The issues after Schiavo

The central news story in the United States over the past few weeks has been the fate of Terri Schiavo. Forty-one-year-old Schiavo had been in a coma for the past 15 years, after suffering brain damage in 1990 after a heart attack brought on by an eating disorder. Schiavo’s husband, Michael, was granted an order by the US courts for his wife’s feeding tube to be removed so she could die. Her parents who have fought her husband for years on this matter, had lost battle after battle in the courts of the United States. US judges stood firmly on the side of the law despite pressure from President Bush and the US Congress.

The case has generated great controversy, to the extent that US President George W Bush even cut short his vacation to sign a law in an attempt to reverse the judge’s decision. “It is wise to always err on the side of life,” Mr Bush said — and the irony has not been lost on commentators, who have pointed out Mr Bush’s steadfast support for the death penalty and, of course, the innocent persons killed daily as a result of the occupation of Iraq. At the same time, the media brouhaha removed any chance of a dignified death for Terri Schiavo who passed away yesterday morning two weeks after the feeding tube was removed. Everything became a bone of contention as parents fought her husband on almost every issue and even now there is disagreement over her funeral.

The media debate has been long on passion and short on reason, with one network even calling in a TV psychic to take part in a panel discussion. Michael Schiavo has been demonised, and accused of spousal abuse, adultery, even murder, while the judge has been depicted as part of a dark conspiracy to murder Terri Schiavo. Then there was the incredible statement of a Republican senator who commenting on the court’s decision said “it was time to rein in the courts.” None of this, however, removes the true ethical difficulties surrounding this case, nor the sincere passions of those trying to get the court’s decision reversed. But passionate certitude is not necessarily moral rectitude. The only way to resolve issues like these is to examine all the arguments dispassionately, with the intention of attaining a greater good.

While a case like this is hardly likely to arise in Trinidad and Tobago, where our hospitals have enough trouble keeping normally ill persons alive, the question of withdrawing care for terminally ill patients is a live one. Our doctors regularly have to make such calls, and do so by their own best judgment. This can hardly be considered a satisfactory state of affairs but, while hospitals themselves undoubtedly have guidelines on such matters, there is no official Government policy that we are aware of. And that, of course, is to be expected in a society reluctant to have public discussions about hard ethical questions. But even in developed nations, which have established laws and procedures on such matters, debate continues to rage. At the centre of the Schiavo case is, of course, the question of what it means to be human. Did the fact that Terri Schiavo was alive suffice?

Are perception and social interaction and self-consciousness necessary conditions of humanness? If so, where do we draw a line for different levels and capabilities? Should such a line be drawn at all? What is the role of technology in preserving human life? The slippery slope follows from these questions. If you begin to attach conditions to being human, where do you stop? Does intelligence, maturity, even race, then become criteria for being human, as was the case in the not-too-distant past? How should laws and guidelines be altered in the face of advancing technology? Should a person’s wishes be respected? Who should have the final word? A spouse? The parents? Who decides on whether a person is in a permanent vegetative state? These are just a few of the issues which need to be raised and confronted in any debate. They are not abstract philosophical conundrums, but issues that go to the heart of how  we wish to define ourselves as a society.