aefenglommung (aefenglommung) wrote,

Last Word

Okay, now that Terri Schiavo has passed on, let's go over the principles involved for future reference.

1. You have a right to refuse medical care of any sort; this includes ordinary care, such as food and water.

2. If you are unable to exercise this right, then your wishes are still enforceable through a written instrument like a living will or through the person who has power of attorney over your affairs (often, presumably, your spouse or next of kin, unless you say otherwise).

3. If there is any doubt about your wishes or who should speak for you, then certain things come into play.
a. As long as you are in reasonable shape, doctors and hospitals will presume that you would want treatment; even if you are in horrible shape, there is a quantum leap between denying a person drugs or machines to prolong life and denying somebody food and water (which is ordinary care, even if delivered through a feeding tube).

b. Absent clear evidence of your wishes, if you are bad enough off that you are expected to die in a short time, hospitals and doctors are willing to concur more readily about discontinuing (or not starting) care if all the important people in your life are in harmony about what should be done.

c. Absent clear evidence of your wishes, and if there is significant difference of opinion among those who matter to you, hospitals and doctors are going to be very reluctant (and should be) to do anything that will make you die sooner. At the very least, they will be likely to insist on ordinary care, which includes the administration of food and water. Resolving your family's inability to speak with one voice is not their problem.

d. If this situation escalates to the point where a court gets involved, then the proper course is to appoint a guardian ad litem until such time as it is clear what the patient's wishes were or who speaks for the patient. Even if one single person (such as a surviving spouse) is given guardianship = the right to speak for you, that person's ability to make drastic decisions in the teeth of objections by everybody else should be handled by courts with great circumspection.

4. If errors are to be made, then everybody involved should err on the side of life, unless everybody involved agrees that the situation is beyond hope -- in which case, you're toast, but any error was at least a loving one.

In the Schiavo case, several things jump out at me.

1. At one time, Michael Schiavo and Terri's family were in agreement on what should be done for her. But it would seem that both parties have changed their story since that time. We may never know what was at play here.

2. Michael Schiavo's quest to discontinue treatment -- including food and water -- should have been investigated more thoroughly by the court, which should also have been more amenable to reviewing the case as more accusations and opinions were offered. A co-guardianship of Terri between Michael Schiavo and a guardian ad litem would have been wise. The court is as much at fault (and all the courts above this court) for this deplorable outcome, simply because the court seems to have been unwilling to review its own reasoning in the light of new facts. Where I come from, this is called "arrogance." And in a judge, it might be called "abuse of power."

3. I do not blame Michael Schiavo for wanting to start over again, but I think he should have sought to relinquish or share his guardianship of Terri Schiavo (through divorce or other arrangements). His situation had a truly rotten appearance of impropriety, even thinking the best of him. Once again, the court should have taken cognizance of this.

4. I'm not sure that the Schindlers have been simon-pure from the beginning of all this, but their offer to care for Terri seemed genuine enough to me. As long as they assumed responsibility for her, I'd've let them do it. I would have made their guardianship a co-guardianship with a guardian ad litem, too.

5. The attempt by some folks to say, there go the Republicans again, meddling with your life, is repugnant and contemptible. Better to say, there go some responsible people, trying to make sure that nobody gets offed just because somebody is tired of her living. At that, though, if Mr. Schiavo and his in-laws and the court in Florida had all been something other than butt-heads, it needn't have come to this.

And that's my final word.

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