator or an artificial heart or kidney, as opposed to a feeding device. As a medical device, they say, it can be removed, even though removing it will certainly kill the patient. (Giving a comatose patient food and water orally, or by means of a tube down the nose into the throat and stomach, is no solution, at least over a period of more than a few days, since it's likely to cause gagging and choking, along with certain physical irritation and finally infection.) This is not the position of most Torahdecisors. So long as the means exist to simply and safely provide a patient with the plain necessities of food and water, through a PEG tube or otherwise, food and water must be provided. In a hospital setting, they say, the Law would permit a DNR - a "do not resuscitate" order - meaning a patient should not be subjected to "heroic" or extraordinary lifesaving measures. But G-d would never countenance a DNT - a "do not treat" order - if it meant withholding life's ordinary necessities. These authorities view the PEG tube as a relatively simple feeding device. And this is a uniform rule governing all humanity, they say: when the means exist to deliver food and water to one who needs them, food and water must be provided. Let this be the end of the matter.
Whether one's loved ones or doctors regard one as being "hopeless" or not, people have the inalienable right not to be killed, or be pressed to kill themselves, or be quietly hustled off in any way before their time. The question here isn't really "what would I do if this were my loved one?" or "what would I want done if this were me? "We need to recognize that our obligation as human beings is to bring holiness to earth, to protect civilization and improve it. It isn't for mortal men to assess the comparative current value of any human life. Human beings are notlike the lesser animals, to be "put down" whenever life becomes difficult or inconvenient. Even when there is very little life left in a person, that life still matters.
Mrs. Schiavo's husband has been demonized by the media, but the record shows that, for the
first four years after his wife became comatose, he did everything he could, working with therapists and other experts, nurses and her family, to revive her. He gave up hope, apparently, only after her neurologists told
him that there was no hope. Her heart stoppage had caused irreversible brain damage. They showed him that her cerebral cortex, which controls the brain's higher functions, was liquefying, and that she would never again become conscious. Mrs. Schiavo continued to receive visitors frequently, as well as a remarkably high level
of care. In 15 years, all parties agreed, she never had a single bedsore. Nurses would get her out of bed daily, clean her, and sit her in a chair. Family members, including her husband (who, after the first four years, started another family, without divorcing Terri), massaged her, brushed her hair, and tried to exercise her muscles for her. She was loved, at least by her blood relatives, but even love couldn't revive her. She remained comatose.
In the light of Gd's Law every human life, including the life of one who is terminally ill or comatose, is sacred. G-d created man not just for the pursuit of animal pleasure and avoidance of animal discomfort but to
serve Him. We serve Him by living life until the last moment until He takes it. Our lives are not whole otherwise; no one has a right to diminish a human life by encroaching on His prerogatives. Human beings may take animal life, but our dominion doesn't extend to our fellow men. Only G-d may take an innocent human life. To die in G-d's time and at His command brings man blessing - that is, atonement. Still, one need not be conscious in order to die, and our Maker absolutely does not prevent us from administering drugs, or other appropriate
therapies, to relieve pain and suffering. We don't serve G-d with our pain but with our lives. Nothing may be done to shorten them. A "hopeless" person is never to be regarded as a dead person. However, G-d doesn't
necessarily require us to pursue heroic measures to prolong the last moments, days or years. One must try to
supply even a medically hopeless patient with life's ordinary necessities, such as food, water, air, warmth, and (by transfusion) blood, because the obligation to save or preserve human life is always paramount. Furthermore,
the patient has an obligation to accept such necessities. No one has the right to commit suicide by willfully starving or refusing liquids until death comes.
No legal arrangement or written instrument to that effect, calling for the withholding of life's ordinary necessities while one is still alive, is moral. When the time to die has in fact arrived, the patient, or the patient's representatives, may refuse, and the physician may withhold, treatment by means of surgery, drugs, artificial stimulation, or other extraordinary intervening measures. There are times when one simply doesn't try to shock a heart back into beating, for instance, or administer powerful drugs. But Mrs. Schiavo wasn't anywhere near the edge of death. Neither was there any question here of taking her off a medical device that was doing her body's work for her - a respirator, say, doing the work of her lungs, or a heart machine, pumping her blood, or a kidney dialysis device, or the like. She simply needed food and water and loving care, as she had been receiving. She was like a baby - helpless, unable to communicate, unable to feed herself, needing others' help. Terri Schiavo, after a long drawn-out battle in the courts between her husband and the rest of her family, was finally killed by dehydration.
Her PEG tube remained in her stomach but, pursuant to court order and after numerous appeals, the people attending her stopped putting anything through it. So, after almost two weeks without water, she died, still in her coma. Among attorneys, judges and legislators, one frequently hears the expression, "hard cases make bad law." Unusually unhappy or difficult factual circumstances can easily lead to bad legal decisions. Terri Schiavo's case exemplifies that principle. In the last few years, much of the worldwide medical establishment has been advocating death by dehydration - by cutting off all water - to "hopeless" patients. One should consider that if this approach to human life were valid, the cause of mercy would be far better served by simply slitting the patient's throat, or by injecting him or her with poison. Nonetheless, American jurisprudence seems to be heading in this direction especially after Terri Schiavo.
Some interpreters of Torah argue that a PEG tube is a medical device, like a respirator or an artificial heart or kidney, as opposed to a feeding device. As a medical device, they say, it can be removed, even though removing it will certainly kill the patient. (Giving a comatose patient food and water orally, or by means of a tube down the nose into the throat and stomach, is no solution, at least over a period of more than a few days, since it's likely to cause gagging and choking, along with certain physical irritation and finally infection.) This is not the position of most Torahdecisors. So long as the means exist to simply and safely provide a patient with the plain necessities of food and water, through a PEG tube or otherwise, food and water must be provided. In a hospital setting, they say, the Law would permit a DNR - a "do not resuscitate" order - meaning a patient should not be subjected to "heroic" or extraordinary lifesaving measures. But G-d would never countenance a DNT - a "do not treat" order - if it meant withholding life's ordinary necessities. These authorities view the PEG tube as a relatively simple feeding device. And this is a uniform rule governing all humanity, they say: when the means exist to deliver food and water to one who needs them, food and water must be provided. Let this be the end of the matter.
Whether one's loved ones or doctors regard one as being "hopeless" or not, people have the inalienable right not to be killed, or be pressed to kill themselves, or be quietly hustled off in any way before their time. The question here isn't really "what would I do if this were my loved one?" or "what would I want done if this were me? "We need to recognize that our obligation as human beings is to bring holiness to earth, to protect civilization and improve it. It isn't for mortal men to assess the comparative current value of any human life. Human beings are notlike the lesser animals, to be "put down" whenever life becomes difficult or inconvenient. Even when there is very little life left in a person, that life still matters.